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Dam S, Batail JM, Robert GH, Drapier D, Maurel P, Coloigner J. Structural Brain Connectivity and Treatment Improvement in Mood Disorder. Brain Connect 2024; 14:239-251. [PMID: 38534988 DOI: 10.1089/brain.2023.0063] [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: 04/25/2024] Open
Abstract
Background: The treatment of depressive episodes is well established, with clearly demonstrated effectiveness of antidepressants and psychotherapies. However, more than one-third of depressed patients do not respond to treatment. Identifying the brain structural basis of treatment-resistant depression could prevent useless pharmacological prescriptions, adverse events, and lost therapeutic opportunities. Methods: Using diffusion magnetic resonance imaging, we performed structural connectivity analyses on a cohort of 154 patients with mood disorder (MD) and 77 sex- and age-matched healthy control (HC) participants. To assess illness improvement, the patients with MD went through two clinical interviews at baseline and at 6-month follow-up and were classified based on the Clinical Global Impression-Improvement score into improved or not-improved (NI). First, the threshold-free network-based statistics (NBS) was conducted to measure the differences in regional network architecture. Second, nonparametric permutations tests were performed on topological metrics based on graph theory to examine differences in connectome organization. Results: The threshold-free NBS revealed impaired connections involving regions of the basal ganglia in patients with MD compared with HC. Significant increase of local efficiency and clustering coefficient was found in the lingual gyrus, insula, and amygdala in the MD group. Compared with the NI, the improved displayed significantly reduced network integration and segregation, predominately in the default-mode regions, including the precuneus, middle temporal lobe, and rostral anterior cingulate. Conclusions: This study highlights the involvement of regions belonging to the basal ganglia, the fronto-limbic network, and the default mode network, leading to a better understanding of MD disease and its unfavorable outcome.
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Affiliation(s)
- Sébastien Dam
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
| | - Jean-Marie Batail
- Academic Psychiatry Department, Centre Hospitalier Guillaume Régnier, Rennes, France
- CIC 1414, CHU de Rennes, INSERM, Rennes, France
| | - Gabriel H Robert
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
- Academic Psychiatry Department, Centre Hospitalier Guillaume Régnier, Rennes, France
- CIC 1414, CHU de Rennes, INSERM, Rennes, France
| | - Dominique Drapier
- Academic Psychiatry Department, Centre Hospitalier Guillaume Régnier, Rennes, France
- CIC 1414, CHU de Rennes, INSERM, Rennes, France
| | - Pierre Maurel
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
| | - Julie Coloigner
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
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Fan S, Zhang J, Wu Y, Yu Y, Zheng H, Guo YY, Ji Y, Pang X, Tian Y. Changed brain entropy and functional connectivity patterns induced by electroconvulsive therapy in majoy depression disorder. Psychiatry Res Neuroimaging 2024; 339:111788. [PMID: 38335560 DOI: 10.1016/j.pscychresns.2024.111788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/09/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Our objective is to innovatively integrate both linear and nonlinear characteristics of brain signals in Electroconvulsive Therapy (ECT) research, with the goal of uncovering deeper insights into the pathogenesis of Major Depressive Disorder (MDD) and identifying novel targets for other physical intervention therapies. METHODS We measured brain entropy (BEN) in 42 MDD patients and 42 matched healthy controls (HC) using rs-fMRI data. Brain regions that differed significantly in patients with MDD before and after ECT were extracted. Then, we use these brain regions as seed points to investigate the differences in whole-brain resting-state functional connectivity (RSFC) patterns before and after ECT. RESULTS Compared to HCs, patients had higher BEN levels in the right precuneus (PCUN.R) and right angular gyrus (ANG.R). After ECT, patients had lower BEN levels in the PCUN.R and ANG.R. Compared with before ECT, patients showed significantly increased RSFC after ECT between the PCUN.R and right middle temporal gyrus and ANG.R. Significantly increased RSFC was observed between the ANG.R and right middle frontal gyrus and right supramarginal gyrus after ECT. CONCLUSION Combining the linear and nonlinear characteristics of brain signals can effectively explore the pathogenesis of depression and provide new targets for ECT.
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Affiliation(s)
- Siyu Fan
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei. 230022, PR China
| | - Jiahua Zhang
- The College of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, PR China
| | - Yue Wu
- Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei,. 230601, PR China
| | - Yue Yu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei. 230022, PR China
| | - Hao Zheng
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei. 230022, PR China
| | - Yuan Yuan Guo
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei. 230022, PR China
| | - Yang Ji
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei. 230022, PR China
| | - Xiaonan Pang
- Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, PR China.
| | - Yanghua Tian
- The College of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, PR China; Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, PR China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230032, PR China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, PR China; Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei,. 230601, PR China.
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3
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Pasquini L, Fryer SL, Eisendrath SJ, Segal ZV, Lee AJ, Brown JA, Saggar M, Mathalon DH. Dysfunctional Cortical Gradient Topography in Treatment-Resistant Major Depressive Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:928-939. [PMID: 36754677 PMCID: PMC10150583 DOI: 10.1016/j.bpsc.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/13/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Treatment-resistant depression (TRD) refers to patients with major depressive disorder who do not remit after 2 or more antidepressant trials. TRD is common and highly debilitating, but its neurobiological basis remains poorly understood. Recent neuroimaging studies have revealed cortical connectivity gradients that dissociate primary sensorimotor areas from higher-order associative cortices. This fundamental topography determines cortical information flow and is affected by psychiatric disorders. We examined how TRD impacts gradient-based hierarchical cortical organization. METHODS In this secondary study, we analyzed resting-state functional magnetic resonance imaging data from a mindfulness-based intervention enrolling 56 patients with TRD and 28 healthy control subjects. Using gradient extraction tools, baseline measures of cortical gradient dispersion within and between functional brain networks were derived, compared across groups, and associated with graph theoretical measures of network topology. In patients, correlation analyses were used to associate measures of cortical gradient dispersion with clinical measures of anxiety, depression, and mindfulness at baseline and following the intervention. RESULTS Cortical gradient dispersion was reduced within major intrinsic brain networks in patients with TRD. Reduced cortical gradient dispersion correlated with increased network degree assessed through graph theory-based measures of network topology. Lower dispersion among default mode, control, and limbic network nodes related to baseline levels of trait anxiety, depression, and mindfulness. Patients' baseline limbic network dispersion predicted trait anxiety scores 24 weeks after the intervention. CONCLUSIONS Our findings provide preliminary support for widespread alterations in cortical gradient architecture in TRD, implicating a significant role for transmodal and limbic networks in mediating depression, anxiety, and lower mindfulness in patients with TRD.
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Affiliation(s)
- Lorenzo Pasquini
- Department of Neurology, University of California, San Francisco, San Francisco, California.
| | - Susanna L Fryer
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California; San Francisco Veteran Affairs Health Care System, San Francisco, California
| | - Stuart J Eisendrath
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California
| | - Zindel V Segal
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California
| | - Alex J Lee
- Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Jesse A Brown
- Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Manish Saggar
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California; San Francisco Veteran Affairs Health Care System, San Francisco, California
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4
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Grehl MM, Hameed S, Murrough JW. Brain Features of Treatment-Resistant Depression: A Review of Structural and Functional Connectivity Magnetic Resonance Imaging Studies. Psychiatr Clin North Am 2023; 46:391-401. [PMID: 37149352 DOI: 10.1016/j.psc.2023.02.009] [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] [Indexed: 05/08/2023]
Abstract
Increased awareness of the growing disease burden of treatment resistant depression (TRD), in combination with technological advances in MRI, affords the unique opportunity to research biomarkers that characterize TRD. We provide a narrative review of MRI studies investigating brain features associated with treatment-resistance and treatment outcome in those with TRD. Despite heterogeneity in methods and outcomes, relatively consistent findings include reduced gray matter volume in cortical regions and reduced white matter structural integrity in those with TRD. Alterations in resting state functional connectivity of the default mode network were also found. Larger studies with prospective designs are warranted.
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Affiliation(s)
- Mora M Grehl
- Department of Psychology and Neuroscience, 1701 North 13th Street, Temple University, Philadelphia, PA 19122, USA.
| | - Sara Hameed
- Depression and Anxiety Center for Discovery and Treatment, 1399 Park Avenue, 2nd Floor, New York, NY 10029
| | - James W Murrough
- Depression and Anxiety Center for Discovery and Treatment, 1399 Park Avenue, 2nd Floor, New York, NY 10029.
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5
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Fu CHY, Erus G, Fan Y, Antoniades M, Arnone D, Arnott SR, Chen T, Choi KS, Fatt CC, Frey BN, Frokjaer VG, Ganz M, Garcia J, Godlewska BR, Hassel S, Ho K, McIntosh AM, Qin K, Rotzinger S, Sacchet MD, Savitz J, Shou H, Singh A, Stolicyn A, Strigo I, Strother SC, Tosun D, Victor TA, Wei D, Wise T, Woodham RD, Zahn R, Anderson IM, Deakin JFW, Dunlop BW, Elliott R, Gong Q, Gotlib IH, Harmer CJ, Kennedy SH, Knudsen GM, Mayberg HS, Paulus MP, Qiu J, Trivedi MH, Whalley HC, Yan CG, Young AH, Davatzikos C. AI-based dimensional neuroimaging system for characterizing heterogeneity in brain structure and function in major depressive disorder: COORDINATE-MDD consortium design and rationale. BMC Psychiatry 2023; 23:59. [PMID: 36690972 PMCID: PMC9869598 DOI: 10.1186/s12888-022-04509-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Efforts to develop neuroimaging-based biomarkers in major depressive disorder (MDD), at the individual level, have been limited to date. As diagnostic criteria are currently symptom-based, MDD is conceptualized as a disorder rather than a disease with a known etiology; further, neural measures are often confounded by medication status and heterogeneous symptom states. METHODS We describe a consortium to quantify neuroanatomical and neurofunctional heterogeneity via the dimensions of novel multivariate coordinate system (COORDINATE-MDD). Utilizing imaging harmonization and machine learning methods in a large cohort of medication-free, deeply phenotyped MDD participants, patterns of brain alteration are defined in replicable and neurobiologically-based dimensions and offer the potential to predict treatment response at the individual level. International datasets are being shared from multi-ethnic community populations, first episode and recurrent MDD, which are medication-free, in a current depressive episode with prospective longitudinal treatment outcomes and in remission. Neuroimaging data consist of de-identified, individual, structural MRI and resting-state functional MRI with additional positron emission tomography (PET) data at specific sites. State-of-the-art analytic methods include automated image processing for extraction of anatomical and functional imaging variables, statistical harmonization of imaging variables to account for site and scanner variations, and semi-supervised machine learning methods that identify dominant patterns associated with MDD from neural structure and function in healthy participants. RESULTS We are applying an iterative process by defining the neural dimensions that characterise deeply phenotyped samples and then testing the dimensions in novel samples to assess specificity and reliability. Crucially, we aim to use machine learning methods to identify novel predictors of treatment response based on prospective longitudinal treatment outcome data, and we can externally validate the dimensions in fully independent sites. CONCLUSION We describe the consortium, imaging protocols and analytics using preliminary results. Our findings thus far demonstrate how datasets across many sites can be harmonized and constructively pooled to enable execution of this large-scale project.
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Affiliation(s)
- Cynthia H Y Fu
- Department of Psychological Sciences, University of East London, London, UK.
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Guray Erus
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Yong Fan
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Mathilde Antoniades
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Danilo Arnone
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Taolin Chen
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Cherise Chin Fatt
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, USA
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Mood Disorders Treatment and Research Centre and Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Vibe G Frokjaer
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Melanie Ganz
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Jose Garcia
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Beata R Godlewska
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Stefanie Hassel
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Keith Ho
- Department of Psychiatry, University Health Network, Toronto, Canada
| | - Andrew M McIntosh
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Kun Qin
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Susan Rotzinger
- Department of Psychiatry, University Health Network, Toronto, Canada
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, Canada
| | - Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | | | - Haochang Shou
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Penn Statistics in Imaging and Visualization Endeavor (PennSIVE) Center, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, USA
| | - Ashish Singh
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Aleks Stolicyn
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Irina Strigo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Stephen C Strother
- Rotman Research Institute, Baycrest Centre, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | | | - Dongtao Wei
- School of Psychology, Southwest University, Chongqing, China
| | - Toby Wise
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rachel D Woodham
- Department of Psychological Sciences, University of East London, London, UK
| | - Roland Zahn
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Ian M Anderson
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - J F William Deakin
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA
| | - Rebecca Elliott
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, USA
| | | | - Sidney H Kennedy
- Department of Psychiatry, University Health Network, Toronto, Canada
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, Canada
- Unity Health Toronto, Toronto, Canada
| | - Gitte M Knudsen
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Jiang Qiu
- School of Psychology, Southwest University, Chongqing, China
| | - Madhukar H Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, USA
| | - Heather C Whalley
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Chao-Gan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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Sun J, Ma Y, Guo C, Du Z, Chen L, Wang Z, Li X, Xu K, Luo Y, Hong Y, Yu X, Xiao X, Fang J, Lu J. Distinct patterns of functional brain network integration between treatment-resistant depression and non treatment-resistant depression: A resting-state functional magnetic resonance imaging study. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110621. [PMID: 36031163 DOI: 10.1016/j.pnpbp.2022.110621] [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: 06/09/2022] [Revised: 08/13/2022] [Accepted: 08/21/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Previous neuroimaging has paid little attention to the differences in brain network integration between patients with treatment-resistant depression(TRD) and non-TRD (nTRD), and the relationship between their impaired brain network integration and clinical symptoms has not been elucidated. METHOD Eighty one major depressive disorder (MDD) patients (40 in TRD, 41 in nTRD) and 40 healthy controls (HCs) were enrolled for the functional magnetic resonance imaging (fMRI) scans. A seed-based functional connectivity (FC) method was used to investigate the brain network abnormalities of default mode network (DMN), affective network (AN), salience network (SN) and cognitive control network (CCN) for the MDD. Finally, the correlation was analyzed between the abnormal FCs and 17-item Hamilton Rating Scale for Depression scale (HAMD-17) scores. RESULTS Compared with the HC group, the FCs in DMN, AN, SN, CCN were altered in both the TRD and nTRD groups. Compared with the nTRD group, FC alterations in the AN and CCN were more abnormal in the TRD group, and the FC alterations were generally decreased at the SN in the TRD group. In addition, the FC values of right dorsolateral prefrontal cortices and left caudate nucleus in the TRD group and the FC values of right subgenual anterior cingulate cortex and left middle temporal gyrus in the nTRD group were positively correlated with HAMD-17 scale scores. CONCLUSIONS Abnormal FCs are present in four brain networks (DMN, AN, SN, CCN) in both the TRD and nTRD groups. Except of DMN, FCs in AN, SN and CCN maybe underlay the neurobiological mechanism in differentiating TRD from nTRD.
