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Brendler A, Schneider M, Elbau IG, Sun R, Nantawisarakul T, Pöhlchen D, Brückl T, Czisch M, Sämann PG, Lee MD, Spoormaker VI. Assessing hypo-arousal during reward anticipation with pupillometry in patients with major depressive disorder: replication and correlations with anhedonia. Sci Rep 2024; 14:344. [PMID: 38172509 PMCID: PMC10764729 DOI: 10.1038/s41598-023-48792-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
Major depressive disorder (MDD) is a devastating and heterogenous disorder for which there are no approved biomarkers in clinical practice. We recently identified anticipatory hypo-arousal indexed by pupil responses as a candidate mechanism subserving depression symptomatology. Here, we conducted a replication and extension study of these findings. We analyzed a replication sample of 40 unmedicated patients with a diagnosis of depression and 30 healthy control participants, who performed a reward anticipation task while pupil responses were measured. Using a Bayesian modelling approach taking measurement uncertainty into account, we could show that the negative correlation between pupil dilation and symptom load during reward anticipation is replicable within MDD patients, albeit with a lower effect size. Furthermore, with the combined sample of 136 participants (81 unmedicated depressed and 55 healthy control participants), we further showed that reduced pupil dilation in anticipation of reward is inversely associated with anhedonia items of the Beck Depression Inventory in particular. Moreover, using simultaneous fMRI, particularly the right anterior insula as part of the salience network was negatively correlated with depressive symptom load in general and anhedonia items specifically. The present study supports the utility of pupillometry in assessing noradrenergically mediated hypo-arousal during reward anticipation in MDD, a physiological process that appears to subserve anhedonia.
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Affiliation(s)
- Andy Brendler
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
| | - Max Schneider
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
| | - Immanuel G Elbau
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Rui Sun
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Taechawidd Nantawisarakul
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
| | - Dorothee Pöhlchen
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
| | - Tanja Brückl
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
| | | | | | - Michael D Lee
- Department of Cognitive Sciences, University of California, Irvine, USA
| | - Victor I Spoormaker
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany.
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Lynch CJ, Elbau IG, Zhu S, Ayaz A, Bukhari H, Power JD, Liston C. Precision mapping and transcranial magnetic stimulation of individual-specific functional brain networks in humans. STAR Protoc 2023; 4:102118. [PMID: 36853696 PMCID: PMC9958066 DOI: 10.1016/j.xpro.2023.102118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/18/2022] [Accepted: 01/29/2023] [Indexed: 02/16/2023] Open
Abstract
Spatial targeting in transcranial magnetic stimulation protocols does not typically account for the idiosyncratic functional organization of individual human brains. Here, we provide a protocol for implementing targeted functional network stimulation (TANS), which accounts for each individual's unique functional neuroanatomy and cortical folding patterns. Using an example dataset, we describe how to create a head model and estimate the best coil placement and stimulation intensity to minimize off-target effects. For complete details on the use and execution of this protocol, please refer to Lynch et al. (2022).1.
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Affiliation(s)
- Charles J Lynch
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY, USA.
| | - Immanuel G Elbau
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY, USA
| | - Shasha Zhu
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY, USA
| | - Aliza Ayaz
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY, USA
| | - Hussain Bukhari
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY, USA
| | - Jonathan D Power
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY, USA
| | - Conor Liston
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY, USA.
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Elbau IG, Lynch CJ, Downar J, Vila-Rodriguez F, Power JD, Solomonov N, Daskalakis ZJ, Blumberger DM, Liston C. Functional Connectivity Mapping for rTMS Target Selection in Depression. Am J Psychiatry 2023; 180:230-240. [PMID: 36855880 DOI: 10.1176/appi.ajp.20220306] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE Repetitive transcranial magnetic stimulation (rTMS) protocols increasingly use subgenual anterior cingulate cortex (sgACC) functional connectivity to individualize treatment targets. However, the efficacy of this approach is unclear, with conflicting findings and varying effect sizes across studies. Here, the authors investigated the effect of the stimulation site's functional connectivity with the sgACC (sgACC-StimFC) on treatment outcome to rTMS in 295 patients with major depression. METHODS The reliability and accuracy of estimating sgACC functional connectivity were validated with data from individuals who underwent extensive functional MRI testing. Electric field modeling was used to analyze associations between sgACC-StimFC and clinical improvement using standardized assessments and to evaluate sources of heterogeneity. RESULTS An imputation-based method provided reliable and accurate sgACC functional connectivity estimates. Treatment responses weakly but robustly correlated with sgACC-StimFC (r=-0.16), but only when the stimulated cortex was identified using electric field modeling. Surprisingly, this association was driven by patients with strong global signal fluctuations stemming from a specific periodic respiratory pattern (r=-0.49). CONCLUSIONS Functional connectivity between the sgACC and the stimulated cortex was correlated with individual differences in treatment outcomes, but the association was weaker than those observed in previous studies and was accentuated in a subgroup of patients with distinct, respiration-related signal patterns in their scans. These findings indicate that in a large representative sample of patients with major depressive disorder, individual differences in sgACC-StimFC explained only ∼3% of the variance in outcomes, which may limit the utility of existing sgACC-based targeting protocols. However, these data also provide strong evidence for a true-albeit small-effect and highlight opportunities for incorporating additional functional connectivity measures to generate models of rTMS response with enhanced predictive power.
