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Dubey S, Das S, Ghosh R, Dubey MJ, Chakraborty AP, Roy D, Das G, Dutta A, Santra A, Sengupta S, Benito-León J. The Effects of SARS-CoV-2 Infection on the Cognitive Functioning of Patients with Pre-Existing Dementia. J Alzheimers Dis Rep 2023; 7:119-128. [PMID: 36891252 PMCID: PMC9986710 DOI: 10.3233/adr-220090] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/03/2023] [Indexed: 02/05/2023] Open
Abstract
Background Cognitive postscripts of COVID-19, codenamed as 'cognitive COVID' or 'brain fog,' characterized by multidomain cognitive impairments, are now being reckoned as the most devastating sequelae of COVID-19. However, the impact on the already demented brain has not been studied. Objective We aimed to assess the cognitive functioning and neuroimaging following SARS-CoV-2 infection in patients with pre-existing dementia. Methods Fourteen COVID-19 survivors with pre-existing dementia (four with Alzheimer's disease, five with vascular dementia, three with Parkinson's disease dementia, and two with the behavioral variant of frontotemporal dementia) were recruited. All these patients had detailed cognitive and neuroimaging evaluations within three months before suffering from COVID-19 and one year later. Results Of the 14 patients, ten required hospitalization. All developed or increased white matter hyperintensities that mimicked multiple sclerosis and small vessel disease. There was a significant increase in fatigue (p = 0.001) and depression (p = 0.016) scores following COVID-19. The mean Frontal Assessment Battery (p < 0.001) and Addenbrooke's Cognitive Examination (p = 0.001) scores also significantly worsened. Conclusion The rapid progression of dementia, the addition of further impairments/deterioration of cognitive abilities, and the increase or new appearance of white matter lesion burden suggest that previously compromised brains have little defense to withstand a new insult (i.e., 'second hit' like infection/dysregulated immune response, and inflammation). 'Brain fog' is an ambiguous terminology without specific attribution to the spectrum of post-COVID-19 cognitive sequelae. We propose a new codename, i.e. 'FADE-IN MEMORY' (i.e., Fatigue, decreased Fluency, Attention deficit, Depression, Executive dysfunction, slowed INformation processing speed, and subcortical MEMORY impairment).
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Affiliation(s)
- Souvik Dubey
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Shambaditya Das
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Ritwik Ghosh
- Department of General Medicine, Burdwan Medical College, and Hospital, Burdwan, West Bengal, India
| | - Mahua Jana Dubey
- Department of Psychiatry, Berhampur Mental Hospital, Berhampur, West Bengal, India
| | - Arka Prava Chakraborty
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Dipayan Roy
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India.,Indian Institute of Technology (IIT), Madras, Tamil Nadu, India.,School of Sciences, Indira Gandhi National Open University, New Delhi, India
| | - Gautam Das
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Ajitava Dutta
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Arindam Santra
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Samya Sengupta
- Department of General Medicine, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Julián Benito-León
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.,Centro de Investigación Biomódica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Department of Medicine, Complutense University, Madrid, Spain
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2
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Lai CW, Shih CW, Chang CH. Analysis of collateral projections from the lateral orbitofrontal cortex to nucleus accumbens and basolateral amygdala in rats. J Neurophysiol 2022; 127:1535-1546. [PMID: 35507506 DOI: 10.1152/jn.00127.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The orbitofrontal cortex (OFC) is an important brain area for executive functions. The OFC projects to both the nucleus accumbens (NAc) and the basolateral nucleus of the amygdala (BLA). These two pathways share some similar behavioral functions, but their anatomical and physiological properties have not been compared before. In this study, we first explored the connection of the lateral OFC (lOFC) to NAc core (NAcc) and/or BLA, especially the collateral projections (Experiment 1 and 2) with rats. In Experiment 1, fluorophore-conjugated retrograde tracers were locally infused into the NAcc and the BLA to sample neurons in the lOFC. Our results revealed that along the anterior-posterior axis of the lOFC, more NAcc- and/or BLA-projecting neurons were distributed toward the posterior end, but the average percentage of collateral projecting neurons at the four sampled lOFC levels remained fairly stable. In Experiment 2, antidromic single units in the lOFC responsive to the NAcc and/or the BLA stimulation were identified in anesthetized rats. However, we found that collateral projections from the lOFC to NAcc and BLA were sparse. We next studied the physiological characteristics of these two pathways (Experiment 3). In this experiment, orthodromic single units in the NAcc or the BLA responsive to the lOFC stimulation were located in anesthetized rats. Our results showed no difference in the evoked thresholds or the intensity-response probability curves between the two. Together, our results showed that these two pathways were similar in projecting neuron distribution and physiological characteristics.
