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Couto TA, Gao F, Lak DC, Yuan Z. Combined EEG-tDCS approach in resting state to reduce comorbid anxiety and depressive symptoms in affective disorders: A sham-controlled pilot study. IBRO Neurosci Rep 2024; 16:571-581. [PMID: 38764542 PMCID: PMC11101867 DOI: 10.1016/j.ibneur.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/19/2024] [Accepted: 04/27/2024] [Indexed: 05/21/2024] Open
Abstract
Continuous challenges have been imposed on mental health science by Anxiety and Depression disorders as the most prevalent and debilitating psychiatric conditions worldwide. Pharmacologic and cognitive behavioral therapies, either alone or in combination, have been considered as the first-line therapies, however, resistant symptomatology is prevalent in comorbid conditions with symptoms remaining after interventions. The demand for new therapeutic solutions has given space to the development of non-invasive brain stimulation techniques (NIBS), and the transmagnetic direct current stimulation (tDCS) has been reported as a safe and well-tolerated technique for the treatment of several mental health conditions, including Anxiety and Depression disorders. Relying on quantitative electroencephalography(qEEG)- tDCS approach, the current study aims to inspect the effect of tDCS intervention on patients who suffer from anxiety-depression comorbidity, in particular, the impact of tDCS intervention on qEEG spectral power activity and resting-state connectivity organization during eyes closed and eyes open protocols. QEEG data were acquired from eight patients suffering from moderate to severe anxiety-depression comorbid symptoms along with poor coping skills to manage stress and negative affect. Twelve control subjects allocated in the control group exhibiting low to moderate symptoms in both anxiety and depression conditions went also through the qEEG data acquisition. In addition, a sham-controlled study was conducted, and the patient group went through resting-state qEEG-tDCS neuromodulation once a week for ten weeks. Various-stage qEEG recordings were performed to inspect the efficacy of tDCS treatment during the modulation of brain regions involved in the regulation of affective responses. Our results demonstrated that after tDCS neuromodulation, the patients' groups exhibited decreased absolute power abnormalities over the left anterior cingulate cortex and reduced abnormal activity in the alpha band over posterior regions; improved functional connectivity indexes; decreased anxiety and depressive scores while positive affect score was improved. Besides the promising improvements, our study did not find a significant tDCS effect on perceived stress and negative affect scores. Consistently, significant differences in absolute spectral power over the left anterior cingulate cortex were detected among the patient group, as compared to the controls, as expected. Therefore, our study offers preliminary data to understand the neuroplasticity changes that potentially result from the manipulation of cortical excitability during affective regulation protocols followed by the consequent decrease of comorbid anxiety and depressive symptomatology. The pilot study was followed by prospective registration with ChiCTR2200062142.
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Affiliation(s)
- Tania A. Couto
- Faculty of Health Sciences. Centre for Cognitive and Brain Sciences. University of Macau, Taipa 999078, Macau, Special Administrative region of China
- Brain, Language and Computation Laboratory. University Research Facility in Behavioural and Systems Neuroscience. The Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China
| | - Fei Gao
- Faculty of Health Sciences. Centre for Cognitive and Brain Sciences. University of Macau, Taipa 999078, Macau, Special Administrative region of China
- Fudan University, Shanghai, China
| | - Davis C. Lak
- Alpha Positive Limited, Central, 999077, Hong Kong Special Administrative Region of China
- Department of Psychology. The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Zhen Yuan
- Faculty of Health Sciences. Centre for Cognitive and Brain Sciences. University of Macau, Taipa 999078, Macau, Special Administrative region of China
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Dos Santos Alves Maria G, Dias NS, Nicolato R, de Paula JJ, Bicalho MAC, Cunha RS, Silva LC, de Miranda DM, de Mattos Viana B, Romano-Silva MA. Safety and efficacy of repetitive stimulation of the left dorsolateral prefrontal cortex using transcranial focused ultrasound in treatment-resistant depressed patients: A non-inferiority randomized controlled trial protocol. Asian J Psychiatr 2024; 95:103994. [PMID: 38547573 DOI: 10.1016/j.ajp.2024.103994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/21/2024] [Accepted: 03/03/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND About 30% of patients diagnosed with major depressive disorder fail with the mainstream pharmacological treatment. Patients who do not achieve clinical remission of symptoms, even with two different antidepressants, are classified with treatment-resistant depression (TDR). This condition imposes an additional burden with increased Disability Adjusted Life Years. Therefore, complementary treatments, such as neuromodulation, are necessary. The transcranial focused ultrasound (tFUS) has emerged in the past few years as a reliable method for non-invasive neuromodulation in humans and may help treat TRD. This study aims to propose a research protocol for a non-inferiority randomized clinical trial of TDR with tFUS. METHODS Patients with documented TRD will be screened upon entering the TRD outpatient clinic at UFMG (Brazil). One hundred patients without a clinical history of other psychiatric illness, anatomical abnormalities on magnetic resonance imaging (MRI), or treatment with electroconvulsive therapy will be invited to participate. Patients will be randomized (1:1) into two groups: 1) treatment with a previously established protocol of transcranial magnetic stimulation; and 2) treatment with a similar protocol using the stimulation. Besides regular consultations in the outpatient clinic, both groups will attend 7 protocolled spaced days of brain stimulation targeted at the left dorsolateral prefrontal cortex. They will also be submitted to 4 sessions of image studies (2 MRIs, 2 positron-emission tomography), 3 of neuropsychological assessments (at baseline, 1 week and 2 months after treatment), the Montgomery-Åsberg Depression Rating Scale to analyze the severity of depressive symptoms. DISCUSSION This clinical trial intends to verify the safety and clinical efficacy of tFUS stimulation of the dorsolateral prefrontal cortex of patients with TRD, compared with a previously established neuromodulation method.
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Affiliation(s)
- Gustavo Dos Santos Alves Maria
- Department of Psychiatry, School of Medicine, Federal University of Minas Gerais, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil; Center of Technology in Molecular Medicine, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil
| | - Natália Silva Dias
- University Hospital of the Federal University of Minas Gerais, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil
| | - Rodrigo Nicolato
- Department of Psychiatry, School of Medicine, Federal University of Minas Gerais, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil; Center of Technology in Molecular Medicine, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil; National Institutes of Science and Technology in Responsible Neurotechnology (INCT-NeuroTecR), Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil
| | - Jonas Jardim de Paula
- Department of Psychiatry, School of Medicine, Federal University of Minas Gerais, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil; Center of Technology in Molecular Medicine, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil; National Institutes of Science and Technology in Responsible Neurotechnology (INCT-NeuroTecR), Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil
| | - Maria Aparecida Camargos Bicalho
- Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil
| | - Renan Souza Cunha
- Center of Technology in Molecular Medicine, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil
| | - Luciana Costa Silva
- Instituto Hermes Pardini (Grupo Fleury), Street Aimorés, 66, Belo Horizonte, Minas Gerais 30.140-920, Brazil
| | - Débora Marques de Miranda
- Center of Technology in Molecular Medicine, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil; National Institutes of Science and Technology in Responsible Neurotechnology (INCT-NeuroTecR), Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil; Department of Pediatrics, School of Medicine, Federal University of Minas Gerais, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil
| | - Bernardo de Mattos Viana
- Department of Psychiatry, School of Medicine, Federal University of Minas Gerais, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil; Center of Technology in Molecular Medicine, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil; National Institutes of Science and Technology in Responsible Neurotechnology (INCT-NeuroTecR), Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil
| | - Marco Aurélio Romano-Silva
- Department of Psychiatry, School of Medicine, Federal University of Minas Gerais, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil; Center of Technology in Molecular Medicine, Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil; National Institutes of Science and Technology in Responsible Neurotechnology (INCT-NeuroTecR), Professor Alfredo Balena Avenue, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil.
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Colita D, Burdusel D, Glavan D, Hermann DM, Colită CI, Colita E, Udristoiu I, Popa-Wagner A. Molecular mechanisms underlying major depressive disorder and post-stroke affective disorders. J Affect Disord 2024; 344:149-158. [PMID: 37827260 DOI: 10.1016/j.jad.2023.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/24/2023] [Accepted: 10/08/2023] [Indexed: 10/14/2023]
Abstract
Two of the most common and incapacitating mental health disorders around the world are major depressive disorder (MDD) and post-stroke depression (PSD). MDD is thought to result from abnormal connectivity between the monoaminergic, glutamatergic, GABAergic, and/or cholinergic pathways. Additional factors include the roles of hormonal, immune, ageing, as well as the influence of cellular, molecular, and epigenetics in the development of mood disorders. This complexity of factors has been anticipated by the Swiss psychiatrists Paul Kielholz and Jules Angst who introduced a multimodal treatment of MDD. Depression is the predominant mood disorder, impacting around one-third of individuals who have experienced a stroke. MDD and PSD share common underlying biological mechanisms related to the disruption of monoaminergic pathways. The major contributor to PSD is the stroke lesion location, which can involve the disruption of the serotoninergic, dopaminergic, glutamatergic, GABAergic, or cholinergic pathways. Additionally, various other disorders such as mania, bipolar disorder, anxiety disorder, and apathy might occur post-stroke, although their prevalence is considerably lower. However, there are differences in the onset of MDD among mood disorders. Some mood disorders develop gradually and can persist for a lifetime, potentially culminating in suicide. In contrast, PSD has a rapid onset because of the severe disruption of neural pathways essential for mood behavior caused by the lesion. However, PSD might also spontaneously resolve several months after a stroke, though it is associated with higher mortality. This review also provides a brief overview of the treatments currently available in medical practice.
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Affiliation(s)
- Daniela Colita
- Doctoral School, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania
| | - Daiana Burdusel
- Department of Psychiatry, University of Medicine and Pharmacy, 200349 Craiova, Romania; Chair of Vascular Neurology, Dementia and Ageing, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Daniela Glavan
- Department of Psychiatry, University of Medicine and Pharmacy, 200349 Craiova, Romania; Chair of Vascular Neurology, Dementia and Ageing, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Dirk M Hermann
- Chair of Vascular Neurology, Dementia and Ageing, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Cezar-Ivan Colită
- Doctoral School, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania
| | - Eugen Colita
- Doctoral School, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania
| | - Ion Udristoiu
- Department of Psychiatry, University of Medicine and Pharmacy, 200349 Craiova, Romania.
| | - Aurel Popa-Wagner
- Chair of Vascular Neurology, Dementia and Ageing, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.
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Wang Z, Baeken C, Wu GR. Metabolic Covariance Connectivity of Posterior Cingulate Cortex Associated with Depression Symptomatology Level in Healthy Young Adults. Metabolites 2023; 13:920. [PMID: 37623864 PMCID: PMC10456574 DOI: 10.3390/metabo13080920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
Early detection in the development of a Major Depressive Disorder (MDD) could guide earlier clinical interventions. Although MDD can begin at a younger age, most people have their first episode in young adulthood. The underlying pathophysiological mechanisms relating to such an increased risk are not clear. The posterior cingulate cortex (PCC), exhibiting high levels of brain connectivity and metabolic activity, plays a pivotal role in the pathological mechanism underlying MDD. In the current study, we used the (F-18) fluorodeoxyglucose (FDG) positron emission tomography (PET) to measure metabolic covariance connectivity of the PCC and investigated its association with depression symptomatology evaluated by the Centre for Epidemiological Studies Depression Inventory-Revised (CESD-R) among 27 healthy individuals aged between 18 and 23 years. A significant negative correlation has been observed between CESD-R scale scores and the PCC metabolic connectivity with the anterior cingulate, medial prefrontal cortex, inferior and middle frontal gyrus, as well as the insula. Overall, our findings suggest that the neural correlates of depressive symptomatology in healthy young adults without a formal diagnosis involve the metabolic connectivity of the PCC. Our findings may have potential implications for early identification and intervention in people at risk of developing depression.