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Affiliation(s)
- Immanuel G Elbau
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York (Elbau, Lynch, Power, Solomonov, Liston); Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, and Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto (Downar, Blumberger); Non-Invasive Neurostimulation Therapies Lab and Department of Psychiatry, University of British Columbia, Vancouver (Vila-Rodriguez); Department of Psychiatry, University of California, San Diego (Daskalakis)
| | - Charles J Lynch
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York (Elbau, Lynch, Power, Solomonov, Liston); Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, and Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto (Downar, Blumberger); Non-Invasive Neurostimulation Therapies Lab and Department of Psychiatry, University of British Columbia, Vancouver (Vila-Rodriguez); Department of Psychiatry, University of California, San Diego (Daskalakis)
| | - Jonathan Downar
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York (Elbau, Lynch, Power, Solomonov, Liston); Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, and Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto (Downar, Blumberger); Non-Invasive Neurostimulation Therapies Lab and Department of Psychiatry, University of British Columbia, Vancouver (Vila-Rodriguez); Department of Psychiatry, University of California, San Diego (Daskalakis)
| | - Fidel Vila-Rodriguez
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York (Elbau, Lynch, Power, Solomonov, Liston); Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, and Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto (Downar, Blumberger); Non-Invasive Neurostimulation Therapies Lab and Department of Psychiatry, University of British Columbia, Vancouver (Vila-Rodriguez); Department of Psychiatry, University of California, San Diego (Daskalakis)
| | - Jonathan D Power
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York (Elbau, Lynch, Power, Solomonov, Liston); Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, and Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto (Downar, Blumberger); Non-Invasive Neurostimulation Therapies Lab and Department of Psychiatry, University of British Columbia, Vancouver (Vila-Rodriguez); Department of Psychiatry, University of California, San Diego (Daskalakis)
| | - Nili Solomonov
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York (Elbau, Lynch, Power, Solomonov, Liston); Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, and Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto (Downar, Blumberger); Non-Invasive Neurostimulation Therapies Lab and Department of Psychiatry, University of British Columbia, Vancouver (Vila-Rodriguez); Department of Psychiatry, University of California, San Diego (Daskalakis)
| | - Zafiris J Daskalakis
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York (Elbau, Lynch, Power, Solomonov, Liston); Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, and Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto (Downar, Blumberger); Non-Invasive Neurostimulation Therapies Lab and Department of Psychiatry, University of British Columbia, Vancouver (Vila-Rodriguez); Department of Psychiatry, University of California, San Diego (Daskalakis)
| | - Daniel M Blumberger
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York (Elbau, Lynch, Power, Solomonov, Liston); Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, and Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto (Downar, Blumberger); Non-Invasive Neurostimulation Therapies Lab and Department of Psychiatry, University of British Columbia, Vancouver (Vila-Rodriguez); Department of Psychiatry, University of California, San Diego (Daskalakis)
| | - Conor Liston
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York (Elbau, Lynch, Power, Solomonov, Liston); Department of Psychiatry and Institute of Medical Science, Faculty of Medicine, University of Toronto, and Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto (Downar, Blumberger); Non-Invasive Neurostimulation Therapies Lab and Department of Psychiatry, University of British Columbia, Vancouver (Vila-Rodriguez); Department of Psychiatry, University of California, San Diego (Daskalakis)
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Lynch CJ, Elbau IG, Ng TH, Wolk D, Zhu S, Ayaz A, Power JD, Zebley B, Gunning FM, Liston C. Automated optimization of TMS coil placement for personalized functional network engagement. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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5
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Lynch CJ, Elbau IG, Ng TH, Wolk D, Zhu S, Ayaz A, Power JD, Zebley B, Gunning FM, Liston C. Automated optimization of TMS coil placement for personalized functional network engagement. Neuron 2022; 110:3263-3277.e4. [PMID: 36113473 DOI: 10.1016/j.neuron.2022.08.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/20/2022] [Accepted: 08/05/2022] [Indexed: 12/11/2022]
Abstract
Transcranial magnetic stimulation (TMS) is used to treat multiple psychiatric and neurological conditions by manipulating activity in particular brain networks and circuits, but individual responses are highly variable. In clinical settings, TMS coil placement is typically based on either group average functional maps or scalp heuristics. Here, we found that this approach can inadvertently target different functional networks in depressed patients due to variability in their functional brain organization. More precise TMS targeting should be feasible by accounting for each patient's unique functional neuroanatomy. To this end, we developed a targeting approach, termed targeted functional network stimulation (TANS). The TANS approach improved stimulation specificity in silico in 8 highly sampled patients with depression and 6 healthy individuals and in vivo when targeting somatomotor functional networks representing the upper and lower limbs. Code for implementing TANS and an example dataset are provided as a resource.