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Affiliation(s)
- Chien-Wen Lai
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Cheng-Wei Shih
- Institute of Systems Neuroscience, National Tsing Hua University, Hsinchu, Taiwan.,Brain Research Center, National Tsing Hua University, Hsinchu, Taiwan
| | - Chun-Hui Chang
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu, Taiwan.,Institute of Systems Neuroscience, National Tsing Hua University, Hsinchu, Taiwan.,Brain Research Center, National Tsing Hua University, Hsinchu, Taiwan
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3
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Song W, Wang W, Yu S, Lin GN. Dissection of the Genetic Association between Anorexia Nervosa and Obsessive-Compulsive Disorder at the Network and Cellular Levels. Genes (Basel) 2021; 12:491. [PMID: 33801746 PMCID: PMC8065602 DOI: 10.3390/genes12040491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 12/15/2022] Open
Abstract
Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) exhibit a high co-morbidity rate, similar symptoms, and a shared genetic basis. However, an understanding of the specific underlying mechanisms of these commonalities is currently limited. Here, we collected Genome-Wide Association Analysis results for AN and OCD, and obtained genes hit by the top SNPs as the risk genes. We then carried out an integrative coexpression network analysis to explore the convergence and divergence of AN and OCD risk genes. At first, we observed that the AN risk genes were enriched in coexpression modules that involved extracellular matrix functions and highly are expressed in the postnatal brain, limbic system, and non-neuronal cell types, while the OCD risk genes were enriched in modules of synapse function, the prenatal brain, cortex layers, and neurons. Next, by comparing the expressions from the eating disorder and OCD postmortem patient brain tissues, we observed both disorders have similar prefrontal cortex expression alterations influencing the synapse transmission, suggesting that the two diseases could have similar functional pathways. We found that the AN and OCD risk genes had distinct functional and spatiotemporal enrichment patterns but carried similar expression alterations as a disease mechanism, which may be one of the key reasons they had similar but not identical clinical phenotypes.
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Affiliation(s)
| | | | | | - Guan Ning Lin
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; (W.S.); (W.W.); (S.Y.)
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Hwang H, Bae S, Hong JS, Han DH. Comparing Effectiveness Between a Mobile App Program and Traditional Cognitive Behavior Therapy in Obsessive-Compulsive Disorder: Evaluation Study. JMIR Ment Health 2021; 8:e23778. [PMID: 33464208 PMCID: PMC7854038 DOI: 10.2196/23778] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study proposes a digital program for the treatment of mental illness that could increase motivation and improve learning outcomes for patients. Several studies have already applied this method by using an exposure and response prevention-inspired serious game to treat patients with obsessive-compulsive disorder (OCD). OBJECTIVE We hypothesized that a mobile cognitive behavior therapy (CBT) program would be as effective in treating OCD as traditional offline CBT. In addition, the treatment efficacy in response to mobile CBT for OCD might be associated with increased brain activity within the cortico-striato-thalamo-cortical (CSTC) tract. METHODS The digital CBT treatment program for OCD, OCfree, consists of 6 education sessions, 10 quests, and 7 casual games. Information was gathered from 27 patients with OCD (15 offline CBT and 12 OCfree CBT). During the 6-week intervention period, changes in clinical symptoms and brain function activity were analyzed. RESULTS There was no significant difference in the change in OCD symptoms and depressive symptoms between the two groups. However, the OCfree group showed greater improvement in anxiety symptoms compared to the offline CBT group. Both offline CBT and OCfree CBT increased the functional connectivity within the CSTC tract in all patients with OCD. However, CBT using OCfree showed greater changes in brain connectivity within the thalamus and insula, compared to offline CBT. CONCLUSIONS OCfree, an OCD treatment app program, was effective in the treatment of drug-naïve patients with OCD. The treatment effects of OCfree are associated with increased brain connectivity within the CSTC tract. Multisensory stimulation by education, quests, and games in OCfree increases the activity within the thalamus and insula in patients with OCD.
