Aberrant functional connectivity in depression as an index of state and trait rumination

Functional connectivity density of postcentral gyrus predicts rumination and major depressive disorders in males

Major depressive disorder (MDD) is characterized by persistent sadness and loss of interest. Recent evidence suggested that abnormal functional connectivity (FC) may be linked to the development of MDD, and gender differences existed in FC patterns. In this study, we utilized resting-state functional magnetic resonance imaging (RS-fMRI) data from 41 healthy participants to identify FC patterns that correlate with levels of rumination in both genders. A 2-sample t-test showed no gender differences in rumination levels. A functional connectivity density (FCD) analysis was then conducted using DPABI. It was revealed that in males, the FCD of the postcentral gyrus (PCG) was negatively correlated with the levels of rumination and brooding (Pearson's r > 0.25), while not with reflection. No FCD in females was related to rumination or its subtypes. Further FC analysis revealed that the FC between the PCG and several regions, predominantly from the default mode network (DMN), were negatively correlated with rumination levels (Pearson's r > 0.25). This link was assumed to be a risk factor for rumination and MDD in males. In conclusion, our findings indicate that the PCG-DMN connectivity is a potential risk factor for MDD in males, while no FC risk factors were found in females.

The mind wanders to dark places: Mind-wandering catalyzes rumination in the context of negative affect and impulsivity

Spontaneous mind-wandering has been theorized to increase susceptibility for rumination, contributing to risk for major depressive disorder (MDD). Clarifying whether-and under what circumstances-mind-wandering leads to rumination could inform the development of targeted interventions to reduce risk for ruminative sequelae. Using intensively sampled data in 44 young adults with remitted MDD and 38 healthy volunteers with 1,558 total observations collected from 2018 to 2022, we conducted multilevel models to investigate temporal relationships between mind-wandering and rumination. Contextual factors (e.g., intensity of negative affect; momentary impulsivity) and individual factors (e.g., MDD history) were examined as moderators of these relationships. Mind-wandering predicted increased rumination, whereas rumination did not predict increased mind-wandering. When individuals experienced greater negative affect or acted more impulsively compared to their usual levels, they showed a stronger relationship between mind-wandering and subsequent rumination. Depression history did not significantly moderate temporal relationships between mind-wandering and rumination. Spontaneous mind-wandering may transition into rumination, particularly during moments when people experience more negative affect or impulsivity compared to usual. Delivering interventions in these moments could reduce risk for ruminative sequelae. The tendency to ruminate in response to mind-wandering is suggested to be consistent regardless of depression history, suggesting the transdiagnostic and dimensional nature of rumination as a possible consequence of mind-wandering. Future work is needed to determine whether these associations are generalizable across the lifespan. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Functional connectivity profiles in remitted depression and their relation to ruminative thinking

The triple network model suggests that dysfunction in three major brain networks - the default mode network (DMN), central executive network (CEN), and salience network (SN) - might contribute to cognitive impairments in various psychiatric disorders, including major depressive disorder (MDD). While hyperconnectivity in the DMN, hypoconnectivity in the CEN, and abnormal SN connectivity have been observed in acutely depressed patients, evidence for network alterations during remission is limited. Further, there are few studies examining connectivity in people in remission from MDD (rMDD) during emotional processing tasks, including during affective cognition (i.e., tasks that encompass affective processing in the context of cognitive processes, such as inhibition). To address these literature gaps, this study compared functional connectivity (FC) between resting and task conditions, specifically during the emotional Stroop (eStroop) task, as well as between rMDD and healthy volunteers (HVs), within and between nodes of the three networks. We also explored how FC relates to rumination in the rMDD group, given that rumination tends to persist in rMDD and involves affective and cognitive networks. We unexpectedly found greater FC during the task vs. rest condition within the DMN, and decreased FC during the task vs. rest conditions within the CEN and SN across the groups. Greater FC during the task vs. rest condition between DMN and SN nodes, as well as between CEN and SN nodes were also observed. These effects were more pronounced in the rMDD group as per our exploratory analyses. Additionally, the rMDD vs. HV group showed higher FC between DMN-CEN nodes, regardless of condition. Higher hopeless rumination scores were associated with decreased resting FC within the DMN, while higher active problem-solving scores were associated with increased task FC within the DMN in the rMDD group. These findings suggest that tasks engaging affective cognition processes influence FC within and among the three networks, with this effect more pronounced in the rMDD group. This might indicate potential protective and compensatory mechanisms in rMDD and expands our understanding of large-scale intrinsic network connectivity alterations during remission from depression. However, given the limited sample and the exploratory nature of some of our analyses, replication is necessary.

Increased Insular Functional Connectivity During Repetitive Negative Thinking in Major Depression and Healthy Volunteers

Background

Repetitive negative thinking (RNT) in major depressive disorder (MDD) involves persistent focus on negative self-related experiences. Resting-state fMRI shows that the functional connectivity (FC) between the insula and the superior temporal sulcus is critical to RNT intensity. This study examines how insular FC patterns differ between resting-state and RNT-induction in MDD and healthy participants (HC).

Methods

Forty-one individuals with MDD and twenty-eight HCs (total n=69) underwent resting-state and RNT-induction fMRI scans. Seed-to-whole brain analysis using insular subregions as seeds was performed.

Results

No diagnosis-by-run interaction effects were observed across insular subregions. MDD participants showed greater FC between bilateral anterior, middle, and posterior insular regions and the cerebellum (z = 4.31 to 6.15). During RNT-induction, both MDD and HC participants demonstrated increased FC between bilateral anterior and middle insula and key brain regions, including prefrontal cortices, parietal lobes, posterior cingulate cortex, and medial temporal gyrus, encompassing the STS (z = 4.47 to 8.31). Higher trait-RNT was associated with increased FC between the right dorsal anterior and middle insula and regions in the DMN and salience network in MDD participants (z = 4.31 to 6.15). Greater state-RNT scores were linked to increased FC in similar insular regions, the bilateral angular gyrus and right middle temporal gyrus (z = 4.47 to 8.31).