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Affiliation(s)
- Jifei Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Yue Ma
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Chunlei Guo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Zhongming Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, 100700 Beijing, China
| | - Limei Chen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Zhi Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Xiaojiao Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Ke Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Yi Luo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Yang Hong
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Xue Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, 100026 Beijing, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, 100026 Beijing, China
| | - Jiliang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China.
| | - Jie Lu
- Xuanwu Hospital, Capital Medical University, 100053 Beijing, China.
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7
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Sun J, Xu L, Ma Y, Guo C, Du Z, Gao S, Luo Y, Chen Q, Hong Y, Yu X, Xiao X, Fang J. Different characteristics of striatal resting-state functional conectivity in treatment-resistant and non-treatment-resistant depression. Psychiatry Res Neuroimaging 2023; 328:111567. [PMID: 36462466 DOI: 10.1016/j.pscychresns.2022.111567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/25/2022] [Accepted: 11/08/2022] [Indexed: 11/23/2022]
Abstract
Major depressive disorder is associated with a reward deficit manifested by abnormal striatal function. However, differences between treatment-resistant depression (TRD) and non TRD (nTRD) in striatal whole-brain functional connectivity (FC) have not been elucidated. Thirty-eight patients with TRD, 42 patients with nTRD, and 39 healthy controls (HCs) were recruited for this study. A seed-based FC approach was used to analyze abnormalities in six predefined striatal subregion circuits in the three groups of subjects, and further explore the correlation between abnormal FC and clinical symptoms. Results revealed that compared with the nTRD group, the TRD group showed increased FC of the inferior ventral striatum with the bilateral orbital area of the middle frontal gyrus, right cerebellum posterior lobe, left parahippocampal gyrus, left middle occipital gyrus and left lingual gyrus. Compared with the HC group, the TRD group showed a wider range of altered striatal function than the nTRD group. In the TRD group, the HAMD-17 scores were positively correlated with the FC between the right VRP and the left caudate. This study provides new insights into understanding the specificity of TRD striatal circuits.
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Affiliation(s)
- Jifei Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Linjie Xu
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Yue Ma
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Chunlei Guo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Zhongming Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Shanshan Gao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Yi Luo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Qingyan Chen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Yang Hong
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Xue Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing 100026, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing 100026, China
| | - Jiliang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
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8
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Resting state functional connectivity as a marker of internalizing disorder onset in high-risk youth. Sci Rep 2022; 12:21337. [PMID: 36494495 PMCID: PMC9734132 DOI: 10.1038/s41598-022-25805-y] [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: 08/26/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
While research has linked alterations in functional connectivity of the default mode (DMN), cognitive control (CCN), and salience networks (SN) to depression and anxiety, little research has examined whether these alterations may be premorbid vulnerabilities. This study examined resting state functional connectivity (RSFC) of the CCN, DMN, and SN as markers of risk for developing an onset of a depressive or anxiety disorder in adolescents at high familial risk for these disorders. At baseline, 135 participants aged 11-17 completed resting-state functional magnetic resonance imaging, measures of internalizing symptoms, and diagnostic interviews to assess history of depressive and anxiety disorders. Diagnostic assessments were completed again at 9- or 18-month follow-up for 112 participants. At baseline, increased CCN connectivity to areas of the visual network, and decreased connectivity between the left SN and the precentral gyrus, predicted an increased likelihood of a new onset at follow-up. Increased connectivity between the right SN and postcentral gyrus at baseline predicted first episode onsets at follow-up. Altered connectivity between these regions may represent a risk factor for developing a clinically significant onset of an internalizing disorder. Results may have implications for understanding the neural bases of internalizing disorders for early identification and prevention efforts.
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Sun J, Du Z, Ma Y, Chen L, Wang Z, Guo C, Luo Y, Gao D, Hong Y, Zhang L, Han M, Cao J, Hou X, Xiao X, Tian J, Yu X, Fang J, Zhao Y. Altered functional connectivity in first-episode and recurrent depression: A resting-state functional magnetic resonance imaging study. Front Neurol 2022; 13:922207. [PMID: 36119680 PMCID: PMC9475213 DOI: 10.3389/fneur.2022.922207] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/28/2022] [Indexed: 01/10/2023] Open
Abstract
Background Functional magnetic resonance imaging (fMRI) studies examining differences in the activity of brain networks between the first depressive episode (FDE) and recurrent depressive episode (RDE) are limited. The current study observed and compared the altered functional connectivity (FC) characteristics in the default mode network (DMN), cognitive control network (CCN), and affective network (AN) between the RDE and FDE. In addition, we further investigated the correlation between abnormal FC and clinical symptoms. Methods We recruited 32 patients with the RDE, 31 patients with the FDE, and 30 healthy controls (HCs). All subjects underwent resting-state fMRI. The seed-based FC method was used to analyze the abnormal brain networks in the DMN, CCN, and AN among the three groups and further explore the correlation between abnormal FC and clinical symptoms. Results One-way analysis of variance showed significant differences the FC in the DMN, CCN, and AN among the three groups in the frontal, parietal, temporal, and precuneus lobes and cerebellum. Compared with the RDE group, the FDE group generally showed reduced FC in the DMN, CCN, and AN. Compared with the HC group, the FDE group showed reduced FC in the DMN, CCN, and AN, while the RDE group showed reduced FC only in the DMN and AN. Moreover, the FC in the left posterior cingulate cortices and the right inferior temporal gyrus in the RDE group were positively correlated with the 17-item Hamilton Rating Scale for Depression (HAMD-17), and the FC in the left dorsolateral prefrontal cortices and the right precuneus in the FDE group were negatively correlated with the HAMD-17. Conclusions The RDE and FDE groups showed multiple abnormal brain networks. However, the alterations of abnormal FC were more extensive and intensive in the FDE group.
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Affiliation(s)
- Jifei Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhongming Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Ma
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Limei Chen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhi Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunlei Guo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Luo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Deqiang Gao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Hong
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lei Zhang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ming Han
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiudong Cao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaobing Hou
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Jing Tian
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Xue Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Jiliang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Jiliang Fang
| | - Yanping Zhao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Yanping Zhao
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10
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Sun J, Guo C, Ma Y, Du Z, Wang Z, Luo Y, Chen L, Gao D, Li X, Xu K, Hong Y, Yu X, Xiao X, Fang J, Liu Y. A comparative study of amplitude of low-frequence fluctuation of resting-state fMRI between the younger and older treatment-resistant depression in adults. Front Neurosci 2022; 16:949698. [PMID: 36090288 PMCID: PMC9462398 DOI: 10.3389/fnins.2022.949698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/08/2022] [Indexed: 12/02/2022] Open
Abstract
Background Treatment-resistant depression (TRD) may have different physiopathological neuromechanism in different age groups. This study used the amplitude of low frequency fluctuations (ALFF) to initially compare abnormalities in local functional brain activity in younger and older patients with TRD. Materials and methods A total of 21 older TRD patients, 19 younger TRD, 19 older healthy controls (HCs), and 19 younger HCs underwent resting-state functional MRI scans, and the images were analyzed using the ALFF and further analyzed for correlation between abnormal brain regions and clinical symptoms in TRD patients of different age groups. Results Compared with the older TRD, the younger TRD group had increased ALFF in the left middle frontal gyrus and decreased ALFF in the left caudate nucleus. Compared with the matched HC group, ALFF was increased in the right middle temporal gyrus and left pallidum in the older TRD group, whereas no significant differences were found in the younger TRD group. In addition, ALFF values in the left middle frontal gyrus in the younger TRD group and in the right middle temporal gyrus in the older TRD were both positively correlated with the 17-item Hamilton Rating Scale for Depression score. Conclusion Different neuropathological mechanisms may exist in TRD patients of different ages, especially in the left middle frontal gyrus and left caudate nucleus. This study is beneficial in providing potential key targets for the clinical management of TRD patients of different ages.
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Affiliation(s)
- Jifei Sun
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunlei Guo
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Ma
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhongming Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi Wang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Luo
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Limei Chen
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Deqiang Gao
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaojiao Li
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ke Xu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Hong
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xue Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Jiliang Fang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Jiliang Fang,
| | - Yong Liu
- Affiliated Hospital of Traditional Chinese Medicine, Southwest Medical University, Luzhou, China
- Yong Liu,
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11
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Gregory EC, Torres IJ, Blumberger DM, Downar J, Daskalakis ZJ, Vila-Rodriguez F. Repetitive Transcranial Magnetic Stimulation Shows Longitudinal Improvements in Memory in Patients With Treatment-Resistant Depression. Neuromodulation 2022; 25:596-605. [DOI: 10.1016/j.neurom.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/27/2021] [Accepted: 09/13/2021] [Indexed: 10/19/2022]
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12
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Rubart AK, Zurowski B, Veer IM, Schön D, Göttlich M, Klein JP, Schramm E, Wenzel JG, Haber C, Schoepf D, Sommer J, Konrad C, Schnell K, Walter H. Precuneus connectivity and symptom severity in chronic depression ✰. Psychiatry Res Neuroimaging 2022; 322:111471. [PMID: 35378340 DOI: 10.1016/j.pscychresns.2022.111471] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 02/24/2022] [Accepted: 03/28/2022] [Indexed: 11/28/2022]
Abstract
Although abnormal resting state connectivity within several brain networks has been repeatedly reported in depression, little is known about connectivity in patients with early onset chronic depression. We compared resting state connectivity in a homogenous sample of 32 unmedicated patients with early onset chronic depression and 40 healthy control participants in a seed-to-voxel-analysis. According to previous meta-analyses on resting state connectivity in depression, 12 regions implicated in default mode, limbic, frontoparietal and ventral attention networks were chosen as seeds. We also investigated associations between connectivity values and severity of depression. Patients with chronic depression exhibited stronger connectivity between precuneus and right pre-supplementary motor area than healthy control participants, possibly reflecting aberrant information processing and emotion regulation deficits in depression. Higher depression severity scores (Hamilton Rating Scale for Depression) were strongly and selectively associated with weaker connectivity between the precuneus and the subcallosal anterior cingulate. Our findings correspond to results obtained in studies including both episodic and chronic depression. This suggests that there may be no strong differences between subtypes of depression regarding the seeds analyzed here. To further clarify this issue, future studies should directly compare patients with different courses of depression.
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Affiliation(s)
- Antonie K Rubart
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
| | - Bartosz Zurowski
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Ilya M Veer
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Daniela Schön
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Martin Göttlich
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Jan Philipp Klein
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Elisabeth Schramm
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Julia G Wenzel
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Charlotte Haber
- Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Dieter Schoepf
- Department of Psychiatry and Psychotherapy, CBASP Center of Competence, University of Bonn, Bonn, Germany
| | - Jens Sommer
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Psychosocial Medicine, Agaplesion Diakonieklinikum Rotenburg, Rotenburg, Germany
| | - Knut Schnell
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Psychiatry and Psychotherapy, CBASP Center of Competence, University of Bonn, Bonn, Germany
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13
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Teng C, Liu T, Zhang N, Zhong Y, Wang C. Cognitive behavioral therapy may rehabilitate abnormally functional communication pattern among the triple-network in major depressive disorder: A follow-up study. J Affect Disord 2022; 304:28-39. [PMID: 35192866 DOI: 10.1016/j.jad.2022.02.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cognitive behavioral therapy (CBT) is an established treatment for Major Depressive Disorder (MDD). MDD is characterized by imbalanced communication patterns among three networks: the central executive network (CEN), the default mode network (DMN) and the salience network (SN). The effect of CBT in restoring communications among these networks in MDD is unknown. METHODS Thirty-three patients with MDD and 27 healthy controls (HC) participated in the study. Patients were treated with CBT. Resting-state functional magnetic resonance imaging (rs-fMRI) data were obtained in patients at three stages (T0: before treatment; T1: after 6 weeks CBT; T2: after 28 weeks CBT) and in HC (only T0). Both independent component analysis (ICA) and granger causality analysis (GCA) were used to explore dynamic causal communication patterns among the three networks (CEN, DMN, SN) over a course of CBT treatment. RESULTS In the HC group, the SN had an inhibitory causal effect on CEN; the CEN and DMN had an excitatory causal effect on the SN. The SN had an inhibitory causal effect on the CEN and the DMN; only the DMN had an excitatory causal effect on the SN in the MDD patients at the T0 stage. As the CBT treatment went on for MDD patients, the CEN restored excitatory causal effect on the SN, and the SN lost inhibitory effect on the DMN. This result mimicked the one found in the HC group. Four regions, left ventromedial prefrontal cortex (lvmPFC), posterior cingulate gyrus (PCC), right inferior parietal lobule (rIPL) and right insula, were implicated in mediating network communications. LIMITATIONS The findings should be considered preliminary given the small sample sizes, and assessed only one stage in HC subjects. CONCLUSION CBT may enhance the regulatory function of the SN, and rehabilitate the imbalanced brain network communication mode in the MDD. PCC, lvmPFC and rIPL may all be potential targets of CBT.