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Affiliation(s)
- Zhixin Wang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing 400715, China;
| | - Chris Baeken
- Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, 9000 Ghent, Belgium;
| | - Guo-Rong Wu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing 400715, China;
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Individual- and Connectivity-Based Real-Time fMRI Neurofeedback to Modulate Emotion-Related Brain Responses in Patients with Depression: A Pilot Study. Brain Sci 2022; 12:brainsci12121714. [PMID: 36552173 PMCID: PMC9775232 DOI: 10.3390/brainsci12121714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/08/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Individual real-time functional magnetic resonance imaging neurofeedback (rtfMRI NF) might be a promising adjuvant in treating depressive symptoms. Further studies showed functional variations and connectivity-related changes in the dorsolateral prefrontal cortex (dlPFC) and the insular cortex. OBJECTIVES The aim of this pilot study was to investigate whether individualized connectivity-based rtfMRI NF training can improve symptoms in depressed patients as an adjunct to a psychotherapeutic programme. The novel strategy chosen for this was to increase connectivity between individualized regions of interest, namely the insula and the dlPFC. METHODS Sixteen patients diagnosed with major depressive disorder (MDD, ICD-10) and 19 matched healthy controls (HC) participated in a rtfMRI NF training consisting of two sessions with three runs each, within an interval of one week. RtfMRI NF was applied during a sequence of negative emotional pictures to modulate the connectivity between the dlPFC and the insula. The MDD REAL group was divided into a Responder and a Non-Responder group. Patients with an increased connectivity during the second NF session or during both the first and the second NF session were identified as "MDD REAL Responder" (N = 6). Patients that did not show any increase in connectivity and/or a decreased connectivity were identified as "MDD REAL Non-Responder" (N = 7). RESULTS Before the rtfMRI sessions, patients with MDD showed higher neural activation levels in ventromedial PFC and the insula than HC; by contrast, HC revealed increased hemodynamic activity in visual processing areas (primary visual cortex and visual association cortex) compared to patients with MDD. The comparison of hemodynamic responses during the first compared to during the last NF session demonstrated significantly increased BOLD-activation in the medial orbitofrontal cortex (mOFC) in patients and HC, and additionally in the lateral OFC in patients with MDD. These findings were particularly due to the MDD Responder group, as the MDD Non-Responder group showed no increase in this region during the last NF run. There was a decrease of neural activation in emotional processing brain regions in both groups in the last NF run compared to the first: HC showed differences in the insula, parahippocampal gyrus, basal ganglia, and cingulate gyrus. Patients with MDD demonstrated deceased responses in the parahippocampal gyrus. There was no significant reduction of BDI scores after NF training in patients. CONCLUSIONS Increased neural activation in the insula and vmPFC in MDD suggests an increased emotional reaction in patients with MDD. The activation of the mOFC could be associated with improved control-strategies and association-learning processes. The increased lOFC activation could indicate a stronger sensitivity to failed NF attempts in MDD. A stronger involvement of visual processing areas in HC may indicate better adaptation to negative emotional stimuli after repeated presentation. Overall, the rtfMRI NF had an impact on neurobiological mechanisms, but not on psychometric measures in patients with MDD.
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Altered gamma oscillations and beta-gamma coupling in drug-naive first-episode major depressive disorder: Association with sleep and cognitive disturbance. J Affect Disord 2022; 316:99-108. [PMID: 35973509 DOI: 10.1016/j.jad.2022.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/25/2022] [Accepted: 08/10/2022] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Gamma oscillations contribute to the pathogenesis mechanisms of major depressive disorder (MDD) have been proposed, but gamma activity is not well characterized. This study is the first attempt to investigate the altered gamma oscillations in first-episode MDD, particularly the beta-gamma coupling, and to determine the potential symptomatic relationship with the identified gamma dysregulation. METHODS Resting electroencephalography was recorded for 43 drug-naive first-episode MDD and 57 healthy control (HC) subjects. Integrated analysis of relative spectral power, weighted phase lag index, and phase-amplitude coupling (PAC) were utilized to reveal the alterations of gamma activities. Pearson's correlation was implemented to identify the relationship between altered gamma activities and the clinical depressive symptoms, which were categorized into four factors: anxiety somatization, retardation, cognitive disturbance, and sleep disturbance. RESULTS Compared with HC subjects, MDD patients showed not only significantly decreased gamma powers in the left temporal and the bilateral occipital regions but also weakened gamma connectivity between the left hemisphere and the right frontal region. Furthermore, attenuated beta-gamma PAC of MDD patients was observed in the left temporal regions. Importantly, the suppression of left occipital mid- and high gamma oscillations were negatively correlated with sleep disturbance, while the deficits in left temporal beta-mid-gamma PAC and beta-high gamma PAC showed negative correlations with cognitive disturbance. LIMITATIONS Important limitations are the small sample size and the possible inclusion of bipolar depression in the MDD group. CONCLUSIONS Our findings provide the first evidence that in first-episode MDD, aberrant gamma powers and beta-gamma coupling are associated with sleep and cognitive impairments, respectively, deepening our understanding of the physiological mechanisms underlying sleep and cognitive symptoms in first-episode MDD. Altered gamma oscillations emerge as promising biomarkers for diagnosing MDD.
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Kamishikiryo T, Okada G, Itai E, Masuda Y, Yokoyama S, Takamura M, Fuchikami M, Yoshino A, Mawatari K, Numata S, Takahashi A, Ohmori T, Okamoto Y. Left DLPFC activity is associated with plasma kynurenine levels and can predict treatment response to escitalopram in major depressive disorder. Psychiatry Clin Neurosci 2022; 76:367-376. [PMID: 35543406 PMCID: PMC9544423 DOI: 10.1111/pcn.13373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/16/2022] [Accepted: 04/24/2022] [Indexed: 11/27/2022]
Abstract
AIM To establish treatment response biomarkers that reflect the pathophysiology of depression, it is important to use an integrated set of features. This study aimed to determine the relationship between regional brain activity at rest and blood metabolites related to treatment response to escitalopram to identify the characteristics of depression that respond to treatment. METHODS Blood metabolite levels and resting-state brain activity were measured in patients with moderate to severe depression (n = 65) before and after 6-8 weeks of treatment with escitalopram, and these were compared between Responders and Nonresponders to treatment. We then examined the relationship between blood metabolites and brain activity related to treatment responsiveness in patients and healthy controls (n = 36). RESULTS Thirty-two patients (49.2%) showed a clinical response (>50% reduction in the Hamilton Rating Scale for Depression score) and were classified as Responders, and the remaining 33 patients were classified as Nonresponders. The pretreatment fractional amplitude of low-frequency fluctuation (fALFF) value of the left dorsolateral prefrontal cortex (DLPFC) and plasma kynurenine levels were lower in Responders, and the rate of increase of both after treatment was correlated with an improvement in symptoms. Moreover, the fALFF value of the left DLPFC was significantly correlated with plasma kynurenine levels in pretreatment patients with depression and healthy controls. CONCLUSION Decreased resting-state regional activity of the left DLPFC and decreased plasma kynurenine levels may predict treatment response to escitalopram, suggesting that it may be involved in the pathophysiology of major depressive disorder in response to escitalopram treatment.
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Affiliation(s)
- Toshiharu Kamishikiryo
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Go Okada
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Eri Itai
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshikazu Masuda
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoshi Yokoyama
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Takamura
- Department of Neurology, Faculty of Medicine, Shimane University, Izumo-shi, Japan
| | - Manabu Fuchikami
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Atsuo Yoshino
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuaki Mawatari
- Department of Preventive Environment and Nutrition, Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Shusuke Numata
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Akira Takahashi
- Department of Preventive Environment and Nutrition, Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Tetsuro Ohmori
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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Luxotonic signals in human prefrontal cortex as a possible substrate for effects of light on mood and cognition. Proc Natl Acad Sci U S A 2022; 119:e2118192119. [PMID: 35867740 PMCID: PMC9282370 DOI: 10.1073/pnas.2118192119] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Studies with experimental animals have revealed a mood-regulating neural pathway linking intrinsically photosensitive retinal ganglion cells (ipRGCs) and the prefrontal cortex (PFC), involved in the pathophysiology of mood disorders. Since humans also have light-intensity-encoding ipRGCs, we asked whether a similar pathway exists in humans. Here, functional MRI was used to identify PFC regions and other areas exhibiting light-intensity-dependent signals. We report 26 human brain regions having activation that either monotonically decreases or monotonically increases with light intensity. Luxotonic-related activation occurred across the cerebral cortex, in diverse subcortical structures, and in the cerebellum, encompassing regions with functions related to visual image formation, motor control, cognition, and emotion. Light suppressed PFC activation, which monotonically decreased with increasing light intensity. The sustained time course of light-evoked PFC responses and their susceptibility to prior light exposure resembled those of ipRGCs. These findings offer a functional link between light exposure and PFC-mediated cognitive and affective phenomena.
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Lu X, Zhang JF, Gu F, Zhang HX, Zhang M, Zhang HS, Song RZ, Shi YC, Li K, Wang B, Zhang ZJ, Northoff G. Altered task modulation of global signal topography in the default-mode network of unmedicated major depressive disorder. J Affect Disord 2022; 297:53-61. [PMID: 34610369 DOI: 10.1016/j.jad.2021.09.093] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/07/2021] [Accepted: 09/26/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Altered global signal (GS) topography features in the resting-state fMRI of major depressive disorder (MDD), showing abnormally strong global signal representation in the default-mode network (DMN). Whether the abnormal local to global change also shapes activity during task states, and how it relates to psychopathological symptoms, e.g., abnormally slow time speed of motor, cognitive, and affective symptoms, remains unknown. METHODS We investigated fMRI-based GS with its topographical representation during task states in unmedicated 51 MDD subjects and 28 healthy subjects. Task-related global signal correlation (GSCORR) was probed by a novel paradigm testing the processing of negative/neutral emotions during different time speeds, i.e., slow and fast. RESULTS We observed a significant interaction between time speed and emotion of GSCORR in various DMN regions in healthy subjects. Next, we showed that MDD exhibits reduced task-related GSCORR in various DMN regions during specifically the fast processing of negative emotions. Finally, we demonstrated that GSCORR in DMN and other brain regions (motor-related regions, inferior frontal cortex) correlated with the degree of psychomotor retardation especially during the fast emotional stimuli. LIMITATIONS The measurement of interoceptive variables like respiration rate or heart rate were not included in our fMRI acquisition. CONCLUSION Together, we demonstrated the functional relevance of GS topography by showing reduced GSCORR in DMN during specifically the fast processing of negative emotions in MDD, suggesting the abnormal slowness, i.e., reduced time speed, to be a key feature of both brain and symptoms in MDD.
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Affiliation(s)
- Xiang Lu
- Department of Neurology of Affiliated ZhongDa Hospital, Institute of Neuropsychiatry and Medical School of Southeast University, Nanjing 210009, Jiangsu Province, China; Royal Ottawa Mental Health Centre, University of Ottawa(,) Institute of Mental Health Research(,) Ottawa(,) Ontario K1Z 7K4, Canada; Department of Neurology, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University(,) Yangzhou 225001, Jiangsu Province, China
| | - Jian-Feng Zhang
- Center for Brain Disorders and Cognitive Sciences(,) Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Feng Gu
- Royal Ottawa Mental Health Centre, University of Ottawa(,) Institute of Mental Health Research(,) Ottawa(,) Ontario K1Z 7K4, Canada
| | - Hong-Xing Zhang
- Department of Psychology of Xinxiang Medical University, Xinxiang 453003, Henan Province, China; Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Xinxiang 453002, Henan Province, China
| | - Meng Zhang
- Department of Psychology of Xinxiang Medical University, Xinxiang 453003, Henan Province, China
| | - Hai-San Zhang
- Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Xinxiang 453002, Henan Province, China
| | - Rui-Ze Song
- Department of Neurology of Affiliated ZhongDa Hospital, Institute of Neuropsychiatry and Medical School of Southeast University, Nanjing 210009, Jiangsu Province, China
| | - Ya-Chen Shi
- Department of Neurology of Affiliated ZhongDa Hospital, Institute of Neuropsychiatry and Medical School of Southeast University, Nanjing 210009, Jiangsu Province, China
| | - Kun Li
- Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Xinxiang 453002, Henan Province, China
| | - Bi Wang
- Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Xinxiang 453002, Henan Province, China
| | - Zhi-Jun Zhang
- Department of Neurology of Affiliated ZhongDa Hospital, Institute of Neuropsychiatry and Medical School of Southeast University, Nanjing 210009, Jiangsu Province, China; Department of Psychology of Xinxiang Medical University, Xinxiang 453003, Henan Province, China; Mental Health Center, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China; Shenzhen institute of advanced technology, Chinese academy of sciences, Shenzhen 518055, Guangdong Province, China.
| | - Georg Northoff
- Department of Neurology of Affiliated ZhongDa Hospital, Institute of Neuropsychiatry and Medical School of Southeast University, Nanjing 210009, Jiangsu Province, China; Royal Ottawa Mental Health Centre, University of Ottawa(,) Institute of Mental Health Research(,) Ottawa(,) Ontario K1Z 7K4, Canada; Mental Health Center, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China; Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa(,) Ottawa, Ontario K1Z 7K4(,) Canada; Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou 310013, Zhejiang Province, China.