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Affiliation(s)
- Charles J Lynch
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY 10021, USA.
| | - Immanuel G Elbau
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY 10021, USA
| | - Tommy H Ng
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY 10021, USA
| | - Danielle Wolk
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY 10021, USA
| | - Shasha Zhu
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY 10021, USA
| | - Aliza Ayaz
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY 10021, USA
| | - Jonathan D Power
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY 10021, USA
| | - Benjamin Zebley
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY 10021, USA
| | - Faith M Gunning
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY 10021, USA
| | - Conor Liston
- Department of Psychiatry, Weill Cornell Medicine, 413 East 69th Street, Box 204, New York, NY 10021, USA.
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6
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Elbau IG, Lynch CJ, Downar J, Vila-Rodriguez F, Daskalakis ZJ, Blumberger DM, Liston C. Effect of E-field based sgACC connectivity on rTMS outcome in the THREE-D trial. Brain Stimul 2021. [DOI: 10.1016/j.brs.2021.10.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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7
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Schneider M, Elbau IG, Nantawisarakul T, Pöhlchen D, Brückl T, BeCOME Working Group, Czisch M, Saemann PG, Lee MD, Binder EB, Spoormaker VI. Pupil Dilation during Reward Anticipation Is Correlated to Depressive Symptom Load in Patients with Major Depressive Disorder. Brain Sci 2020; 10:E906. [PMID: 33255604 PMCID: PMC7760331 DOI: 10.3390/brainsci10120906] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/17/2020] [Accepted: 11/21/2020] [Indexed: 12/18/2022] Open
Abstract
Depression is a debilitating disorder with high prevalence and socioeconomic cost, but the brain-physiological processes that are altered during depressive states are not well understood. Here, we build on recent findings in macaques that indicate a direct causal relationship between pupil dilation and anterior cingulate cortex mediated arousal during anticipation of reward. We translated these findings to human subjects with concomitant pupillometry/fMRI in a sample of unmedicated participants diagnosed with major depression and healthy controls. We could show that the upregulation and maintenance of arousal in anticipation of reward was disrupted in patients in a symptom-load dependent manner. We could further show that the failure to maintain reward anticipatory arousal showed state-marker properties, as it tracked the load and impact of depressive symptoms independent of prior diagnosis status. Further, group differences of anticipatory arousal and continuous correlations with symptom load were not traceable only at the level of pupillometric responses, but were mirrored also at the neural level within salience network hubs. The upregulation and maintenance of arousal during reward anticipation is a novel translational and well-traceable process that could prove a promising gateway to a physiologically informed patient stratification and targeted interventions.
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Affiliation(s)
- Max Schneider
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany; (M.S.); (I.G.E.); (T.N.); (D.P.); (T.B.); (BeCOME Working Group); (M.C.); (P.G.S.); (E.B.B.)
| | - Immanuel G. Elbau
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany; (M.S.); (I.G.E.); (T.N.); (D.P.); (T.B.); (BeCOME Working Group); (M.C.); (P.G.S.); (E.B.B.)
| | - Teachawidd Nantawisarakul
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany; (M.S.); (I.G.E.); (T.N.); (D.P.); (T.B.); (BeCOME Working Group); (M.C.); (P.G.S.); (E.B.B.)
| | - Dorothee Pöhlchen
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany; (M.S.); (I.G.E.); (T.N.); (D.P.); (T.B.); (BeCOME Working Group); (M.C.); (P.G.S.); (E.B.B.)