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Affiliation(s)
- Changjun Teng
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China; Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tianchen Liu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China; Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China; School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.
| | - Chun Wang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China; Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China; School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.
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14
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Sun J, Ma Y, Chen L, Wang Z, Guo C, Luo Y, Gao D, Li X, Xu K, Hong Y, Hou X, Tian J, Yu X, Wang H, Fang J, Xiao X. Altered Brain Function in Treatment-Resistant and Non-treatment-resistant Depression Patients: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2022; 13:904139. [PMID: 35935411 PMCID: PMC9352890 DOI: 10.3389/fpsyt.2022.904139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/23/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE In this study, we used amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) to observe differences in local brain functional activity and its characteristics in patients with treatment-resistant depression (TRD) and non-treatment-resistant depression (nTRD), and to explore the correlation between areas of abnormal brain functional activity and clinical symptoms. METHOD Thirty-seven patients with TRD, 36 patients with nTRD, and 35 healthy controls (HCs) were included in resting-state fMRI scans. ALFF and ReHo were used for image analysis and further correlation between abnormal brain regions and clinical symptoms were analyzed. RESULTS ANOVA revealed that the significantly different brain regions of ALFF and ReHo among the three groups were mainly concentrated in the frontal and temporal lobes. Compared with the nTRD group, the TRD group had decreased ALFF in the left/right inferior frontal triangular gyrus, left middle temporal gyrus, left cuneus and bilateral posterior lobes of the cerebellum, and increased ALFF in the left middle frontal gyrus and right superior temporal gyrus, and the TRD group had decreased ReHo in the left/right inferior frontal triangular gyrus, left middle temporal gyrus, and increased ReHo in the right superior frontal gyrus. Compared with the HC group, the TRD group had decreased ALFF/ReHo in both the right inferior frontal triangular gyrus and the left middle temporal gyrus. Pearson correlation analysis showed that both ALFF and ReHo values in these abnormal brain regions were positively correlated with HAMD-17 scores (P < 0.05). CONCLUSION Although the clinical symptoms were similar in the TRD and nTRD groups, abnormal neurological functional activity were present in some of the same brain regions. Compared with the nTRD group, ALFF and ReHo showed a wider range of brain area alterations and more complex neuropathological mechanisms in the TRD group, especially in the inferior frontal triangular gyrus of the frontal lobe and the middle temporal gyrus of the temporal lobe.
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Affiliation(s)
- Jifei Sun
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Ma
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Limei Chen
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhi Wang
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunlei Guo
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Luo
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Deqiang Gao
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaojiao Li
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ke Xu
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Hong
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaobing Hou
- Department of Psychiatric, Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Jing Tian
- Department of Psychiatric, Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Xue Yu
- Department of Psychiatric, Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Hongxing Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jiliang Fang
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xue Xiao
- Department of Psychiatric, Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
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15
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Sun J, Ma Y, Du Z, Wang Z, Guo C, Luo Y, Chen L, Gao D, Li X, Xu K, Hong Y, Xu F, Yu X, Xiao X, Fang J, Hou X. Immediate Modulation of Transcutaneous Auricular Vagus Nerve Stimulation in Patients With Treatment-Resistant Depression: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2022; 13:923783. [PMID: 35845466 PMCID: PMC9284008 DOI: 10.3389/fpsyt.2022.923783] [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: 04/20/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies found that transcutaneous auricular vagus nerve stimulation (taVNS) was clinically effective in treating a case of treatment-resistant depression (TRD). However, the brain neural mechanisms underlying the immediate effects of taVNS treatment for TRD have not been elucidated. MATERIALS AND METHODS Differences in the amplitude of low-frequency fluctuations (ALFF) between TRD and healthy control (HC) groups were observed. The TRD group was treated with taVNS for 30 min, and changes in ALFF in the TRD group before and after immediate treatment were observed. The ALFF brain regions altered by taVNS induction were used as regions of interest to analyze whole-brain functional connectivity (FC) changes in the TRD group. RESULTS A total of 44 TRD patients and 44 HCs completed the study and were included in the data analysis. Compared with the HC group, the TRD group had increased ALFF in the left orbital area of the middle frontal gyrus. After taVNS treatment, ALFF in the left orbital area of the middle frontal gyrus and right middle frontal gyrus decreased in the TRD group, while ALFF in the right orbital area of the superior frontal gyrus increased. The FC in the left orbital area of the middle frontal gyrus with left middle frontal gyrus and the right inferior occipital gyrus was significantly increased. CONCLUSION Transcutaneous auricular vagus nerve stimulation demonstrates immediate modulation of functional activity in the emotional network, cognitive control network, and visual processing cortex, and may be a potential brain imaging biomarker for the treatment of TRD.
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Affiliation(s)
- Jifei Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Ma
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhongming Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunlei Guo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Luo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Limei Chen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Deqiang Gao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaojiao Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ke Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Hong
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fengquan Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xue Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Jiliang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaobing Hou
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
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16
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Kuburi S, Di Passa AM, Tassone VK, Mahmood R, Lalovic A, Ladha KS, Dunlop K, Rizvi S, Demchenko I, Bhat V. Neuroimaging Correlates of Treatment Response with Psychedelics in Major Depressive Disorder: A Systematic Review. CHRONIC STRESS 2022; 6:24705470221115342. [PMID: 35936944 PMCID: PMC9350516 DOI: 10.1177/24705470221115342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/07/2022] [Indexed: 12/03/2022]
Abstract
Preliminary evidence supports the use of psychedelics for major depressive
disorder (MDD). However, less attention has been given to the neural mechanisms
behind their effects. We conducted a systematic review examining the
neuroimaging correlates of antidepressant response following psychedelic
interventions for MDD. Through MEDLINE, Embase, and APA PsycINFO, 187 records
were identified and 42 articles were screened. Six published studies and one
conference abstract were included. Five ongoing trials were included from
subjective outcomesTrials.gov. Our search covered several psychedelics, though
included studies were specific to psilocybin, ayahuasca, and lysergic acid
diethylamide. Three psilocybin studies noted amygdala activity and functional
connectivity (FC) alterations that correlated with treatment response. Two
psilocybin studies reported that FC changes in the medial and ventromedial
prefrontal cortices correlated with treatment response. Two trials from a single
study reported global decreases in brain network modularity which correlated
with antidepressant response. One ayahuasca study reported increased activity in
the limbic regions following treatment. Preliminary evidence suggests that the
default mode and limbic networks may be a target for future research on the
neural mechanisms of psychedelics. More data is required to corroborate these
initial findings as the evidence summarized in this review is based on four
datasets.
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Affiliation(s)
- Sarah Kuburi
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael’s Hospital, 193 Yonge Street 6-013, M5B 1M8, Toronto, Ontario, Canada
| | - Anne-Marie Di Passa
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael’s Hospital, 193 Yonge Street 6-013, M5B 1M8, Toronto, Ontario, Canada
| | - Vanessa K. Tassone
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael’s Hospital, 193 Yonge Street 6-013, M5B 1M8, Toronto, Ontario, Canada
| | - Raesham Mahmood
- Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, M5S 1A8, Toronto, Ontario, Canada
| | - Aleksandra Lalovic
- Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, M5T 1R8, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, M5B 1T8, Toronto, Ontario, Canada
| | - Karim S. Ladha
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, M5B 1T8, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, 250 College Street, M5T 1R8, Toronto, Ontario, Canada
- Department of Anesthesia, St. Michael's Hospital, 193 Yonge Street 6-013, M5B 1M8, Toronto, Ontario, Canada
| | - Katharine Dunlop
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael’s Hospital, 193 Yonge Street 6-013, M5B 1M8, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, M5T 1R8, Toronto, Ontario, Canada
- Center for Depression and Suicide Studies, St. Michael’s Hospital, Unity Health Toronto, 30 Bond Street, M5B 1W8, Toronto, ON, Canada
- Keenan Research Center for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, 30 Bond Street, M5B 1W8, Toronto, Ontario, Canada
| | - Sakina Rizvi
- Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, M5T 1R8, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, M5B 1T8, Toronto, Ontario, Canada
| | - Ilya Demchenko
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael’s Hospital, 193 Yonge Street 6-013, M5B 1M8, Toronto, Ontario, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael’s Hospital, 193 Yonge Street 6-013, M5B 1M8, Toronto, Ontario, Canada
- Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, M5S 1A8, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, M5T 1R8, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, M5B 1T8, Toronto, Ontario, Canada
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17
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Runia N, Yücel DE, Lok A, de Jong K, Denys DAJP, van Wingen GA, Bergfeld IO. The neurobiology of treatment-resistant depression: A systematic review of neuroimaging studies. Neurosci Biobehav Rev 2021; 132:433-448. [PMID: 34890601 DOI: 10.1016/j.neubiorev.2021.12.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/08/2021] [Accepted: 12/06/2021] [Indexed: 12/17/2022]
Abstract
Treatment-resistant depression (TRD) is a debilitating condition associated with higher medical costs, increased illness burden, and reduced quality of life compared to non-treatment-resistant major depressive disorder (MDD). The question arises whether TRD can be considered a distinct MDD sub-type based on neurobiological features. To answer this question we conducted a systematic review of neuroimaging studies investigating the neurobiological differences between TRD and non-TRD. Our main findings are that patients with TRD show 1) reduced functional connectivity (FC) within the default mode network (DMN), 2) reduced FC between components of the DMN and other brain areas, and 3) hyperactivity of DMN regions. In addition, aberrant activity and FC in the occipital lobe may play a role in TRD. The main limitations of most studies were related to inherent confounding factors for comparing TRD with non-TRD, such as differences in disease chronicity/severity and medication history. Future studies may use prospective longitudinal neuroimaging designs to delineate which effects are present in treatment-naive patients and which effects are the result of disease progression.
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Affiliation(s)
- Nora Runia
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands.
| | - Dilan E Yücel
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - Anja Lok
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - Kiki de Jong
- University of Amsterdam, Amsterdam, the Netherlands
| | - Damiaan A J P Denys
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - Guido A van Wingen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - Isidoor O Bergfeld
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands.
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18
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Liu S, Luo S, Yan T, Ma W, Wei X, Chen Y, Zhan S, Wang B. Differential Modulating Effect of Acupuncture in Patients With Migraine Without Aura: A Resting Functional Magnetic Resonance Study. Front Neurol 2021; 12:680896. [PMID: 34122321 PMCID: PMC8193984 DOI: 10.3389/fneur.2021.680896] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/04/2021] [Indexed: 02/05/2023] Open
Abstract
Introduction: Migraine is a recurrent neurological disorder, the symptoms of which can be significantly relieved by acupuncture. However, the central mechanism via which acupuncture exerts its therapeutic effect in migraine is unclear. The aim of this study was to compare the differences in regional homogeneity (ReHo) between patients with migraine without aura (MwoA) and healthy controls (HCs) and to explore the immediate and cumulative therapeutic effect of acupuncture in patients with MwoA using resting-state functional magnetic resonance imaging (fMRI). Methods: The study subjects were 40 patients with MwoA and 16 matched HCs. The patients with MwoA received acupuncture on 2 days per week for 6 weeks for a total of 12 sessions followed by 24 weeks of follow-up. The primary clinical efficacy outcomes were the number of days with migraine and the average severity of headache. Secondary outcomes were the Migraine-Specific Quality of Life Questionnaire, Self-Rating Anxiety Scale, and Self-Rating Depression Scale scores. In the migraine group, resting-state blood-oxygen-level-dependent fMRI scans were obtained at baseline and after the first and 12th acupuncture sessions to measure the ReHo value. In the HCs, only a baseline resting-state blood-oxygen-level-dependent fMRI scan was obtained. Results: Compared with the control group, the migraine group had a significantly lower ReHo value in the cerebellum, which increased after the first acupuncture session. Long-term acupuncture significantly improved migraine symptoms and mood with a therapeutic effect that lasted for at least 6 months. After 12 acupuncture sessions, there were significant increase of cerebellum and angular gyrus in the migraine group. Conclusion: These findings suggest that migraine is related to cerebellar dysfunction. Acupuncture can relieve the symptoms of migraine, improve dysfunction of cerebellum, and activate brain regions involved in modulation of pain and emotion The cumulative therapeutic effect of acupuncture is more extensive and significant than its immediate effect.
