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Shin JE, Lee YS, Park SY, Jeong MY, Choi JK, Cha JH, Lee YJ. The Relationship between Depression Severity and Prefrontal Hemodynamic Changes in Adolescents with Major Depression Disorder: A Functional Near-infrared Spectroscopy Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2024; 22:118-128. [PMID: 38247418 PMCID: PMC10811388 DOI: 10.9758/cpn.23.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/17/2023] [Accepted: 06/17/2023] [Indexed: 01/23/2024]
Abstract
Objective : Numerous studies have identified hemodynamic changes in adults with major depressive disorder (MDD) by using functional near-infrared spectroscopy (fNIRS). However, studies on adolescents with MDD are limited. As adolescence is a stage of rapid brain development, differences may occur depending on age. This study used fNIRS as an objective tool to investigate hemodynamic changes in the frontal lobe according to depression severity and age in adolescents with MDD. Methods : Thirty adolescents (12 aged 12-15 years and 18 aged 16-18 years) were retrospectively investigated. The Children's Depression Inventory was used as a psychiatric evaluation scale, fNIRS was used as an objective brain function evaluation tool, and the Verbal Fluency Test was performed. Results : During the Verbal Fluency Test, in the younger MDD group, oxygenated-hemoglobin concentration increased in the right dorsolateral prefrontal cortex region as the severity of depression increased. In the older MDD group, the oxygenated-hemoglobin concentration decreased in the right dorsolateral prefrontal cortex region as the severity of depression increased. Conclusion : These results suggest that fNIRS may be an objective tool for identifying age differences among adolescents with MDD. To generalize the results and verify fNIRS as a potential biomarker tool, follow-up studies with a larger sample group should be conducted.
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Affiliation(s)
- Jeong Eun Shin
- Department of Medical Sciences, Graduate School of Soonchunhyang University, Asan, Korea
| | - Yun Sung Lee
- Sejong Special Self-Governing City Mental Health Welfare Center, Sejong, Korea
| | - Seo Young Park
- Sejong Special Self-Governing City Mental Health Welfare Center, Sejong, Korea
| | - Mi Young Jeong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | | | - Yeon Jung Lee
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Kawabata Y, Imazu SI, Matsumoto K, Toyoda K, Kawano M, Kubo Y, Kinoshita S, Nishizawa Y, Kanazawa T. rTMS Therapy Reduces Hypofrontality in Patients With Depression as Measured by fNIRS. Front Psychiatry 2022; 13:814611. [PMID: 35815029 PMCID: PMC9257165 DOI: 10.3389/fpsyt.2022.814611] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 05/26/2022] [Indexed: 11/15/2022] Open
Abstract
Multichannel functional near-infrared spectroscopy (fNIRS) is a tool used to capture changes in cerebral blood flow. A consistent result for depression is a decrease in blood flow in the frontal cortex leading to hypofrontality, which indicates multidomain functional impairment. Repetitive transcranial magnetic stimulation (rTMS) and elective convulsive therapy (ECT) are alternatives to antidepressant drugs for the treatment of depression but the underlying mechanism is yet to be elucidated. The aim of the current study was to evaluate cerebral blood flow using fNIRS following rTMS treatment in patients with depression. The cerebral blood flow of 15 patients with moderate depression after rTMS treatment was measured using fNIRS. While there was clear hypofrontality during pre-treatment (5 ± 2.5), a notable increase in oxygenated hemoglobin was observed after 30 sessions with rTMS (50 ± 15). This increased blood flow was observed in a wide range of channels in the frontal cortex; however, the centroid values were similar between the treatments. Increased blood flow leads to the activation of neuronal synapses, as noted with other neuromodulation treatments such as electroconvulsive therapy. This study describes the rTMS-induced modulation of blood oxygenation response over the prefrontal cortex in patients with depression, as captured by fNIRS. Future longitudinal studies are needed to assess cerebral blood flow dynamics during rTMS treatment for depression.
