Cognitive impairment and depression: Meta-analysis of structural magnetic resonance imaging studies

Aberrant white matter structural connectivity of nucleus accumbens in patients with major depressive disorder: A probabilistic fibre tracing study

BACKGROUND

Extensive neuroimaging studies have established that functional abnormalities and morphological alterations in the nucleus accumbens (NAc) are implicated in major depressive disorder (MDD), but changes in its white matter structural connectivity (SC) remain unclear. We aimed to elucidate the changes in the white matter fibre connectivity of the NAc in MDD patients.

METHODS

This study used probabilistic fibre tracking to analyze the diffusion tensor imaging (DTI) data of 125 MDD patients and 129 healthy controls (HCs), calculating the strength of SC (sSC) from bilateral NAc to the entire brain and its correlation with depressive symptoms.

RESULTS

Compared to HCs, MDD exhibited increased sSC between the left NAc (L.NAc) and regions involving the left middle frontal gyrus, bilateral cingulate gyrus (CG), bilateral hippocampus, left caudate, left medial superior occipital gyrus, right globus pallidus, right superior and middle temporal gyrus, right precuneus, right insula, and right posterior parietal thalamus. Enhanced sSC was also observed between the right NAc (R.NAc) and the left temporal lobe, left posterior superior temporal sulcus (pSTS), bilateral lateral occipital cortex, left hippocampus, right putamen and right ventral occipital cortex. The sSC of L.NAc-left CG and R.NAc-left pSTS was positively correlated with HAMD scores in MDD.

CONCLUSIONS

Abnormal white matter connectivity of the NAc primarily affects the cortico-limbic circuit, cortico-basal ganglia circuit, and the temporal-occipital cortical regions in patients with MDD, along with the asymmetrical features of the inter-hemispheric SC related to NAc. These alteration may underlie the dysfunction of reward processing and emotion regulation in MDD.

Cognitive and metabolic signatures of early and late-onset depression: A comparative study

BACKGROUND

Early-onset depression (EOD) and late-onset depression (LOD) are prevalent subtypes of major depressive disorder (MDD), but the clinical distinction between EOD and LOD remains blurred due to nonspecific symptoms and lack of biomarkers. This study aims to elucidate the characteristics in cognitive function and biochemical metabolism of EOD and LOD, and to identify biological factors influencing age of onset (AOO).

METHODS

Seventy patients with MDD (40 with EOD and 30 with LOD) and sixty-eight age-matched healthy controls (HC) were included in this study. Participants were evaluated for clinical features, cognitive function, and serum trace elements levels. Proton magnetic resonance spectroscopy (1H-MRS) was employed to quantify neurometabolites levels, including N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr).

RESULTS

Patients with LOD experienced more episodes and severe depressive symptoms than those with EOD (p = 0.025, p < 0.001). EOD patients performed significantly worse than LOD patients on social cognition (p = 0.005), while LOD patients performed worse than EOD patients on reasoning and problem solving (p = 0.005). Additionally, LOD patients displayed higher ceruloplasmin (Cp) levels compared to EOD patients (p = 0.004), but no difference was found in neurometabolic levels between EOD and LOD. Multiple linear regression indicated a positive correlation between serum Cp levels and AOO of depression (p < 0.001), while bilateral thalamic NAA/Cr showed a negative correlation with AOO (p = 0.012, p = 0.016).

CONCLUSIONS

Patients with EOD were characterized by social cognition impairments, while patients with LOD were marked by reasoning and problem-solving deficits. Serum Cp levels demonstrated an AOO-related effect and served as a positive predictor for the AOO of depression. Furthermore, a negative correlation has been established between bilateral thalamic NAA/Cr and the AOO of MDD.

LIMITATIONS

The limited sample size and the challenge in distinguishing whether observed results are attributed to age or AOO effects.

Research progress in predicting the conversion from mild cognitive impairment to Alzheimer's disease via multimodal MRI and artificial intelligence

Predicting the transition from mild cognitive impairment (MCI) to Alzheimer's disease (AD) has important clinical significance for dementia prevention and improving patient prognosis. Multimodal magnetic resonance imaging (MRI) techniques (including structural MRI, functional MRI, and cerebral perfusion MRI) can yield information on the morphology, structure, and function of the brain from multiple dimensions, providing a key basis for revealing the pathophysiological mechanisms during the conversion from MCI to AD. Artificial intelligence (AI) methods based on deep learning and machine learning, with their powerful data processing and pattern recognition capabilities, have shown great potential in mining the features of multimodal MRI data and constructing prediction models for MCI conversion. Therefore, this paper systematically reviews the research progress of multimodal MRI techniques in capturing brain changes related to MCI conversion, as well as the practical experience of AI algorithms in constructing efficient prediction models, analyses the current technical challenges faced by the research, and discusses future directions, with the goal of providing a scientific reference for the early and accurate prediction of MCI conversion and the formulation of intervention strategies.

Structural Brain Changes Associated With Risky Drinking in Late-Life Depression

Objectives

As alcohol use is common among older depressives, we assessed structural brain changes over 2 years and examined their association with changes in alcohol consumption.

Design

Longitudinal cohort study.

Setting

Academic health center.

Participants

Adults aged 60 and older who met DSM criteria for a major depressive episode.

Intervention

Participants were offered treatment with sertraline.

Measurements

Participants completed structured interviews for reported alcohol consumption, had a clinical interview with a study psychiatrist, completed a cognitive battery at baseline and every twelve months, and underwent a 3T structural MRI as baseline and at 2-year follow-up. Volumetric brain changes were calculated.

Results

Among 58 participants, 45 were classified as moderate drinkers (≤7 drinks/week) and 13 as risky drinkers (>7 drinks/week). Compared with moderate drinkers, risky drinkers at baseline had significantly thinner cortical thickness and smaller volume in several frontal cortical regions, posterior cingulate, postcentral cortices, right insula, right putamen, and right inferior parietal sulcus. Annualized change in cortical thickness and volume correlated negatively with changes in the average number of drinks per week. Decreased depression severity, increased cognitive function score, and decreased alcohol consumption over the 2-year follow-up were each associated with annualized volumetric changes in specific common regions.

Conclusion

These MRI findings demonstrate the adverse impact of alcohol use in older adults on the fronto-striatal circuit. They highlight the need for careful screening and treatment referral for risky alcohol use among older adults with depression.

Network analysis of Internet addiction and depression among Chinese adolescents

BACKGROUND

Internet addiction (IA) and depression are common mental health concerns, with burgeoning empirical evidence highlighting their significant comorbid relationship among adolescents. We aimed to establish network structures for IA and depression among Chinese adolescents, and to identify the core and bridge symptoms.

METHODS

A total of 8176 participants were recruited from Henan Province, Central China. The 10-item Center for Epidemiological Studies Depression Scale (CESD) and 20-item Self-report Internet Addiction Test (IAT) was used to measure depression and IA, respectively. IA, depression and the co-occurrence network structures were constructed using network analysis. Strength, the centrality index, was used to identify the core symptoms. Bridge symptoms were assessed using the bridge strength.

RESULTS

Node CESD7 ("Could not get things going") was the most influential node in the depression network model, followed by CESD1 ("Felt sadness") and CESD2 ("Everything was an effort"). Node IAT16 ("Reluctant to be offline") was the most influential node in the IA network model, followed by IAT20 ("Web made you feel better"), IAT15 ("Fantasized about being on the web") and IAT2 ("Neglected household chores"). CESD7 ("Could not get things going") in the depression-IA network was the most key bridge symptom linking depression and IA, followed by CESD8 ("Trouble focus"). Significant gender difference in edge weights was observed (p = 0.002).

LIMITATIONS

This cross-sectional study collected data through self-report measures.

CONCLUSIONS

The core symptoms and key bridge symptoms in the networks are crucial for the precise intervention of adolescent depression and IA.

Risk factors and mediation role of sleep quality for depression in cognitively frail older adults: a cross-sectional study

Objective

Aimed to investigate the risk factors associated with depression in community-dwelling older adults with cognitive frailty and to examine the mediating role of sleep quality in the relationship between activities of daily living (ADL) and depression.

Methods

A cross-sectional study was conducted using convenience sampling, enrolling older adults with cognitive frailty from six communities in Beijing from July 2023 to December 2023. Cognitive frailty was assessed using the Montreal Cognitive Assessment (MoCA) alongside with the Fried Frailty Phenotype, while depressive symptoms were measured with the Geriatric Depression Scale (GDS-15). Multivariate logistic regression analysis was used to identify risk factors influencing depression, and mediation analysis was employed to explore the mediating effect of sleep quality on the relationship between ADL and depression.

Results

Among the 529 elderly participants with cognitive frailty, 128 (24.2%) were found to exhibit depressive symptoms. Multivariate logistic regression identified ADL [Mild Dependence: OR = 176.729 (95% CI 32.427-963.172), p < 0.001; Moderate Dependence: OR = 51.769 (95% CI 12.541-213.697), p < 0.001], loneliness [OR = 13.821 (95% CI 6.095-31.338), p < 0.001], and sleep quality [Suspected Insomnia: OR = 7.310 (95% CI 2.316-23.074), p = 0.001] were significantly associated with depression. Sleep quality was found to mediate the relationship between ADL and depression, accounting for 2.82% of the total effect.

Conclusion

Dependence in ADL, loneliness, and poor sleep quality are potential risk factors of depression for cognitive frailty in aging adults. Moreover, sleep quality was found to mediate the relationship between ADL dependence and depressive symptoms.

Analysis of the Prevalence of Mild Cognitive Impairment and its Influencing Factors in the Elderly Population in Huzhou City

BACKGROUND

Mild cognitive impairment (MCI) is a critical stage in the development of Alzheimer's disease, and early intervention in patients during this stage may reverse or delay their disease progression. As one of the regions with severe aging in China, it is necessary to understand the prevalence of MCI in Huzhou and adopt effective intervention measures. The study was aimed to investigate the prevalence rate and influencing factors of MCI in the elderly population in Huzhou city.