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Affiliation(s)
- Shanshan Liu
- Department of Acupuncture and Moxibustion, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shilei Luo
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tianwei Yan
- Department of Acupuncture and Moxibustion, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen Ma
- Department of Acupuncture and Moxibustion, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiangyu Wei
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yilei Chen
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Songhua Zhan
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bo Wang
- Department of Acupuncture and Moxibustion, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Roberts H, Jacobs RH, Bessette KL, Crowell SE, Westlund-Schreiner M, Thomas L, Easter RE, Pocius SL, Dillahunt A, Frandsen S, Schubert B, Farstead B, Kerig P, Welsh RC, Jago D, Langenecker SA, Watkins ER. Mechanisms of rumination change in adolescent depression (RuMeChange): study protocol for a randomised controlled trial of rumination-focused cognitive behavioural therapy to reduce ruminative habit and risk of depressive relapse in high-ruminating adolescents. BMC Psychiatry 2021; 21:206. [PMID: 33892684 PMCID: PMC8062943 DOI: 10.1186/s12888-021-03193-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/01/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Adolescent-onset depression often results in a chronic and recurrent course, and is associated with worse outcomes relative to adult-onset depression. Targeting habitual depressive rumination, a specific known risk factor for relapse, may improve clinical outcomes for adolescents who have experienced a depressive episode. Randomized controlled trials (RCTs) thus far have demonstrated that rumination-focused cognitive behavioral therapy (RFCBT) reduces depressive symptoms and relapse rates in patients with residual depression and adolescents and young adults with elevated rumination. This was also observed in a pilot RCT of adolescents at risk for depressive relapse. Rumination can be measured at the self-report, behavioral, and neural levels- using patterns of connectivity between the Default Mode Network (DMN) and Cognitive Control Network (CCN). Disrupted connectivity is a putative important mechanism for understanding reduced rumination via RFCBT. A feasibility trial in adolescents found that reductions in connectivity between DMN and CCN regions following RFCBT were correlated with change in rumination and depressive symptoms. METHOD This is a phase III two-arm, two-stage, RCT of depression prevention. The trial tests whether RFCBT reduces identified risk factors for depressive relapse (rumination, patterns of neural connectivity, and depressive symptoms) in adolescents with partially or fully remitted depression and elevated rumination. In the first stage, RFCBT is compared to treatment as usual within the community. In the second stage, the comparator condition is relaxation therapy. Primary outcomes will be (a) reductions in depressive rumination, assessed using the Rumination Response Scale, and (b) reductions in resting state functional magnetic resonance imaging connectivity of DMN (posterior cingulate cortex) to CCN (inferior frontal gyrus), at 16 weeks post-randomization. Secondary outcomes include change in symptoms of depression following treatment, recurrence of depression over 12 months post-intervention period, and whether engagement with therapy homework (as a dose measure) is related to changes in the primary outcomes. DISCUSSION RFCBT will be evaluated as a putative preventive therapy to reduce the risk of depressive relapse in adolescents, and influence the identified self-report, behavioral, and neural mechanisms of change. Understanding mechanisms that underlie change in rumination is necessary to improve and further disseminate preventive interventions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03859297 , registered 01 March 2019.
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Affiliation(s)
- Henrietta Roberts
- Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN, UK
| | | | - Katie L Bessette
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Sheila E Crowell
- Department of Psychology, University of Utah, Salt Lake City, UT, 84108, USA
| | | | - Leah Thomas
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Rebecca E Easter
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Stephanie L Pocius
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Alina Dillahunt
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Summer Frandsen
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Briana Schubert
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Brian Farstead
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Patricia Kerig
- Department of Psychology, University of Utah, Salt Lake City, UT, 84108, USA
| | - Robert C Welsh
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - David Jago
- Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN, UK
| | - Scott A Langenecker
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Edward R Watkins
- Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN, UK.
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20
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Fu Y, Long Z, Luo Q, Xu Z, Xiang Y, Du W, Cao Y, Cheng X, Du L. Functional and Structural Connectivity Between the Left Dorsolateral Prefrontal Cortex and Insula Could Predict the Antidepressant Effects of Repetitive Transcranial Magnetic Stimulation. Front Neurosci 2021; 15:645936. [PMID: 33841087 PMCID: PMC8032871 DOI: 10.3389/fnins.2021.645936] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background The efficacy of repetitive transcranial magnetic stimulation (rTMS) in depression is nonuniform across patients. This study aims to determine whether baseline neuroimaging characters can provide a pretreatment predictive effect for rTMS. Methods Twenty-seven treatment-naive patients with major depressive disorder (MDD) were enrolled and scanned with resting-state functional magnetic resonance imaging (fMRI) and diffusion tensor imaging. Clinical symptoms were assessed pre- and post-rTMS. Functional and structural connectivity between the left dorsolateral prefrontal cortex (DLPFC) and bilateral insula were measured, and the connectivity strength in each modality was then correlated to the clinical efficacy of rTMS. Results When the coordinates of left DLPFC were located as a node in the central executive network, the clinical efficacy of rTMS was significantly correlated with the functional connectivity strength between left DLPFC and bilateral insula (left insula: r = 0.66; right insula: r = 0.65). The structural connectivity strength between the left DLPFC and left insular cortex also had a significantly positive correlation with symptom improvement (rs = 0.458). Conclusion This study provides implications that rTMS might act more effectively when the pretreatment functional and structural connectivity between the insula and left DLPFC is stronger.
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Affiliation(s)
- Yixiao Fu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiliang Long
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
| | - Qinghua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhen Xu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yisijia Xiang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wanyi Du
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuanyuan Cao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoli Cheng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lian Du
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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21
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Nakamura T, Tomita M, Horikawa N, Ishibashi M, Uematsu K, Hiraki T, Abe T, Uchimura N. Functional connectivity between the amygdala and subgenual cingulate gyrus predicts the antidepressant effects of ketamine in patients with treatment-resistant depression. Neuropsychopharmacol Rep 2021; 41:168-178. [PMID: 33615749 PMCID: PMC8340826 DOI: 10.1002/npr2.12165] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 12/28/2022] Open
Abstract
Aim Approximately one‐third of patients with major depressive disorder develop treatment‐resistant depression. One‐third of patients with treatment‐resistant depression demonstrate resistance to ketamine, which is a novel antidepressant effective for this disorder. The objective of this study was to examine the utility of resting‐state functional magnetic resonance imaging for the prediction of treatment response to ketamine in treatment‐resistant depression. Methods An exploratory seed‐based resting‐state functional magnetic resonance imaging analysis was performed to examine baseline resting‐state functional connectivity differences between ketamine responders and nonresponders before treatment with multiple intravenous ketamine infusions. Results Fifteen patients with treatment‐resistant depression received multiple intravenous subanesthetic (0.5 mg/kg/40 minutes) ketamine infusions, and nine were identified as responders. The exploratory resting‐state functional magnetic resonance imaging analysis identified a cluster of significant baseline resting‐state functional connectivity differences associating ketamine response between the amygdala and subgenual anterior cingulate gyrus in the right hemisphere. Using anatomical region of interest analysis of the resting‐state functional connectivity, ketamine response was predicted with 88.9% sensitivity and 100% specificity. The resting‐state functional connectivity of significant group differences between responders and nonresponders retained throughout the treatment were considered a trait‐like feature of heterogeneity in treatment‐resistant depression. Conclusion This study suggests the possible clinical utility of resting‐state functional magnetic resonance imaging for predicting the antidepressant effects of ketamine in treatment‐resistant depression patients and implicated resting‐state functional connectivity alterations to determine the trait‐like pathophysiology underlying treatment response heterogeneity in treatment‐resistant depression. This study illustrates that the alteration in the RSFC within the right AN in TRD patients reflects the antidepressant response to ketamine at baseline. The alteration remained throughout the 2‐week treatment with multiple ketamine infusions and seemed to reflect the trait‐like features underlying treatment heterogeneity in TRD. By employing an anatomical ROI of the sc/sgACC, the present study also suggests the possible clinical utility of the rsfMRI to predict the treatment response to ketamine in TRD patients.
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Affiliation(s)
- Tomoyuki Nakamura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume City, Japan
| | - Masaru Tomita
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume City, Japan.,Elm-tree Mental Clinic, Ogori City, Japan
| | - Naoki Horikawa
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume City, Japan.,Nozoe Hills Hospital, Kurume City, Japan
| | - Masatoshi Ishibashi
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume City, Japan
| | - Ken Uematsu
- Uematsu Mental Clinic, Chikugo City, Japan.,Department of Pharmacology, Kurume University School of Medicine, Kurume City, Japan
| | - Teruyuki Hiraki
- Department of Anaesthesiology, Kurume University School of Medicine, Kurume City, Japan
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, Kurume City, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume City, Japan
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22
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Chen MH, Lin WC, Tu PC, Li CT, Bai YM, Tsai SJ, Su TP. Antidepressant and antisuicidal effects of ketamine on the functional connectivity of prefrontal cortex-related circuits in treatment-resistant depression: A double-blind, placebo-controlled, randomized, longitudinal resting fMRI study. J Affect Disord 2019; 259:15-20. [PMID: 31437695 DOI: 10.1016/j.jad.2019.08.022] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 08/10/2019] [Accepted: 08/13/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Increasing evidence suggests that infusion of a subanesthetic dose of ketamine exerts antidepressant and antisuicidal effects in patients with treatment-resistant depression (TRD). AIMS In this investigation, we used the resting functional connectivity magnetic resonance imaging (fcMRI) to determine the effects of ketamine on the functional connectivity (FC) of prefrontal cortex (PFC)-related circuits in patients with TRD. METHODS Forty-eight patients with TRD were recruited and randomly divided into three groups on the basis of ketamine infusion dose: 0.5 mg/kg (standard dose), 0.2 mg/kg (low dose), or normal saline (a placebo infusion). Resting functional MRI data and clinical data were recorded at the baseline and on the third day after ketamine infusion treatment. RESULTS The standard-dose group showed a reduction in the FC of the left dorsal anterior cingulate cortex (dACC) and right dorsolateral (dl)PFC with the other frontal regions. The low-dose group demonstrated a more pervasive reduction of FC in the bilateral dACC with other frontal and parietal regions. A negative correlation was observed between the reduction in suicidal ideation and the reduction in the FC between the left dACC and right ACC regions in the standard-dose group, whereas a positive correlation was observed between the reduction in suicidal ideation and the increase in the FC between the right dlPFC and left superior parietal region in the low-dose group. CONCLUSIONS Our results support the hypothesis that PFC-related circuit modulation is crucial to the antidepressant and antisuicidal effects of the ketamine infusion treatment.
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan.
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23
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Geugies H, Opmeer EM, Marsman JBC, Figueroa CA, van Tol MJ, Schmaal L, van der Wee NJA, Aleman A, Penninx BWJH, Veltman DJ, Schoevers RA, Ruhé HG. Decreased functional connectivity of the insula within the salience network as an indicator for prospective insufficient response to antidepressants. NEUROIMAGE-CLINICAL 2019; 24:102064. [PMID: 31795046 PMCID: PMC6883326 DOI: 10.1016/j.nicl.2019.102064] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/01/2019] [Accepted: 11/03/2019] [Indexed: 01/04/2023]
Abstract
Connectivity analyses complemented with a metric exploring switching in brain activity. Lower insula-salience connectivity predicts insufficient antidepressant response. This same insula region is activated less when switching from task to a rest. This could be a potential biomarkers for predicting future antidepressant response.
Insufficient response to treatment is the main cause of prolonged suffering from major depressive disorder (MDD). Early identification of insufficient response could result in faster and more targeted treatment strategies to reduce suffering. We therefore explored whether baseline alterations within and between resting state functional connectivity networks could serve as markers of insufficient response to antidepressant treatment in two years of follow-up. We selected MDD patients (N = 17) from the NEtherlands Study of Depression and Anxiety (NESDA), who received ≥ two antidepressants, indicative for insufficient response, during the two year follow-up, a group of MDD patients who received only one antidepressant (N = 32) and a healthy control group (N = 19) matched on clinical characteristics and demographics. An independent component analysis (ICA) of baseline resting-state scans was conducted after which functional connectivity within the components was compared between groups. We observed lower connectivity of the right insula within the salience network in the group with ≥ two antidepressants compared to the group with one antidepressant. No difference in connectivity was found between the patient groups and healthy control group. Given the suggested role of the right insula in switching between task-positive mode (activation during attention-demanding tasks) and task-negative mode (activation during the absence of any task), we explored whether right insula activation differed during switching between these two modes. We observed that in the ≥2 antidepressant group, the right insula was less active compared to the group with one antidepressant, when switching from task-positive to task-negative mode than the other way around. These findings imply that lower right insula connectivity within the salience network may serve as an indicator for prospective insufficient response to antidepressants. This result, supplemented by the diminished insula activation when switching between task and rest related networks, could indicate an underlying mechanism that, if not sufficiently targeted by current antidepressants, could lead to insufficient response. When replicated, these findings may contribute to the identification of biomarkers for early detection of insufficient response.
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Affiliation(s)
- H Geugies
- University Medical Center Groningen, University Center for Psychiatry, Mood and Anxiety Disorders, University of Groningen, Groningen, the Netherlands; University Medical Center Groningen, Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, Groningen, the Netherlands.
| | - E M Opmeer
- University Medical Center Groningen, Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, Groningen, the Netherlands
| | - J B C Marsman
- University Medical Center Groningen, Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, Groningen, the Netherlands
| | - C A Figueroa
- Department of Psychiatry, Amsterdam UMC, Locatie AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - M J van Tol
- University Medical Center Groningen, Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, Groningen, the Netherlands
| | - L Schmaal
- Department of Psychiatry, Amsterdam UMC, Locatie VUmc, VU University Amsterdam, Amsterdam, the Netherlands; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - N J A van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - A Aleman
- University Medical Center Groningen, Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, Groningen, the Netherlands; Department of Psychology, University of Groningen, Groningen, the Netherlands
| | - B W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Locatie VUmc, VU University Amsterdam, Amsterdam, the Netherlands
| | - D J Veltman
- Department of Psychiatry, Amsterdam UMC, Locatie VUmc, VU University Amsterdam, Amsterdam, the Netherlands
| | - R A Schoevers
- University Medical Center Groningen, University Center for Psychiatry, Mood and Anxiety Disorders, University of Groningen, Groningen, the Netherlands; Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; University of Groningen, Research School of Behavioural and Cognitive Neurosciences (BCN), Groningen, the Netherlands
| | - H G Ruhé
- University Medical Center Groningen, University Center for Psychiatry, Mood and Anxiety Disorders, University of Groningen, Groningen, the Netherlands; Department of Psychiatry, Amsterdam UMC, Locatie AMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands.