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10
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Anatomical and fMRI-network comparison of multiple DLPFC targeting strategies for repetitive transcranial magnetic stimulation treatment of depression. Brain Stimul 2022; 15:63-72. [PMID: 34767967 PMCID: PMC8900427 DOI: 10.1016/j.brs.2021.11.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 10/14/2021] [Accepted: 11/08/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The efficacy of repetitive transcranial magnetic stimulation (rTMS) for depression may vary depending on the subregion stimulated within the dorsolateral prefrontal cortex (DLPFC). Clinical TMS typically uses scalp-based landmarks for DLPFC targeting, rather than individualized MRI guidance. OBJECTIVE In rTMS patients, determine the brain systems targeted by multiple DLPFC stimulation rules by computing several surrogate measures: underlying brain targets labeled with connectivity-based atlases, subgenual cingulate anticorrelation strength, and functionally connected networks. METHODS Forty-nine patients in a randomized controlled trial of rTMS therapy for treatment resistant major depression underwent structural and functional MRI. DLPFC rules were applied virtually using MR-image guidance. Underlying cortical regions were labeled, and connectivity with the subgenual cingulate and whole-brain computed. RESULTS Scalp-targeting rules applied post hoc to these MRIs that adjusted for head size, including Beam F3, were comparably precise, successful in directly targeting classical DLPFC and frontal networks, and anticorrelated with the subgenual cingulate. In contrast, all rules involving fixed distances introduced variability in regions and networks targeted. The 5 cm rule targeted a transitional DLPFC region with a different connectivity profile from the adjusted rules. Seed-based connectivity analyses identified multiple regions, such as posterior cingulate and inferior parietal lobe, that warrant further study in order to understand their potential contribution to clinical response. CONCLUSION EEG-based rules consistently targeted DLPFC brain regions with resting-state fMRI features known to be associated with depression response. These results provide a bridge from lab to clinic by enabling clinicians to relate scalp-targeting rules to functionally connected brain systems.
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11
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Yu WS, Kwon SH, Agadagba SK, Chan LLH, Wong KH, Lim LW. Neuroprotective Effects and Therapeutic Potential of Transcorneal Electrical Stimulation for Depression. Cells 2021; 10:cells10092492. [PMID: 34572141 PMCID: PMC8466154 DOI: 10.3390/cells10092492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/29/2021] [Accepted: 09/17/2021] [Indexed: 12/22/2022] Open
Abstract
Transcorneal electrical stimulation (TES) has emerged as a non-invasive neuromodulation approach that exerts neuroprotection via diverse mechanisms, including neurotrophic, neuroplastic, anti-inflammatory, anti-apoptotic, anti-glutamatergic, and vasodilation mechanisms. Although current studies of TES have mainly focused on its applications in ophthalmology, several lines of evidence point towards its putative use in treating depression. Apart from stimulating visual-related structures and promoting visual restoration, TES has also been shown to activate brain regions that are involved in mood alterations and can induce antidepressant-like behaviour in animals. The beneficial effects of TES in depression were further supported by its shared mechanisms with FDA-approved antidepressant treatments, including its neuroprotective properties against apoptosis and inflammation, and its ability to enhance the neurotrophic expression. This article critically reviews the current findings on the neuroprotective effects of TES and provides evidence to support our hypothesis that TES possesses antidepressant effects.
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Affiliation(s)
- Wing-Shan Yu
- Neuromodulation Laboratory, School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (W.-S.Y.); (S.-H.K.); (K.-H.W.)
| | - So-Hyun Kwon
- Neuromodulation Laboratory, School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (W.-S.Y.); (S.-H.K.); (K.-H.W.)
| | - Stephen Kugbere Agadagba
- Department of Electrical Engineering, City University of Hong Kong, Hong Kong, China; (S.K.A.); (L.-L.-H.C.)
| | - Leanne-Lai-Hang Chan
- Department of Electrical Engineering, City University of Hong Kong, Hong Kong, China; (S.K.A.); (L.-L.-H.C.)
| | - Kah-Hui Wong
- Neuromodulation Laboratory, School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (W.-S.Y.); (S.-H.K.); (K.-H.W.)
- Department of Anatomy, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Lee-Wei Lim
- Neuromodulation Laboratory, School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (W.-S.Y.); (S.-H.K.); (K.-H.W.)
- Correspondence:
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12
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Ploski JE, Vaidya VA. The Neurocircuitry of Posttraumatic Stress Disorder and Major Depression: Insights Into Overlapping and Distinct Circuit Dysfunction-A Tribute to Ron Duman. Biol Psychiatry 2021; 90:109-117. [PMID: 34052037 PMCID: PMC8383211 DOI: 10.1016/j.biopsych.2021.04.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 12/14/2022]
Abstract
The neurocircuitry that contributes to the pathophysiology of posttraumatic stress disorder and major depressive disorder, psychiatric conditions that exhibit a high degree of comorbidity, likely involves both overlapping and unique structural and functional changes within multiple limbic brain regions. In this review, we discuss neurobiological alterations that are associated with posttraumatic stress disorder and major depressive disorder and highlight both similarities and differences that may exist between these disorders to argue for the existence of a shared neurobiology. We highlight the key contributions based on preclinical studies, emerging from the late Professor Ronald Duman's research, that have shaped our understanding of the neurocircuitry that contributes to both the etiopathology and treatment of major depressive disorder and posttraumatic stress disorder.
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Affiliation(s)
- Jonathan E. Ploski
- Department of Neuroscience and Molecular & Cell Biology, School of Behavioral and Brain Sciences, University of Texas at Dallas, GR41, 800 W Campbell Road, Richardson, TX 75080-3021, USA
| | - Vidita A. Vaidya
- Department of Biological Sciences, Tata Institute of Fundamental Research, 1 Homi Bhabha Road, Colaba, Mumbai, Maharashtra, 400005, India
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13
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Zhai T, Salmeron BJ, Gu H, Adinoff B, Stein EA, Yang Y. Functional connectivity of dorsolateral prefrontal cortex predicts cocaine relapse: implications for neuromodulation treatment. Brain Commun 2021; 3:fcab120. [PMID: 34189458 PMCID: PMC8226190 DOI: 10.1093/braincomms/fcab120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/27/2021] [Accepted: 05/03/2021] [Indexed: 11/13/2022] Open
Abstract
Relapse is one of the most perplexing problems of addiction. The dorsolateral prefrontal cortex is crucially involved in numerous cognitive and affective processes that are implicated in the phenotypes of both substance use disorders and other neuropsychiatric diseases and has become the principal site to deliver transcranial magnetic stimulation for their treatment. However, the dorsolateral prefrontal cortex is an anatomically large and functionally heterogeneous region, and the specific dorsolateral prefrontal cortex locus and dorsolateral prefrontal cortex-based functional circuits that contribute to drug relapse and/or treatment outcome remain unknown. We systematically investigated the relationship of cocaine relapse with functional circuits from 98 dorsolateral prefrontal cortex regions-of-interest defined by evenly sampling the entire surface of bilateral dorsolateral prefrontal cortex in a cohort of cocaine dependent patients (n = 43, 5 Fr) following a psychosocial treatment intervention. Cox regression models were utilized to predict relapse likelihood based on dorsolateral prefrontal cortex functional connectivity strength. Functional connectivity from only 3 of the 98 dorsolateral prefrontal cortex loci, one in the left and two in the right hemisphere, significantly predicted cocaine relapse with an accuracy of 83.9%, 84.6% and 85.4%, respectively. Combining all three loci significantly improved prediction validity to 87.5%. Protective and risk circuits related to these dorsolateral prefrontal cortex loci were identified that have previously been implicated to support 'bottom up' drive to use drug and 'top down' control over behaviour together with social emotional, learning and memory processing. Three dorsolateral prefrontal cortex-centric circuits were identified that predict relapse to cocaine use with high accuracy. These functionally distinct dorsolateral prefrontal cortex-based circuits provide insights into the multiple roles played by the dorsolateral prefrontal cortex in cognitive and affective functioning that affects treatment outcome. The identified dorsolateral prefrontal cortex loci may serve as potential neuromodulation targets to be tested in subsequent clinical studies for addiction treatment and as clinically relevant biomarkers of its efficacy. Zhai et al. identify three dorsolateral prefrontal cortex (dlPFC)-centric circuits that predict cocaine relapse with high accuracy, providing insights into the multiple roles of the dlPFC in brain functioning that affects treatment outcome and suggesting the dlPFC loci as potential neuromodulation targets for addiction treatment.
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Affiliation(s)
- Tianye Zhai
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Betty Jo Salmeron
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Hong Gu
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Bryon Adinoff
- Veterans Affairs North Texas Health Care System, Dallas, TX 75216, USA.,Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.,Department of Psychiatry-Residency, School of Medicine, University of Colorado, Aurora, CO 80045, USA
| | - Elliot A Stein
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Yihong Yang
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
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14
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Yang J, Hellerstein DJ, Chen Y, McGrath PJ, Stewart JW, Liu Z, Peterson BS, Wang Z. Gray matter reorganization underpinnings of antidepressant treatment of persistent depressive disorder. Eur Neuropsychopharmacol 2021; 43:129-138. [PMID: 33402259 DOI: 10.1016/j.euroneuro.2020.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 10/29/2020] [Accepted: 12/23/2020] [Indexed: 11/30/2022]
Abstract
Brain gray matter is organized in a manner with interconnected brain regions, resulting in a notable covariance pattern that recapitulates either the functional coactivation or structural connectivity of brain regions, which is believed to underpin psychiatric disorders such as depression. This study aimed to investigate whether and how antidepressants took effect in treating depression and reducing symptoms by altering the gray matter covariance pattern. We combined structural magnetic resonance imaging (MRI) scans acquired in two randomized, double-blind, placebo-controlled trial (RCT) studies of the treatment using serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant medications in patients with persistent depressive disorder (PDD). One was an RCT of 10-week duloxetine medication that consisted of patients who received duloxetine (N = 21) or placebo (N = 21), and the other was an RCT of 12-week desvenlafaxine medication that consisted of 19 and 17 patients respectively who received desvenlafaxine or placebo. We examined treatment effect on gray matter volume (GMV) and topological organization of GMV covariance pattern (i.e., GMV-based network). We found a treatment-by-time effect on GMV in the angular gyrus and cuneus areas, whereas the GMV change rate of the cuneus was inversely correlated with the response rate. We observed a significant increase in the local efficiency of the GMV-based network following medication treatment compared with placebo. Our findings provide preliminary evidence for a GMV-based network-specific reconfiguration caused by antidepressants compared to placebo and the cuneus may be a possible candidate region to predict antidepressant response.
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Affiliation(s)
- Jie Yang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, 139 Renming Z Rd, Changsha, Hunan 410011, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; New York State Psychiatric Institute, New York, NY, USA.
| | - David J Hellerstein
- New York State Psychiatric Institute, New York, NY, USA; Columbia University College of Physicians and Surgeons, New York, NY, USA.
| | - Ying Chen
- New York State Psychiatric Institute, New York, NY, USA; Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Patrick J McGrath
- New York State Psychiatric Institute, New York, NY, USA; Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Jonathan W Stewart
- New York State Psychiatric Institute, New York, NY, USA; Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, 139 Renming Z Rd, Changsha, Hunan 410011, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China
| | - Bradley S Peterson
- Institute for the Developing Mind, Children's Hospital Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zhishun Wang
- New York State Psychiatric Institute, New York, NY, USA; Columbia University College of Physicians and Surgeons, New York, NY, USA
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15
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Su Q, Yu M, Liu F, Zhang Z, Lei M, Jiang Y, Luo T, Guo W. Frequency-specific alterations of the frontal-cerebellar circuit in first-episode, drug-naive somatization disorder. J Affect Disord 2021; 280:319-325. [PMID: 33221718 DOI: 10.1016/j.jad.2020.11.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 09/28/2020] [Accepted: 11/08/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND With the development of imaging techniques, evidence of abnormal neural activity has been implicated in patients with somatization disorder (SD). It remains unclear whether abnormal spontaneous neural activities are related to specific frequency bands. In this study, resting-state functional magnetic resonance imaging (fMRI) using the frequency-specific amplitude of low frequency fluctuation (ALFF) approach was applied to investigate changes in spontaneous neural activity in different frequency bands in patients with SD. METHODS Twenty-five first-episode, medication-naive patients with SD and 28 age-, sex-, education-matched healthy controls (HCs) underwent resting-state fMRI. The ALFF method with the classical low-frequency (0.01 - 0.08 Hz), slow-5 (0.01 - 0.027 Hz) and slow-4 (0.027 - 0.08 Hz) bands was employed to analyze the data. RESULTS With the classical low-frequency and slow-5 bands, patients with SD showed significantly increased ALFF in the left orbitofrontal cortex (OFC) and reduced ALFF in the right cerebellum compared with HCs. With the slow-4 band, patients with SD exhibited significantly reduced ALFF in the right cerebellum compared with HCs. However, no significant correlation was observed between the ALFF value in the left OFC or right cerebellum and clinical/cognitive variables. CONCLUSIONS Our findings indicate that there are abnormal regional activities of the left OFC and right cerebellum in first-episode, treatment-naive patients with SD, suggesting that these alterations occur early in the course of the disease and are independent of medication status. Our study provides novel evidence that different regional activities of the frontal-cerebellar circuit may be involved in the pathophysiology of SD.