Conclusions

Hyperconnectivity in insula subregions during active rumination, especially involving the DMN and salience network, supports theories of heightened self-focused and negative emotional processing in depression. These findings emphasize the neural basis of RNT when actively elicited in MDD.

The associations among glycemic control, heart variability, and autonomic brain function in healthy individuals: Age- and sex-related differences

INTRODUCTION

The purpose of this study was to clarify the relationships between glycemia and function of the autonomic nervous system (ANS), assessed via resting-state functional connectivity (FC) and heart-rate variability (HRV).

METHODS

Data for this study were extracted from the Leipzig Study for Mind-Body-Emotion Interactions, including 146 healthy adults (114 young, 32 older). Variables of interest were glycated hemoglobin (HbA1c), resting-state FC in the salience aspect of the central-autonomic (S-CAN) and salience network (SN) and HRV (RMSSD and high-frequency HRV (HF-HRV)).

RESULTS

HbA1c was inversely correlated with FC in the S-CAN but not SN. HbA1c was inversely correlated with HRV. Both RMSSD and log(HF-HRV) were correlated with FC in the S-CAN and SN. Age- (not sex-related) differences were observed in the Hb1Ac-FC associations (stronger in older adults) while sex- (not age-related) differences were observed in the HRV-FC (stronger in females).

CONCLUSIONS

These findings extend the diabetes literature to healthy adults in relating glycemia and brain function. The age- and sex-related differences in these relationships highlight the need to account for the potential effects of age and sex in future investigations.

Shared and distinctive brain networks underlying trait and state rumination

Although trait and state rumination play a central role in the exacerbation of negative affect, evidence suggests that they are weakly correlated and exert distinct influences on emotional reactivity to stressors. Whether trait and state rumination share a common or exhibit distinct neural substrate remains unclear. In this study, we utilized functional near-infrared spectroscopy (fNIRS) combined with connectome-based predictive modeling (CPM) to identify neural fingerprints associated with trait and state rumination. CPM identified distinctive functional connectivity (FC) profiles that contribute to the prediction of trait rumination, primarily involving FC within the default mode network (DMN) and the dorsal attention network (DAN) as well as FC between the DMN, control network (CN), DAN, and salience network (SN). Conversely, state rumination was predominantly associated with FC between the DMN and CN. Furthermore, the predictive features of trait rumination can be robustly generalized to predict state rumination, and vice versa. In conclusion, this study illuminates the importance of both DMN and non-DMN systems in the emergence and persistence of rumination. While trait rumination was associated with stronger and broader FC than state rumination, the generalizability of the predictive features underscores the presence of shared neural mechanisms between the two forms of rumination. These identified connectivity fingerprints may hold promise as targets for innovative therapeutic interventions aimed at mitigating rumination-related negative affect.

Electroacupuncture improves vascular cognitive impairment no dementia: A Randomized Clinical Trial

BACKGROUND

Electroacupuncture (EA) could represent a clinically effective treatment strategy for patients with vascular cognitive impairment no dementia (VCIND). This randomized trial aims to explore the underlying mechanism of EA in VCIND patients through cognitive function assessment and neuroimaging assessment.

METHODS

140 eligible patients with VCIND were recruited and randomly divided into EA group (n = 70) and Control group (n = 70). The Montreal Cognitive Assessment (MoCA), and the Auditory Verbal Learning Test (AVLT), the Stroop color-naming task (STROOP), and the resting-state functional magnetic resonance imaging assessment. The EA group received treatment for 30 min/day, 5 times/week, for 8 weeks.

RESULTS

EA intervention could increase the MoCA score and improve the neutral and consistency response of the STROOP test in VCIND patients (P < 0.05). fMRI functional connectivity analysis showed that, after EA, the default mode network (DMN) function of the posterior cingulate gyrus, left middle frontal gyrus, left anterior cingulate gyrus, left and right superior temporal gyrus, right insula, left precentral gyrus and other brain regions were significantly higher than that in the control group. The functional connectivity between the posterior cingulate gyrus-left middle frontal gyrus and the posterior cingulate gyrus-right superior temporal gyrus was positively correlated with cognitive function (P < 0.05). Gray Matter Volume increased in VCIND after EA(P < 0.05).

CONCLUSIONS

EA can increase the functional connectivity between posterior cingulate gyrus-other gyri in VCIND patients. The functional connectivity is positively correlated with cognitive function.

Differential effects of hypnotherapy and cognitive behavioral therapy on the default mode network of depressed patients

Hypnosis has been applied in healing procedures since the earliest of recorded history and today it is implemented in a wholesome concept Hypnotherapy (HT1). On a neurophysiological level, hypnosis has been associated with parts of the Default Mode Network (DMN2), but its effects on this network when induced in a treatment setting of a widespread disorder, namely depression, have never been investigated. Depression is associated with abnormal functional connectivity (FC3) of the DMN. Cognitive Behavioral Therapy (CBT4) has proven itself to be an effective treatment for depression; effects of CBT on DMN-related regions are heterogeneous. In the past years, HT was found to be a promising alternative or helpful adjunction. Yet, its underlying mechanisms remain to be unclear. In this original study 75 depressed patients receiving either CBT or HT were included and measured during resting-state before and after therapy with functional near-infrared-spectroscopy (fNIRS5). On symptom level, results show a significant reduction in both groups. On a neurophysiological level, first exploratory analyses hint toward treatment effects in two components of the DMN. However, these effects do not withstand correction for multiple testing. Still, our study is a first stepstone in the investigation of neural mechanisms of HT and offers first ideas about possible implications.

Functional connectivity in rumination: a systematic review of magnetic resonance imaging studies

INTRODUCTION

Rumination, defined as intrusive and repetitive thoughts in response to negative emotions, uncertainty, and inconsistency between goal and current situation, is a significant risk factor for depressive disorders. The rumination literature presents diverse findings on functional connectivity and shows heterogeneity in research methods. This systematic review seeks to integrate these findings and provide readers diverse perspectives.

METHOD

For this purpose, the literature on functional connectivity in rumination was reviewed according to the PRISMA guidelines. Regional connectivity and network connectivity results were scrutinized according to the presence of depression, research methods, and type of rumination. After screening 492 articles, a total of 36 studies were included.