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24
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Altered dynamic functional connectivity in weakly-connected state in major depressive disorder. Clin Neurophysiol 2019; 130:2096-2104. [PMID: 31541987 DOI: 10.1016/j.clinph.2019.08.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 05/27/2019] [Accepted: 08/14/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is accompanied by abnormal changes in dynamic functional connectivity (FC) among brain regions. The aim of this study is to investigate whether the abnormalities of dynamic FC in MDD are state-dependent (related to a specific connectivity state). METHODS We performed time-varying connectivity analysis on resting-state functional magnetic resonance imaging (rs-fMRI) of 49 MDD patients and 54 matched healthy controls (HCs). FC differences between groups in each connectivity state were analyzed and associations between disease severity and dynamics of aberrant FC were explored. RESULTS Two distinct connectivity states (i.e., weakly-connected and strongly-connected state) were identified. Compared to HCs, MDD patients were associated with increased mean dwell time and decreased FC between and within subnetworks in the weakly-connected state. Dynamics of reduced FC between cognitive control network and default mode network as well as within cognitive control network predicted individual differences in depression symptom severity. CONCLUSIONS Our findings suggested that the MDD-caused FC alterations mostly appeared in the weakly-connected state, which might contribute to clinical diagnosis of MDD. SIGNIFICANCE These findings provide new perspectives for understanding the state-dependent neurophysiological mechanisms in MDD.
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25
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Yao Z, Zou Y, Zheng W, Zhang Z, Li Y, Yu Y, Zhang Z, Fu Y, Shi J, Zhang W, Wu X, Hu B. Structural alterations of the brain preceded functional alterations in major depressive disorder patients: Evidence from multimodal connectivity. J Affect Disord 2019; 253:107-117. [PMID: 31035211 DOI: 10.1016/j.jad.2019.04.064] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/11/2019] [Accepted: 04/08/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Recent studies showed that major depressive disorder (MDD) has been involved in abnormal functional and structural connections in specific brain regions. However, comprehensive researches on MDD-related alterations in the topological organization of brain functional and structural networks are still limited. METHODS Functional network (FN) was constructed from resting-state functional MRI temporal series correlations and structural network (SN) was established by Diffusion tensor imaging (DTI) data in 58 MDD patients and 71 healthy controls (HC). The measurements of the network properties were calculated for two networks respectively. Correlations were conducted between altered network parameters and Hamilton depression scale (HAMD) score. Additionally, network resilient analysis were conducted on FN and SN. RESULTS The losses of small-worldness charateristics and the decline of nodal efficiency across FN and SN were found in MDD patients. Based on network-based statistic (NBS) approach, the decreased connections in MDD patients were mainly found in the superior occipital gyrus, superior temporal gyrus for FN and SN, while the increased connections were distributed in putamen, superior frontal gyrus only for SN. Compared with the FN, the SN showed less resilient to targeted or random node failure. Besides, altered edges in NBS and regions with decreased nodal efficiency were negatively associated with HAMD score in MDD patients. LIMITATIONS The samples size is small and most of the MDD patients take different antidepressant medications. CONCLUSIONS Alterations of SN in the brain of MDD patients preceded that of FN to some extent, and reorganization of the brain network was a mechanism which compensated for functional and structural alterations during disease progression.
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Affiliation(s)
- Zhijun Yao
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R. China
| | - Ying Zou
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R. China
| | - Weihao Zheng
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, P.R. China
| | - Zhe Zhang
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R. China
| | - Yuan Li
- School of Information Science and Engineering, Shandong Normal University, Jinan, Shandong Province, 250358, P.R. China
| | - Yue Yu
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R. China
| | - Zicheng Zhang
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R. China
| | - Yu Fu
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R. China
| | - Jie Shi
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R. China
| | - Wenwen Zhang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, Gansu Province, 730000, P.R. China
| | - Xia Wu
- College of Information Science and Technology, Beijing Normal University, Beijing, 100000, P.R. China.
| | - Bin Hu
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R. China.
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Alonzo A, Fong J, Ball N, Martin D, Chand N, Loo C. Pilot trial of home-administered transcranial direct current stimulation for the treatment of depression. J Affect Disord 2019; 252:475-483. [PMID: 31005790 DOI: 10.1016/j.jad.2019.04.041] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 03/13/2019] [Accepted: 04/07/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Transcranial Direct Current Stimulation (tDCS) is a non-invasive, neuromodulation approach with promising efficacy for treating depression. To date, tDCS has been limited to clinical or research centre settings with treatment administered by staff. The aim of this study is to examine the efficacy, tolerability and feasibility of home-administered, remotely-supervised tDCS for depression. METHODS In an open label trial, 34 participants used a Soterix 1 × 1 mini-CT device to self-administer 20-28 tDCS sessions (2 mA, 30 min, F3-anode and F8-cathode montage according to 10-20 EEG placement) over 4 weeks followed by a taper phase of 4 sessions 1 week apart. Participants were initially monitored via video link and then through completion of an online treatment diary. Mixed effects repeated measures analyses assessed change in mood scores. RESULTS Mood improved significantly from baseline (27.47 on Montgomery-Asberg Depression Rating Scale) to 1 month after the end of acute treatment (15.48) (p < 0.001). Side effects were largely transient and minor. Outcomes were comparable to those reported in clinic-based trials. Protocol adherence was excellent with a drop-out rate of 6% and 93% of scheduled sessions completed. LIMITATIONS The tDCS and remote monitoring procedures employed in this study require a level of manual dexterity and computer literacy, which may be challenging for some patients. This study did not have a control condition. CONCLUSIONS This study provides initial evidence that home-based, remotely-supervised tDCS treatment may be efficacious and feasible for depressed patients and has high translational potential.
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Affiliation(s)
- Angelo Alonzo
- School of Psychiatry, University of New South Wales/Black Dog Institute, Hospital Road, Randwick, NSW 2031, Australia.
| | - Joanna Fong
- School of Psychiatry, University of New South Wales/Black Dog Institute, Hospital Road, Randwick, NSW 2031, Australia
| | - Nicola Ball
- School of Psychiatry, University of New South Wales/Black Dog Institute, Hospital Road, Randwick, NSW 2031, Australia
| | - Donel Martin
- School of Psychiatry, University of New South Wales/Black Dog Institute, Hospital Road, Randwick, NSW 2031, Australia
| | - Nicholas Chand
- School of Psychiatry, University of New South Wales/Black Dog Institute, Hospital Road, Randwick, NSW 2031, Australia
| | - Colleen Loo
- School of Psychiatry, University of New South Wales/Black Dog Institute, Hospital Road, Randwick, NSW 2031, Australia; St George Hospital, South Eastern Sydney Health, Level 2, James Laws House, Gray St, Kogarah, NSW 2217, Australia
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Langenecker SA, Klumpp H, Peters AT, Crane NA, DelDonno SR, Bessette KL, Ajilore O, Leow A, Shankman SA, Walker SJ, Ransom MT, Hsu DT, Phan KL, Zubieta JK, Mickey BJ, Stange JP. Multidimensional imaging techniques for prediction of treatment response in major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:38-48. [PMID: 30009871 PMCID: PMC6556149 DOI: 10.1016/j.pnpbp.2018.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/31/2018] [Accepted: 07/03/2018] [Indexed: 12/21/2022]
Abstract
A large number of studies have attempted to use neuroimaging tools to aid in treatment prediction models for major depressive disorder (MDD). Most such studies have reported on only one dimension of function and prediction at a time. In this study, we used three different tasks across domains of function (emotion processing, reward anticipation, and cognitive control, plus resting state connectivity completed prior to start of medication to predict treatment response in 13-36 adults with MDD. For each experiment, adults with MDD were prescribed only label duloxetine (all experiments), whereas another subset were prescribed escitalopram. We used a KeyNet (both Task derived masks and Key intrinsic Network derived masks) approach to targeting brain systems in a specific match to tasks. The most robust predictors were (Dichter et al., 2010) positive response to anger and (Gong et al., 2011) negative response to fear within relevant anger and fear TaskNets and Salience and Emotion KeyNet (Langenecker et al., 2018) cognitive control (correct rejections) within Inhibition TaskNet (negative) and Cognitive Control KeyNet (positive). Resting state analyses were most robust for Cognitive control Network (positive) and Salience and Emotion Network (negative). Results differed by whether an -fwhm or -acf (more conservative) adjustment for multiple comparisons was used. Together, these results implicate the importance of future studies with larger sample sizes, multidimensional predictive models, and the importance of using empirically derived masks for search areas.
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Affiliation(s)
| | - Heide Klumpp
- University of Illinois at Chicago,University of Michigan
| | | | | | | | | | | | | | | | - Sara J. Walker
- University of Michigan,University of Oregon Health Sciences
| | | | | | - K. Luan Phan
- University of Illinois at Chicago,University of Michigan
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Luan SX, Zhang L, Wang R, Zhao H, Liu C. A resting-state study of volumetric and functional connectivity of the habenular nucleus in treatment-resistant depression patients. Brain Behav 2019; 9:e01229. [PMID: 30806014 PMCID: PMC6456806 DOI: 10.1002/brb3.1229] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 01/18/2019] [Accepted: 01/19/2019] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To investigate the volumetric and functional connectivity of the habenular nucleus in treatment-resistant depression (TRD) patients using the resting-state functional magnetic resonance imaging (rs-fMRI) approach. METHODS A total of 15 TRD patients, who visited the Mental Health Institute of the First Hospital Affiliated with Jilin University between August 2014 and March 2015, along with 15 normal subjects, were enrolled into this study for structural and functional imaging. Functional connectivity analysis was performed using bilateral habenular nuclei as the region of interest in contrast to whole-brain voxels. RESULTS No significant difference of absolute volume was found in bilateral habenular nuclei between TRD patients and healthy controls, or after controlling for individual total intracranial volume. However, functional connectivity analysis showed increased connectivity between the right habenular nucleus with the medial superior frontal gyrus, anterior cingulate cortex and medial orbitofrontal gyrus, and decreased connectivity with the corpus callosum in the TRD group. For the left habenular nucleus seed, the brain region with increased functional connectivity in the inferior temporal gyrus and decreased functional connectivity in the insular was found in the TRD patients. CONCLUSION Abnormal functional connectivity was present between the habenular nucleus and the default mode network in TRD patients. Dysfunction in habenular nucleus-related circuitry for processing negative emotion might form the pathological basis for TRD. Significant asymmetric functional connectivity was also found between bilateral habenular nuclei in TRD patients. Such asymmetry suggests potentially divergent strategy for intervention on bilateral habenular nucleus regions in the future management of depression.
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Affiliation(s)
- Shu-Xin Luan
- Department of Mental Health, The First Hospital of Jilin University, Changchun, China.,Department of Physiology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Lei Zhang
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - Rui Wang
- Department of Mental Health, The First Hospital of Jilin University, Changchun, China
| | - Hua Zhao
- Department of Physiology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Chang Liu
- Department of Mental Health, The First Hospital of Jilin University, Changchun, China
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Li XJ, Wang L, Wang HX, Zhang L, Zhang GL, Rong PJ, Fang JL. The effect of transcutaneous auricular vagus nerve stimulation on treatment-resistant depression monitored by resting-state fMRI and MRS: The first case report. Brain Stimul 2019; 12:377-379. [DOI: 10.1016/j.brs.2018.11.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 11/07/2018] [Accepted: 11/22/2018] [Indexed: 12/28/2022] Open
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Atluri S, Wong W, Moreno S, Blumberger DM, Daskalakis ZJ, Farzan F. Selective modulation of brain network dynamics by seizure therapy in treatment-resistant depression. NEUROIMAGE-CLINICAL 2018; 20:1176-1190. [PMID: 30388600 PMCID: PMC6214861 DOI: 10.1016/j.nicl.2018.10.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 10/01/2018] [Accepted: 10/16/2018] [Indexed: 12/20/2022]
Abstract
Background Electroconvulsive therapy (ECT) is highly effective for treatment-resistant depression, yet its mechanism of action is still unclear. Understanding the mechanism of action of ECT can advance the optimization of magnetic seizure therapy (MST) towards higher efficacy and less cognitive impairment. Given the neuroimaging evidence for disrupted resting-state network dynamics in depression, we investigated whether seizure therapy (ECT and MST) selectively modifies brain network dynamics for therapeutic efficacy. Methods EEG microstate analysis was used to evaluate resting-state network dynamics in patients at baseline and following seizure therapy, and in healthy controls. Microstate analysis defined four classes of brain states (labelled A, B, C, D). Source localization identified the brain regions associated with these states. Results An increase in duration and decrease in frequency of microstates was specific to responders of seizure therapy. Significant changes in the dynamics of States A, C and D were observed and predicted seizure therapy outcome (specifically ECT). Relative change in the duration of States C and D was shown to be a strong predictor of ECT response. Source localization partly associated C and D to the salience and frontoparietal networks, argued to be impaired in depression. An increase in duration and decrease in frequency of microstates was also observed following MST, however it was not specific to responders. Conclusion This study presents the first evidence for the modulation of global brain network dynamics by seizure therapy. Successful seizure therapy was shown to selectively modulate network dynamics for therapeutic efficacy. The (electric or magnetic) induction of seizures is effective for severe depression but its mechanism of action is unclear. We investigated whether the modulation of brain network dynamics underlies the therapeutic efficacy of seizure therapy. Global brain-network dynamics were studied using EEG microstate analysis. Significant changes in microstate characteristics were specific to responders of electroconvulsive therapy (ECT). Relative change in the duration of microstates C and D was shown to be a strong predictor of response to ECT.
