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Taraku B, Zavaliangos-Petropulu A, Loureiro JR, Al-Sharif NB, Kubicki A, Joshi SH, Woods RP, Espinoza R, Narr KL, Sahib AK. White matter microstructural perturbations after total sleep deprivation in depression. Front Psychiatry 2023; 14:1195763. [PMID: 37457774 PMCID: PMC10345348 DOI: 10.3389/fpsyt.2023.1195763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
Background Total sleep deprivation (TSD) transiently reverses depressive symptoms in a majority of patients with depression. How TSD modulates diffusion tensor imaging (DTI) measures of white matter (WM) microstructure, which may be linked with TSD's rapid antidepressant effects, remains uncharacterized. Methods Patients with depression (N = 48, mean age = 33, 26 women) completed diffusion-weighted imaging and Hamilton Depression Rating (HDRS) and rumination scales before and after >24 h of TSD. Healthy controls (HC) (N = 53, 23 women) completed the same assessments at baseline, and after receiving TSD in a subset of HCs (N = 15). Tract based spatial statistics (TBSS) investigated voxelwise changes in fractional anisotropy (FA) across major WM pathways pre-to-post TSD in patients and HCs and between patients and HCs at baseline. Post hoc analyses tested for TSD effects for other diffusion metrics, and the relationships between change in diffusion measures with change in mood and rumination symptoms. Results Significant improvements in mood and rumination occurred in patients with depression (both p < 0.001), but not in HCs following TSD. Patients showed significant (p < 0.05, corrected) decreases in FA values in multiple WM tracts, including the body of the corpus callosum and anterior corona radiata post-TSD. Significant voxel-level changes in FA were not observed in HCs who received TSD (p > 0.05). However, differential effects of TSD between HCs and patients were found in the superior corona radiata, frontal WM and the posterior thalamic radiation (p < 0.05, corrected). A significant (p < 0.05) association between change in FA and axial diffusivity within the right superior corona radiata and improvement in rumination was found post-TSD in patients. Conclusion Total sleep deprivation leads to rapid microstructural changes in WM pathways in patients with depression that are distinct from WM changes associated with TSD observed in HCs. WM tracts including the superior corona radiata and posterior thalamic radiation could be potential biomarkers of the rapid therapeutic effects of TSD. Changes in superior corona radiata FA, in particular, may relate to improvements in maladaptive rumination.
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Affiliation(s)
- Brandon Taraku
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Artemis Zavaliangos-Petropulu
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Joana R. Loureiro
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Noor B. Al-Sharif
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Antoni Kubicki
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shantanu H. Joshi
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Roger P. Woods
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Randall Espinoza
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Katherine L. Narr
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Ashish K. Sahib
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
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Zhang B, Wei D, Yan G, Lei T, Cai H, Yang Z. Feature-level fusion based on spatial-temporal of pervasive EEG for depression recognition. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 226:107113. [PMID: 36103735 DOI: 10.1016/j.cmpb.2022.107113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/23/2022] [Accepted: 09/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE In view of the depression characteristics such as high prevalence, high disability rate, high fatality rate, and high recurrence rate, early identification and early intervention are the most effective methods to prevent irreversible damage of brain function over time. The traditional method of depression recognition based on questionnaires and interviews is time-consuming and labor-intensive, and heavily depends on the doctor's subjective experience. Therefore, accurate, convenient and effective recognition of depression has important social value and scientific significance. METHODS This paper proposes a depression recognition framework based on feature-level fusion of spatial-temporal pervasive electroencephalography (EEG). Time series EEG data were collected by portable three-electrode EEG acquisition instrument, and mapped to a spatial complex network called visibility graph (VG). Then temporal EEG features and spatial VG metric features were extracted and selected. Based on the correlation between features and categories, the differences in contribution of individual feature are explored, and different contribution coefficients are assigned to different features as the data basis of feature-level fusion to ensure the diversity of data. A cascade forest model based on three different decision forests is designed to realize the efficient depression recognition using spatial-temporal feature-level fusion data. RESULTS Experimental data were obtained from 26 depressed patients and 29 healthy controls (HC). The results of multiple control experiments show that compared with single type feature, feature-level fusion without contribution coefficient, and independent classifiers, the feature-level method with contribution coefficient of spatial-temporal has a stronger recognition ability of depression, and the highest accuracy is 92.48%. CONCLUSION Feature-level fusion method provides an effective computer-aided tool for rapid clinical diagnosis of depression.