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Affiliation(s)
- Qinji Su
- Mental Health Center, The Second Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China
| | - Miaoyu Yu
- Mental Health Center, The Second Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhikun Zhang
- Mental Health Center, The Second Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China
| | - Meiying Lei
- Mental Health Center, The Second Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China
| | - Yongmei Jiang
- Mental Health Center, The Second Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China
| | - Tiantian Luo
- Mental Health Center, The Second Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China
| | - Wenbin Guo
- Mental Health Center, The Second Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China; Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China.
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16
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Yoshino Y, Roy B, Kumar N, Shahid Mukhtar M, Dwivedi Y. Molecular pathology associated with altered synaptic transcriptome in the dorsolateral prefrontal cortex of depressed subjects. Transl Psychiatry 2021; 11:73. [PMID: 33483466 PMCID: PMC7822869 DOI: 10.1038/s41398-020-01159-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 02/06/2023] Open
Abstract
Disrupted synaptic plasticity is the hallmark of major depressive disorder (MDD), with accompanying changes at the molecular and cellular levels. Often, the maladaptive molecular changes at the synapse are the result of global transcriptional reprogramming dictated by activity-dependent synaptic modulation. Thus far, no study has directly studied the transcriptome-wide expression changes locally at the synapse in MDD brain. Here, we have examined altered synaptic transcriptomics and their functional relevance in MDD with a focus on the dorsolateral prefrontal cortex (dlPFC). RNA was isolated from total fraction and purified synaptosomes of dlPFC from well-matched 15 non-psychiatric controls and 15 MDD subjects. Transcriptomic changes in synaptic and total fractions were detected by next-generation RNA-sequencing (NGS) and analyzed independently. The ratio of synaptic/total fraction was estimated to evaluate a shift in gene expression ratio in MDD subjects. Bioinformatics and network analyses were used to determine the biological relevance of transcriptomic changes in both total and synaptic fractions based on gene-gene network, gene ontology (GO), and pathway prediction algorithms. A total of 14,005 genes were detected in total fraction. A total of 104 genes were differentially regulated (73 upregulated and 31 downregulated) in MDD group based on 1.3-fold change threshold and p < 0.05 criteria. In synaptosomes, out of 13,236 detectable genes, 234 were upregulated and 60 were downregulated (>1.3-fold, p < 0.05). Several of these altered genes were validated independently by a quantitative polymerase chain reaction (qPCR). GO revealed an association with immune system processes and cell death. Moreover, a cluster of genes belonged to the nervous system development, and psychological disorders were discovered using gene-gene network analysis. The ratio of synaptic/total fraction showed a shift in expression of 119 genes in MDD subjects, which were primarily associated with neuroinflammation, interleukin signaling, and cell death. Our results suggest not only large-scale gene expression changes in synaptosomes, but also a shift in the expression of genes from total to synaptic fractions of dlPFC of MDD subjects with their potential role in immunomodulation and cell death. Our findings provide new insights into the understanding of transcriptomic regulation at the synapse and their possible role in MDD pathogenesis.
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Affiliation(s)
- Yuta Yoshino
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Bhaskar Roy
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Nilesh Kumar
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - M Shahid Mukhtar
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
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17
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Park DI, Novak B, Yan Y, Kaya ME, Turck CW. Paroxetine binding and activation of phosphofructokinase implicates energy metabolism in antidepressant mode of action. J Psychiatr Res 2020; 129:8-14. [PMID: 32540574 DOI: 10.1016/j.jpsychires.2020.05.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/30/2020] [Accepted: 05/31/2020] [Indexed: 12/16/2022]
Abstract
Selective serotonin reuptake inhibitors (SSRIs) are the predominant drugs prescribed for Major Depressive Disorder. The immediate pharmacological target of SSRIs is the serotonin transporter. However, the delayed therapeutic effect and high rate of patient non-response make it highly likely that SSRIs also have other molecular targets that are yet to be identified. Cellular thermal shift assay (CETSA) is a method based on thermal stabilization of target proteins upon drug binding. In the present study, we show that the SSRI paroxetine binds to phosphofructokinase (PFK) protein using CETSA. We found that mouse brain PFK and recombinant human PFK proteins are stabilized by paroxetine incubation. Chronic paroxetine treatment also significantly increased mouse brain PFK thermal stability. Paroxetine significantly elevated in vitro and in vivo PFK activity. Levels of several metabolites in glutamate- and energy metabolism-related pathways are significantly correlated with PFK activity in mouse hippocampus. Our data show that paroxetine can bind to PFK and affect its activity. Implications of these results for the antidepressant mode of action of paroxetine are discussed.
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Affiliation(s)
- Dong Ik Park
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, 80804, Munich, Germany; Danish Research Institute of Translational Neuroscience (DANDRITE), Department of Biomedicine, Aarhus University, Aarhus, Denmark; The Danish National Research Foundation Center, PROMEMO, Department of Biomedicine, Aarhus University, Aarhus, Denmark.
| | - Božidar Novak
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, 80804, Munich, Germany
| | - Yu Yan
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, 80804, Munich, Germany
| | - Melahat Ezgi Kaya
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, 80804, Munich, Germany
| | - Christoph W Turck
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, 80804, Munich, Germany
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18
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Cl N, Dc H, N L, T L, S P, Jp R. The neural basis of hot and cold cognition in depressed patients, unaffected relatives, and low-risk healthy controls: An fMRI investigation. J Affect Disord 2020; 274:389-398. [PMID: 32663968 PMCID: PMC7369634 DOI: 10.1016/j.jad.2020.05.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 03/26/2020] [Accepted: 05/10/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Modern cognitive neuropsychological models of depression posit that negatively biased emotional ("hot") processing confers risk for depression, while preserved executive function ("cold") cognition promotes resilience. METHODS We compared neural responses during hot and cold cognitive tasks in 99 individuals: those at familial risk for depression (N = 30 unaffected first-degree relatives of depressed individuals) and those currently experiencing a major depressive episode (N = 39 unmedicated depressed patients) with low-risk healthy controls (N = 30). Primary analyses assessed neural activation on two functional magnetic resonance imaging tasks previously associated with depression: dorsolateral prefrontal cortex (DLPFC) responsivity during the n-back working memory task; and amygdala and subgenual anterior cingulate cortex (sgACC) responsivity during incidental emotional face processing. RESULTS Depressed patients exhibited significantly attenuated working memory-related DLPFC activation, compared to low-risk controls and unaffected relatives; unaffected relatives did not differ from low-risk controls. We did not observe a complementary pattern during emotion processing. However, we found preliminary support that greater DLPFC activation was associated with lower amygdala response during emotion processing. LIMITATIONS These findings require confirmation in a longitudinal study to observe each individual's risk of developing depression; without this, we cannot identify the true risk level of the first-degree relative or low-risk control group. CONCLUSIONS These findings have implications for understanding the neural mechanisms of risk and resilience in depression: they are consistent with the suggestion that preserved executive function might confer resilience to developing depression in first-degree relatives of depressed patients.
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Affiliation(s)
- Nord Cl
- Institute of Cognitive Neuroscience, University College London, London, UK; MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
| | - Halahakoon Dc
- Institute of Cognitive Neuroscience, University College London, London, UK; Department of Psychiatry, University of Oxford, Oxford, UK
| | - Lally N
- Institute of Cognitive Neuroscience, University College London, London, UK; Warwick Medical School, University of Warwick, Coventry, UK; Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Limbachya T
- Camden and Islington NHS Foundation Trust, London, UK
| | - Pilling S
- Department of Clinical, Educational, and Health Psychology, University College London, London, UK
| | - Roiser Jp
- Institute of Cognitive Neuroscience, University College London, London, UK
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Su Q, Yu M, Liu F, Li Y, Li D, Deng M, Lu J, Wu C, Guo W. Abnormal Functional Asymmetry in the Salience and Auditory Networks in First-episode, Drug-naive Somatization Disorder. Neuroscience 2020; 444:1-8. [DOI: 10.1016/j.neuroscience.2020.07.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 11/16/2022]
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20
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A mind-body lifestyle intervention enhances emotional control in patients with major depressive disorder: a randomized, controlled study. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:1056-1069. [PMID: 32808234 DOI: 10.3758/s13415-020-00819-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To investigate the effects of the Dejian mind-body intervention (DMBI), on depressive symptoms and electroencephalography (EEG) changes in relation to emotional processing in patients with depression. Seventy-five age-, gender-, and education-matched participants with depression were randomly assigned to receive either Cognitive Behavior Therapy (CBT) or DMBI or were placed in a control group. Overall depressive syndrome, specific mood-related symptoms (Hamilton Psychiatric Rating Scale for Depression, Beck Depression Inventory), and EEG data were collected individually during a resting state and during affective image viewing before and after 10 weeks of intervention. After intervention, both the DMBI and CBT groups showed significantly reduced levels of overall depressive syndrome and mood-related symptoms (Ps ≤ 0.002) than the control group. In addition, the DMBI group demonstrated a significantly greater extent of elevation in fronto-posterior EEG theta coherence on the right hemisphere when viewing different mood-induction (neutral, positive, and negative) stimuli than the CBT and control groups (Ps < 0.03). The elevated intra-right fronto-posterior coherence when viewing mood-induction stimuli correlated with improved mood levels after the intervention (Ps < 0.05). Our findings also showed that, only in the DMBI group, there was a significant suppression of theta source activity at the posterior and subcortical brain regions that are known to mediate negative emotional responses and the self-absorbed mode of thinking. The findings of reduced depressive symptoms and elevated frontoposterior coherence suggest that the DMBI can enhance emotional control in depression.
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Gunzler D, Sehgal AR, Kauffman K, Davey CH, Dolata J, Figueroa M, Huml A, Pencak J, Sajatovic M. Identify depressive phenotypes by applying RDOC domains to the PHQ-9. Psychiatry Res 2020; 286:112872. [PMID: 32151848 PMCID: PMC7434666 DOI: 10.1016/j.psychres.2020.112872] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/11/2020] [Accepted: 02/18/2020] [Indexed: 01/30/2023]
Abstract
Major depression consists of multiple phenotypic traits. Our objective was to characterize depressive phenotypes in the patient health questionnaire (PHQ)-9 using the Research Domain Criteria (RDoC) research framework. Cross-sectional data were examined from the 2013-2014 (N = 5397) and 2015-2016 (N = 5164) National Health and Nutrition Examination Survey, a large, nationally representative U.S. sample. Using both factor analysis and qualitative analysis in mapping scale items along RDoC domains, a four factor model was found to be theoretically appropriate and had an excellent model fit for the PHQ-9. The factor structure consisted of phenotypes describing Negative Valence Systems and Externalizing (anhedonia and depression), Negative Valence Systems and Internalizing (depression, guilt and self-harm), Arousal and Regulatory Systems (sleep, fatigue and appetite) and Cognitive and Sensorimotor Systems (concentration and psychomotor). High correlation between these phenotypes did indicate screening and monitoring for depression study population using a single depression score is likely useful in most circumstances. In multiple indicator multiple cause analysis, differences in the means of the phenotypic traits were found by age, race/ethnicity, sex, and number of comorbidities. Future research should explore whether phenotype expression derived from readily available self-rated depression scales can help to inform more personalized care.