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Affiliation(s)
- Sravya Atluri
- Centre for Addiction and Mental Health, 1001 Queen St. W, Toronto, ON M6J 1A8, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Rosebrugh Building, Room 407, 164 College St, Toronto, ON M5S 3G9, Canada
| | - Willy Wong
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Rosebrugh Building, Room 407, 164 College St, Toronto, ON M5S 3G9, Canada; The Edward S. Rogers Sr. Department of Electrical & Computer Engineering, University of Toronto, 10 King's College Road, Toronto, ON M5S 3G4, Canada
| | - Sylvain Moreno
- School of Interactive Art and Technology, Simon Fraser University, 250-13450 102 avenue, Surrey, BC V3T 0A3, Canada
| | - Daniel M Blumberger
- Centre for Addiction and Mental Health, 1001 Queen St. W, Toronto, ON M6J 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Zafiris J Daskalakis
- Centre for Addiction and Mental Health, 1001 Queen St. W, Toronto, ON M6J 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Faranak Farzan
- Centre for Addiction and Mental Health, 1001 Queen St. W, Toronto, ON M6J 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON M5S 1A8, Canada; School of Mechatronic Systems Engineering, Simon Fraser University, 250-13450 102 avenue, Surrey, BC V3T 0A3, Canada.
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Langenecker SA, Crane NA, Jenkins LM, Phan KL, Klumpp H. Pathways to Neuroprediction: Opportunities and challenges to prediction of treatment response in depression. Curr Behav Neurosci Rep 2018; 5:48-60. [PMID: 29892518 PMCID: PMC5992916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE OF REVIEW We set out to review the current state of science in neuroprediction, using biological measures of brain function, with task based fMRI to prospectively predict response to a variety of treatments. RECENT FINDINGS Task-based fMRI neuroprediction studies are balanced between whole brain and ROI specific analyses. The predominant tasks are emotion processing, with ROIs based upon amygdala and subgenual anterior cingulate gyrus, both within the salience and emotion network. A rapidly emerging new area of neuroprediction is of disease course and illness recurrence. Concerns include use of open-label and single arm studies, lack of consideration of placebo effects, unbalanced adjustments for multiple comparisons (over focus on type I error), small sample sizes, unreported effect sizes, overreliance on ROI studies. SUMMARY There is a need to adjust neuroprediction study reporting so that greater coherence can facilitate meta analyses, and increased funding for more multiarm studies in neuroprediction.
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Pathways to Neuroprediction: Opportunities and Challenges to Prediction of Treatment Response in Depression. Curr Behav Neurosci Rep 2018. [DOI: 10.1007/s40473-018-0140-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Feder S, Sundermann B, Wersching H, Teuber A, Kugel H, Teismann H, Heindel W, Berger K, Pfleiderer B. Sample heterogeneity in unipolar depression as assessed by functional connectivity analyses is dominated by general disease effects. J Affect Disord 2017; 222:79-87. [PMID: 28679115 DOI: 10.1016/j.jad.2017.06.055] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 06/07/2017] [Accepted: 06/26/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Combinations of resting-state fMRI and machine-learning techniques are increasingly employed to develop diagnostic models for mental disorders. However, little is known about the neurobiological heterogeneity of depression and diagnostic machine learning has mainly been tested in homogeneous samples. Our main objective was to explore the inherent structure of a diverse unipolar depression sample. The secondary objective was to assess, if such information can improve diagnostic classification. MATERIALS AND METHODS We analyzed data from 360 patients with unipolar depression and 360 non-depressed population controls, who were subdivided into two independent subsets. Cluster analyses (unsupervised learning) of functional connectivity were used to generate hypotheses about potential patient subgroups from the first subset. The relationship of clusters with demographical and clinical measures was assessed. Subsequently, diagnostic classifiers (supervised learning), which incorporated information about these putative depression subgroups, were trained. RESULTS Exploratory cluster analyses revealed two weakly separable subgroups of depressed patients. These subgroups differed in the average duration of depression and in the proportion of patients with concurrently severe depression and anxiety symptoms. The diagnostic classification models performed at chance level. LIMITATIONS It remains unresolved, if subgroups represent distinct biological subtypes, variability of continuous clinical variables or in part an overfitting of sparsely structured data. CONCLUSIONS Functional connectivity in unipolar depression is associated with general disease effects. Cluster analyses provide hypotheses about potential depression subtypes. Diagnostic models did not benefit from this additional information regarding heterogeneity.
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Affiliation(s)
- Stephan Feder
- University Hospital Münster, Department of Clinical Radiology, Münster, Germany; University Hospital Heidelberg, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany
| | - Benedikt Sundermann
- University Hospital Münster, Department of Clinical Radiology, Münster, Germany.
| | - Heike Wersching
- University of Münster, Institute of Epidemiology and Social Medicine, Münster, Germany
| | - Anja Teuber
- University of Münster, Institute of Epidemiology and Social Medicine, Münster, Germany
| | - Harald Kugel
- University Hospital Münster, Department of Clinical Radiology, Münster, Germany
| | - Henning Teismann
- University of Münster, Institute of Epidemiology and Social Medicine, Münster, Germany
| | - Walter Heindel
- University Hospital Münster, Department of Clinical Radiology, Münster, Germany
| | - Klaus Berger
- University of Münster, Institute of Epidemiology and Social Medicine, Münster, Germany
| | - Bettina Pfleiderer
- University Hospital Münster, Department of Clinical Radiology, Münster, Germany; University of Münster, Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, Münster, Germany
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Iadipaolo AS, Marusak HA, Sala-Hamrick K, Crespo LM, Thomason ME, Rabinak CA. Behavioral activation sensitivity and default mode network-subgenual cingulate cortex connectivity in youth. Behav Brain Res 2017; 333:135-141. [PMID: 28666840 PMCID: PMC5555380 DOI: 10.1016/j.bbr.2017.06.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/25/2017] [Accepted: 06/25/2017] [Indexed: 01/19/2023]
Abstract
Increased resting-state functional connectivity (rsFC) between the default mode network (DMN) and subgenual anterior cingulate cortex (sgACC) is consistently reported in adults and youth with psychopathologies related to affect dysregulation (e.g. depression, posttraumatic stress disorder). This pattern of increased rsFC is thought to underlie ruminative thought patterns through integration of negative affect (via sgACC) into self-referential operations supported by the DMN. Neurobiological studies in adults show that behavioral activation system (BAS) sensitivity is a potential protective factor against the development of psychopathology, particularly in the context of stress and trauma exposure. However, whether BAS sensitivity is associated with variation in DMN-sgACC stress-vulnerability circuitry in youth, particularly those at risk for affect dysregulation, has not yet been studied. This association was tested in a sample of ninety-eight children and adolescents (ages 6-17) at high sociodemographic risk for psychopathology (i.e., urban, lower income, high frequency of violence and abuse exposure). Participants underwent a six-minute resting-state functional magnetic resonance imaging scan. Using a targeted, small-volume corrected approach, we found that youth with higher BAS sensitivity demonstrated lower DMN-sgACC rsFC, suggesting a potential link between the purported protective effects of BAS sensitivity and stress-vulnerability circuitry. This work suggests that interventions that augment BAS sensitivity, such as behavioral activation therapy, may protect against the development of stress-related psychopathology by modifying a critical rumination circuitry in the brain. Such interventions may be especially important for bolstering resiliency in at-risk urban youth, who are disproportionately burdened by early stress and associated psychopathology.
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Affiliation(s)
| | - Hilary A Marusak
- Pharmacy Practice, Wayne State University, Detroit, MI, United States
| | | | - Laura M Crespo
- Psychology, Wayne State University, Detroit, MI, United States
| | - Moriah E Thomason
- Pediatrics, Wayne State University, Detroit, MI, United States; Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, United States; Perinatology Research Branch, National Institutes of Health, Wayne State University, Detroit, MI, United States
| | - Christine A Rabinak
- Pharmacy Practice, Wayne State University, Detroit, MI, United States; Pharmaceutical Sciences, Wayne State University, Detroit, MI, United States; Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, United States; Translational Neuroscience Program, Wayne State University, Detroit, MI, United States.
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Lai CH, Wu YT, Hou YM. Functional network-based statistics in depression: Theory of mind subnetwork and importance of parietal region. J Affect Disord 2017; 217:132-137. [PMID: 28407556 DOI: 10.1016/j.jad.2017.03.073] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/27/2017] [Accepted: 03/30/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The functional network analysis of whole brain is an emerging field for research in depression. We initiated this study to investigate which subnetwork is significantly altered within the functional connectome in major depressive disorder (MDD). METHODS The study enrolled 52 first-episode medication-naïve patients with MDD and 40 controls for functional network analysis. All participants received the resting-state functional imaging using a 3-Tesla magnetic resonance scanner. After preprocessing, we calculated the connectivity matrix of functional connectivity in whole brain for each subject. The network-based statistics of connectome was used to perform group comparisons between patients and controls. The correlations between functional connectivity and clinical parameters were also performed. RESULTS MDD patients had significant alterations in the network involving "theory of mind" regions, such as the left precentral gyrus, left angular gyrus, bilateral rolandic operculums and left inferior frontal gyrus. The center node of significant network was the left angular gyrus. No significant correlations of functional connectivity within the subnetwork and clinical parameters were noted. CONCLUSION Functional connectivity of "theory of mind" subnetwork may be the core issue for pathophysiology in MDD. In addition, the center role of parietal region should be emphasized in future study.
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Affiliation(s)
- Chien-Han Lai
- Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan, ROC; Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC.
| | - Yu-Te Wu
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yuh-Ming Hou
- Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan, ROC
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Buch K, Bizzo B, Lev MH. Magnetization Transfer Imaging in Treatment-resistant Depression: Structural Evidence of a Functional Derangement That Might Help Guide Therapy? Radiology 2017; 284:313-315. [DOI: 10.1148/radiol.2017171023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Karen Buch
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696
| | - Bernardo Bizzo
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696
| | - Michael H. Lev
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114-2696
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Aberrant functional connectivity in depression as an index of state and trait rumination. Sci Rep 2017; 7:2174. [PMID: 28526867 PMCID: PMC5438394 DOI: 10.1038/s41598-017-02277-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 04/10/2017] [Indexed: 12/13/2022] Open
Abstract
Depression has been shown to be related to a variety of aberrant brain functions and structures. Particularly the investigation of alterations in functional connectivity (FC) in major depressive disorder (MDD) has been a promising endeavor, since a better understanding of pathological brain networks may foster our understanding of the disease. However, the underling mechanisms of aberrant FC in MDD are largely unclear. Using functional near-infrared spectroscopy (fNIRS) we investigated FC in the cortical parts of the default mode network (DMN) during resting-state in patients with current MDD. Additionally, we used qualitative and quantitative measures of psychological processes (e.g., state/trait rumination, mind-wandering) to investigate their contribution to differences in FC between depressed and non-depressed subjects. Our results indicate that 40% of the patients report spontaneous rumination during resting-state. Depressed subjects showed reduced FC in parts of the DMN compared to healthy controls. This finding was linked to the process of state/trait rumination. While rumination was negatively correlated with FC in the cortical parts of the DMN, mind-wandering showed positive associations.
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A Comparison of Neuroimaging Abnormalities in Multiple Sclerosis, Major Depression and Chronic Fatigue Syndrome (Myalgic Encephalomyelitis): is There a Common Cause? Mol Neurobiol 2017; 55:3592-3609. [PMID: 28516431 PMCID: PMC5842501 DOI: 10.1007/s12035-017-0598-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 05/03/2017] [Indexed: 01/23/2023]
Abstract
There is copious evidence of abnormalities in resting-state functional network connectivity states, grey and white matter pathology and impaired cerebral perfusion in patients afforded a diagnosis of multiple sclerosis, major depression or chronic fatigue syndrome (CFS) (myalgic encephalomyelitis). Systemic inflammation may well be a major element explaining such findings. Inter-patient and inter-illness variations in neuroimaging findings may arise at least in part from regional genetic, epigenetic and environmental variations in the functions of microglia and astrocytes. Regional differences in neuronal resistance to oxidative and inflammatory insults and in the performance of antioxidant defences in the central nervous system may also play a role. Importantly, replicated experimental findings suggest that the use of high-resolution SPECT imaging may have the capacity to differentiate patients afforded a diagnosis of CFS from those with a diagnosis of depression. Further research involving this form of neuroimaging appears warranted in an attempt to overcome the problem of aetiologically heterogeneous cohorts which probably explain conflicting findings produced by investigative teams active in this field. However, the ionising radiation and relative lack of sensitivity involved probably preclude its use as a routine diagnostic tool.