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Affiliation(s)
- Bingtao Zhang
- School of Electronic and Information Engineering, Lanzhou Jiaotong University, Lanzhou 730070, China; School of Information Science and Engineering, Lanzhou University, Lanzhou 730000, China.
| | - Dan Wei
- School of Electronic and Information Engineering, Lanzhou Jiaotong University, Lanzhou 730070, China
| | - Guanghui Yan
- School of Electronic and Information Engineering, Lanzhou Jiaotong University, Lanzhou 730070, China
| | - Tao Lei
- School of Electronic Information and Artificial Intelligence, Shaanxi University of Science and Technology, Xi'an 710021, China
| | - Haishu Cai
- School of Information Science and Engineering, Lanzhou University, Lanzhou 730000, China
| | - Zhifei Yang
- School of Electronic and Information Engineering, Lanzhou Jiaotong University, Lanzhou 730070, China
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Piorecky M, Koudelka V, Miletinova E, Buskova J, Strobl J, Horacek J, Brunovsky M, Jiricek S, Hlinka J, Tomecek D, Piorecka V. Simultaneous fMRI-EEG-Based Characterisation of NREM Parasomnia Disease: Methods and Limitations. Diagnostics (Basel) 2020; 10:diagnostics10121087. [PMID: 33327626 PMCID: PMC7765133 DOI: 10.3390/diagnostics10121087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/29/2020] [Accepted: 12/02/2020] [Indexed: 11/25/2022] Open
Abstract
Functional magnetic resonance imaging (fMRI) techniques and electroencephalography (EEG) were used to investigate sleep with a focus on impaired arousal mechanisms in disorders of arousal (DOAs). With a prevalence of 2–4% in adults, DOAs are significant disorders that are currently gaining attention among physicians. The paper describes a simultaneous EEG and fMRI experiment conducted in adult individuals with DOAs (n=10). Both EEG and fMRI data were validated by reproducing well established EEG and fMRI associations. A method for identification of both brain functional areas and EEG rhythms associated with DOAs in shallow sleep was designed. Significant differences between patients and controls were found in delta, theta, and alpha bands during awakening epochs. General linear models of the blood-oxygen-level-dependent signal have shown the secondary visual cortex and dorsal posterior cingulate cortex to be associated with alpha spectral power fluctuations, and the precuneus with delta spectral power fluctuations, specifically in patients and not in controls. Future EEG–fMRI sleep studies should also consider subject comfort as an important aspect in the experimental design.
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Affiliation(s)
- Marek Piorecky
- National Institute of Mental Health, 25067 Klecany, Czech Republic; (V.K.); (E.M.); (J.B.); (J.H.); (S.J.); (J.H.); (D.T.); (V.P.)
- Department of Biomedical Technology, Faculty of Biomedical Engineering, CTU in Prague, 27201 Kladno, Czech Republic;
- Correspondence: (M.P.); (M.B.); Tel.: +420-224-357-996 (M.P.); +420-283-088-438 (M.B.)
| | - Vlastimil Koudelka
- National Institute of Mental Health, 25067 Klecany, Czech Republic; (V.K.); (E.M.); (J.B.); (J.H.); (S.J.); (J.H.); (D.T.); (V.P.)
| | - Eva Miletinova
- National Institute of Mental Health, 25067 Klecany, Czech Republic; (V.K.); (E.M.); (J.B.); (J.H.); (S.J.); (J.H.); (D.T.); (V.P.)
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| | - Jitka Buskova
- National Institute of Mental Health, 25067 Klecany, Czech Republic; (V.K.); (E.M.); (J.B.); (J.H.); (S.J.); (J.H.); (D.T.); (V.P.)
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| | - Jan Strobl
- Department of Biomedical Technology, Faculty of Biomedical Engineering, CTU in Prague, 27201 Kladno, Czech Republic;
| | - Jiri Horacek
- National Institute of Mental Health, 25067 Klecany, Czech Republic; (V.K.); (E.M.); (J.B.); (J.H.); (S.J.); (J.H.); (D.T.); (V.P.)
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
| | - Martin Brunovsky
- National Institute of Mental Health, 25067 Klecany, Czech Republic; (V.K.); (E.M.); (J.B.); (J.H.); (S.J.); (J.H.); (D.T.); (V.P.)
- Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic
- Correspondence: (M.P.); (M.B.); Tel.: +420-224-357-996 (M.P.); +420-283-088-438 (M.B.)
| | - Stanislav Jiricek
- National Institute of Mental Health, 25067 Klecany, Czech Republic; (V.K.); (E.M.); (J.B.); (J.H.); (S.J.); (J.H.); (D.T.); (V.P.)
- Institute of Computer Science of the Czech Academy of Sciences, 18207 Prague, Czech Republic
- Department of Cybernetics, Faculty of Electrical Engineering, Czech Technical University in Prague, 16627 Prague, Czech Republic
| | - Jaroslav Hlinka
- National Institute of Mental Health, 25067 Klecany, Czech Republic; (V.K.); (E.M.); (J.B.); (J.H.); (S.J.); (J.H.); (D.T.); (V.P.)
- Institute of Computer Science of the Czech Academy of Sciences, 18207 Prague, Czech Republic
| | - David Tomecek
- National Institute of Mental Health, 25067 Klecany, Czech Republic; (V.K.); (E.M.); (J.B.); (J.H.); (S.J.); (J.H.); (D.T.); (V.P.)
- Institute of Computer Science of the Czech Academy of Sciences, 18207 Prague, Czech Republic
- Department of Cybernetics, Faculty of Electrical Engineering, Czech Technical University in Prague, 16627 Prague, Czech Republic
| | - Vaclava Piorecka
- National Institute of Mental Health, 25067 Klecany, Czech Republic; (V.K.); (E.M.); (J.B.); (J.H.); (S.J.); (J.H.); (D.T.); (V.P.)
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Zhang X, Shen J, Din ZU, Liu J, Wang G, Hu B. Multimodal Depression Detection: Fusion of Electroencephalography and Paralinguistic Behaviors Using a Novel Strategy for Classifier Ensemble. IEEE J Biomed Health Inform 2019; 23:2265-2275. [PMID: 31478879 DOI: 10.1109/jbhi.2019.2938247] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Currently, depression has become a common mental disorder and one of the main causes of disability worldwide. Due to the difference in depressive symptoms evoked by individual differences, how to design comprehensive and effective depression detection methods has become an urgent demand. This study explored from physiological and behavioral perspectives simultaneously and fused pervasive electroencephalography (EEG) and vocal signals to make the detection of depression more objective, effective and convenient. After extraction of several effective features for these two types of signals, we trained six representational classifiers on each modality, then denoted diversity and correlation of decisions from different classifiers using co-decision tensor and combined these decisions into the ultimate classification result with multi-agent strategy. Experimental results on 170 (81 depressed patients and 89 normal controls) subjects showed that the proposed multi-modal depression detection strategy is superior to the single-modal classifiers or other typical late fusion strategies in accuracy, f1-score and sensitivity. This work indicates that late fusion of pervasive physiological and behavioral signals is promising for depression detection and the multi-agent strategy can take advantage of diversity and correlation of different classifiers effectively to gain a better final decision.
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Antidepressant treatment effects on dopamine transporter availability in patients with major depression: a prospective 123I-FP-CIT SPECT imaging genetic study. J Neural Transm (Vienna) 2018; 125:995-1005. [DOI: 10.1007/s00702-018-1863-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/15/2018] [Indexed: 10/18/2022]
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Sheng M, Lu H, Liu P, Thomas BP, McAdams CJ. Cerebral perfusion differences in women currently with and recovered from anorexia nervosa. Psychiatry Res 2015; 232:175-83. [PMID: 25795596 PMCID: PMC4417098 DOI: 10.1016/j.pscychresns.2015.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 12/19/2014] [Accepted: 02/19/2015] [Indexed: 12/26/2022]
Abstract
Anorexia nervosa is a serious psychiatric disorder characterized by restricted eating, a pursuit of thinness, and altered perceptions of body shape and size. Neuroimaging in anorexia nervosa has revealed morphological and functional alterations in the brain. A better understanding of physiological changes in anorexia nervosa could provide a brain-specific health marker relevant to treatment and outcomes. In this study, we applied several advanced magnetic resonance imaging (MRI) techniques to quantify regional and global cerebral blood flow (CBF) in 25 healthy women (HC), 23 patients currently with anorexia (AN-C) and 19 patients in long-term weight recovery following anorexia (AN-WR). Specifically, CBF was measured with pseudo-continuous arterial spin labeling (pCASL) MRI and then verified by a different technique, phase contrast (PC) MRI. Venous T2 values were determined by T2 relaxation under spin tagging (TRUST) MRI, and were used to corroborate the CBF results. These novel techniques were implemented on a standard 3T MRI scanner without any exogenous tracers, and the total scan duration was less than 10min. Voxel-wise comparison revealed that the AN-WR group showed lower CBF in bilateral temporal and frontal lobes than the AN-C group. Compared with the HC group, the AN-C group also showed higher CBF in the right temporal lobe. Whole-brain-averaged CBF was significantly decreased in the AN-WR group compared with the AN-C group, consistent with the PC-MRI results. Venous T2 values were lower in the AN-WR group than in the AN-C group, consistent with the CBF results. A review of prior work examining CBF in anorexia nervosa is included in the discussion. This study identifies several differences in the cerebral physiological alterations in anorexia nervosa, and finds specific differences relevant to the current state of the disorder.