RESULTS

The results showed that increased connectivity of the default mode network (DMN) was consistently reported. Other important findings include alterations in the connectivity between the DMN and the frontoparietal network and the salience network (SN) and impaired regulatory function of the SN. Region-level connectivity studies consistently show that increased connectivity between the posterior cingulate cortex and the prefrontal cortex is associated with rumination, which may cause the loss of control of the frontoparietal network over self-referential processes. We have seen that the number of studies examining brooding and reflective rumination as separate dimensions are relatively limited. Although there are overlaps between the connectivity patterns of the two types of rumination in these studies, it can be thought that reflective rumination is more associated with more increased functional connectivity of the prefrontal cortex.

CONCLUSIONS

Although there are many consistent functional connectivity outcomes associated with trait rumination, less is known about connectivity changes during state rumination. Relatively few studies have taken into account the subjective aspect of this thinking style. In order to better explain the relationship between rumination and depression, rumination induction studies during episode and remission periods of depression are needed.

Connectome-based modeling reveals a resting-state functional network that mediates the relationship between social rejection and rumination

Background

Rumination impedes problem solving and is one of the most important factors in the onset and maintenance of multiple psychiatric disorders. The current study aims to investigate the impact of social rejection on rumination and explore the underlying neural mechanisms involved in this process.

Methods

We utilized psychological questionnaire and resting-state brain imaging data from a sample of 560 individuals. The predictive model for rumination scores was constructed using resting-state functional connectivity data through connectome-based predictive modeling. Additionally, a mediation analysis was conducted to investigate the mediating role of the prediction network in the relationship between social rejection and rumination.

Results

A positive correlation between social rejection and rumination was found. We obtained the prediction model of rumination and found that the strongest contributions came from the intra- and internetwork connectivity within the default mode network (DMN), dorsal attention network (DAN), frontoparietal control network (FPCN), and sensorimotor networks (SMN). Analysis of node strength revealed the significance of the supramarginal gyrus (SMG) and angular gyrus (AG) as key nodes in the prediction model. In addition, mediation analysis showed that the strength of the prediction network mediated the relationship between social rejection and rumination.

Conclusion

The findings highlight the crucial role of functional connections among the DMN, DAN, FPCN, and SMN in linking social rejection and rumination, particular in brain regions implicated in social cognition and emotion, namely the SMG and AG regions. These results enhance our understanding of the consequences of social rejection and provide insights for novel intervention strategies targeting rumination.

In situ fNIRS measurements during cognitive behavioral emotion regulation training in rumination-focused therapy: A randomized-controlled trial

Repetitive negative thinking (RNT), including rumination, plays a key role in various psychopathologies. Although several psychotherapeutic treatments have been developed to reduce RNT, the neural correlates of those specific treatments and of psychotherapy in general are largely unknown. Functional near-infrared spectroscopy (fNIRS) offers the potential to investigate the neural correlates of psychotherapeutic techniques in situ. Therefore, in this study we investigated the efficacy and neural correlates of a fNIRS adapted Mindfulness-based Emotion Regulation Training (MBERT) for the treatment of depressive rumination in 42 subjects with major depressive disorder (MDD) in a cross-over designed randomized controlled trial. Using psychometric measures, subjective ratings and fNIRS, we analyzed in situ changes in depressive symptom severity, ruminative thoughts and cortical activity in the Cognitive Control Network (CCN). Our results show that MBERT is effective in treating depressive symptoms and rumination. On a neural level, we found consistently higher cortical activation during emotion regulation training compared to control trials in the bilateral inferior frontal gyrus (IFG) and dorsolateral prefrontal cortex (DLPFC). Furthermore, cortical oxygenation decreased from session to session in the bilateral DLPFC. The relevance of the results for the psychotherapeutic treatment of MDD as well as further necessary investigations are discussed.

Temporal dynamic patterns of the ventromedial prefrontal cortex underlie the association between rumination and depression

As a major contributor to the development of depression, rumination has proven linked with aberrant default-mode network (DMN) activity. However, it remains unclear how the spontaneous spatial and temporal activity of DMN underlie the association between rumination and depression. To illustrate this issue, behavioral measures and resting-state functional magnetic resonance images were connected in 2 independent samples (NSample1 = 100, NSample2 = 95). Fractional amplitude of low-frequency fluctuations (fALFF) and regional homogeneity (ReHo) were used to assess spatial characteristic patterns, while voxel-wise functional concordance (across time windows) (VC) and Hurst exponent (HE) were used to assess temporal dynamic patterns of brain activity. Results from both samples consistently show that temporal dynamics but not spatial patterns of DMN are associated with rumination. Specifically, rumination is positively correlated with HE and VC (but not fALFF and ReHo) values, reflecting more consistent and regular temporal dynamic patterns in DMN. Moreover, subregion analyses indicate that temporal dynamics of the ventromedial prefrontal cortex (VMPFC) reliably predict rumination scores. Furthermore, mediation analyses show that HE and VC of VMPFC mediate the association between rumination and depression. These findings shed light on neural mechanisms of individual differences in rumination and corresponding risk for depression.

Intrinsic Organization of Occipital Hubs Predicts Depression: A Resting-State fNIRS Study

Dysfunctional brain networks have been found in patients with major depressive disorder (MDD). In this study, to verify this in a more straightforward way, we investigated the intrinsic organization of brain networks in MDD by leveraging the resting-state functional near-infrared spectroscopy (rs-fNIRS). Thirty-four MDD patients (24 females, 38.41 ± 13.14 years old) and thirty healthy controls (22 females, 34.43 ± 5.03 years old) underwent a 10 min rest while their brain activity was recorded via fNIRS. The results showed that MDD patients and healthy controls exhibited similar resting-state functional connectivity. Moreover, the depression group showed lower small-world Lambda (1.12 ± 0.04 vs. 1.16 ± 0.10, p = 0.04) but higher global efficiency (0.51 ± 0.03 vs. 0.48 ± 0.05, p = 0.03) than the control group. Importantly, MDD patients, as opposed to healthy controls, showed a significantly lower nodal local efficiency at the left middle occipital gyrus (0.56 ± 0.36 vs. 0.81 ± 0.20, pFDR < 0.05), which predicted the level of depression in MDD (r = 0.45, p = 0.01, R2 = 0.15). In sum, we found a more integrated brain network in MDD patients with a lower nodal local efficiency at the occipital hub, which could predict depressive symptoms.