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Parlar M, Densmore M, Hall GB, Frewen PA, Lanius RA, McKinnon MC. Relation between patterns of intrinsic network connectivity, cognitive functioning, and symptom presentation in trauma-exposed patients with major depressive disorder. Brain Behav 2017; 7:e00664. [PMID: 28523217 PMCID: PMC5434180 DOI: 10.1002/brb3.664] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 01/21/2017] [Accepted: 01/23/2017] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The present study investigated resting fMRI connectivity within the default mode (DMN), salience (SN), and central executive (CEN) networks in relation to neurocognitive performance and symptom severity in trauma-exposed patients with major depressive disorder (MDD). METHOD Group independent component analysis was conducted among patients with MDD (n = 21), examining DMN, SN, and CEN connectivity in relation to neurocognitive performance and symptom severity. Activation in these networks was also compared between the patient group and healthy controls (n = 20). RESULTS Among the patient group, higher levels of performance on measures of verbal memory and executive functioning were related to increased connectivity within the DMN (i.e., inferior parietal lobe; precuneus). Greater depression severity was related to reduced connectivity between the SN and a node of the DMN (i.e., posterior cingulate cortex) and higher depersonalization symptoms were related to enhanced connectivity between the SN and a node of the DMN (i.e., middle temporal gyrus). Higher symptoms of depersonalization were also associated with reduced integration of the DMN with the medial frontal gyrus. Relative to controls, patients with MDD showed greater connectivity of the ventromedial prefrontal cortex within the DMN. CONCLUSION Intrinsic connectivity network patterns are related to cognitive performance and symptom presentation among trauma-exposed patients with MDD.
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Affiliation(s)
- Melissa Parlar
- McMaster Integrative Neuroscience Discovery and Study McMaster University Hamilton ON Canada.,Mood Disorders Program St. Joseph's Healthcare Hamilton ON Canada
| | - Maria Densmore
- Department of Psychiatry University of Western Ontario London ON Canada
| | - Geoffrey B Hall
- Department of Psychology, Neuroscience, and Behaviour McMaster University Hamilton ON Canada
| | - Paul A Frewen
- Department of Psychiatry University of Western Ontario London ON Canada
| | - Ruth A Lanius
- Department of Psychiatry University of Western Ontario London ON Canada
| | - Margaret C McKinnon
- McMaster Integrative Neuroscience Discovery and Study McMaster University Hamilton ON Canada.,Mood Disorders Program St. Joseph's Healthcare Hamilton ON Canada.,Homewood Research Institute Guelph ON Canada
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Jia Z, Peng W, Chen Z, Sun H, Zhang H, Kuang W, Huang X, Lui S, Gong Q. Magnetization Transfer Imaging of Treatment-resistant Depression. Radiology 2017; 284:521-529. [PMID: 28318404 DOI: 10.1148/radiol.2017160820] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Purpose To detect biophysical abnormalities in patients with postmedication treatment-resistant depression (TRD) with magnetization transfer imaging. Materials and Methods This study was approved by the local ethics committee, and written informed consent was obtained from all participants. Participants included 69 patients with major depressive disorder (MDD) (30 with TRD; 39 with non-TRD) and 41 healthy control subjects. Age and sex were examined with one-way analysis of variance and χ2 tests and were well matched among the three groups. Whole-brain voxel-based analysis was used to compare the magnetization transfer ratio (MTR) between the three groups. Regional MTR values were used to analyze the correlations with symptom severity and illness duration. Results MTR differences were identified in the bilateral precentral gyrus, left cerebellum posterior lobe, left middle occipital lobe, left precuneus, and left temporal lobe among the three groups. Relative to patients with non-TRD, those with TRD had significantly lower MTR in the task-positive network regions, including the bilateral precentral gyrus and left middle occipital lobe, and had lower MTR in the default mode network regions, including the left precuneus and left temporal lobe. Regional MTRs were not associated with symptom severity or illness duration. Conclusion These results suggest that treatment resistance in patients with MDD may be mediated by macromolecular abnormalities in the task-positive and default mode functional networks. © RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on March 29, 2017.
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Affiliation(s)
- Zhiyun Jia
- From the Huaxi MR Research Center, Department of Radiology and Nuclear Medicine (Z.J., W.P., Z.C., H.S., H.Z., X.H., S.L., Q.G.), and Department of Psychiatry (W.K.), West China Hospital of Sichuan University, Chengdu 610041, PR China; and Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, PR China (Z.J., W.P., Z.C.,H.S., H.Z., W.K., X.H., S.L., Q.G.)
| | - Wei Peng
- From the Huaxi MR Research Center, Department of Radiology and Nuclear Medicine (Z.J., W.P., Z.C., H.S., H.Z., X.H., S.L., Q.G.), and Department of Psychiatry (W.K.), West China Hospital of Sichuan University, Chengdu 610041, PR China; and Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, PR China (Z.J., W.P., Z.C.,H.S., H.Z., W.K., X.H., S.L., Q.G.)
| | - Ziqi Chen
- From the Huaxi MR Research Center, Department of Radiology and Nuclear Medicine (Z.J., W.P., Z.C., H.S., H.Z., X.H., S.L., Q.G.), and Department of Psychiatry (W.K.), West China Hospital of Sichuan University, Chengdu 610041, PR China; and Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, PR China (Z.J., W.P., Z.C.,H.S., H.Z., W.K., X.H., S.L., Q.G.)
| | - Huaiqiang Sun
- From the Huaxi MR Research Center, Department of Radiology and Nuclear Medicine (Z.J., W.P., Z.C., H.S., H.Z., X.H., S.L., Q.G.), and Department of Psychiatry (W.K.), West China Hospital of Sichuan University, Chengdu 610041, PR China; and Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, PR China (Z.J., W.P., Z.C.,H.S., H.Z., W.K., X.H., S.L., Q.G.)
| | - Huawei Zhang
- From the Huaxi MR Research Center, Department of Radiology and Nuclear Medicine (Z.J., W.P., Z.C., H.S., H.Z., X.H., S.L., Q.G.), and Department of Psychiatry (W.K.), West China Hospital of Sichuan University, Chengdu 610041, PR China; and Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, PR China (Z.J., W.P., Z.C.,H.S., H.Z., W.K., X.H., S.L., Q.G.)
| | - Weihong Kuang
- From the Huaxi MR Research Center, Department of Radiology and Nuclear Medicine (Z.J., W.P., Z.C., H.S., H.Z., X.H., S.L., Q.G.), and Department of Psychiatry (W.K.), West China Hospital of Sichuan University, Chengdu 610041, PR China; and Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, PR China (Z.J., W.P., Z.C.,H.S., H.Z., W.K., X.H., S.L., Q.G.)
| | - Xiaoqi Huang
- From the Huaxi MR Research Center, Department of Radiology and Nuclear Medicine (Z.J., W.P., Z.C., H.S., H.Z., X.H., S.L., Q.G.), and Department of Psychiatry (W.K.), West China Hospital of Sichuan University, Chengdu 610041, PR China; and Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, PR China (Z.J., W.P., Z.C.,H.S., H.Z., W.K., X.H., S.L., Q.G.)
| | - Su Lui
- From the Huaxi MR Research Center, Department of Radiology and Nuclear Medicine (Z.J., W.P., Z.C., H.S., H.Z., X.H., S.L., Q.G.), and Department of Psychiatry (W.K.), West China Hospital of Sichuan University, Chengdu 610041, PR China; and Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, PR China (Z.J., W.P., Z.C.,H.S., H.Z., W.K., X.H., S.L., Q.G.)
| | - Qiyong Gong
- From the Huaxi MR Research Center, Department of Radiology and Nuclear Medicine (Z.J., W.P., Z.C., H.S., H.Z., X.H., S.L., Q.G.), and Department of Psychiatry (W.K.), West China Hospital of Sichuan University, Chengdu 610041, PR China; and Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, PR China (Z.J., W.P., Z.C.,H.S., H.Z., W.K., X.H., S.L., Q.G.)
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Williams LM. Defining biotypes for depression and anxiety based on large-scale circuit dysfunction: a theoretical review of the evidence and future directions for clinical translation. Depress Anxiety 2017; 34:9-24. [PMID: 27653321 PMCID: PMC5702265 DOI: 10.1002/da.22556] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 07/28/2016] [Accepted: 08/15/2016] [Indexed: 01/23/2023] Open
Abstract
Complex emotional, cognitive and self-reflective functions rely on the activation and connectivity of large-scale neural circuits. These circuits offer a relevant scale of focus for conceptualizing a taxonomy for depression and anxiety based on specific profiles (or biotypes) of neural circuit dysfunction. Here, the theoretical review first outlines the current consensus as to what constitutes the organization of large-scale circuits in the human brain identified using parcellation and meta-analysis. The focus is on neural circuits implicated in resting reflection (default mode), detection of "salience," affective processing ("threat" and "reward"), "attention," and "cognitive control." Next, the current evidence regarding which type of dysfunctions in these circuits characterize depression and anxiety disorders is reviewed, with an emphasis on published meta-analyses and reviews of circuit dysfunctions that have been identified in at least two well-powered case:control studies. Grounded in the review of these topics, a conceptual framework is proposed for considering neural circuit-defined "biotypes." In this framework, biotypes are defined by profiles of extent of dysfunction on each large-scale circuit. The clinical implications of a biotype approach for guiding classification and treatment of depression and anxiety is considered. Future research directions will develop the validity and clinical utility of a neural circuit biotype model that spans diagnostic categories and helps to translate neuroscience into clinical practice in the real world.
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Affiliation(s)
- Leanne M Williams
- Corresponding author: Leanne M Williams, PhD, Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, California, 94134-5717, , Phone: 650 723 3579
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Hou Z, Wang Z, Jiang W, Yin Y, Yue Y, Zhang Y, Song X, Yuan Y. Divergent topological architecture of the default mode network as a pretreatment predictor of early antidepressant response in major depressive disorder. Sci Rep 2016; 6:39243. [PMID: 27966645 PMCID: PMC5155246 DOI: 10.1038/srep39243] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/21/2016] [Indexed: 12/04/2022] Open
Abstract
Identifying a robust pretreatment neuroimaging marker would be helpful for the selection of an optimal therapy for major depressive disorder (MDD). We recruited 82 MDD patients [n = 42 treatment-responsive depression (RD) and n = 40 non-responding depression (NRD)] and 50 healthy controls (HC) for this study. Based on the thresholded partial correlation matrices of 58 specific brain regions, a graph theory approach was applied to analyse the topological properties. When compared to HC, both RD and NRD patients exhibited a lower nodal degree (Dnodal) in the left anterior cingulate gyrus; as for RD, the Dnodal of the left superior medial orbitofrontal gyrus was significantly reduced, but the right inferior orbitofrontal gyrus was increased (all P < 0.017, FDR corrected). Moreover, the nodal degree in the right dorsolateral superior frontal cortex (SFGdor) was significantly lower in RD than in NRD. Receiver operating characteristic curve analysis demonstrated that the λ and nodal degree in the right SFGdor exhibited a good ability to distinguish nonresponding patients from responsive patients, which could serve as a specific maker to predict an early response to antidepressants. The disrupted topological configurations in the present study extend the understanding of pretreatment neuroimaging predictors for antidepressant medication.
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Affiliation(s)
- Zhenghua Hou
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China.,Department of Psychiatry, Affiliated Wuhu NO.4 Hospital of Shanghai Jiaotong University BIO-X center, Wuhu 241001, China
| | - Zan Wang
- Department of Neurology, Institute of Neuropsychology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Wenhao Jiang
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Yingying Yin
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Yingying Yue
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Yuqun Zhang
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Xiaopeng Song
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Yonggui Yuan
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
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Jacobs RH, Watkins ER, Peters AT, Feldhaus CG, Barba A, Carbray J, Langenecker SA. Targeting Ruminative Thinking in Adolescents at Risk for Depressive Relapse: Rumination-Focused Cognitive Behavior Therapy in a Pilot Randomized Controlled Trial with Resting State fMRI. PLoS One 2016; 11:e0163952. [PMID: 27880789 PMCID: PMC5120778 DOI: 10.1371/journal.pone.0163952] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 09/13/2016] [Indexed: 01/17/2023] Open
Abstract
This pilot randomized control trial was designed to examine whether Rumination-Focused Cognitive Behavior Therapy (RFCBT) reduces rumination and residual depressive symptoms among adolescents with a history of Major Depressive Disorder (MDD) who are at risk for relapse. We also examined whether these changes in symptoms were associated with changes in functional connectivity of the posterior cingulate cortex (PCC), a key node in the default mode network (DMN). Thirty-three adolescents (ages 12–18) were randomized to eight weeks of RFCBT or an assessment only (AO) control. Twenty two adolescents successfully completed fMRI scans pre- and post-intervention. Adolescents were recruited from the clinic and community and met criteria for at least one previous episode of MDD and were currently in full or partial remission. An Independent Evaluator interviewed parent and child before and after the eight-week intervention. The left PCC (-5, -50, 36) seed was used to probe resting state functional connectivity of the DMN. Adolescents who received RFCBT demonstrated reduced rumination (F = -2.76, df = 112, p < .01, 95% CI [-4.72,-0.80]) and self-report depression across eight weeks (F = -2.58, df = 113, p < .01, 95% CI [-4.21, -0.94]). Youth who received RFCBT also demonstrated significant decreases in connectivity between the left PCC and the right inferior frontal gyrus (IFG) and bilateral inferior temporal gyri (ITG). Degree of change in connectivity was correlated with changes in self-report depression and rumination. These data suggest that rumination can be reduced over eight weeks and that this reduction is associated with parallel decreases in residual depressive symptoms and decreased functional connectivity of the left PCC with cognitive control nodes. These changes may enhance the ability of vulnerable youth to stay well during the transition to adulthood. Trial Registration: ClinicalTrials.gov NCT01905267
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Affiliation(s)
- Rachel H. Jacobs
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
- * E-mail:
| | | | - Amy T. Peters
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Claudia G. Feldhaus
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Alyssa Barba
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Julie Carbray
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Scott A. Langenecker
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
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Role of glutamate receptors and glial cells in the pathophysiology of treatment-resistant depression. Prog Neuropsychopharmacol Biol Psychiatry 2016; 70:117-26. [PMID: 27046518 DOI: 10.1016/j.pnpbp.2016.03.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/27/2016] [Accepted: 03/29/2016] [Indexed: 02/07/2023]
Abstract
Treatment-resistant depression (TRD) causes substantial socioeconomic burden. Although a consensus on the definition of TRD has not yet been reached, it is certain that classic monoaminergic antidepressants are ineffective for TRD. One decade ago, many researchers found ketamine, an N-methyl-d-aspartate receptor (NMDAR) antagonist, to be an alternative to classic monoaminergic antidepressants. The major mechanisms of action of ketamine rapidly induce synaptogenesis in the brain-derived neurotrophic factor (BDNF) pathway. Although excessive glutamatergic neurotransmission and consequent excitotoxicity were considered a major cause of TRD, recent evidence suggests that the extrasynaptic glutamatergic receptor signal pathway mainly contributes to the detrimental effects of TRD. Glial cells such as microglia and astrocytes, early life adversity, and glucocorticoid receptor dysfunction participate in complex cross-talk. An appropriate reuptake of glutamate at the astrocyte is crucial for preventing 'spill-over' of synaptic glutamate and binding to the extrasynaptic NMDA receptor. Excessive microglial activation and the inflammatory process cause astrocyte glutamatergic dysfunction, which in turn activates microglial function. Early life adversity and glucocorticoid receptor dysfunction result in vulnerability to stress in adulthood. A maladaptive response to stress leads to increased glutamatergic release and pro-inflammatory cytokines, which then activate microglia. However, since the role of inflammatory mediators such as pro-inflammatory cytokines is not specific for depression, more disease-specific mechanisms should be identified. Last, although much research has focused on ketamine as an alternative antidepressant for TRD, its long-lasting effectiveness and adverse events have not been rigorously demonstrated. Additionally, evidence suggests that substantial brain abnormalities develop in ketamine abusers. Thus, more investigations for ketamine and other novel glutamatergic agents are needed.