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Affiliation(s)
- Min Sheng
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Hanzhang Lu
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States,Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Peiying Liu
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States,Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Binu P. Thomas
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Carrie J. McAdams
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States,Corresponding author. Tel: +1 214 648 4145; fax: +1 214 648 5321. (C.J.McAdams)
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Sleep deprivation increases dorsal nexus connectivity to the dorsolateral prefrontal cortex in humans. Proc Natl Acad Sci U S A 2013; 110:19597-602. [PMID: 24218598 DOI: 10.1073/pnas.1317010110] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In many patients with major depressive disorder, sleep deprivation, or wake therapy, induces an immediate but often transient antidepressant response. It is known from brain imaging studies that changes in anterior cingulate and dorsolateral prefrontal cortex activity correlate with a relief of depression symptoms. Recently, resting-state functional magnetic resonance imaging revealed that brain network connectivity via the dorsal nexus (DN), a cortical area in the dorsomedial prefrontal cortex, is dramatically increased in depressed patients. To investigate whether an alteration in DN connectivity could provide a biomarker of therapy response and to determine brain mechanisms of action underlying sleep deprivations antidepressant effects, we examined its influence on resting state default mode network and DN connectivity in healthy humans. Our findings show that sleep deprivation reduced functional connectivity between posterior cingulate cortex and bilateral anterior cingulate cortex (Brodmann area 32), and enhanced connectivity between DN and distinct areas in right dorsolateral prefrontal cortex (Brodmann area 10). These findings are consistent with resolution of dysfunctional brain network connectivity changes observed in depression and suggest changes in prefrontal connectivity with the DN as a brain mechanism of antidepressant therapy action.
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Watts JM, Whitlow CT, Maldjian JA. Clinical applications of arterial spin labeling. NMR IN BIOMEDICINE 2013; 26:892-900. [PMID: 23378178 DOI: 10.1002/nbm.2904] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 10/23/2012] [Accepted: 11/12/2012] [Indexed: 06/01/2023]
Abstract
MR arterial spin labeling is primarily applied as a neuroimaging method to measure cerebral blood flow. As this technique becomes more widely available, a basic understanding of the clinical applications is necessary for optimal utilization in the setting of patient care. This review focuses on the use of arterial spin labeling imaging for the evaluation of cerebrovascular disease, brain tumors and neuropsychiatric illness.
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Affiliation(s)
- Jonathan M Watts
- Wake Forest School of Medicine, Department of Radiology, Winston Salem, NC, USA
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Abstract
Current antidepressants are ineffective in many depressed patients. Thus there is an urgent need to develop treatment strategies which have significantly faster response, can be sustained and have minimal side-effects. This paper reviews clinical data, potential biomarkers, mechanisms of action and future research directions for two proven strategies that produce marked improvement in severe depressive symptoms within 48 h, ketamine and sleep deprivation therapy (SDT). These treatments provide unequivocal evidence that the depressive process can be rapidly reversed in a subgroup of patients. Seventeen ketamine studies in over 150 patients showed a rapid response. Low-dose intravenous ketamine produced mild psychotomimetic effects but response has not been effectively sustained. SDT has been investigated in over 60 studies with a 40-60% response rate within 48 h. Although SDT is often used in Europe to initiate a rapid response, it is less utilized within the USA, in part, because it has a short duration when administered alone. We review data concerning chronotherapeutic strategies of bright-light therapy (BLT) and sleep-phase advance (SPA) which successfully sustain the antidepressant efficacy of SDT. Evidence is further discussed that a significant group of mood disorders have abnormal circadian rhythms which are known to be controlled by clock genes. It is hypothesized that chronotherapeutic manipulations can reset clock genes and thus, abnormalities in circadian rhythms. Further findings are reviewed that ketamine, in addition to its role as an NMDA antagonist, can also alter circadian rhythms. Thus, ketamine may share a critical mechanism with SDT.