METHODS

A cross-sectional study was conducted involving 800 elderly residents of Huzhou city. The Montreal Cognitive Assessment (MoCA) and the activity of daily living (ADL) were used to assess the occurrence of MCI in the elderly. The influencing factors of MCI were investigated by univariate analysis and multi-factor analysis.

RESULTS

A total of 800 questionnaires were sent out in this survey, and 778 were effectively collected, with an effective recovery rate of 97.25%. Among 778 elderly people in Huzhou city, 668 had normal cognitive function, 82 had MCI, and 28 had dementia, the prevalence rate of MCI was 10.54% (82/778). According to the presence or absence of MCI, the patients were divided into an MCI group (n = 82) and a non-MCI group (n = 668). Female (p = 0.026), high age (p = 0.009), low Community Screening Instrument for Dementia (CSI-D) score (p = 0.007), high Dementia Screening Questionnaire (AD8) score (p < 0.001), high Patient Health Questionnaire Depression Scale (PHQ-9) score (p = 0.037) were all risk factors for MCI in the urban elderly population of Huzhou City.

CONCLUSION

The prevalence of MCI in the elderly population in Huzhou City is high, and its occurrence is closely related to many factors. It is necessary to increase attention to the high-risk population of MCI and implement targeted intervention measures to improve their cognitive function and improve the quality of life of the elderly population.

Long-term consequences of COVID-19 on sleep, mental health, fatigue, and cognition: a preliminary study

INTRODUCTION

Post-COVID-19 Syndrome (PCS) is defined as symptoms persisting beyond 12 weeks from the onset of symptoms. Notably, COVID-19 has been associated with long-term effects on the brain and mental health. This cross-sectional study aims to investigate depression, fatigue, sleep quality, and cognitive dysfunction, particularly working memory, in individuals with PCS compared to a healthy control group.

MATERIAL AND METHODS

Between April and December 2021, 45 COVID-19 individuals and 60 healthy individuals met the eligibility criteria. Demographic information and the Montreal Cognitive Assessment were collected. Two visual working memory tasks, Delayed Match-to-Sample (DMS) and n-back, were performed, along with self-report questionnaires: Beck Depression Inventory, Modified Fatigue Impact Scale, and Pittsburgh Sleep Quality Index.

RESULTS

A total of 105 participants were enrolled. Findings reveal that the PCS group exhibited notably higher levels of cognitive impairment (13.3% vs. 1.6%, p = 0.04), depression (53.9% vs. 25.9%, p = 0.03), and sleep disturbances (53.9% vs. 18.6%, p = 0.01) compared to the healthy control group. Sleep latency and sleep duration were particularly affected. No significant differences in working memory function were observed between the two groups (p = 0.90 for DMS and p = 0.98 for n-back).

CONCLUSION

The study highlights the higher prevalence of sleep disturbance, depression, and cognitive impairment in the PCS phase, with inflammation likely playing a significant role. Moreover, the study suggests that untreated depression and sleep disturbances may pose long-term risks for dementia. Understanding the underlying mechanisms is crucial for developing effective interventions and support for individuals recovering from the infection. Prospective longitudinal studies with larger and more diverse samples are warranted to confirm and expand upon these findings.

Correlation Between COVID-19 Recovery, Executive Function Decline, and Emotional State

Objective

The aim of this study was to determine whether there is a relationship between the time since recovery from coronavirus disease 2019 (COVID-19) and alterations in executive functions. We also evaluate the emotional state of post-COVID-19 patients.

Patients and Methods

We assessed patients between 18 and 50 years old, who had a history of COVID-19 with mild, moderate, or severe illness. We used the Batería Neuropsicológica de Funciones Ejecutivas y Lóbulos Frontales-3 (BANFE-3), Mini-Mental State Examination (MMSE), and Mini-International Neuropsychiatric Interview (MINI), in addition to a semi-structured interview. Spearman's correlation coefficient was used, with a p value <0.05 indicating significance.

Results

We evaluated 67 patients with a mean age of 34.6±9.6 years, most of whom had ≥13 years of schooling (n=55, 82.1%). Among them, 52 (77.6%) reported persistent symptoms after resolution of the condition, with fatigue being the most frequent (n=20, 29.9%). Most participants had an adequate score on the MMSE (n=60, 89.6%). However, 19 (28.4%) showed alterations in the BANFE-3 total score, with mental flexibility as the most affected function (n=25, 37.3%). In participants from the first COVID-19 wave, a negative correlation was observed between the standardized orbitofrontal area scores and the time since recovery from the infection (r=-0.841, p=0.016), suggesting a pattern of deterioration over time, mainly in stimulus inhibition (r=0.880, p=0.021). Regarding emotional state, 45 subjects (67.2%) exhibited emotional alterations, with anxiety symptoms being the most frequent (n=33, 49.3%). Furthermore, individuals with depressive symptoms (n=32, 47.8%) were more likely to experience executive function impairment after COVID-19 (ExpB 0.302, 95% CI 0.098-0.933, p=0.038).

Conclusion

COVID-19 could lead to alterations in executive functions, probably resulting from progressive damage to orbitofrontal area functions, mainly in stimulus inhibition. However, the generalizability of these findings is limited, highlighting the need for further research with robust methodology. Furthermore, depression appears to be an indicator of cognitive impairment in individuals recovering from COVID-19. Therefore, cognitive rehabilitation and psychological support are essential for patients affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection.

Pathogenesis of HIV-associated depression: contributing factors and underlying mechanisms

Cumulative evidence indicates that compared to HIV negative individuals, people living with HIV (PLWH) have a higher likelihood of developing depression, anxiety, and cognitive disorders. Depression, which is known to be a persistent and overwhelming feeling of sadness accompanied by a loss of interest in usual activities, is one of the most common mental illnesses encountered during HIV infection. Experts believe that several factors such as neuroinflammation, life stressors, lack of sleep, poor nutritional state, opportunistic infections and comorbidities, and HIV medications are contributing factors favoring the development of depression in PLWH. However, the fundamental mechanisms which underlie the involvement of these factors in the emergence of depression in the context of HIV remain poorly explored. Past researches describing the role of one or two of the preceding factors do exist; however, very few articles tackle this important topic while considering the several different putative causative factors comprehensively in the particular context of HIV infection. Herein, we elaborate on the factors currently understood to be responsible for the development of depression, and discuss the particular fundamental mechanisms whereby each factor may result in the outcome of depression. We believe that the understanding of these factors and of their underlying mechanisms is essential for the development of future therapeutic interventions to alleviate the burden of depression commonly seen in PLWH, and therefore facilitate the development of strategies to improve their overall quality of life.

Altered resting-state functional connectivity in individuals at risk for Alzheimer's disease: a longitudinal study

Background

Resting-state functional connectivity magnetic resonance imaging (rs-fMRI) is a sensitive tool for detecting early brain changes associated with Alzheimer's disease, even in its preclinical stages. Amnestic mild cognitive impairment (aMCI) and late-life depression (LLD) are two prevalent conditions in older adults that significantly elevate the risk of cognitive decline and dementia. This study aimed to elucidate the underlying neurobiological substrates by longitudinally identifying and comparing distinct connectivity patterns in aMCI subjects and LLD patients, and by examining the associations between these patterns and clinical measures of cognitive and mood impairments.

Methods

The study included three groups: 26 healthy controls (HCs), 15 individuals with aMCI, and 21 patients with LLD. All participants underwent rs-fMRI and neuropsychological assessments at baseline and at a 2-year follow-up. Functional connectivity was analyzed using a group Independent Component Analysis (ICA) model to investigate both group differences and longitudinal changes over time.

Results

At baseline, individuals with aMCI exhibited reduced functional connectivity in the precuneus, whereas LLD patients showed decreased connectivity in frontal, insular, and postcentral regions alongside increased connectivity in posterior parietal and cuneal cortices. Correlation analyses revealed that lower baseline insular connectivity predicted higher depressive symptoms at follow-up in aMCI subjects. In LLD, reduced baseline precuneus connectivity was associated with better two-year outcomes in global cognition and long-term memory.

Conclusions

This study provides evidence of distinct alterations in resting-state functional connectivity in individuals with aMCI and LLD, underscoring region-specific vulnerabilities that may contribute to cognitive decline and depressive symptomatology in older adults.

Risk Factors, Pathological Changes, and Potential Treatment of Diabetes-Associated Cognitive Dysfunction

BACKGROUND

Diabetes is a prevalent public health issue worldwide, and the cognitive dysfunction and subsequent dementia caused by it seriously affect the quality of life of patients.

METHODS

Recent studies were reviewed to provide a comprehensive summary of the risk factors, pathogenesis, pathological changes and potential drug treatments for diabetes-related cognitive dysfunction (DACD).

RESULTS

Several risk factors contribute to DACD, including hyperglycemia, hypoglycemia, blood sugar fluctuations, hyperinsulinemia, aging, and others. Among them, modifiable risk factors for DACD include blood glucose control, physical activity, diet, smoking, and hypertension management, while non-modifiable risk factors include age, genetic predisposition, sex, and duration of diabetes. At the present, the pathogenesis of DACD mainly includes insulin resistance, neuroinflammation, vascular disorders, oxidative stress, and neurotransmitter disorders.

CONCLUSIONS

In this review, we provide a comprehensive summary of the risk factors, pathogenesis, pathological changes and potential drug treatments for DACD, providing information from multiple perspectives for its prevention and management.