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Repetitive transcranial magnetic stimulation for treatment resistant depression: Re-establishing connections. Clin Neurophysiol 2016; 127:3394-3405. [PMID: 27672727 DOI: 10.1016/j.clinph.2016.08.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/28/2016] [Accepted: 08/17/2016] [Indexed: 12/21/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a relatively recent addition to the neurostimulation armamentarium for treating individuals suffering from treatment refractory depression and has demonstrated efficacy in clinical trials. One of the proposed mechanisms of action underlying the therapeutic effects of rTMS for depression involves the modulation of depression-associated dysfunctional activity in distributed brain networks involving frontal cortical and subcortical limbic regions, via changes to aberrant functional and structural connectivity. Although there is currently a paucity of published data, we review changes to functional and structural connectivity following rTMS for depression. Current evidence suggests an rTMS-induced normalisation of depression-associated dysfunction within and between large scale functional networks, including the default mode, central executive and salience networks, associated with an amelioration of depressive symptoms. Additionally, changes to measures of white matter microstructure, primarily in the dorsolateral prefrontal cortex, have also been reported following rTMS for depression, possibly reversing depression-associated abnormalities. We argue that measures of functional and structural connectivity can be used to optimise rTMS targeting within the dorsolateral prefrontal cortex and also to explore novel rTMS targets for depression. Finally, we discuss the utility of measures of brain connectivity as predictive biomarkers of rTMS treatment response in guiding therapeutic decisions.
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Jacobs RH, Barba A, Gowins JR, Klumpp H, Jenkins LM, Mickey BJ, Ajilore O, Peciña M, Sikora M, Ryan KA, Hsu DT, Welsh RC, Zubieta JK, Phan KL, Langenecker SA. Decoupling of the amygdala to other salience network regions in adolescent-onset recurrent major depressive disorder. Psychol Med 2016; 46:1055-1067. [PMID: 26784396 PMCID: PMC4810773 DOI: 10.1017/s0033291715002615] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent meta-analyses of resting-state networks in major depressive disorder (MDD) implicate network disruptions underlying cognitive and affective features of illness. Heterogeneity of findings to date may stem from the relative lack of data parsing clinical features of MDD such as phase of illness and the burden of multiple episodes. METHOD Resting-state functional magnetic resonance imaging data were collected from 17 active MDD and 34 remitted MDD patients, and 26 healthy controls (HCs) across two sites. Participants were medication-free and further subdivided into those with single v. multiple episodes to examine disease burden. Seed-based connectivity using the posterior cingulate cortex (PCC) seed to probe the default mode network as well as the amygdala and subgenual anterior cingulate cortex (sgACC) seeds to probe the salience network (SN) were conducted. RESULTS Young adults with remitted MDD demonstrated hyperconnectivity of the left PCC to the left inferior frontal gyrus and of the left sgACC to the right ventromedial prefrontal cortex (PFC) and left hippocampus compared with HCs. Episode-independent effects were observed between the left PCC and the right dorsolateral PFC, as well as between the left amygdala and right insula and caudate, whereas the burden of multiple episodes was associated with hypoconnectivity of the left PCC to multiple cognitive control regions as well as hypoconnectivity of the amygdala to large portions of the SN. CONCLUSIONS This is the first study of a homogeneous sample of unmedicated young adults with a history of adolescent-onset MDD illustrating brain-based episodic features of illness.
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Affiliation(s)
- R. H. Jacobs
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - A. Barba
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - J. R. Gowins
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - H. Klumpp
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - L. M. Jenkins
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - B. J. Mickey
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - O. Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - M. Peciña
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - M. Sikora
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - K. A. Ryan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - D. T. Hsu
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - R. C. Welsh
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Radiology, Molecular and Behavioral Neuroscience Institute, Ann Arbor, MI, USA
| | - J.-K. Zubieta
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Radiology, Molecular and Behavioral Neuroscience Institute, Ann Arbor, MI, USA
| | - K. L. Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
- Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL, USA
| | - S. A. Langenecker
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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Lan MJ, Chhetry BT, Liston C, Mann JJ, Dubin M. Transcranial Magnetic Stimulation of Left Dorsolateral Prefrontal Cortex Induces Brain Morphological Changes in Regions Associated with a Treatment Resistant Major Depressive Episode: An Exploratory Analysis. Brain Stimul 2016; 9:577-83. [PMID: 27017072 DOI: 10.1016/j.brs.2016.02.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 02/17/2016] [Accepted: 02/24/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (TMS) is an FDA-approved antidepressant treatment but little is known of its mechanism of action. Specifically, downstream effects of TMS remain to be elucidated. OBJECTIVE/HYPOTHESIS This study aims to identify brain structural changes from TMS treatment of a treatment resistant depressive episode through an exploratory analysis. METHODS Twenty-seven subjects in a DSM-IV current major depressive episode and on a stable medication regimen had a 3T magnetic resonance T1 structural scan before and after five weeks of standard TMS treatment to the left dorsolateral prefrontal cortex. Twenty-seven healthy volunteer (HVs) subjects had the same brain MRI acquisition. Voxel-based morphometry was performed using high dimensional non-linear diffusomorphic anatomical registration (DARTEL). RESULTS Six clusters of gray matter volume (GMV) that were lower in pre-treatment MRIs of depressed subjects than in HVs. GMV in four of these regions increased in MDD after TMS treatment by 3.5-11.2%. The four brain regions that changed with treatment were centered in the left anterior cingulate cortex, the left insula, the left superior temporal gyrus and the right angular gyrus. Increases in the anterior cingulate GMV with TMS correlated with improvement in depression severity. CONCLUSIONS To our knowledge, this is the first study of brain structural changes during TMS treatment of depression. The affected brain areas are involved in cognitive appraisal, decision-making and subjective experience of emotion. These effects may have potential relevance for the antidepressant action of TMS.
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Affiliation(s)
- Martin J Lan
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, USA.
| | - Binod Thapa Chhetry
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, USA
| | - Conor Liston
- Department of Psychiatry, Weill Cornell Medical College, USA; Fell Family Brain and Mind Research Institute, Weill Cornell Medical College, USA
| | - J John Mann
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, USA
| | - Marc Dubin
- Department of Psychiatry, Weill Cornell Medical College, USA; Fell Family Brain and Mind Research Institute, Weill Cornell Medical College, USA
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Lener MS, Kundu P, Wong E, Dewilde KE, Tang CY, Balchandani P, Murrough JW. Cortical abnormalities and association with symptom dimensions across the depressive spectrum. J Affect Disord 2016; 190:529-536. [PMID: 26571102 PMCID: PMC4764252 DOI: 10.1016/j.jad.2015.10.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 09/21/2015] [Accepted: 10/15/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Few studies have investigated the relationship between structural brain abnormalities and dimensions of depressive symptomatology. METHODS In the current study, we examined the relationship between cortical structural abnormalities and specific behavioral dimensions relevant to depression in a sample of unmedicated patients with major depressive disorder (MDD, n=57) and demographically similar healthy control volunteers (HC, n=29). All subjects underwent diagnostic assessment with the SCID, MRI at 3T, and dimensional assessments using the visual analog scales (VAS). Cortical regions were extracted for each subject, and group comparisons of cortical volume (CV), surface area (SA), and cortical thickness (CT) were performed controlling for multiple comparisons using a bootstrapping technique. Regions demonstrating group differences were analyzed for correlation with specific dimensions assessments. RESULTS As compared with HC, MDD subjects exhibited reduced CV within the left supramarginal gyrus, right ventrolateral prefrontal cortex (VLPFC), entorhinal cortex, parahippocampal gyrus, fusiform gyrus and pericalcarine; reduced SA in the right VLPFC, cuneus, and left temporal pole; and reduced CT in the right rostral anterior cingulate cortex (rACC) (all p's<0.05, corrected). The largest effect occurred within the right VLPFC for CV and SA (MDD<HC; effect sizes: 0.60). CV in the right VLPFC inversely correlated with sadness, fatigue and worry; CT in the right rACC inversely correlated with irritability and fatigue. LIMITATIONS Future studies will be required to further map the anatomical changes in depression to behavioral dimensions. CONCLUSIONS Our results indicate that specific cortical abnormalities are associated with specific behavioral components linked to depression.
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Affiliation(s)
- Marc S. Lener
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Health, NIH, Bethesda, MD
| | - Prantik Kundu
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Edmund Wong
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kaitlin E. Dewilde
- Mood and Anxiety Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Cheuk Y. Tang
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Priti Balchandani
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - James W. Murrough
- Mood and Anxiety Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
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Mori A, Okamoto Y, Okada G, Takagaki K, Jinnin R, Takamura M, Kobayakawa M, Yamawaki S. Behavioral activation can normalize neural hypoactivation in subthreshold depression during a monetary incentive delay task. J Affect Disord 2016; 189:254-62. [PMID: 26454185 DOI: 10.1016/j.jad.2015.09.036] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/30/2015] [Accepted: 09/18/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Late adolescents are under increased risk of developing depressive symptoms. Behavioral activation is an effective treatment for subthreshold depression, which can prevent the development of subthreshold depression into a major depressive disorder. However, the neural mechanisms underlying the efficacy of behavioral activation have not been clearly understood. We investigated neural responses during reward processing by individuals with subthreshold depression to clarify the neural mechanisms of behavioral activation. METHODS Late adolescent university students with subthreshold depression (n=15, age 18-19 years) as indicated by a high score on the Beck's Depression Inventory-ll (BDI-ll) and 15 age-matched controls with a low BDI-ll score participated in functional magnetic resonance imaging scanning conducted during a monetary incentive delay task on two occasions. The Individuals in the subthreshold depression group received five, weekly behavioral activation sessions between the two scanning sessions. Moreover, they did not receive any medication until the study was completed. RESULTS Behavioral activation significantly reduced depressive symptoms. Moreover, compared to the changes in brain functions in the control group, the behavioral activation group showed functional changes during loss anticipation in brain structures that mediates cognitive and emotional regulation, including the left ventrolateral prefrontal cortex and angular gyrus. LIMITATIONS Replication of the study with a larger sample size is required to increase the generalizability of these results. CONCLUSIONS Behavioral activation results in improved functioning of the fronto-parietal region during loss anticipation. These results increase our understanding of the mechanisms underlying specific psychotherapies.
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Affiliation(s)
- Asako Mori
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Go Okada
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koki Takagaki
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ran Jinnin
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Takamura
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Kobayakawa
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shigeto Yamawaki
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Cognition-related brain networks underpin the symptoms of unipolar depression: Evidence from a systematic review. Neurosci Biobehav Rev 2015; 61:53-65. [PMID: 26562681 DOI: 10.1016/j.neubiorev.2015.09.022] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/16/2015] [Accepted: 09/21/2015] [Indexed: 01/23/2023]
Abstract
This systematic review sources the latest neuroimaging evidence for the role of cognition-related brain networks in depression, and relates their abnormal functioning to symptoms of the disorder. Using theoretically informed and rigorous inclusion criteria, we integrate findings from 59 functional neuroimaging studies of adults with unipolar depression using a narrative approach. Results demonstrate that two distinct neurocognitive networks, the autobiographic memory network (AMN) and the cognitive control network (CCN), are central to the symptomatology of depression. Specifically, hyperactivity of the introspective AMN is linked to pathological brooding, self-blame, rumination. Anticorrelated under-engagement of the CCN is associated with indecisiveness, negative automatic thoughts, poor concentration, distorted cognitive processing. Downstream effects of this imbalance include reduced regulation of networks linked to the vegetative and affective symptoms of depression. The configurations of these networks can change between individuals and over time, plausibly accounting for both the variable presentation of depressive disorders and their fluctuating course. Framing depression as a disorder of neurocognitive networks directly links neurobiology to psychiatric practice, aiding researchers and clinicians alike.
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