| | - Tanja Brückl
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany; (M.S.); (I.G.E.); (T.N.); (D.P.); (T.B.); (BeCOME Working Group); (M.C.); (P.G.S.); (E.B.B.)
| | - BeCOME Working Group
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany; (M.S.); (I.G.E.); (T.N.); (D.P.); (T.B.); (BeCOME Working Group); (M.C.); (P.G.S.); (E.B.B.)
| | - Michael Czisch
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany; (M.S.); (I.G.E.); (T.N.); (D.P.); (T.B.); (BeCOME Working Group); (M.C.); (P.G.S.); (E.B.B.)
| | - Philipp G. Saemann
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany; (M.S.); (I.G.E.); (T.N.); (D.P.); (T.B.); (BeCOME Working Group); (M.C.); (P.G.S.); (E.B.B.)
| | - Michael D. Lee
- Department of Cognitive Sciences, University of California, Irvine, CA 92697-5100, USA;
| | - Elisabeth B. Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany; (M.S.); (I.G.E.); (T.N.); (D.P.); (T.B.); (BeCOME Working Group); (M.C.); (P.G.S.); (E.B.B.)
| | - Victor I. Spoormaker
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany; (M.S.); (I.G.E.); (T.N.); (D.P.); (T.B.); (BeCOME Working Group); (M.C.); (P.G.S.); (E.B.B.)
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8
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Kühnel A, Kroemer NB, Elbau IG, Czisch M, Sämann PG, Walter M, Binder EB. Psychosocial stress reactivity habituates following acute physiological stress. Hum Brain Mapp 2020; 41:4010-4023. [PMID: 32597537 PMCID: PMC7469805 DOI: 10.1002/hbm.25106] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/13/2020] [Accepted: 06/12/2020] [Indexed: 11/08/2022] Open
Abstract
Acute and chronic stress are important factors in the development of mental disorders. Reliable measurement of stress reactivity is therefore pivotal. Critically, experimental induction of stress often involves multiple “hits” and it is an open question whether individual differences in responses to an earlier stressor lead to habituation, sensitization, or simple additive effects on following events. Here, we investigated the effect of the individual cortisol response to intravenous catheter placement (IVP) on subsequent neural, psychological, endocrine, and autonomous stress reactivity. We used an established psychosocial stress paradigm to measure the acute stress response (Stress) and recovery (PostStress) in 65 participants. Higher IVP‐induced cortisol responses were associated with lower pulse rate increases during stress recovery (b = −4.8 bpm, p = .0008) and lower increases in negative affect after the task (b = −4.2, p = .040). While the cortisol response to IVP was not associated with subsequent specific stress‐induced neural activation patterns, the similarity of brain responses Pre‐ and PostStress was higher IVP‐cortisol responders (t[64] = 2.35, p = .022) indicating faster recovery. In conclusion, preparatory stress induced by IVP reduced reactivity in a subsequent stress task by modulating the latency of stress recovery. Thus, an individually stronger preceding release of cortisol may attenuate a second physiological response and perceived stress suggesting that relative changes, not absolute levels are crucial for stress attribution. Our study highlights that considering the entire trajectory of stress induction during an experiment is important to develop reliable individual biomarkers.
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Affiliation(s)
- Anne Kühnel
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Nils B Kroemer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Immanuel G Elbau
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | | | | | - Martin Walter
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,Max Planck Institute of Psychiatry, Munich, Germany
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
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9
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Elbau IG, Cruceanu C, Binder EB. Genetics of Resilience: Gene-by-Environment Interaction Studies as a Tool to Dissect Mechanisms of Resilience. Biol Psychiatry 2019; 86:433-442. [PMID: 31202489 DOI: 10.1016/j.biopsych.2019.04.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/08/2019] [Accepted: 04/17/2019] [Indexed: 12/26/2022]
Abstract
The identification and understanding of resilience mechanisms holds potential for the development of mechanistically informed prevention and interventions in psychiatry. However, investigating resilience mechanisms is conceptually and methodologically challenging because resilience does not merely constitute the absence of disease-specific risk but rather reflects active processes that aid in the maintenance of physiological and psychological homeostasis across a broad range of environmental circumstances. In this conceptual review, we argue that the principle used in gene-by-environment interaction studies may help to unravel resilience mechanisms on different investigation levels. We present how this could be achieved by top-down designs that start with gene-by-environment interaction effects on disease phenotypes as well as by bottom-up approaches that start at the molecular level. We also discuss how recent technological advances may improve both top-down and bottom-up strategies.
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Affiliation(s)
- Immanuel G Elbau
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Cristiana Cruceanu
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
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