The association between indoor air pollution from solid fuels and cognitive impairment: a systematic review and meta-analysis

This study aimed to comprehensively and methodically evaluate the correlation between cognitive impairment and indoor air pollution from solid fuel used for cooking/heating. PubMed, Web of Science, EMBASE, and Cochrane Library databases were searched up to December January 2023. 13 studies from three countries with a total of 277,001 participants were enrolled. A negative correlation was discovered between solid fuel usage for cooking and total cognitive score (β=-0.73, 95 % CI: -0.90 to -0.55) and episodic memory score (β=-0.23, 95 % CI: -0.30 to -0.17). Household solid fuel usage for cooking was considerably associated with a raised risk of cognitive impairment (HR=1.31, 95 % CI: 1.09-1.57) and cognitive decline (HR=1.24, 95 % CI: 1.18-1.30). Compared to continuous solid fuel use for cooking, sustained use of clean fuel and switching from solid fuel to clean fuel were associated with a lower risk of cognitive decline (OR=0.55, 95 % CI: 0.42-0.73; OR=0.81, 95 % CI: 0.71-0.93). A negative association was found between solid fuel usage for heating and total cognitive score (β=-0.43, 95 % CI: -0.59 to -0.26) and episodic memory score (β=-0.22, 95 % CI: -0.34 to -0.10). Our research provided evidence that exposure to indoor air pollution from solid fuel is a potential cause of cognitive impairment and cognitive decline. Making the switch from solid fuels to cleaner fuels could be an important step in preventing cognitive impairment in the elderly.

Peripheral transcutaneous electrical stimulation to improve cognition: a review of the main effects in healthy humans and in mildly cognitively impaired patient populations

Peripheral nerve stimulation (PNS) is an ancient technique, up to now mainly used for pain management. The least invasive approach for PNS is transcutaneous electrical stimulation (TENS), which is performed by delivering mild electric currents through the skin and, depending on the stimulation pattern, activates the somatosensory Aβ-, Aδ- and C-fibers. In addition to its use for pain relief, accumulating data indicates that TENS can have broad-spectrum cognitive effects through the activation of neuromodulatory brain pathways. This review aims to summarize the current evidence on the cognitive effects of TENS, from healthy participants and mildly cognitively affected patients. Most studies on this topic have investigated the effects of TENS on memory, while fewer studies have explored attention, executive functions, and verbal fluency. Overall, promising evidence suggests that TENS may exert positive effects on specific cognitive functions. Further research is needed to build consensus on the most effective stimulation protocols, for both neurorehabilitation and enhancement, and to better understand the neurobiological mechanisms underlying the cognitive effects of TENS.

Anxiety, depression and acromegaly: a systematic review

PURPOSE

scientific literature highlights risk factors linked to the onset of psychopathology in different medical pathological contexts. Acromegaly is a rare condition, particularly noteworthy due to the associated clinical psychological features. This research aimed at understanding the main psychopathological outcomes related to acromegaly, with particular emphasis to anxiety and depression.

METHODS

In January 2024, in line with PRISMA guidelines, a systematic search based on PubMed, Scopus, Web of Science and PsycInfo was conducted to detect studies considering anxiety, depression and alexithymia in patients suffering from acromegaly. The Keywords used for the search phase were "Acromegaly" AND "Depression" OR "Anxiety" OR "Alexithymia".

RESULTS

Fifty-five studies were eligible. Anxiety and depression were significantly present in patients with acromegaly, with prevalence rates variable based on disease status and psycho-diagnostic instruments. None of the included studies reported alexithymia in patients with acromegaly. No significant difference was found regarding anxiety and depressive symptoms in patients with acromegaly in comparison with patients suffering from different pituitary diseases and chronic conditions. Anxiety and depression were associated with lower perceived HR-QoL, presence of comorbidity, joint issues, delayed diagnosis, disease duration and body image concerns.

CONCLUSIONS

Anxiety and depression may be encountered in patients with acromegaly, impacting HR-QoL and the course of the disease. This systematic review suggests that a deeper evaluation of clinical psychological features in patients suffering from acromegaly is needed. Particularly, the early detection of clinical psychological symptoms may lead to multi-integrate interventions promoting individuals' well-being and a better HR-QoL.

Depressive and Negative Symptoms in the Early and Established Stages of Schizophrenia: Integrating Structural Brain Alterations, Cognitive Performance, and Plasma Interleukin 6 Levels

Background

Depressive and negative symptoms are related to poor functional outcomes in schizophrenia. Cognitive deficits, reduced brain cortical thickness and volumes, and inflammation may contribute to depressive and negative symptoms, but pharmacological treatment and disease progression may confound the associations.

Methods

We evaluated whether higher plasma interleukin 6 (IL-6) levels would be associated with more severe negative or depressive symptoms in schizophrenia and explored illness stage utilizing early (BeneMin [Benefit of Minocycline on Negative Symptoms of Psychosis: Extent and Mechanism], n = 201, 72.8% male) and established (iRELATE [Immune Response & Social Cognition in Schizophrenia], n = 94, 67.3% male) schizophrenia cohorts. Using structural equation modeling in a subsample (iRELATE: n = 42, 69.0% male; BeneMin: n = 102, 76.5% male) with data on structural brain metrics (cortical thickness and volume), general cognitive performance, and plasma IL-6 levels, we assessed the interrelationships between these variables on depressive and negative symptom severity in early and established schizophrenia samples combined and in early schizophrenia only. All analyses were adjusted for sex, age, and chlorpromazine equivalent dose.

Results

Higher plasma IL-6 levels were related to more severe depressive symptoms in early schizophrenia (p < .05) and negative symptoms in established schizophrenia (p < .05). Structural equation modeling findings in early and established schizophrenia samples combined and early schizophrenia only showed that the interrelationship between higher plasma IL-6 levels, structural brain metrics, and general cognitive performance did not predict the severity of depressive and negative symptoms (p > .05). Higher plasma IL-6 levels and lower general cognitive performance were associated with reduced brain metrics (p < .05).

Conclusions

Our results indicate that higher plasma IL-6 levels may be differently associated with the severity of depressive and negative symptoms dependent on the illness stage. Future work identifying elevated levels of inflammation in larger samples may allow stratification and personalized intervention by subgroups who are at risk of poor outcomes.

Cerebellum abnormalities in vascular mild cognitive impairment with depression symptom patients: A multimodal magnetic resonance imaging study

BACKGROUND

Subcortical vascular mild cognitive impairment (svMCI) frequently occurs alongside depression symptoms, significantly affecting patients' quality of life. While cognitive decline and depression symptoms are linked to cerebellar changes, the specific relationship between these changes and cognitive status in svMCI patients with depression symptoms remains unclear.

OBJECTIVE

This study aimed to investigates the gray matter volume and functional alterations in the cerebellum of svMCI patients, with and without depression symptoms, and their correlation with cognitive and depressive symptoms.

METHODS

We enrolled 16 svMCI patients with depression symptoms (svMCI+D), 15 without (svMCI-D), and 12 normal controls (NC). Multimodal MRI scans were conducted, assessing gray matter volume and resting-state functional connectivity (RSFC) in the cerebellum. Correlations between RSFC and clinical scores from the Montreal Cognitive Assessment (MoCA) and Hamilton Depression Scale (HAMD) were analyzed.

RESULTS

Structural analysis indicated gray matter atrophy in left cerebellar lobules I_IV and VI (Cere6.L) in svMCI patients. svMCI+D patients showed reduced RSFC between Cere6.L and left cerebellar region IX and the left superior frontal gyrus (SFGdor.L). Both svMCI+D and svMCI-D groups showed increased RSFC between Cere6.L and the right caudate nucleus. RSFC between Cere6.L and SFGdor.L correlated negatively with HAMD scores in svMCI+D and positively with MoCA scores in svMCI-D. RSFC between Cere6.L and the right caudate nucleus also correlated positively with MoCA in the svMCI-D.

CONCLUSION

Cerebellar abnormalities, including the gray matter atrophy and RSFC changes, are associated with svMCI, particularly when depression symptoms are present. These results suggest potential diagnostic and therapeutic implications for svMCI and emphasize the need for further research on the cerebellum's role in cognitive and emotional disorders.

The relationship between sarcopenia and mental health status in Chinese older adults: the mediating role of activities of daily living

BACKGROUND

Most existing studies focus on either the relationship between sarcopenia and depressive symptoms or sarcopenia and cognitive functions. Few studies have examined depressive symptoms and cognitive functions simultaneously. This study aimed to analyze the relationship between sarcopenia and both depressive symptoms and cognitive functions in the elderly by introducing activities of daily living to explore the mediating role of activities of daily living between sarcopenia and mental health.

METHODS

This study used data from the 2015 and 2018 China Health and Retirement Longitudinal Study, including a total of 3,552 older adults aged 60 and above. We conducted descriptive statistical analysis and correlation analysis on the data and used seemingly unrelated regression to examine the relationship between sarcopenia, depressive symptoms, and cognitive functions in older adults. Bootstrap mediation analysis was used to further explore the mediating role of activities of daily living in the relationship between sarcopenia and depressive symptoms and cognitive functions in the elderly.

RESULTS

After adjusting for confounding factors, sarcopenia was positively correlated with depressive symptoms (β = 0.663, p < 0.001) and negatively correlated with cognitive functions (β=-0.748, p < 0.001), indicating a negative impact of sarcopenia on mental health. Activities of daily living mediated the relationship between sarcopenia and mental health, with a stronger mediating effect between sarcopenia and depressive symptoms (18.77%, β = 0.125, 95%CI (0.035, 0.222)) than between sarcopenia and cognitive functions (12.82%, β=-0.099, 95%CI (-0.162, -0.035)).

CONCLUSIONS

Activities of daily living partially mediated the relationship between sarcopenia and mental health status in Chinese older adults. Interventions targeting sarcopenia and activities of daily living may be an effective way to prevent and improve the mental health status of older adults.

Altered brain functional network connectivity and topology in type 2 diabetes mellitus

Introduction

Type 2 diabetes mellitus (T2DM) accelerates brain aging and disrupts brain functional network connectivity, though the specific mechanisms remain unclear. This study aimed to investigate T2DM-driven alterations in brain functional network connectivity and topology.

Methods

Eighty-five T2DM patients and 67 healthy controls (HCs) were included. All participants underwent clinical, neuropsychological, and laboratory tests, followed by MRI examinations, including resting-state functional magnetic resonance imaging (rs-fMRI) and three-dimensional high-resolution T1-weighted imaging (3D-T1WI) on a 3.0 T MRI scanner. Post-image preprocessing, brain functional networks were constructed using the Dosenbach atlas and analyzed with the DPABI-NET toolkit through graph theory.

