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Sheng B, Zhang S, Gao Y, Xia S, Zhu Y, Yan J. Elucidating the influence of familial interactions on geriatric depression: A comprehensive nationwide multi-center investigation leveraging machine learning. Acta Psychol (Amst) 2024; 246:104274. [PMID: 38631151 DOI: 10.1016/j.actpsy.2024.104274] [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] [Received: 10/03/2023] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE A plethora of studies have unequivocally established the profound significance of harmonious familial relationships on the psychological well-being of the elderly. In this study, we elucidate the intergenerational relationships, probing the association between frequent interactions or encounters with their children and the incidence of depression in old age. METHODOLOGY We employed a retrospective cross-sectional study design, sourcing our data from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS). To identify cases of depression, we utilized the 10-item Center for Epidemiologic Studies Depression Scale (CESD). Employing a five-fold cross-validation methodology, we endeavored to fashion five distinct machine learning models. Subsequently, we crafted learning curves to facilitate the refinement of hyperparameters, assessing model classification performance through metrics such as accuracy and the Area Under the Receiver Operating Characteristic (AUROC) curve. To further elucidate the relationship between variables and geriatric depression, logistic regression was subsequently applied. RESULTS Our findings accentuated that sleep patterns emerged as the paramount determinants influencing the onset of depression in the elderly. Relationships with offspring ranked as the second most significant determinant, only surpassed by sleep habits. A negative correlation was observed between sleep patterns (Odds Ratio [OR]: 0.78, 95 % Confidence Interval [CI]: 0.75-0.81, P < 0.01), communication with offspring (OR: 0.86, 95 % CI: 0.82-0.90, P < 0.01), and the prevalence of depressive symptoms. Among the evaluated models, the k-Near Neighbor algorithm demonstrated commendable discriminative power. However, it was the Random Forest algorithm that manifested unparalleled discriminative prowess and precision, establishing itself as the most efficacious classifier. CONCLUSION Prolonging the duration of nocturnal sleep, and elevating the frequency of communication with offspring have been identified as measures conducive to mitigating the onset of geriatric depression.
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Affiliation(s)
- Boyang Sheng
- Hunan University of Chinese Medicine, Changsha 410208, Hunan Province, China
| | - Shina Zhang
- Hunan University of Chinese Medicine, Changsha 410208, Hunan Province, China
| | - Yuan Gao
- Hunan University of Chinese Medicine, Changsha 410208, Hunan Province, China
| | - Shuaishuai Xia
- Hunan University of Chinese Medicine, Changsha 410208, Hunan Province, China
| | - Yong Zhu
- Hunan University of Chinese Medicine, Changsha 410208, Hunan Province, China
| | - Junfeng Yan
- Hunan University of Chinese Medicine, Changsha 410208, Hunan Province, China.
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Tan V, Downar J, Nestor S, Vila-Rodriguez F, Daskalakis ZJ, Blumberger DM, Hawco C. Effects of repetitive transcranial magnetic stimulation on individual variability of resting-state functional connectivity in major depressive disorder. J Psychiatry Neurosci 2024; 49:E172-E181. [PMID: 38729664 PMCID: PMC11090631 DOI: 10.1503/jpn.230135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/30/2024] [Accepted: 03/16/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD), but substantial heterogeneity in outcomes remains. We examined a potential mechanism of action of rTMS to normalize individual variability in resting-state functional connectivity (rs-fc) before and after a course of treatment. METHODS Variability in rs-fc was examined in healthy controls (baseline) and individuals with MDD (baseline and after 4-6 weeks of rTMS). Seed-based connectivity was calculated to 4 regions associated with MDD: left dorsolateral prefrontal cortex (DLPFC), right subgenual anterior cingulate cortex (sgACC), bilateral insula, and bilateral precuneus. Individual variability was quantified for each region by calculating the mean correlational distance of connectivity maps relative to the healthy controls; a higher variability score indicated a more atypical/idiosyncratic connectivity pattern. RESULTS We included data from 66 healthy controls and 252 individuals with MDD in our analyses. Patients with MDD did not show significant differences in baseline variability of rs-fc compared with controls. Treatment with rTMS increased rs-fc variability from the right sgACC and precuneus, but the increased variability was not associated with clinical outcomes. Interestingly, higher baseline variability of the right sgACC was significantly associated with less clinical improvement (p = 0.037, uncorrected; did not survive false discovery rate correction).Limitations: The linear model was constructed separately for each region of interest. CONCLUSION This was, to our knowledge, the first study to examine individual variability of rs-fc related to rTMS in individuals with MDD. In contrast to our hypotheses, we found that rTMS increased the individual variability of rs-fc. Our results suggest that individual variability of the right sgACC and bilateral precuneus connectivity may be a potential mechanism of rTMS.