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Affiliation(s)
- Hyunchan Hwang
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Sujin Bae
- Office of Research, Chung-Ang University, Seoul, Republic of Korea
| | - Ji Sun Hong
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
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5
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Meram TD, Chowdury A, Easter P, Attisha T, Kallabat E, Hanna GL, Arnold P, Rosenberg DR, Diwadkar VA. Evoking network profiles of the dorsal anterior cingulate in youth with Obsessive-Compulsive Disorder during motor control and working memory. J Psychiatr Res 2021; 132:72-83. [PMID: 33068817 PMCID: PMC9351617 DOI: 10.1016/j.jpsychires.2020.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/04/2020] [Accepted: 09/25/2020] [Indexed: 10/23/2022]
Abstract
Interest in the pathology of Obsessive-Compulsive Disorder\has focused on brain network profiles of the dorsal Anterior Cingulate Cortex (dACC), given its role as a principal control region. Both motor control and working memory tasks induce dysfunctional dACC profiles in OCD. H H We contrasted dACC network profiles in OCD and age-comparable controls during both tasks (from data collected in the same participants). The motor task required participants to tap their right forefinger in response to a flashing white probe; the memory task was a standard n-back (2-Back) requiring participants to identify if a current stimulus was identical to the one presented two items before it in the sequence. Network interactions were modeled using Psychophysiological Interactions (PPI), a model of directional functional connectivity. Inter-group analyses indicated a) that the motor control task evoked greater dACC modulation than the working memory task, and b) that the modulatory effect was significantly greater in the OCD group. We also investigated the relationship between OCD symptom dimensions (lifetime obsession and lifetime compulsion measured using the CY-BOCS) and dACC network profiles in OCD. This analysis revealed a dichotomy between Obsessive-Compulsive symptom dimensions and the degree of dACC modulation: primarily increased obsessions predicted increased modulation during the motor control task, but primarily increased compulsions predicted increased modulation during the working memory task. These results re-emphasize the salience of the dACC in OCD, and the primacy of tasks of motor control in evoking dACC pathology in the disorder.