Results

In T2DM patients, functional connectivity within and between the default mode network (DMN), frontal parietal network (FPN), subcortical network (SCN), ventral attention network (VAN), somatosensory network (SMN), and visual network (VN) was significantly reduced compared to HCs. Conversely, two functional connections within the VN and between the DMN and SMN were significantly increased. Global network topology analysis showed an increased shortest path length and decreased clustering coefficient, global efficiency, and local efficiency in the T2DM group. MoCA scores were negatively correlated with the shortest path length and positively correlated with global and local efficiency in the T2DM group. Node network topology analysis indicated reduced clustering coefficient, degree centrality, eigenvector centrality, and nodal efficiency in multiple nodes in the T2DM group. MoCA scores positively correlated with clustering coefficient and nodal efficiency in the bilateral precentral gyrus in the T2DM group.

Discussion

This study demonstrated significant abnormalities in connectivity and topology of large-scale brain functional networks in T2DM patients. These findings suggest that brain functional network connectivity and topology could serve as imaging biomarkers, providing insights into the underlying neuropathological processes associated with T2DM-related cognitive impairment.

Transposable Elements are Dysregulated in Brains of Individuals with Major Depressive Disorder

Transposable elements (TEs) are repetitive DNA sequences capable of being transcribed and reintegrated, or transposed, into distinct loci throughout the genome. While thought to be largely transcriptionally silenced in brain, TE transcription is increasingly recognized as dynamic and involved in human health and disease states, including in disorders of the brain. In this study, we annotated TE transcripts in publicly available RNA sequencing (RNAseq) of postmortem human brain tissue to investigate the expression profile of TE transcripts in individuals with Major Depressive Disorder (MDD) compared to healthy controls. Our findings reveal a robust and uniform downregulation of TE transcript expression in the brains of subjects with MDD relative to controls, this occurs most prominently in the orbitofrontal cortex (OFC) brain region, and MDD differentially impacts this TE expression by age and sex. This work points to the aberrant transcription of cortical TEs as a potentially overlooked molecular signature of MDD.

The Mediating Role of Avoidant Personality Disorder Features in the Relationship Between Stressful Life Events and Depression Among First-Year University Students

Purpose

Stressful life events are risk factors of depression. To explore whether the avoidant personality disorder (AVPD) features play a mediating role between stressful life events (SLEs) and depression among Chinese first-year university students.

Methods

The cross-sectional study was conducted from April to October 2018. The participants were the freshmen selected from Jining Medical University and Weifang Medical University (n=7390) in Shandong Province in China. Depression was assessed by the Beck Depression Inventory-II, AVPD were measured by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5). The data were processed and analyzed by SPSS24.0 software, Pearson correlation analysis and PROCESS3.3 program intermediary analysis. The method of Bootstrap was adopted to determine whether the AVPD features act as mediating factors in the association between the NLEs and depression.

Results

A total of 34.68% of the participants reported one to three AVPD features, and 18.15% reported four to seven AVPD features. AVPD features (r=0.384, P<0.05) and the SLEs (r=0.309, P<0.05) were positively related to the risk of depression, respectively. AVPD features play a partial mediating effect on the relationship between SLEs and depression (the effect value is 0.133, P < 0.01; 32.28% of the total effect).

Limitation

There might be recall bias in this cross-sectional study.

Conclusion

AVPD features are prevalent among Chinese university students. AVPD features displayed the mediation effect on depression related to stressful life events. Psychological interventions for depression in college students should focus not only on stress but on individual personality traits and cognitive mode. Care-givers, teachers, and health professionals should pay more attention to the early identification of the AVPD features among university students.

Amygdala Nuclei Atrophy in Cognitive Impairment and Dementia: Insights from High-Resolution Magnetic Resonance Imaging

Background and Objectives: Cognitive impairment affects memory, reasoning, and problem-solving, with early detection being critical for effective management. The amygdala, a key structure in emotional processing and memory, may play a pivotal role in detecting cognitive decline. This study examines differences in amygdala nuclei volumes in patients with varying levels of cognitive performance to evaluate its potential as a biomarker. Material and methods: This cross-sectional study of 35 participants was conducted and classified into three groups: the normal (≥26), moderate (15-25), and low (≤14) cognitive performance groups based on the Montreal Cognitive Assessment (MoCA) scores. High-resolution magnetic resonance imaging at 3.0 T scanner was used to assess amygdala nuclei volumes. Results: Significant amygdala atrophy was observed in multiple amygdala nuclei across cognitive performance groups, with more pronounced changes in the low-performance group. The right hemisphere nuclei, including the lateral and basal nuclei, showed more significant differences, indicating their sensitivity to cognitive decline. Conclusions: This study highlights the potential of amygdala nuclei atrophy as a biomarker for cognitive impairment. Additional research with larger sample sizes and longitudinal designs is needed to confirm these findings and determine their diagnostic value.

Disrupted Cross-Scale Network Associated With Cognitive-Emotional Disorders in Sudden Sensorineural Hearing Loss

BACKGROUND

Sudden sensorineural hearing loss (SSNHL) is associated with abnormal changes in the brain's central nervous system. Previous studies on the brain networks of SSNHL have primarily focused on functional connectivity within the brain. However, in addition to functional connectivity, structural connectivity also plays a crucial role in brain networks. Moreover, traditional functional connectivity analyses often overlook the spatial and temporal characteristics of connectivity changes and fail to provide directional information and causal relationships.

AIMS

This study utilized Structural Covariance Network (SCN), multilayer network analysis, and Dynamic Causal Modeling (DCM) to investigate the cross-scale changes in neural network structure and function in SSNHL patients with accompanying cognitive and emotional disorders.

MATERIALS & METHODS

We collected 3D-T1 structural magnetic resonance image data and functional magnetic resonance image data from 70 SSNHL patients and 81 healthy controls (HCs). SCN analysis was performed based on gray matter volume, and multilayer network analysis was used to calculate node switching rates. Based on the results of multilayer network analysis, six nodes exhibiting significant inter-group differences in node switching rates were selected as regions of interest (ROIs). DCM was then conducted to explore the causal relationships of functional connectivity between these nodes.

RESULTS

Based on SCN, there were no significant inter-group differences in global network properties between SSNHL and HCs. At the node level, the left precentral gyrus in SSNHL showed a significant decrease in node efficiency. In the multilayer network analysis, SSNHL showed a significantly increased node switching rate at the level of the Left Superior Frontal Gyrus (L.SFG), Left Supplementary Motor Area (L.SMA), Left Superior Parietal Gyrus (L.SPG), Right Superior Parietal Gyrus (R.SPG), Right Inferior Parietal Lobe(R.IPL), and Left Thalamus (L.THA). Furthermore, the node switching rate of L.SFG showed a significant negative correlation with the Self-Rating Anxiety Scale (SAS) scores. DCM analysis of these six nodes revealed differences in the functional effective connectivity between the left superior parietal gyrus (L.SPG) and the left supplementary motor area (L.SMA), which were positively correlated with the AVLT-delay scores.

DISCUSSION

These findings suggest that SSNHL patients experience structural and functional remodeling of the cerebral cortex, with hearing loss leading to the reallocation of cognitive resources.

CONCLUSION

This provides new insights into understanding the potential mechanisms between cross-scale networks and cognitive-emotional disorders in SSNHL.

Hippocampal volume maximally modulates the relationship between subsyndromal symptomatic depression and cognitive impairment in non-demented older adults

BACKGROUND

Subsyndromal symptomatic depression (SSD) is associated with an elevated risk of cognitive impairment in non-demented older adults. Given that hippocampal and middle temporal gyrus atrophy have been shown to cause SSD, our study aimed to investigate the effect of hippocampal volume on the association between SSD and cognitive impairment.

METHODS

338 non-demented older adults from the ADNI (Alzheimer's Disease Neuroimaging Initiative) cohort who underwent cognitive assessments, questionnaires on depressive symptoms and MRI brain were studied. SSD group is defined as a score of 1-5 based on Geriatric Depression Scale scores. We conducted causal mediation analyses to investigate the effect of hippocampal volume on cognitive performance cross-sectionally.

RESULTS

The SSD group displayed lower left and right hippocampal volume (p<0.01) than the non-SSD group. SSD was linked to poorer cognition and smaller hippocampal volume. We found that hippocampal volume partially mediated the effect of SSD on cognitive performance including the global cognition and the cognitive section of Alzheimer's Disease Assessment Scale, with mediation percentages ranging from 6.45 % to 30.46 %. In addition, we found that the thickness of the left middle temporal, right entorhinal and right fusiform gyrus, brain regions linked to AD, mediate the relationship between SSD and cognition with mediation percentages ranging from 8.67 % to 21.44 %.

LIMITATIONS

Our article didn't differentiate between mild cognitive impairment and normal population.

CONCLUSION

The associations of SSD and cognitive impairment are linked to alterations in Alzheimer's Disease related brain regions.

Neutrophil activation and related disrupted frontolimbic circuit may contribute to cognitive progression of minimal depressive symptoms in non-dementia elderly

BACKGROUND

As a more common but easily neglected disorder, minimal depressive symptoms (MDS), it is unclear whether and why it increases the risk of cognitive progression in non-dementia elderly.

METHODS

The Alzheimer's disease Neuroimaging Initiative (ADNI) database was used to assign 1065 non-dementia elderly into normal control (n = 380) and MDS (n = 685) groups via the Geriatric Depression Scale (GDS). Blood neutrophils, transcriptomics and metabolomics, cerebrospinal fluid (CSF) proteomics, and magnetic resonance imaging (MRI) data were analyzed.

RESULTS

MDS was found to increase the risk of cognitive progression independently of multiple psychological symptoms. Increased levels of blood neutrophils were associated with cognitive progression in MDS, as supported by neutrophil-related pathways by transcriptomic enrichment analysis and multi-omics joint analysis. A disrupted frontolimbic circuit was associated with neutrophil activation in MDS.