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Affiliation(s)
- Vinh Tan
- From the Campbell Family Research Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Tan, Blumberger, Hawco); the Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ont. (Downar, Nestor); the Harquail Centre for Neuromodulation, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont. (Nestor, Blumberger, Hawco); the Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC (Vila-Rodriguez); the Department of Psychiatry, University of California, San Diego (Daskalakis); the Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ont. (Blumberger)
| | - Jonathan Downar
- From the Campbell Family Research Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Tan, Blumberger, Hawco); the Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ont. (Downar, Nestor); the Harquail Centre for Neuromodulation, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont. (Nestor, Blumberger, Hawco); the Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC (Vila-Rodriguez); the Department of Psychiatry, University of California, San Diego (Daskalakis); the Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ont. (Blumberger)
| | - Sean Nestor
- From the Campbell Family Research Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Tan, Blumberger, Hawco); the Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ont. (Downar, Nestor); the Harquail Centre for Neuromodulation, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont. (Nestor, Blumberger, Hawco); the Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC (Vila-Rodriguez); the Department of Psychiatry, University of California, San Diego (Daskalakis); the Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ont. (Blumberger)
| | - Fidel Vila-Rodriguez
- From the Campbell Family Research Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Tan, Blumberger, Hawco); the Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ont. (Downar, Nestor); the Harquail Centre for Neuromodulation, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont. (Nestor, Blumberger, Hawco); the Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC (Vila-Rodriguez); the Department of Psychiatry, University of California, San Diego (Daskalakis); the Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ont. (Blumberger)
| | - Zafiris J Daskalakis
- From the Campbell Family Research Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Tan, Blumberger, Hawco); the Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ont. (Downar, Nestor); the Harquail Centre for Neuromodulation, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont. (Nestor, Blumberger, Hawco); the Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC (Vila-Rodriguez); the Department of Psychiatry, University of California, San Diego (Daskalakis); the Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ont. (Blumberger)
| | - Daniel M Blumberger
- From the Campbell Family Research Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Tan, Blumberger, Hawco); the Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ont. (Downar, Nestor); the Harquail Centre for Neuromodulation, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont. (Nestor, Blumberger, Hawco); the Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC (Vila-Rodriguez); the Department of Psychiatry, University of California, San Diego (Daskalakis); the Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ont. (Blumberger)
| | - Colin Hawco
- From the Campbell Family Research Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Tan, Blumberger, Hawco); the Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ont. (Downar, Nestor); the Harquail Centre for Neuromodulation, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont. (Nestor, Blumberger, Hawco); the Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC (Vila-Rodriguez); the Department of Psychiatry, University of California, San Diego (Daskalakis); the Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ont. (Blumberger)
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Runyan A, Cassani A, Reyna L, Walsh EC, Hoks RM, Birn RM, Abercrombie HC, Philippi CL. Effects of Cortisol Administration on Resting-State Functional Connectivity in Women with Depression. Psychiatry Res Neuroimaging 2024; 337:111760. [PMID: 38039780 PMCID: PMC10843737 DOI: 10.1016/j.pscychresns.2023.111760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 11/01/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
Previous resting-state functional connectivity (rsFC) research has identified several brain networks impacted by depression and cortisol, including default mode (DMN), frontoparietal (FPN), and salience networks (SN). In the present study, we examined the effects of cortisol administration on rsFC of these networks in individuals varying in depression history and severity. We collected resting-state fMRI scans and self-reported depression symptom severity for 74 women with and without a history of depression after cortisol and placebo administration using a double-blind, crossover design. We conducted seed-based rsFC analyses for DMN, FPN, and SN seeds to examine rsFC changes after cortisol vs. placebo administration in relation to depression history group and severity. Results revealed a main effect of depression group, with lower left amygdala (SN)-middle temporal gyrus connectivity in women with a history of depression. Cortisol administration increased insula (SN)-inferior frontal gyrus and superior temporal gyrus connectivity. We also found that greater depression severity was associated with increased PCC (DMN)-cerebellum connectivity after cortisol. These results did not survive Bonferroni correction for seed ROIs and should be interpreted with caution. Our findings indicate that acute cortisol elevation may normalize aberrant connectivity of DMN and SN regions, which could help inform clinical treatments for depression.