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Desseilles M, Dang-Vu T, Maquet P. Functional neuroimaging in sleep, sleep deprivation, and sleep disorders. HANDBOOK OF CLINICAL NEUROLOGY 2011; 98:71-94. [DOI: 10.1016/b978-0-444-52006-7.00006-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Pizzagalli DA. Frontocingulate dysfunction in depression: toward biomarkers of treatment response. Neuropsychopharmacology 2011; 36:183-206. [PMID: 20861828 PMCID: PMC3036952 DOI: 10.1038/npp.2010.166] [Citation(s) in RCA: 608] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 08/21/2010] [Accepted: 08/21/2010] [Indexed: 12/13/2022]
Abstract
Increased rostral anterior cingulate cortex (rACC) activity has emerged as a promising predictor of treatment response in depression, but neither the reliability of this relationship nor the mechanisms supporting it have been thoroughly investigated. This review takes a three-pronged approach to these issues. First, I present a meta-analysis demonstrating that the relationship between resting rACC activity and treatment response is robust. Second, I propose that the rACC plays a key role in treatment outcome because of its 'hub' position in the default network. Specifically, I hypothesize that elevated resting rACC activity confers better treatment outcomes by fostering adaptive self-referential processing and by helping to recalibrate relationships between the default network and a 'task-positive network' that comprises dorsolateral prefrontal and dorsal cingulate regions implicated in cognitive control. Third, I support this hypothesis by reviewing neuropsychological, electrophysiological, and neuroimaging data on frontocingulate dysfunction in depression. The review ends with a discussion of the limitations of current work and future directions.
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Affiliation(s)
- Diego A Pizzagalli
- Center for Depression, Anxiety, and Stress Research & Neuroimaging Center, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA.
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Chronic and treatment-resistant depression: a study using arterial spin labeling perfusion MRI at 3Tesla. Psychiatry Res 2010; 182:111-6. [PMID: 20427157 DOI: 10.1016/j.pscychresns.2010.01.009] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Revised: 12/23/2009] [Accepted: 01/14/2010] [Indexed: 11/22/2022]
Abstract
The aim of the present study was to compare patients displaying chronic and treatment-resistant depression with healthy controls, using the resting-state perfusion with arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI) technique at 3T. The study focused on the subgenual anterior cingulate cortex (sACC), which is a key component in the pathophysiology of depression. Six patients with chronic and treatment-resistant depression and six healthy control subjects were included. ASL is an innovative imaging technique which sidesteps the limitations of other functional neuroimaging techniques (functional MRI, positron emission tomography). A statistical analysis of perfusion maps was performed using SPM2 software. Statistically significant hyperperfusion regions were found in the depressed patient group compared with the healthy control group in the following: the bilateral sACC, left prefrontal dorsomedian cortex, left ACC and left subcortical areas (putamen, pallidum and amygdala). This study confirmed the involvement of the sACC in depression, particularly chronic and treatment-resistant depression, using ASL at 3T, a safe perfusion technique that seems to be appropriate for investigating functional abnormalities in psychiatric disorders.