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Affiliation(s)
- Thomas D. Meram
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Asadur Chowdury
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Philip Easter
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Tyler Attisha
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Ellanya Kallabat
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Gregory L. Hanna
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Paul Arnold
- Department of Psychiatry & Medical Genetics, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
| | - David R. Rosenberg
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Vaibhav A. Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
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6
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Corrigan FM, Christie-Sands J. An innate brainstem self-other system involving orienting, affective responding, and polyvalent relational seeking: Some clinical implications for a "Deep Brain Reorienting" trauma psychotherapy approach. Med Hypotheses 2019; 136:109502. [PMID: 31794877 DOI: 10.1016/j.mehy.2019.109502] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/11/2019] [Accepted: 11/16/2019] [Indexed: 11/29/2022]
Abstract
Underlying any complex relational intersubjectivity there is an inherent urge to connect, to have proximity, to engage in an experience of interpersonal contact. The hypothesis set out here is that this most basic urge to connect is dependent on circuits based in three main components: the midbrain superior colliculi (SC), the midbrain periaqueductal gray (PAG), and the mesolimbic and mesocortical dopamine systems originating in the midbrain ventral tegmental area. Firstly, there is orienting towards or away from interpersonal contact, dependent on approach and/or defensive/withdrawal areas of the SC. Secondly, there is an affective response to the contact, mediated by the PAG. Thirdly, there is an associated, affectively-loaded, seeking drive based in the mesolimbic and mesocortical dopamine systems. The neurochemical milieu of these dopaminergic systems is responsive to environmental factors, creating the possibility of multiple states of functioning with different affective valences, a polyvalent range of subjectively positive and negative experiences. The recognition of subtle tension changes in skeletal muscles when orienting to an affectively significant experience or event has clinical implications for processing of traumatic memories, including those of a relational/interpersonal nature. Sequences established at the brainstem level can underlie patterns of attachment responding that repeat over many years in different contexts. The interaction of the innate system for connection with that for alarm, through circuits based in the locus coeruleus, and that for defence, based in circuits through the PAG, can lay down deep patterns of emotional and energetic responses to relational stimuli. There may be simultaneous sequences for attachment approach and defensive aggression underlying relational styles that are so deep as to be seen as personality characteristics, for example, of borderline type. A clinical approach derived from these hypotheses, Deep Brain Reorienting, is briefly outlined as it provides a way to address the somatic residues of adverse interpersonal interactions underlying relational patterns and also the residual shock and horror of traumatic experiences. We suggest that the innate alarm system involving the SC and the locus coeruleus can generate a pre-affective shock while an affective shock can arise from excessive stimulation of the PAG. Clinically significant residues can be accessed through careful, mindful, attention to orienting-tension-affect-seeking sequences when the therapist and the client collaborate on eliciting and describing them.
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Affiliation(s)
- F M Corrigan
- Trauma Psychotherapy Scotland, 15 Newton Terrace, Glasgow G3 7PJ, United Kingdom.
| | - J Christie-Sands
- Trauma Psychotherapy Scotland, 15 Newton Terrace, Glasgow G3 7PJ, United Kingdom
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7
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Vawter MP, Hamzeh AR, Muradyan E, Civelli O, Abbott GW, Alachkar A. Association of Myoinositol Transporters with Schizophrenia and Bipolar Disorder: Evidence from Human and Animal Studies. MOLECULAR NEUROPSYCHIATRY 2019; 5:200-211. [PMID: 31768373 PMCID: PMC6873027 DOI: 10.1159/000501125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 05/21/2019] [Indexed: 12/12/2022]
Abstract
Evidence from animal and human studies has linked myo-inositol (MI) with the pathophysiology and/or treatment of psychiatric disorders such as schizophrenia and bipolar disorder. However, there is still controversy surrounding the definitive role of MI in these disorders. Given that brain MI is differentially regulated by three transporters - SMIT1, SMIT2 and/or HMIT (encoded by the genes: SLC5A3, SLC5A11, and SLC2A13, respectively) - we used available datasets to describe the distribution in mouse and human brain of the different MI transporters and to examine changes in mRNA expression of these transporters in patients with schizophrenia and bipolar disorder. We found a differential distribution of the mRNA of each of the three MI transporters in both human and mouse brain regions. Interestingly, while individual neurons express SMIT1 and HMIT, non-neuronal cells express SMIT2, thus partially accounting for different uptake levels of MI and concordance to downstream second messenger signaling pathways. We also found that the expression of MI transporters is significantly changed in schizophrenia and bipolar disorder in a diagnostic-, brain region- and subtype-specific manner. We then examined the effects of germline deletion in mice of Slc5a3 on behavioral phenotypes related to schizophrenia and bipolar disorder. This gene deletion produces behavioral deficits that mirror some specific symptoms of schizophrenia and bipolar disorder. Finally, chronic administration of MI was able to reverse particular, but not all, behavioral deficits in Slc5a3 knockout mice; MI itself induced some behavioral deficits. Our data support a strong correlation between the expression of MI transporters and schizophrenia and bipolar disorder, and suggest that brain region-specific aberration of one or more of these transporters determines the partial behavioral phenotypes and/or symptomatic pattern of these disorders.