Neural correlations between cognitive deficits and emotion regulation strategies: understanding emotion dysregulation in depression from the perspective of cognitive control and cognitive biases

The link between cognitive function and emotion regulation may be helpful in better understanding the onset, maintenance, and treatment for depression. However, it remains unclear whether there are neural correlates between emotion dysregulation and cognitive deficits in depression. To address this question, we first review the neural representations of emotion dysregulation and cognitive deficits in depression (including deficits in cognitive control and cognitive biases). Based on the comparisons of neural representations of emotion dysregulation versus cognitive deficits, we propose an accessible and reasonable link between emotion dysregulation, cognitive control, and cognitive biases in depression. Specifically, cognitive control serves the whole process of emotion regulation, whereas cognitive biases are engaged in emotion regulation processes at different stages. Moreover, the abnormal implementation of different emotion regulation strategies in depression is consistently affected by cognitive control, which is involved in the dorsolateral, the dorsomedial prefrontal cortex, and the anterior cingulate cortex. Besides, the relationship between different emotion regulation strategies and cognitive biases in depression may be distinct: the orbitofrontal cortex contributes to the association between ineffective reappraisal and negative interpretation bias, while the subgenual prefrontal cortex and the posterior cingulate cortex underline the tendency of depressed individuals to ruminate and overly engage in self-referential bias. This review sheds light on the relationship between cognitive deficits and emotion dysregulation in depression and identifies directions in need of future attention.

Neural correlates of repetitive negative thinking: Dimensional evidence across the psychopathological continuum

Repetitive negative thinking (RNT) captures an important transdiagnostic factor that predisposes to a maladaptive stress response and contributes to diverse psychiatric disorders. Although RNT can best be seen as a continuous symptom dimension that cuts across boundaries from health to various psychiatric disorders, the neural mechanisms underlying RNT have almost exclusively been studied in health and stress-related disorders, such as depression and anxiety disorders. We set out to study RNT from a large-scale brain network perspective in a diverse population consisting of healthy subjects and patients with a broader range of psychiatric disorders. We studied 46 healthy subjects along with 153 patients with a stress-related and/or neurodevelopmental disorder. We focused on three networks, that are associated with RNT and diverse psychiatric disorders: the salience network, default mode network (DMN) and frontoparietal network (FPN). We investigated the relationship of RNT with both network connectivity strength at rest and with the stress-induced changes in connectivity. Across our whole sample, the level of RNT was positively associated with the connectivity strength of the left FPN at rest, but negatively associated with stress-induced changes in DMN connectivity. These findings may reflect an upregulation of the FPN in an attempt to divert attention away from RNT, while the DMN result may reflect a less flexible adaptation to stress, related to RNT. Additionally, we discuss how our findings fit into the non-invasive neurostimulation literature. Taken together, our results provide initial insight in the neural mechanisms of RNT across the spectrum from health to diverse psychiatric disorders.

Meta-analytic evidence that mindfulness training alters resting state default mode network connectivity

This meta-analysis sought to expand upon neurobiological models of mindfulness through investigation of inherent brain network connectivity outcomes, indexed via resting state functional connectivity (rsFC). We conducted a systematic review and meta-analysis of rsFC as an outcome of mindfulness training (MT) relative to control, with the hypothesis that MT would increase cross-network connectivity between nodes of the Default Mode Network (DMN), Salience Network (SN), and Frontoparietal Control Network (FPCN) as a mechanism of internally-oriented attentional control. Texts were identified from the databases: MEDLINE/PubMed, ERIC, PSYCINFO, ProQuest, Scopus, and Web of Sciences; and were screened for inclusion based on experimental/quasi-experimental trial design and use of mindfulness-based training interventions. RsFC effects were extracted from twelve studies (mindfulness n = 226; control n = 204). Voxel-based meta-analysis revealed significantly greater rsFC (MT > control) between the left middle cingulate (Hedge's g = .234, p = 0.0288, I2 = 15.87), located within the SN, and the posterior cingulate cortex, a focal hub of the DMN. Egger's test for publication bias was nonsignificant, bias = 2.17, p = 0.162. In support of our hypothesis, results suggest that MT targets internetwork (SN-DMN) connectivity implicated in the flexible control of internally-oriented attention.

Nodal degree changes induced by electroconvulsive therapy in major depressive disorder: Evidence in two independent cohorts

OBJECTIVE

Electroconvulsive therapy (ECT), a rapidly acting treatment for major depressive disorder (MDD), has been reported to regulate brain networks. Nodes and their connections are the main components of the brain network and are essential for establishing and maintaining effective information transmission. This study aimed to evaluate the role of nodes in mediating antidepressant effects of ECT.

METHODS

Voxel-based nodal degree analysis was performed in 42 patients with MDD receiving ECT and 42 matched healthy controls at two time points to identify the nodal changes induced by ECT. Verification analysis was evaluated in a second, independent cohort of 23 MDD patients.

RESULTS

MDD patients showed improved nodal degree of the bilateral angular cortex (AG), precuneus, inferior frontal gyrus (IFG) and the right superior frontal gyrus (SFG) after ECT, and the increased nodal degree index (IND) rate of the AG and precuneus were negatively correlated to the depressive changes following ECT. Furthermore, validation analysis revealed a similar pattern of IND abnormalities in the first and second cohort of MDD patients.

CONCLUSION

ECT regulates the disrupted nodal degree of the AG and precuneus to achieve an antidepressant effect. This study may provide further insights into the pathogenesis of depression and provide potential targets for antidepressant pharmacotherapies.

