Apathy in depression: An arterial spin labeling perfusion MRI study

INTRODUCTION

Apathy, as defined as a deficit in goal-directed behaviors, is a critical clinical dimension in depression associated with chronic impairment. Little is known about its cerebral perfusion specificities in depression. To explore neurovascular mechanisms underpinning apathy in depression by pseudo-continuous arterial spin labeling (pCASL) magnetic resonance imaging (MRI).

METHODS

Perfusion imaging analysis was performed on 90 depressed patients included in a prospective study between November 2014 and February 2017. Imaging data included anatomical 3D T1-weighted and perfusion pCASL sequences. A multiple regression analysis relating the quantified cerebral blood flow (CBF) in different regions of interest defined from the FreeSurfer atlas, to the Apathy Evaluation Scale (AES) total score was conducted.

RESULTS

After confound adjustment (demographics, disease and clinical characteristics) and correction for multiple comparisons, we observed a strong negative relationship between the CBF in the left anterior cingulate cortex (ACC) and the AES score (standardized beta = -0.74, corrected p value = 0.0008).

CONCLUSION

Our results emphasized the left ACC as a key region involved in apathy severity in a population of depressed participants. Perfusion correlates of apathy in depression evidenced in this study may contribute to characterize different phenotypes of depression.

Multimodal MRI cerebral correlates of verbal fluency switching and its impairment in women with depression

BACKGROUND

The search of biomarkers in the field of depression requires easy implementable tests that are biologically rooted. Qualitative analysis of verbal fluency tests (VFT) are good candidates, but its cerebral correlates are unknown.

METHODS

We collected qualitative semantic and phonemic VFT scores along with grey and white matter anatomical MRI of depressed (n = 26) and healthy controls (HC, n = 25) women. Qualitative VFT variables are the "clustering score" (i.e. the ability to produce words within subcategories) and the "switching score" (i.e. the ability to switch between clusters). The clustering and switching scores were automatically calculated using a data-driven approach. Brain measures were cortical thickness (CT) and fractional anisotropy (FA). We tested for associations between CT, FA and qualitative VFT variables within each group.

RESULTS

Patients had reduced switching VFT scores compared to HC. Thicker cortex was associated with better switching score in semantic VFT bilaterally in the frontal (superior, rostral middle and inferior gyri), parietal (inferior parietal lobule including the supramarginal gyri), temporal (transverse and fusiform gyri) and occipital (lingual gyri) lobes in the depressed group. Positive association between FA and the switching score in semantic VFT was retrieved in depressed patients within the corpus callosum, right inferior fronto-occipital fasciculus, right superior longitudinal fasciculus extending to the anterior thalamic radiation (all p < 0.05, corrected).

CONCLUSION

Together, these results suggest that automatic qualitative VFT scores are associated with brain anatomy and reinforce its potential use as a surrogate for depression cerebral bases.

Apathy in depression: An arterial spin labeling study

Introduction

Apathy is usually defined as a lack of goal-directed behavior. Although it is observed in about 30% of depressed patients, neurovascular mechanisms underpinning apathy remain little-known.

Objectives

The main objective of this study was to compare the cerebral perfusion of apathetic depressed patients with non-apathetic depressed patients by arterial spin labeling (ASL), a quantitative and non-invasive perfusion magnetic resonance imaging (MRI) technique. The secondary objectives were to study their clinical profile and their correlation with cerebral perfusion data.

Methods

This study was conducted from a cohort of depressed patients in Rennes, France. Eighty-three depressed patients were included, of whom 22 were apathetic (AES≥42), 61 non-apathetic (AES < 42). Everyone got a clinical evaluation with scale screenings, especially for apathy (AES), anxiety (STAI) and anhedonia (SHAPS) as well as a cerebral MRI, including a pseudo-continuous ASL sequence.