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Affiliation(s)
- Douglas Gunzler
- Center for Health Care Research & Policy, The MetroHealth System, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH 44109, United States.
| | - Ashwini R Sehgal
- Center for Reducing Health Disparities, The MetroHealth System, Case Western Reserve University, Cleveland, OH, United States
| | - Kelley Kauffman
- Center for Reducing Health Disparities, The MetroHealth System, Case Western Reserve University, Cleveland, OH, United States
| | | | - Jacqueline Dolata
- Center for Reducing Health Disparities, The MetroHealth System, Case Western Reserve University, Cleveland, OH, United States
| | - Maria Figueroa
- Center for Reducing Health Disparities, The MetroHealth System, Case Western Reserve University, Cleveland, OH, United States
| | - Anne Huml
- Center for Reducing Health Disparities, The MetroHealth System, Case Western Reserve University, Cleveland, OH, United States
| | - Julie Pencak
- Center for Reducing Health Disparities, The MetroHealth System, Case Western Reserve University, Cleveland, OH, United States
| | - Martha Sajatovic
- Department of Psychiatry and of Neurology, Case Western Reserve University School of Medicine, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States
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22
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The role of left orbitofrontal cortex in selective attention during automatic emotion regulation: Evidence from transcranial direct current stimulation. ACTA PSYCHOLOGICA SINICA 2020. [DOI: 10.3724/sp.j.1041.2020.01048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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From bed to bench side: Reverse translation to optimize neuromodulation for mood disorders. Proc Natl Acad Sci U S A 2019; 116:26288-26296. [PMID: 31871143 DOI: 10.1073/pnas.1902287116] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The advent of neuroimaging has provided foundational insights into the neural basis of psychiatric conditions, such as major depression. Across countless studies, dysfunction has been localized to distinct parts of the limbic system. Specific knowledge about affected locations has led to the development of circuit modulation therapies to correct dysfunction, notably deep brain stimulation (DBS). This and other emerging neuromodulation approaches have shown great promise, but their refinement has been slow and fundamental questions about their mechanisms of action remain. Here, we argue that their continued development requires reverse translation to animal models with close homology to humans, namely, nonhuman primates. With a particular focus on DBS approaches for depression, we highlight the parts of the brain that have been targeted by neuromodulation in humans, their efficacy, and why nonhuman primates are the most suitable model in which to conduct their refinement. We finish by highlighting key gaps in our knowledge that need to be filled to allow more rapid progress toward effective therapies in patients for whom all other treatment attempts have failed.
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24
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Uscinska M, Polla Mattiot A, Bellino S. Treatment-Induced Brain Plasticity in Psychiatric Disorders. Behav Neurosci 2019. [DOI: 10.5772/intechopen.85448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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25
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Padmanabhan JL, Cooke D, Joutsa J, Siddiqi SH, Ferguson M, Darby RR, Soussand L, Horn A, Kim NY, Voss JL, Naidech AM, Brodtmann A, Egorova N, Gozzi S, Phan TG, Corbetta M, Grafman J, Fox MD. A Human Depression Circuit Derived From Focal Brain Lesions. Biol Psychiatry 2019; 86:749-758. [PMID: 31561861 PMCID: PMC7531583 DOI: 10.1016/j.biopsych.2019.07.023] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/24/2019] [Accepted: 07/25/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Focal brain lesions can lend insight into the causal neuroanatomical substrate of depression in the human brain. However, studies of lesion location have led to inconsistent results. METHODS Five independent datasets with different lesion etiologies and measures of postlesion depression were collated (N = 461). Each 3-dimensional lesion location was mapped to a common brain atlas. We used voxel lesion symptom mapping to test for associations between depression and lesion locations. Next, we computed the network of regions functionally connected to each lesion location using a large normative connectome dataset (N = 1000). We used these lesion network maps to test for associations between depression and connected brain circuits. Reproducibility was assessed using a rigorous leave-one-dataset-out validation. Finally, we tested whether lesion locations associated with depression fell within the same circuit as brain stimulation sites that were effective for improving poststroke depression. RESULTS Lesion locations associated with depression were highly heterogeneous, and no single brain region was consistently implicated. However, these same lesion locations mapped to a connected brain circuit, centered on the left dorsolateral prefrontal cortex. Results were robust to leave-one-dataset-out cross-validation. Finally, our depression circuit derived from brain lesions aligned with brain stimulation sites that were effective for improving poststroke depression. CONCLUSIONS Lesion locations associated with depression fail to map to a specific brain region but do map to a specific brain circuit. This circuit may have prognostic utility in identifying patients at risk for poststroke depression and therapeutic utility in refining brain stimulation targets.
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Affiliation(s)
- Jaya L. Padmanabhan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA,Berenson-Allen Center for Non-Invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Danielle Cooke
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Juho Joutsa
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,Department of Neurology, University of Turku, Turku, Finland,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
| | - Shan H. Siddiqi
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA,Berenson-Allen Center for Non-Invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,Division of Neurotherapeutics, McLean Hospital, Harvard Medical School, Belmont, MA,Center for Neuroscience & Regenerative Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Michael Ferguson
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - R. Ryan Darby
- Department of Neurology, Vanderbilt University Medical Center, Nashville TN
| | - Louis Soussand
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Andreas Horn
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité – University Medicine Berlin
| | - Na Young Kim
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joel L. Voss
- Ken & Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL,Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Andrew M. Naidech
- Ken & Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL,Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Amy Brodtmann
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Natalia Egorova
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Sophia Gozzi
- School of Psychological Sciences, Department of Medicine, Monash University, Melbourne, VIC, Australia,Stroke and Aging Research Group, School of Clinical Sciences, Department of Medicine, Monash University and Stroke Unit, Monash Medical Centre, Melbourne, VIC, Australia
| | - Thanh G Phan
- School of Psychological Sciences, Department of Medicine, Monash University, Melbourne, VIC, Australia,Stroke and Aging Research Group, School of Clinical Sciences, Department of Medicine, Monash University and Stroke Unit, Monash Medical Centre, Melbourne, VIC, Australia
| | - Maurizio Corbetta
- Department of Neuroscience, University of Padova and Padova Neuroscience Center, Padova, Italy,Departments of Neurology, Radiology, Bioengineering, Neuroscience, Washington University School of Medicine, Saint Louis, MO, USA
| | - Jordan Grafman
- Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer’s Disease Research Center, Feinberg School of Medicine and Department of Psychology, Northwestern University, Chicago, IL,Shirley Ryan AbilityLab, Chicago, IL
| | - Michael D. Fox
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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26
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Liu Y, Admon R, Mellem MS, Belleau EL, Kaiser RH, Clegg R, Beltzer M, Goer F, Vitaliano G, Ahammad P, Pizzagalli DA. Machine Learning Identifies Large-Scale Reward-Related Activity Modulated by Dopaminergic Enhancement in Major Depression. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:163-172. [PMID: 31784354 DOI: 10.1016/j.bpsc.2019.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Theoretical models have emphasized systems-level abnormalities in major depressive disorder (MDD). For unbiased yet rigorous evaluations of pathophysiological mechanisms underlying MDD, it is critically important to develop data-driven approaches that harness whole-brain data to classify MDD and evaluate possible normalizing effects of targeted interventions. Here, using an experimental therapeutics approach coupled with machine learning, we investigated the effect of a pharmacological challenge aiming to enhance dopaminergic signaling on whole-brain response to reward-related stimuli in MDD. METHODS Using a double-blind, placebo-controlled design, we analyzed functional magnetic resonance imaging data from 31 unmedicated MDD participants receiving a single dose of 50 mg amisulpride (MDDAmisulpride), 26 MDD participants receiving placebo (MDDPlacebo), and 28 healthy control subjects receiving placebo (HCPlacebo) recruited through two independent studies. An importance-guided machine learning technique for model selection was used on whole-brain functional magnetic resonance imaging data probing reward anticipation and consumption to identify features linked to MDD (MDDPlacebo vs. HCPlacebo) and dopaminergic enhancement (MDDAmisulpride vs. MDDPlacebo). RESULTS Highly predictive classification models emerged that distinguished MDDPlacebo from HCPlacebo (area under the curve = 0.87) and MDDPlacebo from MDDAmisulpride (area under the curve = 0.89). Although reward-related striatal activation and connectivity were among the most predictive features, the best truncated models based on whole-brain features were significantly better relative to models trained using striatal features only. CONCLUSIONS Results indicate that in MDD, enhanced dopaminergic signaling restores abnormal activation and connectivity in a widespread network of regions. These findings provide new insights into the pathophysiology of MDD and pharmacological mechanism of antidepressants at the system level in addressing reward processing deficits among depressed individuals.
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Affiliation(s)
- Yuelu Liu
- BlackThorn Therapeutics, San Francisco, California
| | - Roee Admon
- Department of Psychology, University of Haifa, Haifa, Israel
| | | | - Emily L Belleau
- McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Roselinde H Kaiser
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado
| | | | | | | | - Gordana Vitaliano
- McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | | | - Diego A Pizzagalli
- McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
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27
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Angulo J, Fleury V, Péron JA, Penzenstadler L, Zullino D, Krack P. Shame in Parkinson'S Disease: A Review. JOURNAL OF PARKINSON'S DISEASE 2019; 9:489-499. [PMID: 31081792 PMCID: PMC6700625 DOI: 10.3233/jpd-181462] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Shame is a self-conscious emotion marked by an intensely negative self-evaluation. It is exhibited by an individual upon realizing that she/he has violated an important (usually social) norm. Shame can be a source of emotional distress leading to social withdrawal and depression, with a significant negative impact on quality of life. In Parkinson’s disease (PD), shame is rarely addressed. Based on reports of persons affected with Parkinson’s disease (PwP) as well as a literature review, this article describes PD-related shame. PD-related shame may emerge from motor and non-motor symptoms, from self-perception of inadequacy due to loss of autonomy and need for help, or from perceived deterioration of body image. The neurobiology of shame delineates neuronal networks involved in cognitive and emotions regulation, self-representation and representation of the others mental states. Although this hypothesis remains to be demonstrated, these substrates could be modulated, at least partially, by dopaminergic depletion related to PD, which may open a window for pharmacotherapy. Owing to the negative impact that shame can produce, shame should be actively explored and addressed in the individual PwP. Teaching PwP how to develop resilience to shame may be a useful strategy in preventing the vicious circle of shame. The paucity of existing data on prevalence and management of PD-specific shame contrasts with the manifold reported situations inducing suffering from shame. There is a crucial need for further investigations of shame in PD and the development of interventions to reduce its impact on PwP’s quality of life.
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Affiliation(s)
- Julio Angulo
- Morningview Place, Lake Oswego, OR, USA.,Persons with Parkinson's Advisory Council, Parkinson Foundation, Miami-New York, USA.,Program Design Committee 2019 World Parkinson's Congress, World Parkinson's Coalition, NY, USA
| | - Vanessa Fleury
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, CMU, Geneva, Switzerland
| | - Julie Anne Péron
- Department of Psychology and Swiss Center for Affective Sciences, Neuroscience of Emotion and Affective Dynamics laboratory, University of Geneva, Geneva, Switzerland.,Department of Neurology, Neuropsychology Unit, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Daniele Zullino
- Department of Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Paul Krack
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, CMU, Geneva, Switzerland
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28
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Latorre A, Rocchi L, Berardelli A, Bhatia KP, Rothwell JC. The use of transcranial magnetic stimulation as a treatment for movement disorders: A critical review. Mov Disord 2019; 34:769-782. [PMID: 31034682 DOI: 10.1002/mds.27705] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 04/04/2019] [Accepted: 04/07/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Transcranial magnetic stimulation is a safe and painless non-invasive brain stimulation technique that has been largely used in the past 30 years to explore cortical function in healthy participants and, inter alia, the pathophysiology of movement disorders. During the years, its use has evolved from primarily research purposes to treatment of a large variety of neurological and psychiatric diseases. In this article, we illustrate the basic principles on which the therapeutic use of transcranial magnetic stimulation is based and review the clinical trials that have been performed in patients with movement disorders. METHODS A search of the PubMed database for research and review articles was performed on therapeutic applications of transcranial magnetic stimulation in movement disorders. The search included the following conditions: Parkinson's disease, dystonia, Tourette syndrome and other chronic tic disorders, Huntington's disease and choreas, and essential tremor. The results of the studies and possible mechanistic explanations for the relatively minor effects of transcranial magnetic stimulation are discussed. Possible ways to improve the methodology and achieve greater therapeutic efficacy are discussed. CONCLUSION Despite the promising and robust rationales for the use of transcranial magnetic stimulations as a treatment tool in movement disorders, the results taken as a whole are not as successful as were initially expected. There is encouraging evidence that transcranial magnetic stimulation may improve motor symptoms and depression in Parkinson's disease, but the efficacy in other movement disorders is unclear. Possible improvements in methodology are on the horizon but have yet to be implemented in large clinical studies. © 2019 International Parkinson and Movement Disorder Society © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Anna Latorre
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology University College London, London, UK
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Rocchi
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology University College London, London, UK
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed Institute, Pozzilli, Isernia, Italy
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology University College London, London, UK
| | - John C Rothwell
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology University College London, London, UK
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29
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Chan JYC, Yiu KKL, Kwok TCY, Wong SYS, Tsoi KKF. Depression and Antidepressants as Potential Risk Factors in Dementia: A Systematic Review and Meta-analysis of 18 Longitudinal Studies. J Am Med Dir Assoc 2019; 20:279-286.e1. [PMID: 30711460 DOI: 10.1016/j.jamda.2018.12.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/28/2018] [Accepted: 12/09/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate whether depression and/or antidepressants can be a potential risk factor for the development of dementia and mild cognitive impairment (MCI). DESIGN Systematic review and meta-analysis of longitudinal studies. SETTING AND PARTICIPANTS Community or clinical settings. Participants included patients with depression, antidepressant users, and the general population. MEASURES Longitudinal studies evaluating the risks of dementia or MCI in patients with depression and/or antidepressant users were identified from the OVID database. The outcomes were the number of patients who developed dementia or MCI among the antidepressant users and nonusers. Relative risk (RR) with 95% confidence interval (95% CI) was used to evaluate the association between the use of antidepressants and the risk of dementia and MCI. Meta-analysis was used for combining the effect sizes of individual studies, and the heterogeneity test was performed. Risk of bias and reporting quality of included studies was assessed. Subgroup analyses were conducted for different types of antidepressants. RESULTS A total of 18 studies with 2,119,627 participants with mean age ranging from 55 to 81 years were included. Among patients with depression, antidepressant users showed a significantly higher risk of dementia (RR = 1.37, 95% CI = 1.11-1.70) and MCI (RR = 1.20, 95% CI = 1.02-1.42) than the nonusers. Besides, patients with depression who used antidepressants and who did not use antidepressants also showed significantly higher risk of dementia than the general population (RR = 1.50, 95% CI = 1.26-1.78, and RR = 1.31, 95% CI = 1.15-1.51, respectively). CONCLUSIONS/IMPLICATIONS Patients with depression are associated with a higher risk of dementia, and the use of antidepressants is not shown to be a protective factor of dementia. Further large-scale trials are required for investigation of the benefit-risk ratio between depression relapse and dementia when prescribing antidepressants.