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Affiliation(s)
- Marquis P. Vawter
- Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Abdul Rezzak Hamzeh
- John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Edgar Muradyan
- Department of Pharmacology, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Olivier Civelli
- Department of Pharmacology, School of Medicine, University of California, Irvine, Irvine, California, USA
- Department of Pharmaceutical Sciences, School of Medicine, University of California, Irvine, Irvine, California, USA
- Department of Developmental and Cell Biology, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Geoffrey W. Abbott
- Bioelectricity Laboratory, Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Amal Alachkar
- Department of Pharmacology, School of Medicine, University of California, Irvine, Irvine, California, USA
- Department of Pharmaceutical Sciences, School of Medicine, University of California, Irvine, Irvine, California, USA
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Abstract
OBJECTIVE An obsessive-compulsive disorder (OCD) subtype has been associated with streptococcal infections and is called pediatric autoimmune neuropsychiatric disorders associated with streptococci (PANDAS). The neuroanatomical characterization of subjects with this disorder is crucial for the better understanding of its pathophysiology; also, evaluation of these features as classifiers between patients and controls is relevant to determine potential biomarkers and useful in clinical diagnosis. This was the first multivariate pattern analysis (MVPA) study on an early-onset OCD subtype. METHODS Fourteen pediatric patients with PANDAS were paired with 14 healthy subjects and were scanned to obtain structural magnetic resonance images (MRI). We identified neuroanatomical differences between subjects with PANDAS and healthy controls using voxel-based morphometry, diffusion tensor imaging (DTI), and surface analysis. We investigated the usefulness of these neuroanatomical differences to classify patients with PANDAS using MVPA. RESULTS The pattern for the gray and white matter was significantly different between subjects with PANDAS and controls. Alterations emerged in the cortex, subcortex, and cerebellum. There were no significant group differences in DTI measures (fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity) or cortical features (thickness, sulci, volume, curvature, and gyrification). The overall accuracy of 75% was achieved using the gray matter features to classify patients with PANDAS and healthy controls. CONCLUSION The results of this integrative study allow a better understanding of the neural substrates in this OCD subtype, suggesting that the anatomical gray matter characteristics could have an immune origin that might be helpful in patient classification.
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Lin TC, Lo YC, Lin HC, Li SJ, Lin SH, Wu HF, Chu MC, Lee CW, Lin IC, Chang CW, Liu YC, Chen TC, Lin YJ, Ian Shih YY, Chen YY. MR imaging central thalamic deep brain stimulation restored autistic-like social deficits in the rat. Brain Stimul 2019; 12:1410-1420. [PMID: 31324604 DOI: 10.1016/j.brs.2019.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/23/2019] [Accepted: 07/05/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Social deficit is a core symptom in autism spectrum disorder (ASD). Although deep brain stimulation (DBS) has been proposed as a potential treatment for ASD, an ideal target nucleus is yet to be identified. DBS at the central thalamic nucleus (CTN) is known to alter corticostriatal and limbic circuits, and subsequently increase the exploratory motor behaviors, cognitive performance, and skill learning in neuropsychiatric and neurodegenerative disorders. OBJECTIVE We first investigated the ability of CTN-DBS to selectively engage distinct brain circuits and compared the spatial distribution of evoked network activity and modulation. Second, we investigated whether CTN-DBS intervention improves social interaction in a valproic acid-exposed ASD rat offspring model. METHODS Brain regions activated through CTN-DBS by using a magnetic resonance (MR)-compatible neural probe, which is capable of inducing site-selective microstimulations during functional MRI (fMRI), were investigated. We then performed functional connectivity MRI, the three-chamber social interaction test, and Western blotting analyses to evaluate the therapeutic efficacy of CTN-DBS in an ASD rat offspring model. RESULTS The DBS-evoked fMRI results indicated that the activated brain regions were mainly located in cortical areas, limbic-related areas, and the dorsal striatum. We observed restoration of brain functional connectivity (FC) in corticostriatal and corticolimbic circuits after CTN-DBS, accompanied with increased social interaction and decreased social avoidance in the three-chamber social interaction test. The dopamine D2 receptor decreased significantly after CTN-DBS treatment, suggesting changes in synaptic plasticity and alterations in the brain circuits. CONCLUSIONS Applying CTN-DBS to ASD rat offspring increased FC and altered the synaptic plasticity in the corticolimbic and the corticostriatal circuits. This suggests that CTN-DBS could be an effective treatment for improving the social behaviors of individuals with ASD.