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Abstract
INTRODUCTION Cerebral perfusion imaging using magnetic resonance imaging (MRI) is widely used in the research and clinical fields to assess the profound changes in blood flow related to ischemic events such as acute stroke, chronic steno-occlusive disease, vasospasm, and abnormal vessel formations from congenital conditions or tumoral neovascularity. With continuing improvements in the precision of MRI-based perfusion techniques, it is increasingly feasible to use this tool in the study of the subtle brain perfusion changes occurring in psychiatric illnesses. This article aims to review the existing literature on applications of perfusion MRI in psychiatric disorder and substance abuse research. The article also provides a brief introductory overview of dynamic susceptibility contrast MRI and arterial spin labeling techniques. An outlook of necessary steps to bring perfusion MRI into the realm of clinical psychiatry as a diagnostic tool is brought forth. Opportunities for research in unexplored disorders and with higher field strengths are briefly examined. METHODS PubMed, ISI Web of Knowledge & Scopus were used to search the literature and cross reference several neuropsychiatric disorders with a search term construct, including "magnetic resonance imaging," "dynamic susceptibility contrast," "arterial spin labeling," perfusion or "cerebral blood flow" or "cerebral blood volume" or "mean transit time." The list of disorders used in the search included schizophrenia, depression and bipolar disorder, dementia and Alzheimer's disease, Parkinson's disease, posttraumatic stress disorder, autism, Asperger disease, attention deficit, Tourette syndrome, obsessive-compulsive disorder, Huntington's disease, bulimia nervosa, anorexia nervosa, and substance abuse. For each disorder for which perfusion MRI studies were found, a brief overview of the disorder symptoms, treatment, prevalence, and existing models is provided, and previous findings from nuclear medicine-based perfusion imaging are overviewed. Findings of perfusion MRI studies are then summarized, and overlap of findings are discussed. Overarching conclusions are made, or an outlook for future work in the area is offered, where appropriate. RESULTS Despite the now fairly broad availability of perfusion MRI, only a limited number of studies were found using this technology. The search produced 13 studies of schizophrenia, 7 studies in major depression, 12 studies in Alzheimer's disease, and 2 studies in Parkinson's disease. Drug abuse and other disorders have mainly been studied with nuclear medicine-based perfusion imaging. The literature concerning the use of perfusion imaging in psychiatry has not been reviewed in the last 5 years or more. The use of MRI for perfusion measurements in psychiatry has not been reviewed in 10 years. CONCLUSIONS Although MRI-based perfusion imaging in psychiatry has mainly been used as a research tool, a path is progressively being cleared for its application in clinical diagnostic and treatment monitoring. The precision of perfusion MRI methods now rivals that of nuclear medicine-based perfusion imaging techniques. Because of their noninvasive nature, arterial spin labeling methods have gained popularity in studies of neuropsychiatric disorders such as schizophrenia, depression, Alzheimer's, and Parkinson's diseases. Perfusion imaging measurements have yet to be included within the diagnostic criteria of neuropsychiatric disorders despite having shown to have great discriminant power in specific disorders. As this young methodology continues to improve and research studies demonstrate the correlation of measured perfusion abnormalities to microcirculatory abnormalities and neuropsychiatric symptomatology, the idea of including such a test within diagnostic criteria for certain mental illnesses becomes increasingly plausible.
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Maclean RR, Datta S. The relationship between anxiety and sleep-wake behavior after stressor exposure in the rat. Brain Res 2007; 1164:72-80. [PMID: 17644077 PMCID: PMC1994477 DOI: 10.1016/j.brainres.2007.06.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 06/15/2007] [Accepted: 06/19/2007] [Indexed: 12/30/2022]
Abstract
Disturbed sleep is a common subjective complaint among individuals diagnosed with anxiety disorders. In rodents, sleep is often recorded after exposure to various foot-shock paradigms designed to induce an anxiety state. Although differences in sleep-wake architecture are noted, the relationship to specific level of anxiety is often assumed or absent. Utilizing the elevated plus-maze (EPM) after exposure to escapable shock (ES), inescapable shock (IS) or fear conditioning (FC), resulting differences in sleep architecture were compared to an objective measure of anxiety. Male Wistar rats were implanted with EEG, EMG and hippocampal theta electrodes to record sleep-wake behavior. After recovery and recording of baseline sleep, rats were exposed to one of five manipulations: ES, IS, FC or control (CES or CIS; utilizing either chamber with no shock exposure). Shortly after experimental manipulation, the EPM was employed to quantify traditional and ethological measures of anxiety and polygraphic signs of sleep-wake behavior were recorded continuously for 6 h. Although no significance was observed in EPM measurements across groups, profound differences in sleep architecture were present. Individual correlation analysis revealed no differences in anxiety level and total percentage of time spent in sleep-wake states. These results indicate that differences in sleep architecture after foot-shock exposure may not be simply due to increased anxiety. Rather, individual anxiety may be exacerbated by disrupted sleep. To fully understand the relationship between anxiety and sleep-wake behavior, a more objective analysis of anxiety after stressor exposure is mandated.