The effects of hypnotherapy compared to cognitive behavioral therapy in depression: a NIRS-study using an emotional gait paradigm

Hypnotherapy (HT) is a promising approach to treating depression, but so far, no data are available on the neuronal mechanisms of functional reorganization after HT for depressed patients. Here, 75 patients with mild to moderate depression, who received either HT or Cognitive Behavioral Therapy (CBT), were measured before and after therapy using functional near-infrared spectroscopy. We investigated the patients' cerebral activation during an emotional human gait paradigm. Further, rumination was included as predictor. Our results showed a decrease of functional connectivity (FC) between two regions that are crucial to emotional processing, the Extrastriate Body Area (EBA) and the Superior Temporal Sulcus (STS). This FC decrease was traced back to an activation change throughout therapy in the right STS, not the EBA and was only found in the HT group, depending on rumination: less ruminating HT patients showed a decrease in right STS activation, while highly ruminating patients showed an increase. We carefully propose that this activation change is due to the promotion of emotional experiences during HT, while in CBT a focus lay on activating behavior and changing negative cognitions. HT seemed to have had differential effects on the patients, depending on their rumination style: The increase of right STS activation in highly ruminating patients might mirror the improvement of impaired emotional processing, whilst the decrease of activation in low ruminating patients might reflect a dismissal of an over-compensation, associated with a hyperactivity before therapy. We conclude that HT affects emotional processing and this effect is moderated by rumination.

Disrupted Spatiotemporal Complexity of Resting-State Electroencephalogram Dynamics Is Associated With Adaptive and Maladaptive Rumination in Major Depressive Disorder

Patients with major depressive disorder (MDD) exhibit abnormal rumination, including both adaptive and maladaptive forms. However, the neural substrates of rumination in depression remain poorly understood. We hypothesize that divergent spatiotemporal complexity of brain oscillations would be associated with the levels of rumination in MDD. We employed the multi-scale entropy (MSE), power and phase-amplitude coupling (PAC) to estimate the complexity of rhythmic dynamics from the eye-closed high-density electroencephalographic (EEG) data in treatment-naive patients with MDD (n = 24) and healthy controls (n = 22). The depressive, brooding, and reflective subscales of the Ruminative Response Scale were assessed. MDD patients showed higher MSE in timescales finer than 5 (cluster P = 0.038) and gamma power (cluster P = 0.034), as well as lower PAC values between alpha/low beta and gamma bands (cluster P = 0.002- 0.021). Higher reflective rumination in MDD was region-specifically associated with the more localized EEG dynamics, including the greater MSE in scales finer than 8 (cluster P = 0.008), power in gamma (cluster P = 0.018) and PAC in low beta-gamma (cluster P = 0.042), as well as weaker alpha-gamma PAC (cluster P = 0.016- 0.029). Besides, the depressive and brooding rumination in MDD showed the lack of correlations with global long-range EEG variables. Our findings support the disturbed neural communications and point to the spatial reorganization of brain networks in a timescale-dependent migration toward local during adaptive and maladaptive rumination in MDD. These findings may provide potential implications on probing and modulating dynamic neuronal fluctuations during the rumination in depression.

BMRMI Reduces Depressive Rumination Possibly through Improving Abnormal FC of Dorsal ACC

Rumination is a common symptom of major depressive disorder (MDD) and has been characterized as a vulnerability factor for the onset or recurrence of MDD. However, the neurobiological mechanisms underlying rumination and appropriate treatment strategies remain unclear. In the current study, we used resting-state functional magnetic resonance imaging to investigate the effects of body-mind relaxation meditation induction (BMRMI) intervention in MDD with rumination. To this aim, we have recruited 25 MDD and 24 healthy controls (HCs). Changes in functional connectivity (FC) of the anterior cingulate cortex (ACC) subregion and the scores of clinical measurements were examined using correlation analysis. At baseline, MDD showed stronger FC between the right dorsal ACC (dACC) and right superior frontal gyrus than did the HC group. Compared to baseline, the HC group showed a significantly enhanced FC between the right dACC and right superior frontal gyrus, and the MDD group demonstrated a significantly weaker FC between the left dACC and right middle frontal gyrus (MFG) after the intervention. Furthermore, the FC between the right dACC and right superior frontal gyrus was positively associated with rumination scores across all participants at baseline. The above results indicate that BMRMI may regulate self-referential processing and cognitive function through modulating FC of the dACC in MDD with rumination.

C-reactive protein is related to a distinct set of alterations in resting-state functional connectivity contributing to a differential pathophysiology of major depressive disorder

BACKGROUND

Several studies in major depressive disorder (MDD) have found inflammation, especially C-reactive protein (CRP), to be consistently associated with MDD and network dysfunction. The aim was to investigate whether CRP is linked to a distinct set of resting-state functional connectivity (RSFC) alterations.

METHODS

For this reason, we investigated the effects of diagnosis and elevated blood plasma CRP levels on the RSFC in 63 participants (40 females, mean age 31.4 years) of which were 27 patients with a primary diagnosis of MDD and 36 healthy control-subjects (HC), utilizing a seed-based approach within five well-established RSFC networks obtained using fMRI.

RESULTS

Of the ten network pairs examined, five showed increased between-network RSFC-values unambiguously connected either to a diagnosis of MDD or elevated CRP levels. For elevated CRP levels, increased RSFC between DMN and AN was found. Patients showed increased RSFC within DMN areas and between the DMN and ECN and VAN, ECN and AN and AN and DAN.

CONCLUSIONS

The results of this study show dysregulated neural circuits specifically connected to elevated plasma CRP levels and independent of other alterations of RSFC in MDD. This dysfunction in neural circuits might in turn result in a certain immune-inflammatory subtype of MDD.