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Affiliation(s)
- Joyce Y C Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Karen K L Yiu
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong
| | - Timothy C Y Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Samuel Y S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Kelvin K F Tsoi
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
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30
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Rao VR, Sellers KK, Wallace DL, Lee MB, Bijanzadeh M, Sani OG, Yang Y, Shanechi MM, Dawes HE, Chang EF. Direct Electrical Stimulation of Lateral Orbitofrontal Cortex Acutely Improves Mood in Individuals with Symptoms of Depression. Curr Biol 2018; 28:3893-3902.e4. [DOI: 10.1016/j.cub.2018.10.026] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/16/2018] [Accepted: 10/10/2018] [Indexed: 11/30/2022]
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31
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Weigand A, Horn A, Caballero R, Cooke D, Stern AP, Taylor SF, Press D, Pascual-Leone A, Fox MD. Prospective Validation That Subgenual Connectivity Predicts Antidepressant Efficacy of Transcranial Magnetic Stimulation Sites. Biol Psychiatry 2018; 84:28-37. [PMID: 29274805 PMCID: PMC6091227 DOI: 10.1016/j.biopsych.2017.10.028] [Citation(s) in RCA: 252] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 10/07/2017] [Accepted: 10/31/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND The optimal target in the dorsolateral prefrontal cortex for treating depression with repetitive transcranial magnetic stimulation (rTMS) remains unknown. Better efficacy has been associated with stimulation sites that are 1) more anterior and lateral and 2) more functionally connected to the subgenual cingulate. Here we prospectively test whether these factors predict response in individual patients. METHODS A primary cohort (Boston, n = 25) with medication-refractory depression underwent conventional open-label rTMS to the left dorsolateral prefrontal cortex. A secondary cohort (Michigan, n = 16) underwent 4 weeks of sham followed by open-label rTMS for nonresponders (n = 12). In each patient, the location of the stimulation site was recorded with frameless stereotaxy. Connectivity between each patient's stimulation site and the subgenual cingulate was assessed using resting-state functional connectivity magnetic resonance imaging from a cohort of healthy subjects (n = 1000) and confirmed using connectivity from patients with depression (n = 38). RESULTS In our primary cohort, antidepressant efficacy was predicted by stimulation sites that were both more anterolateral (r = .51, p < .01) and more negatively correlated with the subgenual cingulate (r = -.55, p < .005). However, subgenual connectivity was the only independent predictor of response and the only factor to predict response to active (r = -.52, p < .05) but not sham rTMS in our secondary cohort. CONCLUSIONS This study provides prospective validation that functional connectivity between an individual's rTMS cortical target and the subgenual cingulate predicts antidepressant response. Implications for improving the cortical rTMS target for depression are discussed.
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Affiliation(s)
- Anne Weigand
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Luisenstrasse 56, 10099 Berlin, Germany
| | - Andreas Horn
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215,Department of Neurology, Movement Disorder and Neuromodulation Unit, Charité – Universitätsmedizin, Berlin, Germany
| | - Ruth Caballero
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215,Bioengineering and Telemedicine Center, ETSI Telecomunicación, Universidad Politécnica de Madrid, Avenida Complutense No 30 Ciudad Universitaria, 28040 Madrid, Spain
| | - Danielle Cooke
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215
| | - Adam P. Stern
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215,Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215
| | - Stephan F. Taylor
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109
| | - Daniel Press
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215,Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215,Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215,Institut Guttmann, Universitat Autonoma de Barcelona, Badalona, Barcelona, Spain
| | - Michael D. Fox
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129,Corresponding author.
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Astrocyte pathology in the ventral prefrontal white matter in depression. J Psychiatr Res 2018; 102:150-158. [PMID: 29660602 PMCID: PMC6005746 DOI: 10.1016/j.jpsychires.2018.04.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/22/2018] [Accepted: 04/05/2018] [Indexed: 12/15/2022]
Abstract
Astrocyte functions in white matter are less well understood than in gray matter. Our recent study of white matter in ventral prefrontal cortex (vPFC) revealed alterations in expression of myelin-related genes in major depressive disorder (MDD). Since white matter astrocytes maintain myelin, we hypothesized that morphometry of these cells will be altered in MDD in the same prefrontal white matter region in which myelin-related genes are altered. White matter adjacent to vPFC was examined in 25 MDD and 21 control subjects. Density and size of GFAP-immunoreactive (-ir) astrocyte cell bodies was measured. The area fraction of GFAP-ir astrocytes (cell bodies + processes) was also estimated. GFAP mRNA expression was determined using qRT-PCR. The density of GFAP-ir astrocytes was also measured in vPFC white matter of rats subjected to chronic unpredictable stress (CUS) and control animals. Fibrous and smooth GFAP-ir astrocytes were distinguished in human white matter. The density of both types of astrocytes was significantly decreased in MDD. Area fraction of GFAP immunoreactivity was significantly decreased in MDD, but mean soma size remained unchanged. Expression of GFAP mRNA was significantly decreased in MDD. In CUS rats there was a significant decrease in astrocyte density in prefrontal white matter. The decrease in density and area fraction of white matter astrocytes and GFAP mRNA in MDD may be linked to myelin pathology previously noted in these subjects. Astrocyte pathology may contribute to axon disturbances in axon integrity reported by neuroimaging studies in MDD and interfere with signal conduction in the white matter.
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Non-invasive vagus nerve stimulation significantly improves quality of life in patients with persistent postural-perceptual dizziness. J Neurol 2018; 265:63-69. [PMID: 29785522 DOI: 10.1007/s00415-018-8894-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/02/2018] [Accepted: 05/04/2018] [Indexed: 12/26/2022]
Abstract
Persistent postural-perceptual dizziness (PPPD) is one of the most common causes of chronic vestibular disorders, with a substantial portion of the affected patients showing no significant improvement to standard therapies (i.e., pharmacotherapy, behavioral psychotherapy). Patients with PPPD have been shown to have a significant comorbidity with anxiety disorders and depression. Further, these patients show an activation of the autonomic nervous system resulting in symptoms such as nausea, increase of heart rate, and sweating. Based on the comorbidities and the activation of the autonomic nervous system, we addressed the question whether non-invasive vagus nerve stimulation (nVNS) might be a treatment option for these patients. In this prospective study we, therefore, applied nVNS to patients with treatment-refractory (to the standard therapy) PPPD. The stimulation protocol was similar to previous studies in patients with cluster headache and consisted of stimulations during exacerbations or acute attacks of vertigo, but also with regular stimulations in the morning and evening as prophylactic treatment. Results showed that non-invasive vagus nerve stimulation significantly improved quality of life, as measured by the EQ-5D-3L (p = 0.04), and depression, as measured by the HADS-D (p = 0.002), in the nVNS group, but not in the age- and sex-matched group with standard of care (SOC) treatment. Moreover, in the pooled analysis (additional 4 weeks of stimulation also in the SOC-group), less severe vertigo attacks/exacerbations (p = 0.04), a decrease in total postural sway path as measured by posturography (p = 0.02), as well as tendentious less anxiety (p = 0.08), occurred after stimulation. These data imply that short term nVNS is a safe and promising treatment option in patients with otherwise refractory PPPD.
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Guo W, Liu F, Chen J, Wu R, Li L, Zhang Z, Chen H, Zhao J. Anatomical distance affects cortical-subcortical connectivity in first-episode, drug-naive somatization disorder. J Affect Disord 2017; 217:153-158. [PMID: 28411503 DOI: 10.1016/j.jad.2017.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/30/2017] [Accepted: 04/07/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Brain structural and functional alterations in the cortical-subcortical circuits have been observed in somatization disorder (SD). However, whether and how anatomical distance affects the cortical-subcortical connectivity in SD remain unclear. This study aims to examine whether anatomical distance affects the cortical-subcortical in first-episode, drug-naive SD. METHODS Twenty-five first-episode, drug-naive patients with SD and twenty-eight healthy controls were recruited for a resting-state scan. Regional functional connectivity strength (FCS) was calculated for each voxel in the brain, which was further divided into short- and long-range FCSs. Correlation analyses were conducted between abnormal FCS and clinical/cognitive variables in the patients. RESULTS Compared with the controls, the patients showed increased short-range positive FCS (spFCS) in the right superior frontal gyrus (SFG) and decreased spFCS in the left pallidum, and increased long-range positive FCS (lpFCS) in the left middle frontal gyrus and right inferior temporal gyrus (ITG). Positive correlations were observed between the spFCS values in the right SFG and Eysenck Personality Questionnaire psychoticism scores (r=0.441, p=0.027, uncorrected) and between the lpFCS values in the right ITG and scores of digit symbol-coding of Wechsler Adult Intelligence Scale (r=0.416, p=0.039, uncorrected) in the patients CONCLUSIONS: The patients exhibited increased spFCS/lpFCS in the cortical regions and decreased spFCS in the subcortical regions. The left pallidum is first reported here to show decreased spFCS in SD. The present results suggest that abnormal cortical-subcortical circuits may play an important role in SD neurobiology.
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Affiliation(s)
- Wenbin Guo
- Department of Psychiatry of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China; National Technology Institute on Mental Disorders, Changsha, Hunan 410011, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China.
| | - Feng Liu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jindong Chen
- Department of Psychiatry of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China; National Technology Institute on Mental Disorders, Changsha, Hunan 410011, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Renrong Wu
- Department of Psychiatry of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China; National Technology Institute on Mental Disorders, Changsha, Hunan 410011, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Lehua Li
- Department of Psychiatry of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China; National Technology Institute on Mental Disorders, Changsha, Hunan 410011, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Zhikun Zhang
- Mental Health Center of the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Huafu Chen
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jingping Zhao
- Department of Psychiatry of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan 410011, China; National Technology Institute on Mental Disorders, Changsha, Hunan 410011, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China.
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Kong XM, Xu SX, Sun Y, Wang KY, Wang C, Zhang J, Xia JX, Zhang L, Tan BJ, Xie XH. Electroconvulsive therapy changes the regional resting state function measured by regional homogeneity (ReHo) and amplitude of low frequency fluctuations (ALFF) in elderly major depressive disorder patients: An exploratory study. Psychiatry Res Neuroimaging 2017; 264:13-21. [PMID: 28412557 DOI: 10.1016/j.pscychresns.2017.04.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 04/06/2017] [Accepted: 04/06/2017] [Indexed: 02/07/2023]
Abstract
Electroconvulsive therapy (ECT) is the most effective and rapid treatment for severe major depressive disorder (MDD) in elderly patients. The mechanism of ECT is unclear, and studies on ECT in elderly MDD patients by resting-state functional magnetic resonance imaging are rare. Thirteen elderly MDD patients were scanned before and after ECT using a 3.0T MRI scanner. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuations (ALFF) were processed to compare resting-state function before and after treatment. Depression and anxiety symptoms of all patients abated after ECT. Decreased ReHo values in the bilateral superior frontal gyrus (SFG) were observed after ECT, and the values of right SFG significantly correlated with an altered Hamilton depression rating scale score. Increased ALFF values in the left middle frontal gyrus, right middle frontal gyrus, orbital part, and decreased ALFF values in the left midcingulate area, left precentral gyrus, right SFG/middle frontal gyrus after ECT were also observed. These results support the hypothesis that ECT may affect the regional resting state brain function in geriatric MDD patients.