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Affiliation(s)
- Ting-Chun Lin
- Department of Biomedical Engineering, National Yang Ming University, No.155, Sec.2, Linong St, Taipei, 11221, Taiwan, ROC
| | - Yu-Chun Lo
- The Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, No. 250 Wu-Xing St, Taipei, 11031, Taiwan, ROC; Research Center for Brain and Consciousness, Taipei Medical University, Shuang Ho Hospital, No. 291, Zhongzheng Rd, New Taipei City, 23561, Taiwan, ROC
| | - Hui-Ching Lin
- Department and Institute of Physiology, National Yang Ming University, No.155, Sec.2, Linong St, Taipei, 11221, Taiwan, ROC
| | - Ssu-Ju Li
- Department of Biomedical Engineering, National Yang Ming University, No.155, Sec.2, Linong St, Taipei, 11221, Taiwan, ROC
| | - Sheng-Huang Lin
- Department of Neurology, Tzu Chi General Hospital, Tzu Chi University, No. 707, Sec. 3, Chung Yang Rd, Hualien, 97002, Taiwan, ROC
| | - Han-Fang Wu
- Department and Institute of Physiology, National Yang Ming University, No.155, Sec.2, Linong St, Taipei, 11221, Taiwan, ROC
| | - Ming-Chia Chu
- Department and Institute of Physiology, National Yang Ming University, No.155, Sec.2, Linong St, Taipei, 11221, Taiwan, ROC
| | - Chi-Wei Lee
- The Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, No. 250 Wu-Xing St, Taipei, 11031, Taiwan, ROC; Department and Institute of Physiology, National Yang Ming University, No.155, Sec.2, Linong St, Taipei, 11221, Taiwan, ROC
| | - I-Cheng Lin
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd, New Taipei City, 23561, Taiwan, ROC
| | - Ching-Wen Chang
- Department of Biomedical Engineering, National Yang Ming University, No.155, Sec.2, Linong St, Taipei, 11221, Taiwan, ROC
| | - Yin-Chieh Liu
- Department of Biomedical Engineering, National Yang Ming University, No.155, Sec.2, Linong St, Taipei, 11221, Taiwan, ROC
| | - Ting-Chieh Chen
- Department of Biomedical Engineering, National Yang Ming University, No.155, Sec.2, Linong St, Taipei, 11221, Taiwan, ROC
| | - Yu-Ju Lin
- Department of Psychiatry, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd, New Taipei City, 22060, Taiwan, ROC.
| | - Yen-Yu Ian Shih
- Departments of Neurology, Biomedical Engineering and Biomedical Research Imaging Center University of North Carolina at Chapel Hill, 125 Mason Farm Rd, CB# 7513, Chapel Hill, NC, 27599, USA
| | - You-Yin Chen
- Department of Biomedical Engineering, National Yang Ming University, No.155, Sec.2, Linong St, Taipei, 11221, Taiwan, ROC; The Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, No. 250 Wu-Xing St, Taipei, 11031, Taiwan, ROC.