LIMITATIONS

The heterogeneity of the sample limited the generalizability of results, and the lack of follow-up data limited the research on the mechanism of neutrophil activation influencing cognitive function in MDS.

CONCLUSIONS

Cognitive progression occurs as early as the MDS stage. And this phenomenon may attribute to the neutrophil activation and the related disrupted frontolimbic circuit.

Different dorsolateral prefrontal activation during an emotionalautobiographical memory task between male and female depressed individuals: a fNIRS study

Depression in male and female are commonly associated with different prevalence, severity, and, in some cases, distinct syndromes or subtypes. However, only a small amount of research has been conducted to completely understand the underlying neuroanatomical mechanisms. The goal of the current study was to provide neural markers for specific depression therapies by demonstrating the differences in aberrant prefrontal activity between male and female depressed subjects during an emotional autobiographical memory test. The study included 127 young adults who were randomly assigned to one of two groups: male depression (62 participants) or female depression (65 participants). The average oxyhemoglobin levels in the dorsolateral prefrontal cortex throughout the emotional autobiographical memory task were assessed utilizing 53-channel functional near-infrared spectroscopy imaging equipment. The oxy-Hb activation in the left dorsolateral prefrontal cortex (lDLPFC) and right dorsolateral prefrontal cortex (rDLPFC) had no significant interaction between groups and emotional valences. A significant main effect was found between male and female, with female depression groups showing lower oxy-Hb activity in lDLPFC and rDLPFC than male depression groups. Male and female depression patients showed distinct brain activation in the DLPFC during an emotional autobiographical memory test, suggesting potential specific neurological indicators for varied somatic symptoms in male and female depression patients. These distinctions should be taken into account while creating preventive measures.

Association between loneliness and mild cognitive impairment in older adults: a meta-analysis of longitudinal studies

OBJECTIVES

Prior studies reporting the effects of loneliness on mild impairment cognitive (MCI) have generated inconsistent results. This meta-analysis aimed to investigate the longitudinal association between loneliness and risk of MCI among community-dwelling middle-aged and older adults.

METHOD

Five electronic databases were searched from inception to 9 May 2023. Eligible studies examined the longitudinal association between loneliness and cognitive outcomes, including incident MCI, cognitive impairment, and cognitive decline. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated using random-effects or fixed-effects meta-analysis. Sensitivity analysis and subgroup analysis were conducted. Publication bias was examined using Egger's and Begg tests.

RESULTS

Eight studies were included. Among the 45,032 participants, 10,570 were diagnosed with MCI/cognitive decline. Loneliness was positively associated with an increased risk of MCI (overall OR = 1.14; 95% CI = 1.05, 1.23), with moderate heterogeneity (I2 = 44.2%). Sensitivity analysis have minimal influence on the aforementioned pooled effect. Subgroup analyses indicated stronger associations in studies which employed incident MCI as cognitive outcome (OR = 2.55, 95%CI = 1.31, 1.83), were conducted in non-Asia countries (OR = 1.52, 95%CI = 0.95, 1.20), and reported no depression adjustment (OR = 1.51, 95%CI = 1.04, 1.25). The association between loneliness and MCI was stronger among males compare to females. The Egger test and Begg test showed no evidence of significant publication bias (p = .493; p = .474).

CONCLUSION

The findings indicated that loneliness was associated with an increased risk of MCI. Future longitudinal studies should evaluate potential cases of MCI through comprehensive clinical assessments by practitioners to draw robust findings on the association of loneliness with MCI.

Neuroanatomical substrates of depression in dementia with Lewy bodies and Alzheimer's disease

Dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) are often associated with depressive symptoms from the prodromal stage. The aim of the present study was to investigate the neuroanatomical correlates of depression in prodromal to mild DLB patients compared with AD patients. Eighty-three DLB patients, 37 AD patients, and 18 healthy volunteers were enrolled in this study. Depression was evaluated with the Mini International Neuropsychiatric Interview (MINI), French version 5.0.0. T1-weighted three-dimensional anatomical images were acquired for all participants. Regression and comparison analyses were conducted using a whole-brain voxel-based morphometry (VBM) approach on the grey matter volume (GMV). DLB patients presented a significantly higher mean MINI score than AD patients (p = 0.004), 30.1% of DLB patients had clinical depression, and 56.6% had a history of depression, while 0% of AD patients had clinical depression and 29.7% had a history of depression. VBM regression analyses revealed negative correlations between the MINI score and the GMV of right prefrontal regions in DLB patients (p < 0.001, uncorrected). Comparison analyses between DLB patients taking and those not taking an antidepressant mainly highlighted a decreased GMV in the bilateral middle/inferior temporal gyrus (p < 0.001, uncorrected) in treated DLB patients. In line with the literature, our behavioral analyses revealed higher depression scores in DLB patients than in AD patients. We also showed that depressive symptoms in DLB are associated with decreased GMV in right prefrontal regions. Treated DLB patients with long-standing depression would be more likely to experience GMV loss in the bilateral middle/inferior temporal cortex. These findings should be taken into account when managing DLB patients.

A comparative meta-analysis of structural magnetic resonance imaging studies and gene expression profiles revealing the similarities and differences between late life depression and mild cognitive impairment

BACKGROUND

Late-life depression (LLD) predisposes individuals to cognitive decline, often leading to misdiagnoses as mild cognitive impairment (MCI). Voxel-based morphometry (VBM) can distinguish the profiles of these disorders according to gray matter (GM) volumes. We integrated findings from previous VBM studies for comparative analysis and extended the research into molecular profiles to facilitate inspection and intervention.

METHODS

We comprehensively searched PubMed and Web of Science for VBM studies that compared LLD and MCI cases with matched healthy controls (HCs) from inception to 31st December 2023. We included 13 studies on LLD (414 LLDs, 350 HCs) and 50 on MCI (1878 MCIs, 2046 HCs). Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) was used for voxel-based meta-analysis to assess GM atrophy, spatially correlated with neuropsychological profiles. We then used multimodal and linear-model analysis to assess the similarities and differences in GM volumetric changing patterns. Partial least squares (PLS) regression and gene enrichment were employed for transcription-neuroimaging associations.

RESULTS

GM volumes in the left hippocampus and right parahippocampal gyrus are more affected in MCI, along with memory impairment. MCI was spatially correlated with a more extensive reduction in the levels of neurotransmitters and a severe downregulation of genes related to cellular potassium ion transport and metal ion transmembrane transporter activity.

CONCLUSION

Compared to LLD, MCI exhibited more GM atrophy in the hippocampus and parahippocampal gyrus and lower gene expression of ion transmembrane transport. Our findings provided imaging-transcriptomic-genetic integrative profiles for differential diagnosis and precise intervention between LLD and MCI.

Characterizing Cerebral Perfusion Changes in Subjective Cognitive Decline Using Single Photon Emission Computed Tomography: A Case-Control Study

Background/Objectives: Subjective cognitive decline (SCD) may serve as an early indicator of Alzheimer's disease (AD). This study investigates regional cerebral blood flow (rCBF) alterations in individuals with SCD using single photon emission computed tomography (SPECT). To characterize rCBF patterns in SCD patients compared to healthy controls and examine the relationship between rCBF and cognitive function. Methods: We compared rCBF in 20 SCD patients and 20 age- and sex-matched healthy controls using 99mTc-ECD SPECT imaging. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Geriatric Depression Scale (GDS), and Cognitive Abilities Screening Instrument (CASI). Results: SCD patients demonstrated significantly reduced rCBF in the right superior temporal gyrus (rSTG) (mean uptake ratio [UR] = 0.864 ± 0.090 vs. 1.030 ± 0.074, p < 0.001) and right caudate (mean UR = 0.783 ± 0.068 vs. 0.947 ± 0.062, p < 0.001) compared to controls. Additionally, negative correlations were observed between rCBF in these regions and CDR scores, particularly in the memory domain (rSTG: r = -0.37, p = 0.016; right caudate: r = -0.39, p = 0.011). Conclusions: Reduced rCBF in the rSTG and right caudate may represent early biomarkers for SCD, which could aid in the early detection of AD. These findings suggest that SPECT imaging might be a valuable tool for identifying individuals at risk of cognitive decline, potentially allowing for earlier intervention and targeted preventive strategies in the management of AD.

Depressive symptoms and cognitive decline in older adults

OBJECTIVES

Few studies have examined the impact of late-life depression trajectories on specific domains of cognitive function. This study aims to delineate how different depressive symptom trajectories specifically affect cognitive function in older adults.

DESIGN

Prospective longitudinal cohort study.

SETTING

Australia and the United States of America.

PARTICIPANTS

In total, 11,035 community-dwelling older adults with a mean age of 75 years.

MEASUREMENTS

Depressive trajectories were modelled from depressive symptoms according to annual Centre for Epidemiological Studies Depression Scale 10 (CES-D-10) surveys. Four trajectories of depressive symptoms were identified: low ("nondepressed"), consistently mild ("subthreshold depression"), consistently moderate ("persistent depression"), and initially low but increasing ("emerging depression"). Global cognition (Modified Mini-Mental State Examination [3MS]), verbal fluency (Controlled Oral Word Association Test [COWAT]), processing speed (Symbol Digit Modalities Test [SDMT]), episodic memory (Hopkins Verbal Learning Test - Revised [HVLT-R]), and a composite z-score were assessed over a subsequent median 2 years.

RESULTS

Subthreshold depression predicted impaired performance on the SDMT (Cohen's d -0.04) and composite score (-0.03); emerging depression predicted impaired performance on the SDMT (-0.13), HVLT-R (-0.09), 3 MS (-0.08) and composite score (-0.09); and persistent depression predicted impaired performance on the SDMT (-0.08), 3 MS (-0.11), and composite score (-0.09).

CONCLUSIONS

Depressive symptoms are associated with later impaired processing speed. These effects are small. Diverse depression trajectories have different impacts on cognitive function.