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Affiliation(s)
- Xiao-Ming Kong
- Department of psychiatry, Anhui Mental Health Center, Hefei, China
| | - Shu-Xian Xu
- Department of psychiatry, Huizhou 2nd Municipal Hospital, Huizhou, China; Department of psychiatry, Anhui Medical University, Hefei, China
| | - Yan Sun
- Department of endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ke-Yong Wang
- Department of psychiatry, Anhui Mental Health Center, Hefei, China.
| | - Chen Wang
- Department of psychiatry, Anhui Mental Health Center, Hefei, China; Department of psychiatry, Anhui Medical University, Hefei, China
| | - Ji Zhang
- Department of magnetic resonance imaging, Hefei 2nd Municipal Hospital, Hefei, China
| | - Jin-Xiang Xia
- Department of magnetic resonance imaging, Hefei 2nd Municipal Hospital, Hefei, China
| | - Li Zhang
- Department of psychiatry, Anhui Mental Health Center, Hefei, China
| | - Bo-Jian Tan
- Department of psychiatry, Huizhou 2nd Municipal Hospital, Huizhou, China
| | - Xin-Hui Xie
- Department of psychiatry, Anhui Mental Health Center, Hefei, China; Department of psychiatry, Huizhou 2nd Municipal Hospital, Huizhou, China; Department of psychiatry, Anhui Medical University, Hefei, China.
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36
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Miller CWT. Epigenetic and Neural Circuitry Landscape of Psychotherapeutic Interventions. PSYCHIATRY JOURNAL 2017; 2017:5491812. [PMID: 29226124 PMCID: PMC5684598 DOI: 10.1155/2017/5491812] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 04/11/2017] [Indexed: 11/21/2022]
Abstract
The science behind psychotherapy has garnered considerable interest, as objective measures are being developed to map the patient's subjective change over the course of treatment. Prenatal and early life influences have a lasting impact on how genes are expressed and the manner in which neural circuits are consolidated. Transgenerationally transmitted epigenetic markers as well as templates of enhanced thought flexibility versus evasion can be passed down from parent to child. This influences gene expression/repression (impacting neuroplasticity) and kindling of neurocircuitry which can perpetuate maladaptive cognitive processing seen in a number of psychiatric conditions. Importantly, genetic factors and the compounding effects of early life adversity do not inexorably lead to certain fated outcomes. The concepts of vulnerability and resilience are becoming more integrated into the framework of "differential susceptibility," speaking to how corrective environmental factors may promote epigenetic change and reconfigure neural templates, allowing for symptomatic improvement. Psychotherapy is one such factor, and this review will focus on our current knowledge of its epigenetic and neurocircuitry impact.
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Affiliation(s)
- Christopher W. T. Miller
- University of Maryland School of Medicine, 701 W. Pratt St., 4th Floor, Baltimore, MD 21201, USA
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37
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Fettes P, Schulze L, Downar J. Cortico-Striatal-Thalamic Loop Circuits of the Orbitofrontal Cortex: Promising Therapeutic Targets in Psychiatric Illness. Front Syst Neurosci 2017; 11:25. [PMID: 28496402 PMCID: PMC5406748 DOI: 10.3389/fnsys.2017.00025] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 04/07/2017] [Indexed: 12/18/2022] Open
Abstract
Corticostriatal circuits through the orbitofrontal cortex (OFC) play key roles in complex human behaviors such as evaluation, affect regulation and reward-based decision-making. Importantly, the medial and lateral OFC (mOFC and lOFC) circuits have functionally and anatomically distinct connectivity profiles which differentially contribute to the various aspects of goal-directed behavior. OFC corticostriatal circuits have been consistently implicated across a wide range of psychiatric disorders, including major depressive disorder (MDD), obsessive compulsive disorder (OCD), and substance use disorders (SUDs). Furthermore, psychiatric disorders related to OFC corticostriatal dysfunction can be addressed via conventional and novel neurostimulatory techniques, including deep brain stimulation (DBS), electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS). Such techniques elicit changes in OFC corticostriatal activity, resulting in changes in clinical symptomatology. Here we review the available literature regarding how disturbances in mOFC and lOFC corticostriatal functioning may lead to psychiatric symptomatology in the aforementioned disorders, and how psychiatric treatments may exert their therapeutic effect by rectifying abnormal OFC corticostriatal activity. First, we review the role of OFC corticostriatal circuits in reward-guided learning, decision-making, affect regulation and reappraisal. Second, we discuss the role of OFC corticostriatal circuit dysfunction across a wide range of psychiatric disorders. Third, we review available evidence that the therapeutic mechanisms of various neuromodulation techniques may directly involve rectifying abnormal activity in mOFC and lOFC corticostriatal circuits. Finally, we examine the potential of future applications of therapeutic brain stimulation targeted at OFC circuitry; specifically, the role of OFC brain stimulation in the growing field of individually-tailored therapies and personalized medicine in psychiatry.
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Affiliation(s)
- Peter Fettes
- Institute of Medical Science, University of TorontoToronto, ON, Canada
| | - Laura Schulze
- Institute of Medical Science, University of TorontoToronto, ON, Canada
| | - Jonathan Downar
- Institute of Medical Science, University of TorontoToronto, ON, Canada.,Krembil Research Institute, University Health NetworkToronto, ON, Canada.,Department of Psychiatry, University of TorontoToronto, ON, Canada.,MRI-Guided rTMS Clinic, University Health NetworkToronto, ON, Canada
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38
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Radman T, Lisanby SH. New directions in the rational design of electrical and magnetic seizure therapies: individualized Low Amplitude Seizure Therapy (iLAST) and Magnetic Seizure Therapy (MST). Int Rev Psychiatry 2017; 29:63-78. [PMID: 28430533 DOI: 10.1080/09540261.2017.1304898] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Electroconvulsive therapy remains a key treatment option for severe cases of depression, but undesirable side-effects continue to limit its use. Innovations in the design of novel seizure therapies seek to improve its risk benefit ratio through enhanced control of the focality of stimulation. The design of seizure therapies with increased spatial precision is motivated by avoiding stimulation of deep brain structures implicated in memory retention, including the hippocampus. The development of two innovations in seizure therapy-individualized low-amplitude seizure therapy (iLAST) and magnetic seizure therapy (MST), are detailed. iLAST is a method of seizure titration involving reducing current spread in the brain by titrating current amplitude from the traditional fixed amplitudes. MST, which can be used in conjunction with iLAST dosing methods, involves the use of magnetic stimulation to reduce shunting and spreading of current by the scalp occurring during electrical stimulation. Evidence is presented on the rationale for increasing the focality of ECT in hopes of preserving its effectiveness, while reducing cognitive side-effects. Finally, the value of electric field and neural modelling is illustrated to explain observed clinical effects of modifications to ECT technique, and their utility in the rational design of the next generation of seizure therapies.
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Affiliation(s)
- Thomas Radman
- a National Institute of Mental Health , Bethesda , MD , USA
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39
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Feelings of shame, embarrassment and guilt and their neural correlates: A systematic review. Neurosci Biobehav Rev 2016; 71:455-471. [DOI: 10.1016/j.neubiorev.2016.09.019] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 08/19/2016] [Accepted: 09/23/2016] [Indexed: 01/10/2023]
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40
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Moreno-López L, Sahakian BJ, Manktelow A, Menon DK, Stamatakis EA. Depression following traumatic brain injury: A functional connectivity perspective. Brain Inj 2016; 30:1319-1328. [DOI: 10.1080/02699052.2016.1186839] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
| | - Barbara J. Sahakian
- Department of Psychiatry, MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Anne Manktelow
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - David K. Menon
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
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41
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Huebl J, Brücke C, Merkl A, Bajbouj M, Schneider GH, Kühn AA. Processing of emotional stimuli is reflected by modulations of beta band activity in the subgenual anterior cingulate cortex in patients with treatment resistant depression. Soc Cogn Affect Neurosci 2016; 11:1290-8. [PMID: 27013105 DOI: 10.1093/scan/nsw038] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 03/17/2016] [Indexed: 01/09/2023] Open
Abstract
Deep brain stimulation (DBS) of the subgenual anterior cingulate cortex (sgACC) has emerged as a new therapeutic option in patients with treatment resistant depression (TRD). At the same time, DBS offers a unique opportunity as an innovative research tool to study brain function in vivo Indirect measures of brain function such as positron-emission-tomography imaging findings have revealed a hypermetabolism in the sgACC area in patients with TRD that normalizes in parallel with treatment response to DBS. We used direct intracranial recordings via implanted DBS electrodes to study the neuronal oscillatory activity in the sgACC area during a picture viewing task including emotional and neutral stimuli in eight patients with TRD who underwent DBS.We found a stimulus-induced decrease in beta-band and increase in gamma-band activity, with a main effect of valence for event-related desynchronisation in the beta-frequency range (14-30 Hz). Unpleasant stimuli induced the strongest and most sustained beta-power decrease. The degree of beta-band modulation upon emotional stimuli correlated with the patients' rating of stimulus valence. Our findings confirm the involvement of the sgACC area in emotional processing that was more enhanced for unpleasant stimuli. Moreover, stimulus evaluation may be encoded by modulations of beta-band activity.
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Affiliation(s)
| | | | - Angela Merkl
- Department of Neurology Department of Psychiatry and Psychotherapy
| | | | | | - Andrea A Kühn
- Department of Neurology Mind & Brain School NeuroCure, Cluster of Excellence, Charité - University Medicine Berlin, Germany
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42
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Su Q, Yao D, Jiang M, Liu F, Long L, Dai Y, Yu M, Zhang Z, Zhang J, Liu J, Xiao C, Zhao J, Guo W. Decreased interhemispheric functional connectivity in insula and angular gyrus/supramarginal gyrus: Significant findings in first-episode, drug-naive somatization disorder. Psychiatry Res Neuroimaging 2016; 248:48-54. [PMID: 26826895 DOI: 10.1016/j.pscychresns.2016.01.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 11/01/2015] [Accepted: 01/03/2016] [Indexed: 01/14/2023]
Abstract
Neuroimaging data have demonstrated brain functional alterations in patients with somatization disorder (SD). However, there is little information on interhemispheric resting-state functional connectivity (FC) in SD. In this study, resting-state functional magnetic resonance imaging (fMRI) and voxel-mirrored homotopic connectivity (VMHC) were applied to examine the changes of interhemispheric FC of the whole brain in patients with SD. A total of 25 first-episode, medication-naive SD patients and 28 age-, sex-, education-matched healthy controls (HC) underwent resting-state fMRI, and the data were analyzed by VMHC. Compared with HC, patients had lower VMHC in the angular gyrus/supramarginal gyrus (AG/SG) and insula. The reproducibility of the results was validated using the split-half and leave-one-out validations. No significant correlation was found between the VMHC in AG/SG or insula and clinical variables. Our findings indicate that the interhemispheric FC in the AG/SG and insula is decreased in first-episode, treatment-naive patients with SD, and thus provide new insight for disruption of interhemispheric FC in the pathophysiological mechanism of SD.
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Affiliation(s)
- Qinji Su
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China
| | - Dapeng Yao
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China
| | - Muliang Jiang
- Department of Radiology, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China
| | - Feng Liu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, PR China
| | - Liling Long
- Department of Radiology, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China
| | - Yi Dai
- Department of Radiology, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China
| | - Miaoyu Yu
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China
| | - Zhikun Zhang
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China
| | - Jian Zhang
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China
| | - Jianrong Liu
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China
| | - Changqing Xiao
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China
| | - Jingping Zhao
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan 410011, PR China
| | - Wenbin Guo
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China.