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Affiliation(s)
- Adam Runyan
- Department of Psychological Sciences, University of Central Missouri, 116 West S. St., Warrensburg, MO 64093, USA
| | - Alexis Cassani
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, MO 63121, USA
| | - Leah Reyna
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, MO 63121, USA
| | - Erin C Walsh
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, CB# 7167, Chapel Hill, NC 27599, USA
| | - Roxanne M Hoks
- Center for Healthy Minds, University of Wisconsin-Madison, 625W. Washington Ave., Madison, WI 53703, USA
| | - Rasmus M Birn
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd., Madison, Wisconsin, 53719, USA
| | - Heather C Abercrombie
- Center for Healthy Minds, University of Wisconsin-Madison, 625W. Washington Ave., Madison, WI 53703, USA
| | - Carissa L Philippi
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, MO 63121, USA.
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Philippi CL, Leutzinger K, Pessin S, Cassani A, Mikel O, Walsh EC, Hoks RM, Birn RM, Abercrombie HC. Neural signal variability relates to maladaptive rumination in depression. J Psychiatr Res 2022; 156:570-578. [PMID: 36368247 PMCID: PMC9817305 DOI: 10.1016/j.jpsychires.2022.10.070] [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: 08/24/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/05/2022]
Abstract
Rumination is a common feature of depression and predicts the onset and maintenance of depressive episodes. Maladaptive and adaptive subtypes of rumination contribute to distinct outcomes, with brooding worsening negative mood and reflection related to fewer depression symptoms in healthy populations. Neuroimaging studies have implicated several cortical midline and lateral prefrontal brain regions in rumination. Recent research indicates that blood oxygen level-dependent (BOLD) signal variability may be a novel predictor of cognitive flexibility. However, no prior studies have investigated whether brooding and reflection are associated with distinct patterns of BOLD signal variability in depression. We collected resting-state fMRI data for 79 women with different depression histories: no history, past history, and current depression. We examined differences in BOLD signal variability (BOLDSD) related to rumination subtypes for the following regions of interest previously implicated in rumination: amygdala, medial prefrontal, anterior cingulate, posterior cingulate, and dorsolateral prefrontal cortices (dlPFC). Rumination subtype was associated with BOLDSD in the dlPFC, with greater levels of brooding associated with lower BOLDSD in the dlPFC, even after controlling for depression severity. Depression history was related to BOLDSD in the dlPFC, with reduced BOLDSD in those with current depression versus no history of depression. These findings provide a novel demonstration of the neural circuitry associated with maladaptive rumination in depression and implicate decreased prefrontal neural signal variability in the pathophysiology of depression.
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Affiliation(s)
- Carissa L Philippi
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, 63121, USA.
| | - Katie Leutzinger
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, 63121, USA
| | - Sally Pessin
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, 63121, USA
| | - Alexis Cassani
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, 63121, USA
| | - Olivia Mikel
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, 63121, USA
| | - Erin C Walsh
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, CB# 7167, Chapel Hill, NC, 27599, USA
| | - Roxanne M Hoks
- Center for Healthy Minds, University of Wisconsin-Madison, 625 W. Washington Ave., Madison, WI, 53703, USA
| | - Rasmus M Birn
- Department of Psychiatry, University of Wisconsin-Madison, University of Wisconsin-Madison, 6001 Research Park Blvd., Madison, WI, 53719, USA
| | - Heather C Abercrombie
- Center for Healthy Minds, University of Wisconsin-Madison, 625 W. Washington Ave., Madison, WI, 53703, USA
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