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Shivakumar V, Dinakaran D, Narayanaswamy JC, Venkatasubramanian G. Noninvasive brain stimulation in obsessive-compulsive disorder. Indian J Psychiatry 2019; 61:S66-S76. [PMID: 30745679 PMCID: PMC6343411 DOI: 10.4103/psychiatry.indianjpsychiatry_522_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is a complex neuropsychiatric disorder with a chronic course, contributing to significant socio-occupational dysfunction. Forty percent of patients remain treatment refractive despite mainstream treatment options such as serotonin-reuptake inhibitors and cognitive behavior therapy. Noninvasive brain stimulation approaches such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have piqued interest as add-on treatment options in OCD. This review focuses on summarizing the TMS and tDCS studies in OCD with respect to their study design and stimulation parameters and key findings. We also briefly discuss the limitations and future directions noninvasive brain stimulation in OCD.
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Affiliation(s)
- Venkataram Shivakumar
- Department of Psychiatry, WISER Neuromodulation Program, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.,Department of Psychiatry, OCD Clinic, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Damodharan Dinakaran
- Department of Psychiatry, WISER Neuromodulation Program, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Janardhanan C Narayanaswamy
- Department of Psychiatry, WISER Neuromodulation Program, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.,Department of Psychiatry, OCD Clinic, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, WISER Neuromodulation Program, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Yazdi-Ravandi S, Akhavanpour H, Shamsaei F, Matinnia N, Ahmadpanah M, Ghaleiha A, Khosrowabadi R. Differential pattern of brain functional connectome in obsessive-compulsive disorder versus healthy controls. EXCLI JOURNAL 2018; 17:1090-1100. [PMID: 30564085 PMCID: PMC6295628 DOI: 10.17179/excli2018-1757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 10/31/2018] [Indexed: 02/06/2023]
Abstract
Researchers believe that recognition of functional impairment in some of brain networks such as frontal-parietal, default mode network (DMN), anterior medial prefrontal cortex (MPFC) and striatal structures could be a beneficial biomarker for diagnosis of obsessive-compulsive disorder (OCD). Although it is well recognized brain functional connectome in OCD patients shows changes, debate still remains on characteristics of the changes. In this regard, little has been done so far to statistically assess the altered pattern using whole brain electroencephalography. In this study, resting state EEG data of 39 outpatients with OCD and 19 healthy controls (HC) were recorded. After, brain functional network was estimated from the cleaned EEG data using the weighted phase lag index algorithm. Output matrices of OCD group and HCs were then statistically compared to represent meaningful differences. Significant differences in functional connectivity pattern were demonstrated in several regions. As expected the most significant changes were observed in frontal cortex, more significant in frontal-temporal connections (between F3 and F7, and T5 regions). These results in OCD patients are consistent with previous studies and confirm the role of frontal and temporal brain regions in OCD.