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Affiliation(s)
- Robert Ross Maclean
- Sleep and Cognitive Neuroscience Laboratory, Department of Psychiatry, Boston University School of Medicine, 85 E. Newton St. M-902, Boston, MA 02118, USA
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Dang-Vu TT, Desseilles M, Petit D, Mazza S, Montplaisir J, Maquet P. Neuroimaging in sleep medicine. Sleep Med 2007; 8:349-72. [PMID: 17470413 DOI: 10.1016/j.sleep.2007.03.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2007] [Accepted: 03/07/2007] [Indexed: 10/23/2022]
Abstract
The development of neuroimaging techniques has made possible the characterization of cerebral function throughout the sleep-wake cycle in normal human subjects. Indeed, human brain activity during sleep is segregated within specific cortical and subcortical areas in relation to the sleep stage, sleep physiological events and previous waking activity. This approach has allowed sleep physiological theories developed from animal data to be confirmed, but has also introduced original concepts about the neurobiological mechanisms of sleep, dreams and memory in humans. In contrast, at present, few neuroimaging studies have been dedicated to human sleep disorders. The available work has brought interesting data that describe some aspects of the pathophysiology and neural consequences of disorders such as insomnia, sleep apnea and narcolepsy. However, the interpretation of many of these results is restricted by limited sample size and spatial/temporal resolution of the employed technique. The use of neuroimaging in sleep medicine is actually restrained by concerns resulting from the technical experimental settings and the characteristics of the diseases. Nevertheless, we predict that future studies, conducted with state of the art techniques on larger numbers of patients, will be able to address these issues and contribute significantly to the understanding of the neural basis of sleep pathologies. This may finally offer the opportunity to use neuroimaging, in addition to the clinical and electrophysiological assessments, as a helpful tool in the diagnosis, classification, treatment and monitoring of sleep disorders in humans.
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Affiliation(s)
- Thien Thanh Dang-Vu
- Cyclotron Research Centre B30, University of Liege - Sart Tilman, 4000 Liege, Belgium.
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Clark CP, Brown GG, Frank L, Thomas L, Sutherland AN, Gillin JC. Improved anatomic delineation of the antidepressant response to partial sleep deprivation in medial frontal cortex using perfusion-weighted functional MRI. Psychiatry Res 2006; 146:213-22. [PMID: 16545553 PMCID: PMC2468216 DOI: 10.1016/j.pscychresns.2005.12.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2005] [Revised: 12/13/2005] [Accepted: 12/13/2005] [Indexed: 10/24/2022]
Abstract
This study used functional magnetic resonance imaging (fMRI) to clarify the sites of brain activity associated with the antidepressant effects of sleep deprivation (SD). We hypothesized: 1) depressed responders' baseline ventral anterior cingulate (AC) perfusion will be greater than that of nonresponders and controls; 2) following partial sleep deprivation (PSD), ventral AC perfusion will significantly decrease in responders only. Seventeen unmedicated outpatients with current major depression and eight controls received perfusion-weighted fMRI and structural MRI at baseline and following 1 night of late-night PSD. Talairach-transformed gray matter masks were merged with Talairach Daemon-based region of interest (ROI) templates. Baseline left ventral AC (LVAC) perfusion was greater in responders than nonresponders. There was no difference involving the medial frontal cortex. Responders' LVAC perfusion dropped from baseline to PSD scans compared with nonresponders and controls, as did perfusion in the right dorsal AC. In the patient group as a whole, decrease in LVAC perfusion from baseline to PSD scans correlated directly with the decrease in the modified 17-item Hamilton Depression Rating Scale (HDRS17) between baseline and PSD conditions. These data--the first using fMRI--show greater anatomic specificity than previous findings of SD and depression in linking decreased brain activity in this area with clinical improvement.
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Affiliation(s)
- Camellia P Clark
- Department of Psychiatry, University of California-San Diego, La Jolla, CA 92093, USA.