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43
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Dunlop K, Hanlon CA, Downar J. Noninvasive brain stimulation treatments for addiction and major depression. Ann N Y Acad Sci 2016; 1394:31-54. [PMID: 26849183 PMCID: PMC5434820 DOI: 10.1111/nyas.12985] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Major depressive disorder (MDD) and substance use disorders (SUDs) are prevalent, disabling, and challenging illnesses for which new treatment options are needed, particularly in comorbid cases. Neuroimaging studies of the functional architecture of the brain suggest common neural substrates underlying MDD and SUDs. Intrinsic brain activity is organized into a set of functional networks, of which two are particularly relevant to psychiatry. The salience network (SN) is crucial for cognitive control and response inhibition, and deficits in SN function are implicated across a wide variety of psychiatric disorders, including MDD and SUDs. The ventromedial network (VMN) corresponds to the classic reward circuit, and pathological VMN activity for drug cues/negative stimuli is seen in SUDs/MDD. Noninvasive brain stimulation (NIBS) techniques, including rTMS and tDCS, have been used to enhance cortico–striatal–thalamic activity through the core SN nodes in the dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, and anterior insula. Improvements in both MDD and SUD symptoms ensue, including in comorbid cases, via enhanced cognitive control. Inhibition of the VMN also appears promising in preclinical studies for quenching the pathological incentive salience underlying SUDs and MDD. Evolving techniques may further enhance the efficacy of NIBS for MDD and SUD cases that are unresponsive to conventional treatments.
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Affiliation(s)
- Katharine Dunlop
- MRI-Guided rTMS Clinic, University Health Network, Toronto, Ontario, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Colleen A Hanlon
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina.,Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina.,Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina
| | - Jonathan Downar
- MRI-Guided rTMS Clinic, University Health Network, Toronto, Ontario, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
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44
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Brown S, Fite PJ, Stone K, Bortolato M. Accounting for the associations between child maltreatment and internalizing problems: The role of alexithymia. CHILD ABUSE & NEGLECT 2016; 52:20-8. [PMID: 26774529 DOI: 10.1016/j.chiabu.2015.12.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/10/2015] [Accepted: 12/15/2015] [Indexed: 05/26/2023]
Abstract
Internalizing difficulties are one of the most widely documented consequences of child maltreatment. However, there is a need for studies delineating the factors that account for this association. Despite research showing that alexithymia is associated with both child maltreatment and internalizing problems, the role of alexithymia in the link between child maltreatment and internalizing problems has not received much attention in the literature. The current study evaluated whether a history of child maltreatment was associated with symptoms of depression, anxiety, and loneliness in emerging adulthood, and whether alexithymia partially accounted for these associations. Participants included 339 emerging adults ranging between 18 and 25 years of age (M=19.00, SD=1.26, 51.3% male). Exposure to child maltreatment (i.e., physical abuse, physical neglect, sexual abuse, emotional abuse, and emotional neglect) was positively associated with depression, anxiety, and loneliness symptoms. Tests of indirect effects suggested that associations between emotional neglect and symptoms of depression, anxiety, and loneliness were partially explained by alexithymia. However, alexithymia did not account for any other associations between the remaining four maltreatment types and internalizing problems. Findings highlight the need for further evaluation of the factors that might account for associations between child maltreatment and internalizing difficulties. Future directions and implications for interventions are reviewed.
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Affiliation(s)
- Shaquanna Brown
- Clinical Child Psychology Program and Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, 2009 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045, USA
| | - Paula J Fite
- Clinical Child Psychology Program and Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, 2009 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045, USA
| | - Katie Stone
- Clinical Child Psychology Program and Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, 2009 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045, USA
| | - Marco Bortolato
- Department of Pharmacology and Toxicology and ConTRADA, University of Kansas, 5040 Malott Hall, 1251 Wescoe Hall Road, Lawrence, KS 66045, USA
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Cognition-related brain networks underpin the symptoms of unipolar depression: Evidence from a systematic review. Neurosci Biobehav Rev 2015; 61:53-65. [PMID: 26562681 DOI: 10.1016/j.neubiorev.2015.09.022] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/16/2015] [Accepted: 09/21/2015] [Indexed: 01/23/2023]
Abstract
This systematic review sources the latest neuroimaging evidence for the role of cognition-related brain networks in depression, and relates their abnormal functioning to symptoms of the disorder. Using theoretically informed and rigorous inclusion criteria, we integrate findings from 59 functional neuroimaging studies of adults with unipolar depression using a narrative approach. Results demonstrate that two distinct neurocognitive networks, the autobiographic memory network (AMN) and the cognitive control network (CCN), are central to the symptomatology of depression. Specifically, hyperactivity of the introspective AMN is linked to pathological brooding, self-blame, rumination. Anticorrelated under-engagement of the CCN is associated with indecisiveness, negative automatic thoughts, poor concentration, distorted cognitive processing. Downstream effects of this imbalance include reduced regulation of networks linked to the vegetative and affective symptoms of depression. The configurations of these networks can change between individuals and over time, plausibly accounting for both the variable presentation of depressive disorders and their fluctuating course. Framing depression as a disorder of neurocognitive networks directly links neurobiology to psychiatric practice, aiding researchers and clinicians alike.
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Young KD, Bellgowan PSF, Bodurka J, Drevets WC. Functional neuroimaging correlates of autobiographical memory deficits in subjects at risk for depression. Brain Sci 2015; 5:144-64. [PMID: 25919972 PMCID: PMC4493461 DOI: 10.3390/brainsci5020144] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/03/2015] [Accepted: 04/14/2015] [Indexed: 01/31/2023] Open
Abstract
Overgeneral autobiographical memory (AM) manifests in individuals with major depressive disorder (MDD) tested during depressed (dMDD) or remitted phases (rMDD), and healthy individuals at high-risk (HR) for developing MDD. The current study aimed to elucidate differences in hemodynamic correlates of AM recall between rMDDs, HRs, and controls (HCs) to identify neural changes following previous depressive episodes without the confound of current depressed mood. HCs, HRs, and unmedicated rMDDs (n = 20/group) underwent fMRI while recalling AMs in response to emotionally valenced cue words. HRs and rMDDs recalled fewer specific and more categorical AMs relative to HCs. During specific AM recall, HRs had increased activity relative to rMDDs and HCs in left ventrolateral prefrontal cortex (VLPFC) and lateral orbitofrontal cortex. During positive specific AM recall, HRs and HCs had increased activity relative to rMDDs in bilateral dorsomedial prefrontal cortex (DMPFC) and left precuneus. During negative specific AM recall HRs and HCs had increased activity in left VLPFC and right DMPFC, while rMDDs had increased activity relative to HRs and HCs in right DLPFC and precuneus. Differential recruitment of medial prefrontal regions implicated in emotional control suggests experiencing a depressive episode may consequently reduce one’s ability to regulate emotional responses during AM recall.
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Affiliation(s)
- Kymberly D Young
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA.
| | - Patrick S F Bellgowan
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA.
- Biomedical Engineering Center, College of Engineering, University of Oklahoma, Norman, OK 73019, USA.
| | - Wayne C Drevets
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA.
- Janssen Research and Development, LLC, of Johnson & Johnson, Inc., Titusville, NJ 08560, USA.
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47
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Somatostatin, neuronal vulnerability and behavioral emotionality. Mol Psychiatry 2015; 20:377-87. [PMID: 25600109 PMCID: PMC4355106 DOI: 10.1038/mp.2014.184] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 10/13/2014] [Accepted: 11/17/2014] [Indexed: 12/16/2022]
Abstract
Somatostatin (SST) deficits are common pathological features in depression and other neurological disorders with mood disturbances, but little is known about the contribution of SST deficits to mood symptoms or causes of these deficits. Here we show that mice lacking SST (Sst(KO)) exhibit elevated behavioral emotionality, high basal plasma corticosterone and reduced gene expression of Bdnf, Cortistatin and Gad67, together recapitulating behavioral, neuroendocrine and molecular features of human depression. Studies in Sst(KO) and heterozygous (Sst(HZ)) mice show that elevated corticosterone is not sufficient to reproduce the behavioral phenotype, suggesting a putative role for Sst cell-specific molecular changes. Using laser capture microdissection, we show that cortical SST-positive interneurons display significantly greater transcriptome deregulations after chronic stress compared with pyramidal neurons. Protein translation through eukaryotic initiation factor 2 (EIF2) signaling, a pathway previously implicated in neurodegenerative diseases, was most affected and suppressed in stress-exposed SST neurons. We then show that activating EIF2 signaling through EIF2 kinase inhibition mitigated stress-induced behavioral emotionality in mice. Taken together, our data suggest that (1) low SST has a causal role in mood-related phenotypes, (2) deregulated EIF2-mediated protein translation may represent a mechanism for vulnerability of SST neurons and (3) that global EIF2 signaling has antidepressant/anxiolytic potential.
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48
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Su Q, Yao D, Jiang M, Liu F, Jiang J, Xu C, Dai Y, Yu M, Long L, Li H, Liu J, Zhang Z, Zhang J, Xiao C, Guo W. Increased functional connectivity strength of right inferior temporal gyrus in first-episode, drug-naive somatization disorder. Aust N Z J Psychiatry 2015; 49:74-81. [PMID: 25313257 DOI: 10.1177/0004867414553949] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Evidence of brain structural and functional alterations have been implicated in patients with somatization disorder (SD). However, little is known about brain functional connectivity in SD. In the present study, resting-state functional magnetic resonance imaging (fMRI) and graph theory were used to obtain a comprehensive view of whole-brain functional connectivity and to investigate the changes of voxel-wise functional networks in patients with SD. METHODS Twenty-five first-episode, medication-naive patients with SD and 28 age-, sex- and education-matched healthy controls (HCs) underwent resting-state fMRI. The graph theory approach was employed to analyze the data. RESULTS Compared to the HCs, patients with SD showed significantly increased functional connectivity strength in the right inferior temporal gyrus (ITG). There is a significant positive correlation between the z-values of the cluster in the right ITG and Hamilton Anxiety Scale scores. CONCLUSIONS Our findings indicate that there is a disruption of the functional connectivity pattern in the right ITG in first-episode, treatment-naive patients with SD, which bears clinical significance.
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Affiliation(s)
- Qinji Su
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Dapeng Yao
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Muliang Jiang
- Department of Radiology, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Feng Liu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jiajing Jiang
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Chunxing Xu
- Mental Health Institute, The 303rd Hospital of Chinese People's Liberation Army, Nanning, Guangxi, China
| | - Yi Dai
- Department of Radiology, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Miaoyu Yu
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Liling Long
- Department of Radiology, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Hongzheng Li
- Mental Health Institute, The 303rd Hospital of Chinese People's Liberation Army, Nanning, Guangxi, China
| | - Jianrong Liu
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Zhikun Zhang
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Jian Zhang
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Changqing Xiao
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Wenbin Guo
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
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49
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Dusi N, Barlati S, Vita A, Brambilla P. Brain Structural Effects of Antidepressant Treatment in Major Depression. Curr Neuropharmacol 2015; 13:458-65. [PMID: 26412065 PMCID: PMC4790407 DOI: 10.2174/1570159x1304150831121909] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/16/2014] [Accepted: 12/19/2015] [Indexed: 01/26/2023] Open
Abstract
Depressive disorder is a very frequent and heterogeneous syndrome. Structural imaging techniques offer a useful tool in the comprehension of neurobiological alterations that concern depressive disorder. Altered brain structures in depressive disorder have been particularly located in the prefrontal cortex (medial prefrontal cortex and orbitofrontal cortex, OFC) and medial temporal cortex areas (hippocampus). These brain areas belong to a structural and functional network related to cognitive and emotional processes putatively implicated in depressive symptoms. These volumetric alterations may also represent biological predictors of response to pharmacological treatment. In this context, major findings of magnetic resonance (MR) imaging, in relation to treatment response in depressive disorder, will here be presented and discussed.
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Affiliation(s)
| | | | | | - Paolo Brambilla
- Dipartimento di Neuroscienze e Salute Mentale, Università degli Studi di Milano, U.O.C. Psichiatria, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35 - 20122 Milano.
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50
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Liberg B, Rahm C. The functional anatomy of psychomotor disturbances in major depressive disorder. Front Psychiatry 2015; 6:34. [PMID: 25806006 PMCID: PMC4354237 DOI: 10.3389/fpsyt.2015.00034] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 02/19/2015] [Indexed: 12/16/2022] Open
Abstract
Psychomotor disturbances (PMD) are a classic feature of depressive disorder that provides rich clinical information. The aim our narrative review was to characterize the functional anatomy of PMD by summarizing findings from neuroimaging studies. We found evidence across several neuroimaging modalities that suggest involvement of fronto-striatal neurocircuitry, and monoaminergic pathways and metabolism. We suggest that PMD in major depressive disorder emerge from an alteration of limbic signals, which influence emotion, volition, higher-order cognitive functions, and movement.
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Affiliation(s)
- Benny Liberg
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne , Melbourne, VIC , Australia ; Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet , Stockholm , Sweden
| | - Christoffer Rahm
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne , Melbourne, VIC , Australia ; Unit of Metabolism, Department of Medicine Huddinge, Karolinska Institutet , Stockholm , Sweden
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