Psychometric Properties of the Chinese Version of the Brief State Rumination Inventory

State rumination, unlike trait rumination which is described as a persistent and stable response style, is usually triggered by a specific stressful event and causes negative emotions within a short period of time. The measurement methods of trait rumination, such as the ruminative response scale (RRS), are therefore not fully applicable to state rumination. Recently, researchers have developed the brief state rumination inventory (BSRI) to characterize state rumination, addressing the gap in the field of accurate measurement of state rumination. To develop such an effective tool in the Chinese context, we developed a Chinese version of the BSRI and tested its psychometric properties. Two studies were conducted to address the research goal. In Study 1, we recruited 512 subjects, each of whom completed the Chinese version of the BSRI, RRS, emotional regulation questionnaire (ERQ), depression–anxiety–stress scale (DASS), and positive and negative affect scale (PANAS). Results showed that the scores of the BSRI were positively correlated with all other scale scores (ps < 0.001), and the correlation with the RRS was the highest, indicating that the BSRI showed good convergent validity. Additionally, the Cronbach's alpha coefficient for the Chinese version of the BSRI was 0.93. Study 2 aimed to examine the ecological validity of the Chinese version of the BSRI. We recruited another 54 subjects who were randomly divided into two groups, with 27 in the rumination induction group and 27 in the distraction group, and recorded the BSRI scores of the two groups before and after a specific experiment. We found there was a significant increase in BSRI scores after rumination induction (t = 3.91, p < 0.001), while there was no significant difference in the concrete distraction group before and after the experiment (t = 0.70, p = 0.48). In sum, the Chinese version of the BSRI showed good reliability and validity for assessing state rumination in the general Chinese population.

Aberrant functional metastability and structural connectivity are associated with rumination in individuals with major depressive disorder

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Higher synchrony and lower metastability in adults with higher levels of rumination.

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Prefrontal white matter integrity deficits are also associated with rumination.

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Most prominent aberrations were found in the genu of the corpus callosum.

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Structural connectivity as the basis between dynamic connectivity and rumination.

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New outlook on altered structural integrity and metastability subserving rumination.

Rumination is a repetitive and compulsive thinking focusing on oneself, and the nature and consequences of distress. It is a core characteristic in psychiatric disorders characterized by affective dysregulation, and emerging evidence suggests that rumination is associated with aberrant dynamic functional connectivity and structural connectivity. However, the underlying neural mechanisms remain poorly understood. Here, we adopted a multimodal approach and tested the hypothesis that white matter connectivity forms the basis of the implications of temporal dynamics of functional connectivity in the rumination trait. Fifty-three depressed and ruminative individuals and a control group of 47 age- and gender-matched individuals with low levels of rumination underwent resting-state fMRI and diffusion tensor imaging. We found that lower global metastability and higher global synchrony of the dynamic functional connectivity were associated with higher levels of rumination. Specifically, the altered global synchrony and global metastability mediated the association between white matter integrity of the genu of the corpus callosum to rumination. Hence, our findings offered the first line of evidence for the intricate role of (sub)optimal transition of functional brain states in the connection of structural brain connectivity in ruminative thinking.

The Relationship Between Default Mode and Dorsal Attention Networks Is Associated With Depressive Disorder Diagnosis and the Strength of Memory Representations Acquired Prior to the Resting State Scan

Previous research indicates that individuals with depressive disorders (DD) have aberrant resting state functional connectivity and may experience memory dysfunction. While resting state functional connectivity may be affected by experiences preceding the resting state scan, little is known about this relationship in individuals with DD. Our study examined this question in the context of object memory. 52 individuals with DD and 45 healthy controls (HC) completed clinical interviews, and a memory encoding task followed by a forced-choice recognition test. A 5-min resting state fMRI scan was administered immediately after the forced-choice task. Resting state networks were identified using group Independent Component Analysis across all participants. A network modeling analysis conducted on 22 networks using FSLNets examined the interaction effect of diagnostic status and memory accuracy on the between-network connectivity. We found that this interaction significantly affected the relationship between the network comprised of the medial prefrontal cortex, posterior cingulate cortex, and hippocampal formation and the network comprised of the inferior temporal, parietal, and prefrontal cortices. A stronger positive correlation between these two networks was observed in individuals with DD who showed higher memory accuracy, while a stronger negative correlation (i.e., anticorrelation) was observed in individuals with DD who showed lower memory accuracy prior to resting state. No such effect was observed for HC. The former network cross-correlated with the default mode network (DMN), and the latter cross-correlated with the dorsal attention network (DAN). Considering that the DMN and DAN typically anticorrelate, we hypothesize that our findings indicate aberrant reactivation and consolidation processes that occur after the task is completed. Such aberrant processes may lead to continuous "replay" of previously learned, but currently irrelevant, information and underlie rumination in depression.

Temporal Predictability Modulates Cortical Activity and Functional Connectivity in the Frontoparietal Network in 6-Month-Old Infants

Despite the abundance of behavioral evidence showing the interaction between attention and prediction in infants, the neural underpinnings of this interaction are not yet well-understood. The endogenous attentional function in adults have been largely localized to the frontoparietal network. However, resting-state and neuroanatomical investigations have found that this frontoparietal network exhibits a protracted developmental trajectory and involves weak and unmyelinated long-range connections early in infancy. Can this developmentally nascent network still be modulated by predictions? Here, we conducted the first investigation of infant frontoparietal network engagement as a function of the predictability of visual events. Using functional near-infrared spectroscopy, the hemodynamic response in the frontal, parietal, and occipital lobes was analyzed as infants watched videos of temporally predictable or unpredictable sequences. We replicated previous findings of cortical signal attenuation in the frontal and sensory cortices in response to predictable sequences and extended these findings to the parietal lobe. We also estimated background functional connectivity (i.e., by regressing out task-evoked responses) to reveal that frontoparietal functional connectivity was significantly greater during predictable sequences compared to unpredictable sequences, suggesting that this frontoparietal network may underlie how the infant brain communicates predictions. Taken together, our results illustrate that temporal predictability modulates the activation and connectivity of the frontoparietal network early in infancy, supporting the notion that this network may be functionally available early in life despite its protracted developmental trajectory.

Mindfulness-Based Cognitive Therapy in Recurrent MDD Patients With Residual Symptoms: Alterations in Resting-State Theta Oscillation Dynamics Associated With Changes in Depression and Rumination

Many patients with major depressive disorder (MDD) suffer from residual symptoms. Rumination is a specific known risk factor for the onset, severity, prolongation, and relapse of MDD. This study aimed to examine the efficacy and EEG substrates of mindfulness-based cognitive therapy (MBCT) in alleviating depression and rumination in an MDD population with residual symptoms. We recruited 26 recurrent MDD individuals who had residual symptoms with their current antidepressants to participate in the 8-week MBCT intervention. We evaluated the efficacy and changes in the dynamics of resting-state theta rhythm after the intervention, as well as the associations between theta alterations and improvements in depression and rumination. The participants showed reduced depression, enhanced adaptive reflective rumination, and increased theta power and phase synchronization after MBCT. The increased theta-band phase synchronizations between the right occipital regions and the right prefrontal, central, and parietal regions were associated with reduced depression, while the increase in theta power in the left parietal region was associated with improvements in reflective rumination. MBCT could alleviate depression and enhance adaptive, reflective rumination in recurrent MDD individuals with residual symptoms through the modulation of theta dynamics in specific brain regions.