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Affiliation(s)
- Yasuo Kawabata
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Shin-Ichi Imazu
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Koichi Matsumoto
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Katsunori Toyoda
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Makoto Kawano
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yoichiro Kubo
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Shinya Kinoshita
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yoshitaka Nishizawa
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, Osaka, Japan.,Stanford University, Stanford, CA, United States
| | - Tetsufumi Kanazawa
- Department of Neuropsychiatry, Osaka Medical and Pharmaceutical University, Osaka, Japan.,The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
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Ji S, Liu B, Li Y, Chen N, Fu Y, Shi J, Zhao Z, Yao Z, Hu B. Trait and state alterations in excitatory connectivity between subgenual anterior cingulate cortex and cerebellum in patients with current and remitted depression. Psychiatry Res Neuroimaging 2021; 317:111356. [PMID: 34509806 DOI: 10.1016/j.pscychresns.2021.111356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 07/06/2021] [Accepted: 08/03/2021] [Indexed: 11/27/2022]
Abstract
Neuroimaging studies have indicated that the altered functional connectivity (FC) of the subgenual anterior cingulate cortex (sgACC) might be potential pathophysiology of major depressive disorder (MDD). However, directed connectivity is proven to be more closely to neurophysiological processes underlying brain activity than FC. This study aimed to identify the alterations underlying directed connectivity of the sgACC in patients with current and remitted MDD. We conducted a cross-sectional neuroimaging study by recruiting 36 patients with current MDD, 20 patients with remitted MDD, and 36 matched healthy controls. Multiple linear regression was employed to estimate bidirectional connectivity between bilateral sgACC and 115 brain regions over 230 time points. Besides, graph theory was applied to further investigate the information transfer across bilateral sgACC and abnormal brain regions. We found that both patients with current and remitted MDD showed a similar abnormality in bidirectional excitatory connectivity between the left sgACC and the right cerebellum. Patients with current MDD exhibited an increase in excitatory connectivity from the left cerebellum to the right sgACC, which was positively correlated with the HAMD score. Meanwhile, significantly decreased betweenness of the left sgACC was detected in all depressive patients. Our findings suggest that the changed bidirectional excitatory connectivity between the left sgACC and the right cerebellum might be a trait alteration and the abnormal increased excitatory connectivity from the left cerebellum to the right sgACC might be a state alteration of MDD. This work may provide a valuable contribution to identify trait and state alterations in the brain for depression.
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Affiliation(s)
- Shanling Ji
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Bangshan Liu
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, PR China
| | - Yongchao Li
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Nan Chen
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Yu Fu
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Jie Shi
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Ziyang Zhao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Zhijun Yao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China.
| | - Bin Hu
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, PR China.
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Lee YJ, Park SY, Sung LY, Kim JH, Choi J, Oh K, Hahn SW. Reduced left ventrolateral prefrontal cortex activation during verbal fluency tasks is associated with suicidal ideation severity in medication-naïve young adults with major depressive disorder: A functional near-infrared spectroscopy study. Psychiatry Res Neuroimaging 2021; 312:111288. [PMID: 33872934 DOI: 10.1016/j.pscychresns.2021.111288] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/16/2021] [Accepted: 04/08/2021] [Indexed: 12/01/2022]
Abstract
The reduction in the oxygenation dynamics in the prefrontal cortex (PFC) during cognitive tasks is a well-known occurrence in major depressive disorders (MDD). Studies focusing on oxygenation changes in the PFC in individuals with suicidal ideation are limited. Therefore, this study investigated and confirmed the presence of prefrontal dysfunction depending on the intensity of suicidal ideation among 77 young adults (45 patients with MDD and 32 healthy controls) using near-infrared spectroscopy (NIRS). All participants underwent assessment with the Beck Depression Inventory-II, Beck Anxiety Inventory, and Beck Scale for Suicidal ideation. NIRS revealed relative hypofunction in the left dorsolateral PFC, left ventrolateral PFC (LVLPFC), and both orbitofrontal cortices in young adults with MDD compared to that in the healthy controls during verbal fluency tasks. Furthermore, the oxyhaemoglobin changes in the LVLPFC mediated the indirect effect of depression severity on suicidal ideation intensity. Our results confirmed that functional NIRS is a useful auxiliary tool for objectively assessing the risk of suicidal ideation.