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Clark CP, Brown GG, Archibald SL, Fennema-Notestine C, Braun DR, Thomas LS, Sutherland AN, Gillin JC. Does amygdalar perfusion correlate with antidepressant response to partial sleep deprivation in major depression? Psychiatry Res 2006; 146:43-51. [PMID: 16380239 PMCID: PMC2468214 DOI: 10.1016/j.pscychresns.2005.09.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2005] [Revised: 08/28/2005] [Accepted: 09/24/2005] [Indexed: 11/24/2022]
Abstract
This study used functional MRI (fMRI) to clarify the sites of brain activity associated with the antidepressant effects of sleep deprivation (SD). We hypothesized: (1) baseline perfusion in right and left amygdalae will be greater in responders than in nonresponders; (2) following partial sleep deprivation (PSD), perfusion in responders' right and left amygdalae would decrease. Seventeen unmedicated outpatients with current major depression and eight controls received perfusion-weighted fMRI and structural MRI at baseline and following 1 night of late-night PSD. Baseline bilateral amygdalar perfusion was greater in responders than nonresponders. Clusters involving both amygdalae decreased from baseline to PSD specifically in responders. Right amygdalar perfusion diverged with PSD, increasing in nonresponders and decreasing in responders. These novel amygdalar findings are consistent with the overarousal hypothesis of SD as well as other functional imaging studies showing increased baseline amygdalar activity in depression and decreased amygdalar activity with remission or antidepressant medications.
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Affiliation(s)
- Camellia P Clark
- Department of Psychiatry 9151B, San Diego V.A. Medical Center, University of California at San Diego, La Jolla, CA 92093, USA.
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Germain A, Buysse DJ, Wood A, Nofzinger E. Functional neuroanatomical correlates of eye movements during rapid eye movement sleep in depressed patients. Psychiatry Res 2004; 130:259-68. [PMID: 15135159 DOI: 10.1016/j.pscychresns.2003.12.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2003] [Revised: 09/23/2003] [Accepted: 12/15/2003] [Indexed: 10/26/2022]
Abstract
In depressed patients, REM density, or the number of rapid eye movements (REMs) per minute of REM sleep, is a correlate of depression severity and clinical outcomes. We investigated the functional neuroanatomical correlates of average REM counts (RC), an automated analog of REM density, in depression. Thirteen medication-free depressed patients underwent all night polysomnography and positron emission tomography (PET) scans using [(18)F]fluoro-2-deoxy-d-glucose ([(18)F] FDG) during REM sleep. Regression analyses were conducted with Statistical Parametric Mapping (SPM-99). Average RC significantly and positively correlated with relative regional cerebral metabolic rate of glucose (rCMRglc) bilaterally in the striate cortex, the posterior parietal cortices, and in the medial and ventrolateral prefrontal cortices. Average RC were negatively correlated with rCMRglc in areas corresponding bilaterally to the lateral occipital cortex, cuneus, temporal cortices, and parahippocampal gyri. The areas where average RC was positively correlated with rCMRglc appear to constitute a diffuse cortical system involved in the regulation of emotion-induced arousal. The observed pattern of correlations suggests that average RC may be a marker of hypofrontality during REM sleep in depressed patients.
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Affiliation(s)
- Anne Germain
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, E-1116, Pittsburgh, PA 15213, USA.
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Sewards TV, Sewards MA. Representations of motivational drives in mesial cortex, medial thalamus, hypothalamus and midbrain. Brain Res Bull 2003; 61:25-49. [PMID: 12788205 DOI: 10.1016/s0361-9230(03)00069-8] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We propose that neural representations of motivational drives, including sexual desire, hunger, thirst, fear, power-dominance, the motivational aspect of pain, the need for sleep, and nurturance, are represented in four areas in the brain. These are located in the medial hypothalamic/preoptic area, the periaqueductal gray matter (PAG) in the midbrain/pons, the midline and intralaminar thalamic nuclei, and in the anterior part of the mesial cortex, including the medial prefrontal and anterior cingulate areas. We attempt to determine the locations of each of these representations within the hypothalamus/preoptic area, periaqueductal gray and cortex, based on the available literature on activation of brain structures by stimuli that evoke these forms of motivation, on the effects of electrical and chemical stimulation and lesions of candidate structures, and on hodological data. We discuss the hierarchical organization of the representations for a given drive, outputs from these representations to premotor structures in the medulla, caudate-putamen, and cortex, and their contributions to involuntary, learned-sequential (operant) and voluntary behaviors.
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Affiliation(s)
- Terence V Sewards
- Sandia Research Center, 21 Perdiz Canyon Road, Placitas, NM 87043, USA.
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Current awareness in NMR in biomedicine. NMR IN BIOMEDICINE 2002; 15:251-262. [PMID: 11968141 DOI: 10.1002/nbm.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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