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Affiliation(s)
- Saeid Yazdi-Ravandi
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hassan Akhavanpour
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University GC, Tehran, Iran
| | - Farshid Shamsaei
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nasrin Matinnia
- Department of Nursing, College of Basic Science, Hamadan Branch, Islamic Azad University, Hamadan, Iran
| | - Mohammad Ahmadpanah
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Ghaleiha
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University GC, Tehran, Iran
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Trambaiolli LR, Biazoli CE, Balardin JB, Hoexter MQ, Sato JR. The relevance of feature selection methods to the classification of obsessive-compulsive disorder based on volumetric measures. J Affect Disord 2017; 222:49-56. [PMID: 28672179 DOI: 10.1016/j.jad.2017.06.061] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 06/01/2017] [Accepted: 06/26/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND Magnetic resonance images (MRI) show detectable anatomical and functional differences between individuals with obsessive-compulsive disorder (OCD) and healthy subjects. Moreover, machine learning techniques have been proposed as tools to identify potential biomarkers and, ultimately, to support clinical diagnosis. However, few studies to date have investigated feature selection (FS) influences in OCD MRI-based classification. METHODS Volumes of cortical and subcortical structures, from MRI data of 38 OCD patients (split into two groups according symptoms severity) and 36 controls, were submitted to seven feature selection algorithms. FS aims to select the most relevant and less redundant features which discriminate between two classes. Then, a classification step was applied, from which the classification performances before and after different FS were compared. For the performance evaluation, leave-one-subject-out accuracies of Support Vector Machine classifiers were considered. RESULTS Using different FS algorithms, performance improvement was achieved for Controls vs. All OCD discrimination (19.08% of improvement reducing by 80% the amount of features), Controls vs. Low OCD (20.10%, 75%), Controls vs. High OCD (17.32%, 85%) and Low OCD vs. High OCD (10.53%, 75%). Furthermore, all algorithms pointed out classical cortico-striato-thalamo-cortical circuitry structures as relevant features for OCD classification. LIMITATIONS Limitations include the sample size and using only filter approaches for FS. CONCLUSIONS Our results suggest that FS positively impacts OCD classification using machine-learning techniques. Complementarily, FS algorithms were able to select biologically plausible features automatically.
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Affiliation(s)
- Lucas R Trambaiolli
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Rua Santa Adélia, 166, Santo André, SP 09210-170, Brazil.
| | - Claudinei E Biazoli
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Rua Santa Adélia, 166, Santo André, SP 09210-170, Brazil
| | - Joana B Balardin
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Rua Santa Adélia, 166, Santo André, SP 09210-170, Brazil
| | - Marcelo Q Hoexter
- Department and Institute of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo 01060-970, SP, Brazil
| | - João R Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Rua Santa Adélia, 166, Santo André, SP 09210-170, Brazil
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Friedman AL, Burgess A, Ramaseshan K, Easter P, Khatib D, Chowdury A, Arnold PD, Hanna GL, Rosenberg DR, Diwadkar VA. Brain network dysfunction in youth with obsessive-compulsive disorder induced by simple uni-manual behavior: The role of the dorsal anterior cingulate cortex. Psychiatry Res 2017; 260:6-15. [PMID: 27992792 PMCID: PMC5302006 DOI: 10.1016/j.pscychresns.2016.12.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 12/09/2016] [Accepted: 12/10/2016] [Indexed: 10/20/2022]
Abstract
In an effort to elucidate differences in functioning brain networks between youth with obsessive-compulsive disorder and controls, we used fMRI signals to analyze brain network interactions of the dorsal anterior cingulate cortex (dACC) during visually coordinated motor responses. Subjects made a uni-manual response to briefly presented probes, at periodic (allowing participants to maintain a "motor set") or random intervals (demanding reactive responses). Network interactions were assessed using psycho-physiological interaction (PPI), a basic model of functional connectivity evaluating modulatory effects of the dACC in the context of each task condition. Across conditions, OCD were characterized by hyper-modulation by the dACC, with loci alternatively observed as both condition-general and condition-specific. Thus, dynamically driven task demands during simple uni-manual motor control induce compensatory network interactions in cortical-thalamic regions in OCD. These findings support previous research in OCD showing compensatory network interactions during complex memory tasks, but establish that these network effects are observed during basic sensorimotor processing. Thus, these patterns of network dysfunction may in fact be independent of the complexity of tasks used to induce brain network activity. Hypothesis-driven approaches coupled with sophisticated network analyses are a highly valuable approach in using fMRI to uncover mechanisms in disorders like OCD.
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Affiliation(s)
- Amy L Friedman
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Ashley Burgess
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Karthik Ramaseshan
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Phil Easter
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Dalal Khatib
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Asadur Chowdury
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Paul D Arnold
- Dept. of Psychiatry and Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada
| | - Gregory L Hanna
- Dept. of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - David R Rosenberg
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Vaibhav A Diwadkar
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
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