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Affiliation(s)
- Yeon Jung Lee
- Department of Psychiatry, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Republic of Korea.
| | - Seo Young Park
- Department of Medical Sciences, Graduate School of Soonchunhyang University, Asan, Republic of Korea
| | - Lee Yun Sung
- Department of Medical Sciences, Graduate School of Soonchunhyang University, Asan, Republic of Korea
| | - Jung Ho Kim
- Department of Nursing, Masan University, Masan, Gyeongnam, Republic of Korea
| | | | | | - Sang-Woo Hahn
- Department of Psychiatry, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Republic of Korea
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Lai CH. Fronto-limbic neuroimaging biomarkers for diagnosis and prediction of treatment responses in major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2021; 107:110234. [PMID: 33370569 DOI: 10.1016/j.pnpbp.2020.110234] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/02/2020] [Accepted: 12/21/2020] [Indexed: 12/23/2022]
Abstract
The neuroimaging is an important tool for understanding the biomarkers and predicting treatment responses in major depressive disorder (MDD). The potential biomarkers and prediction of treatment response in MDD will be addressed in the review article. The brain regions of cognitive control and emotion regulation, such as the frontal and limbic regions, might represent the potential targets for MDD biomarkers. The potential targets of frontal lobes might include anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC). For the limbic system, hippocampus and amygdala might be the potentially promising targets for MDD. The potential targets of fronto-limbic regions have been found in the studies of several major neuroimaging modalities, such as the magnetic resonance imaging, near-infrared spectroscopy, electroencephalography, positron emission tomography, and single-photon emission computed tomography. Additional regions, such as brainstem and midbrain, might also play a part in the MDD biomarkers. For the prediction of treatment response, the gray matter volumes, white matter tracts, functional representations and receptor bindings of ACC, DLPFC, OFC, amygdala, and hippocampus might play a role in the prediction of antidepressant responses in MDD. For the response prediction of psychotherapies, the fronto-limbic, reward regions, and insula will be the potential targets. For the repetitive transcranial magnetic stimulation, the DLPFC, ACC, limbic, and visuospatial regions might represent the predictive targets for treatment. The neuroimaging targets of MDD might be focused in the fronto-limbic regions. However, the neuroimaging targets for the prediction of treatment responses might be inconclusive and beyond the fronto-limbic regions.
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Affiliation(s)
- Chien-Han Lai
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan; PhD Psychiatry & Neuroscience Clinic, Taoyuan, Taiwan.
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Kang SG, Cho SE. Neuroimaging Biomarkers for Predicting Treatment Response and Recurrence of Major Depressive Disorder. Int J Mol Sci 2020; 21:ijms21062148. [PMID: 32245086 PMCID: PMC7139562 DOI: 10.3390/ijms21062148] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/12/2020] [Accepted: 03/19/2020] [Indexed: 12/26/2022] Open
Abstract
The acute treatment duration for major depressive disorder (MDD) is 8 weeks or more. Treatment of patients with MDD without predictors of treatment response and future recurrence presents challenges and clinical problems to patients and physicians. Recently, many neuroimaging studies have been published on biomarkers for treatment response and recurrence of MDD using various methods such as brain volumetric magnetic resonance imaging (MRI), functional MRI (resting-state and affective tasks), diffusion tensor imaging, magnetic resonance spectroscopy, near-infrared spectroscopy, and molecular imaging (i.e., positron emission tomography and single photon emission computed tomography). The results have been inconsistent, and we hypothesize that this could be due to small sample size; different study design, including eligibility criteria; and differences in the imaging and analysis techniques. In the future, we suggest a more sophisticated research design, larger sample size, and a more comprehensive integration including genetics to establish biomarkers for the prediction of treatment response and recurrence of MDD.
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Ho CSH, Lim LJH, Lim AQ, Chan NHC, Tan RS, Lee SH, Ho RCM. Diagnostic and Predictive Applications of Functional Near-Infrared Spectroscopy for Major Depressive Disorder: A Systematic Review. Front Psychiatry 2020; 11:378. [PMID: 32477179 PMCID: PMC7232562 DOI: 10.3389/fpsyt.2020.00378] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/15/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Major depressive disorder (MDD) is a global psychiatric disorder with no established biomarker. There is growing evidence that functional near-infrared spectroscopy (fNIRS) has the ability to aid in the diagnosis and prediction of the treatment response of MDD. The aim of this review was to systematically review, and gather the evidence from existing studies that used fNIRS signals in the diagnosis of MDD, correlations with depression symptomatology, and the monitoring of treatment response. METHODS PubMed, EMBASE, ScienceDirect, and Cochrane Library databases were searched for published English articles from 1980 to June 2019 that focused on the application of fNIRS for (i) differentiating depressed versus nondepressed individuals, (ii) correlating with depression symptomatology, and in turn (iii) monitoring treatment responses in depression. Studies were included if they utilized fNIRS to evaluate cerebral hemodynamic variations in patients with MDD of any age group. The quality of the evidence was assessed using the Newcastle-Ottawa quality assessment scale. RESULTS A total of 64 studies were included in this review, with 12 studies being longitudinal, while the rest were cross-sectional. More than two-thirds of the studies (n = 49) had acceptable quality. fNIRS consistently demonstrated attenuated cerebral hemodynamic changes in depressed compared to healthy individuals. fNIRS signals have also shown promise in correlating with individual symptoms of depression and monitoring various treatment responses. CONCLUSIONS This review provides comprehensive updated evidence of the diagnostic and predictive applications of fNIRS in patients with MDD. Future studies involving larger sample sizes, standardized methodology, examination of more brain regions in an integrative approach, and longitudinal follow-ups are needed.