Results

Apathetic depressed patients were significantly less anxious and less anhedonic. Apathetic perfused better than non-apathetic in the inferior frontal gyrus (P = 0.022). We found a significant positive relationship between apathy and perfusion of the left frontal inferior gyrus (P = 0.05, r = 0.21). State-anxiety was positively correlated with perfusion of the cingulate cortex, the insula and the left amygdala. Anhedonia was positively correlated with the perfusion of the ventromedial prefrontal cortex, the cingulate cortex and the insula.

Conclusions

We have shown that the clinical and perfusional profiles of apathetic depressed and non-apathetic differ. This study suggests the existence of two distinct neurobiological networks for depressed patients; one involving motivational networks for apathetic patients, and another one involving emotional networks for more anhedonic patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Early postnatal development of corpus callosum and corticospinal white matter assessed with quantitative tractography

BACKGROUND AND PURPOSE

The early postnatal period is perhaps the most dynamic phase of white matter development. We hypothesized that the early postnatal development of the corpus callosum and corticospinal tracts could be studied in unsedated healthy neonates by using novel approaches to diffusion tensor imaging (DTI) and quantitative tractography.

MATERIALS AND METHODS

Isotropic 2 x 2 x 2 mm(3) DTI and structural images were acquired from 47 healthy neonates. DTI and structural images were coregistered and fractional anisotropy (FA), mean diffusivity (MD), and normalized T1-weighted (T1W) and T2-weighted (T2W) signal intensities were determined in central midline and peripheral cortical regions of the white matter tracts of the genu and splenium of the corpus callosum and the central midbrain and peripheral cortical regions of the corticospinal tracts by using quantitative tractography.

RESULTS

We observed that central regions exhibited lower MD, higher FA values, higher T1W intensity, and lower T2W intensity than peripheral cortical regions. As expected, MD decreased, FA increased, and T2W signal intensity decreased with increasing age in the genu and corticospinal tract, whereas there was no significant change in T1W signal intensity. The central midline region of the splenium fiber tract has a unique pattern, with no change in MD, FA, or T2W signal intensity with age, suggesting different growth trajectory compared with the other tracts. FA seems to be more dependent on tract organization, whereas MD seems to be more sensitive to myelination.

CONCLUSIONS

Our novel approach may detect small regional differences and age-related changes in the corpus callosum and corticospinal white matter tracts in unsedated healthy neonates and may be used for future studies of pediatric brain disorders that affect developing white matter.

Retrospective evaluation of intersubject brain registration

Although numerous methods to register brains of different individuals have been proposed, no work has been done, as far as we know, to evaluate and objectively compare the performances of different nonrigid (or elastic) registration methods on the same database of subjects. In this paper, we propose an evaluation framework, based on global and local measures of the relevance of the registration. We have chosen to focus more particularly on the matching of cortical areas, since intersubject registration methods are dedicated to anatomical and functional normalization, and also because other groups have shown the relevance of such registration methods for deep brain structures. Experiments were conducted using 6 methods on a database of 18 subjects. The global measures used show that the quality of the registration is directly related to the transformation's degrees of freedom. More surprisingly, local measures based on the matching of cortical sulci did not show significant differences between rigid and non rigid methods.

Interindividual functional mapping: a nonlinear local approach

Within the scope of three-dimensional brain imaging, we propose an interindividual fusion scheme to register functional activations according to anatomical cortical structures, the sulci. This paper is based on the assumption that an important part of functional intersubject variability is encoded in anatomical variability. The aim of this paper is therefore to propose a generic framework to register functional activations according to the relevant anatomical landmarks. Compared to "classical" interindividual fusion schemes, this approach is local. It relies on a statistical sulci shape model accounting for the interindividual variability of a population of subjects and providing deformation modes relative to a reference shape (a mean sulcus). The deformation field obtained between a given sulcus and the reference sulcus is extended to a neighborhood of the given sulcus by using the thin-plate spline interpolation. It is then applied to functional activations located in the vicinity of this sulcus. This approach is compared with rigid and nonrigid registration methods. In this paper, we present results on MEG somatosensory data acquired on 18 subjects. We show that the nonlinear local fusion scheme significantly reduces the observed functional variability.