Mind wandering and depression: A status report

While many clinical studies and overviews on the contribution of rumination to depression exist, relatively little information regarding the role of mind wandering (MW) in general is available. Therefore, it remains an open question whether patterns of MW are altered in depression and, if so, how these alterations are related to rumination. Here, we review and discuss studies investigating MW in cohorts, showing either a clinically significant depression or with clinically significant disorders accompanied by depressive symptoms. These studies yield first tentative insights into major issues. However, further investigations are required, specifically studies which: i) compare patients with a primary diagnosis of major depression with healthy and appropriately matched controls, ii) implement measures of both MW and rumination, iii) are based on experience sampling (in combination with other key approaches), iv) compare experience sampling during daily life, resting state and attentional tasks, v) explore possible biases in the assessment of MW, vi) acquire data not only related to the propensity and contents of MW, but also regarding meta-awareness and intentionality.

Can Molecular Biology Propose Reliable Biomarkers for Diagnosing Major Depression?

BACKGROUND

Modern medicine has provided considerable knowledge of the pathophysiology of mental disorders at the body, systemic, organ and neurochemical levels of the biological organization of the body. Modern clinical diagnostics of depression have some problems, that is why psychiatric society makes use of diagnostics and taxonomy of different types of depression by implemention of modern molecular biomarkers in diagnostic procedures. But up to now, there are no reliable biomarkers of major depressive disorder (MDD) and other types of depression.

OBJECTIVE

The purpose of this review is to find fundamentals in pathological mechanisms of depression, which could be a basis for development of molecular and genetic biomarkers, being the most feasible for clinical use.

METHOD

This review summarizes the published data using PubMed, Science Direct, Google Scholar and Scopus.

RESULTS

In this review, we summarized and discussed findings in molecular biology, genetics, neuroplasticity, neurotransmitters, and neuroimaging that could increase our understanding of the biological foundations of depression and show new directions for the development of reliable biomarkers. We did not find any molecular and genetic biomarker approved for the clinic. But the Genome-Wide Association Study method promises some progress in the development of biomarkers based on SNP in the future. Epigenetic factors also are a promising target for biomarkers. We have found some differences in the etiology of different types of atypical and melancholic depression. This knowledge could be the basis for development of biomarkers for clinical practice in diagnosis, prognosis and selection of treatment.

CONCLUSION

Depression is not a monoetiological disease. Many pathological mechanisms are involved in depression, thus up to now, there is no approved and reliable biomarker for diagnosis, prognosis and correction of treatment of depression. The structural and functional complexity of the brain, the lack of invasive technology, poor correlations between genetic and clinical manifestation of depression, imperfect psychiatric classification and taxonomy of subtypes of disease are the main causes of this situation. One of the possible ways to come over this situation can be to pay attention to the trigger mechanism of disease and its subtypes. Researchers and clinicians should focus their efforts on searching the trigger mechanism of depression and different types of it . HPA axis can be a candidate for such trigger in depression caused by stress, because it influences the main branches of disease: neuroinflammation, activity of biogenic amines, oxidative and nitrosative stress, epigenetic factors, metabolomics, etc. But before we shall find any trigger mechanism, we need to create complex biomarkers reflecting genetic, epigenetic, metabolomics and other pathological changes in different types of depression. Recently the most encouraging results have been obtained from genetics and neuroimaging. Continuing research in these areas should be forced by using computational, statistical and systems biology approaches, which can allow to obtain more knowledge about the neurobiology of depression. In order to obtain clinically useful tests, search for biomarkers should use appropriate research methodologies with increasing samples and identifying more homogeneous groups of depressed patients.

Default mode network activity in depression subtypes

Depression continues to carry a major disease burden worldwide, with limitations on the success of traditional pharmacological or psychological treatments. Recent approaches have therefore focused upon the neurobiological underpinnings of depression, and on the "individualization" of depression symptom profiles. One such model of depression has divided the standard diagnostic criteria into four "depression subtypes", with neurological and behavioral pathways. At the same time, attention has been focused upon the region of the brain known as the "default mode network" (DMN) and its role in attention and problem-solving. However, to date, no review has been published of the links between the DMN and the four subtypes of depression. By searching the literature studies from the last 20 years, 62 relevant papers were identified, and their findings are described for the association they demonstrate between aspects of the DMN and the four depression subtypes. It is apparent from this review that there are potential positive clinical and therapeutic outcomes from focusing upon DMN activation and connectivity, via psychological therapies, transcranial magnetic stimulation, and some emerging pharmacological models.

Reduced functional connectivity of default mode network subsystems in depression: Meta-analytic evidence and relationship with trait rumination