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Affiliation(s)
- Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lucas J H Lim
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - A Q Lim
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - Nicole H C Chan
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - R S Tan
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - S H Lee
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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Ung WC, Yap KH, Ebenezer EGM, Chin PS, Nordin N, Chan SC, Yip HL, Lu CK, Kiguchi M, Tang TB. Assessing Neural Compensation With Visuospatial Working Memory Load Using Near-Infrared Imaging. IEEE Trans Neural Syst Rehabil Eng 2019; 28:13-22. [PMID: 31794398 DOI: 10.1109/tnsre.2019.2956459] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Alzheimer's disease is characterized by the progressive deterioration of cognitive abilities particularly working memory while mild cognitive impairment (MCI) represents its prodrome. It is generally believed that neural compensation is intact in MCI but absent in Alzheimer's disease. This study investigated the effects of increasing task load as a means to induce neural compensation through a novel visual working memory (VSWM) task using functional near-infrared spectroscopy (fNIRS). The bilateral prefrontal cortex (PFC) was explored due to its relevance in VSWM and neural compensation. A total of 31 healthy controls (HC), 12 patients with MCI and 18 patients with mild Alzheimer's disease (mAD) were recruited. Although all groups showed sensitivity in terms of behavioral performance (i.e. score) towards increasing task load (level 1 to 3), only in MCI load effect on cortical response (as measured by fNIRS) was significant. At lower task load, bilateral PFC activation did not differ between MCI and HC. Neural compensation in the form of hyperactivation was only noticeable in MCI with a moderate task load. Lack of hyperactivation in mAD, coupled with significantly poorer task performance across task loads, suggested the inability to compensate due to a greater degree of neurodegeneration. Our findings provided an insight into the interaction of cognitive load theory and neural compensatory mechanisms. The experiment results demonstrated the feasibility of inducing neural compensation with the proposed VSWM task at the right amount of cognitive load. This may provide a promising avenue to develop an effective cognitive training and rehabilitation for dementia population.
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Abstract
The neuroimaging has been applied in the study of pathophysiology in major depressive disorder (MDD). In this review article, several kinds of methodologies of neuroimaging would be discussed to summarize the promising biomarkers in MDD. For the magnetic resonance imaging (MRI) and magnetoencephalography field, the literature review showed the potentially promising roles of frontal lobes, such as anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC). In addition, the limbic regions, such as hippocampus and amygdala, might be the potentially promising biomarkers for MDD. The structures and functions of ACC, DLPFC, OFC, amygdala and hippocampus might be confirmed as the biomarkers for the prediction of antidepressant treatment responses and for the pathophysiology of MDD. The functions of cognitive control and emotion regulation of these regions might be crucial for the establishment of biomarkers. The near-infrared spectroscopy studies demonstrated that blood flow in the frontal lobe, such as the DLPFC and OFC, might be the biomarkers for the field of near-infrared spectroscopy. The electroencephalography also supported the promising role of frontal regions, such as the ACC, DLPFC and OFC in the biomarker exploration, especially for the sleep electroencephalogram to detect biomarkers in MDD. The positron emission tomography (PET) and single-photon emission computed tomography (SPECT) in MDD demonstrated the promising biomarkers for the frontal and limbic regions, such as ACC, DLPFC and amygdala. However, additional findings in brainstem and midbrain were also found in PET and SPECT. The promising neuroimaging biomarkers of MDD seemed focused in the fronto-limbic regions.
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Affiliation(s)
- Chien-Han Lai
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,Psychiatry & Neuroscience Clinic, Taoyuan, Taiwan.,Department of Psychiatry, Yeezen General Hospital, Taoyuan, Taiwan
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