Neurophysiological activity following gains and losses among young adults with non-suicidal self-injury: An ERP study

OBJECTIVE

Non-suicidal self-injury (NSSI) is an increasingly concerning issue that is linked to a range of mental health problems. However, little is known about the potential neurophysiological mechanisms underlying risk decision-making in Major depressive disorder (MDD) patients with NSSI-the present study aimed to fill this important literature gap.

METHODS

A total of 81 MDD patients (with NSSI: n = 40, without NSSI: n = 41) and 44 matched healthy controls (HC) underwent a modified version of the Iowa Gambling Task (IGT) while an electroencephalogram was recorded. Feedback-related negativity (FRN) and P300 were examined during the feedback stage of the risky decision-making process.

RESULTS

Behavioural findings revealed that individuals diagnosed with MDD displayed a greater tendency to make risky decisions compared to the control group. Furthermore, MDD patients with NSSI demonstrated a significantly more negative ΔFN (i.e., the difference in neural response to losses compared to gains) than those without NSSI. Further, NSSI patients showed a larger difference ΔFN (loss minus gain), which was associated with enhanced impulsivity.

CONCLUSIONS

Collectively, the findings suggest that there is an altered processing of risky decision-making in the electrophysiology of patients with MDD who engage in NSSI. The ΔFN may serve as a psychophysiological marker indicating risk for NSSI.

Cognitive Functions in Adolescent Girls with Anorexia Nervosa during Nutritional Rehabilitation

BACKGROUND

The present study aimed to evaluate cognitive function and laboratory parameters in adolescent girls with anorexia nervosa (AN) before and after nutritional rehabilitation (NR) compared to healthy female peers (CG).

METHODS

We evaluated 36 girls with AN at two-time points, during acute malnutrition (AN1) and after NR, in a partially normalized weight status (AN2). We compared their cognitive functions and laboratory parameters to 48 healthy CG subjects. Cognitive function was assessed using a Cognitive Assessment Battery (CAB) assessment, depressive symptom levels were assessed using a Beck Depression Inventory (BDI) assessment, and eating disorders were assessed using an Eating Attitude Test (EAT-26).

RESULTS

The AN1 group scored better in total cognition, attention, estimation, and spatial perception than the CG group (p < 0.05), with scores increasing in the AN2 group. Shifting and visual perception values did not differ between the study groups (p = 0.677, p = 0.506, respectively). Laboratory tests showed no significant abnormalities and did not differ significantly between groups (p > 0.05). There was a negative correlation for EAT-26 and CAB in the AN1 group (rho = -0.43, p = 0.01), but not for BDI.

CONCLUSIONS

Cognitive function in adolescent girls with AN was better than CG and correlated with EAT-26 score. These results highlight the high compensatory capacity of the adolescent body to maintain cognitive function despite severe malnutrition. Our results suggest that although normalization of body weight is crucial, other factors can significantly influence improvements in cognitive function. Cognitive deficits and laboratory tests may not be biomarkers of early forms of AN.

Influence of intergenerational social mobility on brain structure and global cognition: findings from the Whitehall II study across 20 years

BACKGROUND

Whether changes in socioeconomic position (SEP) across generations, i.e. intergenerational social mobility, influence brain degeneration and cognition in later life is unclear.

OBJECTIVE

To examine the association of social mobility, brain grey matter structure and global cognition.

METHODS

We analysed T1 brain MRI data of 771 old adults (69.8 ± 5.2 years) from the Whitehall II MRI substudy, with MRI data collected between 2012 and 2016. Social mobility was defined by SEP changes from their fathers' generation to mid-life status. Brain structural outcomes include grey matter (GM) volume and cortical thickness (CT) covering whole brain. Global cognition was measured by the Mini Mental State Examination. We firstly conducted analysis of covariance to identify regional difference of GM volume and cortical thickness across stable high/low and upward/downward mobility groups, followed with diagonal reference models studying the relationship between mobility and brain cognitive outcomes, apart from SEP origin and destination. We additionally conducted linear mixed models to check mobility interaction over time, where global cognition was derived from three phases across 2002 to 2017.

RESULTS

Social mobility related to 48 out of the 136 GM volume regions and 4 out of the 68 CT regions. Declined volume was particularly seen in response to downward mobility, whereas no independent association of mobility with global cognition was observed.

CONCLUSION

Despite no strong evidence supporting direct influence of mobility on global cognition in later life, imaging findings warranted a severe level of neurodegeneration due to downward mobility from their father's generation.

A non-linear relationship between blood pressure and mild cognitive impairment in elderly individuals: A cohort study based on the Chinese longitudinal healthy longevity survey (CLHLS)

BACKGROUND

Hypertension is an established risk factor for mild cognitive impairment (MCI) in elderly individuals. Nevertheless, the impact of different levels of blood pressure on the progression of MCI remains uncertain. This study aims to investigate the non-linear relationship between blood pressure and MCI in the elderly and detect the critical blood pressure threshold, thus, improving blood pressure management for individuals at high risk of MCI.

METHODS

Data was obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) cohort. We chose normal cognitive elderly individuals who entered the cohort in 2014 for a 5-year follow-up to observe the progression of MCI. Subsequently, we utilized the Cox regression model to identify risk factors for MCI and conducted a Cox-based restricted cubic spline regression (RCS) model to examine the non-linear relationship between systolic blood pressure (SBP) and diastolic blood pressure (DBP) with MCI, determining the critical blood pressure threshold for MCI progression.

RESULTS

In the elderly population, female (HR = 1.489, 95% CI: 1.017-2.180), lacking of exercise in the past (HR = 1.714, 95% CI: 1.108-2.653), preferring animal fats (HR = 2.340, 95% CI: 1.348-4.061), increased age (HR = 1.061, 95% CI: 1.038-1.084), increased SBP (HR = 1.036, 95% CI: 1.024-1.048), and increased DBP (HR = 1.056, 95% CI: 1.031-1.081) were associated with MCI progression. After adjusting factors such as gender, exercise, preferred types of fats, and age, both SBP (P non-linear < 0.001) and DBP (P non-linear < 0.001) in elderly individuals exhibited a non-linear association with MCI. The risk of MCI rose when SBP exceeded 135 mmHg and DBP was in the range of 80-88 mmHg. However, when DBP exceeded 88 mmHg, there was a declining trend in MCI progression, although the HR remained above 1. The identified critical blood pressure management threshold for MCI was 135/80 mmHg.

CONCLUSION

In this study, we discovered that risk factors affecting the progression of MCI in elderly individuals comprise gender (female), preferring to use animal fat, lack of exercise in the past, increased age, increased SBP, and increased DBP. Additionally, a non-linear relationship between blood pressure levels and MCI progression was confirmed, with the critical blood pressure management threshold for MCI onset falling within the prehypertensive range.

Subregions of the fusiform gyrus are differentially involved in the attentional mechanism supporting visual mental imagery in depression

BACKGROUND

Impaired visual mental imagery is an important symptom of depression and has gradually become an intervention target for cognitive behavioral therapy.

METHODS

Our study involved a total of 25 healthy controls (HC) and 23 individuals with moderate depressive symptoms (MD). This study explored the attentional mechanism supporting visual mental imagery impairments in depression using the Vividness of Visual Imagery Questionnaire (VVIQ), attentional network test (ANT), and resting-state functional magnetic resonance imaging (rs-fMRI). The intrinsic activity of attention-related regions relative to those supporting visual mental imagery was identified in depression patients. In addition, a meta-analysis was used to describe the cognitive function related to this intrinsic activity.

RESULTS

The global correlation (GCOR) of the right anterior fusiform gyrus (FG) was decreased in depression patients. Attention-related areas were concentrated in the right posterior FG; the anterior and posterior functional connectivity (FC) of the FG was decreased in depression patients. Graph theoretic analysis showed that the degree of the right anterior FG was decreased, the degree of the anterior insula was increased, and the negative connection between these two regions was strengthened in depression patients. In addition, the degree of the right anterior FG, the FC between the subregions of the right FG, and the FC between the right anterior FG and insula were correlated with VVIQ scores; however, this correlation was not significant in depression patients. The meta-analysis suggested that the changes in the anterior FG in depressed patients may stem from difficulties of semantic memory retrieval.

CONCLUSION

The changed intrinsic activity of subregions of the FG relative to the semantic memory retrieval may be associated with visual mental imagery impairments in depression.

Similarities and differences between post-traumatic stress disorder and major depressive disorder: Evidence from task-evoked functional magnetic resonance imaging meta-analysis

BACKGROUND

Post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) are psychiatric disorders that can present with overlapping symptoms and shared risk factors. However, the extent to which these disorders share common underlying neuropathological mechanisms remains unclear. To investigate the similarities and differences in task-evoked brain activation patterns between patients with PTSD and MDD.

METHODS

A coordinate-based meta-analysis was conducted across 35 PTSD studies (564 patients and 543 healthy controls) and 125 MDD studies (4049 patients and 4170 healthy controls) using anisotropic effect-size signed differential mapping software.

RESULTS

Both PTSD and MDD patients exhibited increased neural activation in the bilateral inferior frontal gyrus. However, PTSD patients showed increased neural activation in the right insula, left supplementary motor area extending to median cingulate gyrus and superior frontal gyrus (SFG), and left fusiform gyrus, and decreased neural activation in the right posterior cingulate gyrus, right middle temporal gyrus, right paracentral lobule, and right inferior parietal gyrus relative to MDD patients.

CONCLUSION

Our meta-analysis suggests that PTSD and MDD share some similar patterns of brain activation, but also have distinct neural signatures. These findings contribute to our understanding of the potential neuropathology underlying these disorders and may inform the development of more targeted and effective treatment and intervention strategies. Moreover, these results may provide useful neuroimaging targets for the differential diagnosis of MDD and PTSD.

From Perspective of Hippocampal Plasticity: Function of Antidepressant Chinese Medicine Xiaoyaosan

The hippocampus is one of the most commonly studied brain regions in the context of depression. The volume of the hippocampus is significantly reduced in patients with depression, which severely disrupts hippocampal neuroplasticity. However, antidepressant therapies that target hippocampal neuroplasticity have not been identified as yet. Chinese medicine (CM) can slow the progression of depression, potentially by modulating hippocampal neuroplasticity. Xiaoyaosan (XYS) is a CM formula that has been clinically used for the treatment of depression. It is known to protect Gan (Liver) and Pi (Spleen) function, and may exert its antidepressant effects by regulating hippocampal neuroplasticity. In this review, we have summarized the association between depression and aberrant hippocampal neuroplasticity. Furthermore, we have discussed the researches published in the last 30 years on the effects of XYS on hippocampal neuroplasticity in order to elucidate the possible mechanisms underlying its therapeutic action against depression. The results of this review can aid future research on XYS for the treatment of depression.

Comparison of Brain Function and Structure in Patients with Major Depression: A Systematic Review and Meta-Analysis of MRI-Based Data

BACKGROUND

Depression is a common mental illness worldwide. Neuroimaging techniques, such as magnetic resonance imaging and functional magnetic resonance imaging, play an essential role in diagnosing and evaluating depression. This study is based on magnetic resonance imaging (MRI)-related research to explore the comparison of brain function and structure between patients with severe depression and normal individuals, and to conduct meta-analysis.

METHODS

We conducted searches in various databases such as PubMed, Web of Science, Embase, and Cochrane Library to obtain research data on comparing brain function and structure between patients with severe depression and healthy individuals. The search keywords included "Major Depressive Disorder", "Brain Function", "Brain Structure", "Depression", "MRI", and "Magnetic Resonance". The quality assessment was conducted using the bias risk assessment tool recommended by the Cochrane Collaborative Network. Literature was screened following the predetermined inclusion and exclusion criteria, and Anisotropic Effect-Size Seed-Based Differential Mapping (AES-SDM) was used for systematic meta-analysis. Regression analysis was performed on age, gender, disease duration, years of education, and treatment status.

RESULTS

After a thorough screening process, 10 documents were selected for subsequent analysis. These studies consisted of 477 study subjects, including 231 depression patients and 246 healthy individuals. The proportion of women was 36%-75%, and the disease duration was 3-60 months. The patients in 4 documents had first attacks, and the patients in the other 6 documents had multiple attacks. The baseline conditions of the 10 included documents were consistent and comparable. None of the studies reported blinding methods, and none of the results had incomplete data. The Regional homogeneity (ReHo) levels in the left precuneus (BA7), lentiform nucleus (BA48), and left prefrontal lobe (BA32) were significantly increased in the depression group, with voxel numbers of 358, 116, and 181, respectively. Conversely, the left postcentral gyrus (BA4), left cerebellar area (hemispheric lobule I, IV/V, lingual gyrus, fusiform gyrus), left fusiform gyrus (BA30), and right cingulate gyrus (BA23) were significantly reduced, with voxel numbers of 17, 50, and 124, respectively. Furthermore, regression analysis showed that gender, age, disease duration, years of education, and disease severity were potential influencing factors, and the disease duration demonstrated the most significant impact on the left cingulate gyrus (SDM = 2.777).

CONCLUSION

There are significant differences in brain function and structure between patients with major depression and healthy individuals. Furthermore, our findings reveal a substantial correlation between the severity of depressive symptoms and brain function and structure indicators. These findings provide novel research directions and ideas for the diagnosis and treatment of depression.

Altered activation of the dorsal anterior cingulate cortex during oddball performance in individuals at risk for Alzheimer's disease

INTRODUCTION

The neural mechanisms underlying neurodegenerative disorders in the elderly remain elusive, despite extensive neuroimaging research in recent decades. Amnestic type mild cognitive impairment (aMCI) and late-life major depressive disorder (MDD) are two such conditions characterized by intersecting cognitive and affective symptomatology, and they are at a higher risk for Alzheimer's disease.

MATERIALS AND METHODS

This study analyzed the neural underpinnings of cognitive and depressive symptoms in a cohort comprising 12 aMCI subjects, 24 late-life MDD patients, and 26 healthy controls (HCs). Participants underwent a detailed neuropsychological assessment and completed a visual attentional oddball task during functional magnetic resonance imaging (fMRI), with evaluations at baseline and at 2-year follow-up.

RESULTS

Initial findings showed that aMCI subjects had reduced dACC activation during oddball (target) stimulus detection, a pattern that persisted in longitudinal analyses and correlated with cognitive functioning measures. For HCs, subsequent dACC activation was linked to depression scores. Furthermore, in the affective-cognitive altered groups, later dACC activation correlated with oddball and memory performance.

CONCLUSIONS

These findings enhance our comprehension of the neurobiological basis of cognitive and depressive disturbances in aging, indicating that dACC activation in response to a visual attentional oddball task could serve as a neural marker for assessing cognitive impairment and depression in conditions predisposing to Alzheimer's disease.

In vivo structural connectivity of the reward system along the hippocampal long axis

Recent work has identified a critical role for the hippocampus in reward-sensitive behaviors, including motivated memory, reinforcement learning, and decision-making. Animal histology and human functional neuroimaging have shown that brain regions involved in reward processing and motivation are more interconnected with the ventral/anterior hippocampus. However, direct evidence examining gradients of structural connectivity between reward regions and the hippocampus in humans is lacking. The present study used diffusion MRI (dMRI) and probabilistic tractography to quantify the structural connectivity of the hippocampus with key reward processing regions in vivo. Using a large sample of subjects (N = 628) from the human connectome dMRI data release, we found that connectivity profiles with the hippocampus varied widely between different regions of the reward circuit. While the dopaminergic midbrain (ventral tegmental area) showed stronger connectivity with the anterior versus posterior hippocampus, the ventromedial prefrontal cortex showed stronger connectivity with the posterior hippocampus. The limbic (ventral) striatum demonstrated a more homogeneous connectivity profile along the hippocampal long axis. This is the first study to generate a probabilistic atlas of the hippocampal structural connectivity with reward-related networks, which is essential to investigating how these circuits contribute to normative adaptive behavior and maladaptive behaviors in psychiatric illness. These findings describe nuanced structural connectivity that sets the foundation to better understand how the hippocampus influences reward-guided behavior in humans.

Altered Brain Function in Pediatric Patients With Complete Spinal Cord Injury: A Resting-State Functional MRI Study

BACKGROUND

Injury to the spinal cord of children may cause potential brain reorganizations, affecting their rehabilitation. However, the specific functional alterations of children after complete spinal cord injury (CSCI) remain unclear.

PURPOSE

To explore the specific functional changes in local brain and the relationship with clinical characteristics in pediatric CSCI patients, clarifying the impact of CSCI on brain function in developing children.

STUDY TYPE

Prospective.

SUBJECTS

Thirty pediatric CSCI patients (7.83 ± 1.206 years) and 30 age-, gender-matched healthy children as controls (HCs) (8.77 ± 2.079 years).

FIELD STRENGTH/SEQUENCE

3.0 T/Resting-state functional MRI (rs-fMRI) using echo-planar-imaging (EPI) sequence.

ASSESSMENT

Amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) were used to characterize regional neural function.

STATISTICAL TESTS

Two-sample t-tests were used to compare the ALFF, fALFF, ReHo values of the brain between pediatric CSCI and HCs (voxel-level FWE correction, P < 0.05). Spearman correlation analyses were performed to analyze the associations between the ALFF, fALFF, ReHo values in altered regions and the injury duration, sensory motor scores of pediatric CSCI patients (P < 0.05). Then receiver operating characteristic (ROC) analysis was conducted to identify possible sensitive imaging indicators for clinical therapy.

RESULTS

Compared with HCs, pediatric CSCI showed significantly decreased ALFF in the right postcentral gyrus (S1), orbitofrontal cortex, and left superior temporal gyrus (STG), increased ALFF in bilateral caudate nucleus, thalamus, middle cingulate gyrus, and cerebellar lobules IV-VI, and increased ReHo in left cerebellum Crus II and Brodmann area 21. The ALFF value in the right S1 negatively correlated with the pinprick and light touch sensory scores of pediatric CSCI. When the left STG was used as an imaging biomarker for pediatric CSCI, it achieved the highest area under the curve of 0.989.

CONCLUSIONS

These findings may provide potential neural mechanisms for sensory motor and cognitive-emotional deficits in children after CSCI.

EVIDENCE LEVEL

2 TECHNICAL EFFICACY: Stage 5.

Functional teeth and cognitive function among the Chinese elderly: The chain mediating effect of depressive symptoms and social participation

The objective of this study was to investigate the chain mediating effects of depressive symptoms and social participation between functional teeth and cognitive function based on the biopsychosocial model. Data from the 2018 China Health and Retirement Longitudinal Study were analyzed. The findings revealed a favorable connection between the lack of edentulism and cognitive function, persisting even when accounting for the mediating factors of denture usage, depressive symptoms, and social participation. Furthermore, the study identified six indirect pathways in this relationship. The present study has substantiated the correlation between edentulism and cognitive function, thereby proposing that interventions aimed at denture usage, depressive symptoms, and social participation could potentially serve as preventive measures against cognitive decline in elderly individuals afflicted with edentulism. This underscores the significance of addressing these factors to alleviate cognitive decline.

Rethinking the role of trazodone in the different depressive dimensions

INTRODUCTION

The efficacy of trazodone for several psychopathologic dimensions of depression has been shown in the literature. Trazodone has been widely used in some clinical contexts (e.g. for insomnia and depression in the elderly). However, the role of trazodone in several aspects of depression is not well known.

AREA COVERED

Eight experts from academic and medical centers across Italy met to identify the difficulties and barriers faced in daily clinical practice in the assessment and management of major depressive disorder and how the use of trazodone could address some unmet needs. The objective of the expert meetings and the present document was to increase knowledge of particular areas of treatment with trazodone.

EXPERT OPINION

Evidence of the role of trazodone in patients affected by major depressive disorder with anxiety symptoms, insomnia, agitation, cognitive deficits, alcohol use disorders, physical comorbidities, and suicide risk has been identified, showing the effectiveness of trazodone in different presentations of major depressive disorder. The main characteristics of patients with depression for whom trazodone seems to be most effective have been identified, providing clinicians with information on possible uses of this drug in such population of patients.

Cognitive and Emotional Effect of a Multi-species Probiotic Containing Lactobacillus rhamnosus and Bifidobacterium lactis in Healthy Older Adults: A Double-Blind Randomized Placebo-Controlled Crossover Trial

As the population ages, cognitive decline becomes more common. Strategies targeting the gut-brain axis using probiotics are emerging to achieve improvements in neuropsychiatric and neurological disorders. However, the beneficial role of probiotics on brain function in healthy older adults remains unclear. Our aim was to evaluate a multi-species probiotic formulation as a therapeutic approach to reduce emotional and cognitive decline associated with aging in healthy adults. A randomized double-blind placebo-controlled crossover trial was conducted. The study involved a 10-week intervention where participants consumed the assigned probiotic product daily, followed by a 4-week washout period before the second condition started. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Psychological Experiments Construction Language Test Battery. At the emotional level, the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were used. Thirty-three participants, recruited between July 2020 and April 2022, ingested a multispecies probiotic (Lactobacillus rhamnosus and Bifidobacterium lactis). After the intervention, noticeable enhancements were observed in cognitive function (mean difference 1.90, 95% CI 1.09 to 2.70, p < 0.005), memory (mean difference 4.60, 95% CI 2.91 to 6.29, p < 0.005) by MMSE and digit task, and depressive symptoms (mean difference 4.09, 95% CI 1.70 to 6.48, p < 0.005) by BDI. Furthermore, there were significant improvements observed in planning and problem-solving skills, selective attention, cognitive flexibility, impulsivity, and inhibitory ability. Probiotics administration improved cognitive and emotional function in older adults. Limited research supports this, requiring more scientific evidence for probiotics as an effective therapy for cognitive decline. This study has been prospectively registered at ClinicalTrials.gov (NCT04828421; 2020/July/17).

MDDOmics: multi-omics resource of major depressive disorder

Major depressive disorder (MDD) is a pressing global health issue. Its pathogenesis remains elusive, but numerous studies have revealed its intricate associations with various biological factors. Consequently, there is an urgent need for a comprehensive multi-omics resource to help researchers in conducting multi-omics data analysis for MDD. To address this issue, we constructed the MDDOmics database (Major Depressive Disorder Omics, (https://www.csuligroup.com/MDDOmics/), which integrates an extensive collection of published multi-omics data related to MDD. The database contains 41 222 entries of MDD research results and several original datasets, including Single Nucleotide Polymorphisms, genes, non-coding RNAs, DNA methylations, metabolites and proteins, and offers various interfaces for searching and visualization. We also provide extensive downstream analyses of the collected MDD data, including differential analysis, enrichment analysis and disease-gene prediction. Moreover, the database also incorporates multi-omics data for bipolar disorder, schizophrenia and anxiety disorder, due to the challenge in differentiating MDD from similar psychiatric disorders. In conclusion, by leveraging the rich content and online interfaces from MDDOmics, researchers can conduct more comprehensive analyses of MDD and its similar disorders from various perspectives, thereby gaining a deeper understanding of potential MDD biomarkers and intricate disease pathogenesis. Database URL: https://www.csuligroup.com/MDDOmics/.

Altered functional brain activity in first-episode major depressive disorder treated with electro-acupuncture: A resting-state functional magnetic resonance imaging study

Background

Previous studies have found electroacupuncture could improve the clinical symptoms of first-episode major depressive disorder (MDD), but the exact neural mechanism of action needs to be further elucidated.

Methods

Twenty-eight first-episode MDD patients were randomly divided into 14 electro-acupuncture stimulation (EAS) groups and 14 sham-acupuncture stimulation (SAS) groups, and clinical symptoms were assessed and functional magnetic resonance imaging (fMRI) scans were done in both groups. Amplitude of low-frequency fluctuations (ALFF) was used to observe the changes between the pre-treatment and post-treatment in the two groups, and the altered brain areas were selected as region of interest (ROI) to observe the FC changes. Meanwhile, the correlation between the altered clinical symptoms and the altered ALFF and FC of brain regions in the two groups was analyzed.

Results

The EAS significantly decreased the HAMD-24 and HAMA-14 scores of MDD than SAS group. The imaging results revealed that both groups were able to increase the ALFF of the left middle temporal gyrus and the left cerebellar posterior lobe. When using the left middle temporal gyrus and the left posterior cerebellar lobe as ROIs, EAS group increased the FC between the left middle temporal gyrus with the left superior frontal gyrus, the left middle frontal gyrus, and the left hippocampus, and decreased the FC between the left posterior cerebellar lobe and the left calcarine gyrus, while SAS group only increased the FC between the left middle temporal gyrus with the left superior frontal gyrus. The alternations in clinical symptoms after EAS treatment were positively correlated with the altered ALFF values in the left middle temporal gyrus and the altered FC values in the left middle temporal gyrus and the left middle frontal gyrus.

Conclusion

EA demonstrates modulation of functional activity in the default mode network (DMN), sensorimotor network (SMN), cognitive control network (CCN), limbic system, and visual network (VN) for the treatment of the first-episode MDD. Our findings contribute to the neuroimaging evidence for the efficacy of EAS.

Comparison of brain gray matter volume changes in peritoneal dialysis and hemodialysis patients with chronic kidney disease: a VBM study

Objective

This study aims to compare gray matter volume changes in patients with chronic kidney disease (CKD) undergoing peritoneal dialysis (PD) and hemodialysis (HD) using voxel-based morphometry (VBM).

Methods

A total of 27 PD patients, 25 HD patients, and 42 healthy controls were included. VBM analysis was performed, and cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment Scale (MoCA). The correlation between cognitive function and changes in brain gray matter volume was analyzed.

Results

Both peritoneal dialysis and hemodialysis patients had partial gray matter volume reduction compared to the controls, but the affected brain regions were not uniform. The hemodialysis patients had greater volume reduction in certain brain regions than the PD patients. The MMSE and MoCA scores were positively correlated with gray matter volume changes.

Conclusion

Different dialysis modalities cause damage to specific areas of the brain, which can be detected using VBM. VBM, combined with cognitive function assessment, can help detect structural brain changes and cognitive impairment in patients with different dialysis modalities. The comprehensive application of VBM in the field of neurological function deserves further exploration.

Association of cognitive impairment with the interaction between chronic kidney disease and depression: findings from NHANES 2011-2014

BACKGROUND

Cognitive impairment (CoI), chronic kidney disease (CKD), and depression are prevalent among older adults and are interrelated, imposing a significant disease burden. This study evaluates the association of CKD and depression with CoI and explores their potential interactions.

METHOD

Data for this study were sourced from the 2011-2014 National Health and Nutritional Examination Survey (NHANES). Multiple binary logistic regression models assessed the relationship between CKD, depression, and CoI while controlling for confounders. The interactions were measured using the relative excess risk of interaction (RERI), the attributable proportion of interaction (AP), and the synergy index (S).

RESULTS

A total of 2,666 participants (weighted n = 49,251,515) were included in the study, of which 700 (16.00%) had CoI. After adjusting for confounding factors, the risk of CoI was higher in patients with CKD compared to non-CKD participants (odds ratio [OR] = 1.49, 95% confidence interval [CI]:1.12-1.99). The risk of CoI was significantly increased in patients with depression compared to those without (OR = 2.29, 95% CI: 1.73-3.03). Furthermore, there was a significant additive interaction between CKD and depression in terms of the increased risk of CoI (adjusted RERI = 2.01, [95% CI: 0.31-3.71], adjusted AP = 0.50 [95% CI: 0.25-0.75], adjusted S = 2.97 [95% CI: 1.27-6.92]).

CONCLUSION

CKD and depression synergistically affect CoI, particularly when moderate-to-severe depression co-occurs with CKD. Clinicians should be mindful of the combined impact on patients with CoI. Further research is needed to elucidate the underlying mechanisms and assess the effects specific to different CKD stages.

Omega-3 polyunsaturated fatty acids supplementation improves memory in first-diagnosed, drug-naïve patients with depression: Secondary analysis of data from a randomized controlled trial

INTRODUCTION

Cognitive impairments are found in most patients with major depressive disorder (MDD). It is believed that low Omega-3 polyunsaturated fatty acids (n-3 PUFAs) level raise the risk of anxiety, depressive symptoms and cognition dysfunction. Since our previous research has found n-3 PUFAs supplementation improves anxiety in MDD, this study was to further explore the effectiveness on cognitive impairment among depressed patients.

METHODS

A total of 72 venlafaxine treated outpatients with first-diagnosed, drug-naïve depression were enrolled. Daily n-3 PUFAs supplementation (2.4 g/d of fish oil, including 1440 mg eicosapentaenoic acid and 960 mg of docosahexaenoic acid) or placebo was used for 12 weeks. Cognitive function, measure by repeatable battery for the assessment of neuropsychological status ([RBANS]) scores, was compared over time.

RESULTS

Immediate memory, delayed memory and RBANS total scores were significant higher in both groups at week 4 and week 12 compared with baseline. Both groups exhibited improvement on attention scores at week 12. No significant differences were observed comparing n-3 PUFAs with placebo groups in the improvement of total RBANS scores and other subscales except in the change of immediate memory at both week 4 and week 12 (p < 0.05).

LIMITATIONS

Sample size was relatively low. Moreover, multiple ethnic populations and the income of patients should be considered. Lastly, we used raw scores instead of the standardized scores of RBANS.

CONCLUSION

N-3 PUFAs supplementation yielded a small but statistically significant improvement on immediate memory in first-diagnosed, drug-naïve depressed patients. While, antidepressant treatment resulted in significant improvement of cognitive function.