Resting-state functional connectivity changes in the default mode network (DMN) of patients with major depressive disorder (MDD) have been linked to rumination. The DMN is divided into three subsystems: a midline Core, a dorsal medial prefrontal cortex (DMPFC) subsystem, and a medial temporal lobe (MTL) subsystem. We examined resting-state functional connectivity within and between DMN subsystems in MDD and its association with rumination. First, we conducted a meta-analysis on a large multi-site dataset of 618 MDD and 683 controls to quantify the differences in DMN subsystem functional connectivity between MDD and controls. Second, we tested the association of DMN subsystem functional connectivity and rumination in a sample of 115 unmedicated participants with symptoms of anxiety/depression and 48 controls. In our meta-analysis, only functional connectivity in the DMN Core was significantly reduced in MDD compared to controls (g = -0.246, CI = [-0.417; -0.074], pFDR = 0.048). Functional connectivity in the DMPFC subsystem and between the Core and DMPFC subsystems was slightly reduced but not significantly (g = -0.162, CI = [-0.310; -0.013], pFDR = 0.096; g = -0.249, CI = [-0.464; -0.034], pFDR = 0.084). Results were heterogeneous across sites for connectivity in the Core and between Core and DMPFC (I2 = 0.348 and I2 = 0.576 respectively). Prediction intervals consistently encompassed 0. In the independent sample we collected, functional connectivity within the DMN Core, DMPFC and between Core and DMPFC was not reduced in MDD compared to controls (all pFDR > 0.05). Trait rumination did not predict connectivity within and between DMN subsystems (all pFDR > 0.05). We conclude that MDD as a diagnostic category shows slightly reduced functional connectivity within the DMN Core, independent of illness duration, treatment, symptoms and trait rumination. However, this effect is small, highly variable and heterogeneous across samples, so that we could only detect it at the meta-analytic level, with a sample size of several hundreds. Our results indicate that reduced Core DMN connectivity has significant limitations as a potential clinical or prognostic marker for the diagnosis of MDD and might be more relevant to consider as a characteristic distinguishing a subgroup of individuals within this diagnostic category.

Immunological Disturbances and Neuroimaging Findings in Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD) Comorbid Patients

Mood disorders and Major Depressive Disorder, in particular, appear to be some of the most common psychiatric disorders with a high rate of comorbidity most frequently of anxiety or substance abuse disorders (alcohol use disorder). In both cases - MDD and AUD, a number of immunological disturbances are observed, such as chronic mild inflammation response, increased level of cytokines, hypercortisolaemia, which lead to specific changes in brain neurotransmitter functions. Some of the contemporary brain imaging techniques are functional magnetic resonance imaging (fMRI) and magnetic spectroscopy which are most commonly used to assess the brain metabolism and functional connectivity changes such as altered responses to emotional stimuli in MDD or overactivation of ventromedial prefrontal areas during delayed and underactivation of dorsolateral prefrontal regions during impulsive reward decisions in AUD and dysfunction of gamma-aminobutyric acid (GABA) and/or glutamate neurotransmitter systems, low NAA and myo-Inositol in both MDD and AUD.

Abnormality of Resting-State Functional Connectivity in Major Depressive Disorder: A Study With Whole-Head Near-Infrared Spectroscopy

Near-infrared spectroscopy (NIRS) is a functional neuroimaging modality that has advantages in clinical usage. Previous functional magnetic resonance imaging (fMRI) studies have found that the resting-state functional connectivity (RSFC) of the default mode network (DMN) is increased, while the RSFC of the cognitive control network (CCN) is reduced in patients with major depressive disorder (MDD) compared with healthy controls. This study tested whether the NIRS-based RSFC measurements can detect the abnormalities in RSFC that have been associated with MDD in previous fMRI studies. We measured 8 min of resting-state brain activity in 34 individuals with MDD and 78 age- and gender-matched healthy controls using a whole-head NIRS system. We applied a previously established partial correlation analysis for estimating RSFCs between the 17 cortical regions. We found that MDD patients had a lower RSFC between the left dorsolateral prefrontal cortex and the parietal lobe that comprise the CCN, and a higher RSFC between the right orbitofrontal cortex and ventrolateral prefrontal cortex, compared to those in healthy controls. The RSFC strength of the left CCN was negatively correlated with the severity of depressive symptoms and the dose of antipsychotic medication and positively correlated with the level of social functioning. The results of this study suggest that NIRS-based measurements of RSFCs have potential clinical applications.

Prefrontal Functional Connectivity During the Verbal Fluency Task in Patients With Major Depressive Disorder: A Functional Near-Infrared Spectroscopy Study

Deviations in activation patterns and functional connectivity have been observed in patients with major depressive disorder (MDD) with prefrontal hemodynamics of patients compared with healthy individuals. The graph-theoretical approach provides useful network metrics for evaluating functional connectivity. The evaluation of functional connectivity during a cognitive task can be used to explain the neurocognitive mechanism underlying the cognitive impairments caused by depression. Overall, 31 patients with MDD and 43 healthy individuals completed a verbal fluency task (VFT) while wearing a head-mounted functional near-infrared spectroscopy (fNIRS) devices. Hemodynamics and functional connectivity across eight prefrontal subregions in the two groups were analyzed and compared. We observed a reduction in prefrontal activation and weaker overall and interhemispheric subregion-wise correlations in the patient group compared with corresponding values in the control group. Moreover, efficiency, the network measure related to the effectiveness of information transfer, showed a significant between-group difference [t (71.64) = 3.66, corrected p < 0.001] along with a strong negative correlation with depression severity (rho = -0.30, p = 0.009). The patterns of prefrontal functional connectivity differed significantly between the patient and control groups during the VFT. Network measures can quantitatively characterize the reduction in functional connectivity caused by depression. The efficiency of the functional network may play an important role in the understanding of depressive symptoms.

Application of Near-Infrared Spectroscopy for Understanding Spontaneous Brain Activity During Resting State in Schizophrenia: A Mini Review

Spontaneous brain activity occurs at rest, as represented by the default mode network. A resting paradigm is suitable for investigating brain function of patients with psychiatric diseases who may have difficulties adhering to goal-oriented tasks. Evidence accumulated in neuroimaging studies using functional magnetic resonance imaging has shown that the resting cerebral blood flow is impaired in psychiatric diseases. Near-infrared spectroscopy (NIRS), a simple neuroimaging modality, is an optimal tool for the resting paradigm, because it can offer a comfortable environment for measurement. Recent NIRS studies have demonstrated some promising data of altered resting activity in the prefrontal cortex of patients with schizophrenia, which may be exploited to develop further applications of NIRS in clinical psychiatry. Based on these findings, we emphasize the benefits of NIRS for assessing the prefrontal pathophysiology during the resting state and some methodological issues to be noted while analyzing cerebral blood flow using NIRS; moreover, we focus on interpreting these changes based on the complex nature of the spontaneous brain activity during resting state.

Intrasubject functional connectivity related to self-generated thoughts

INTRODUCTION

In psychiatric research, functional connectivity (FC) derived from resting-state functional MRI (rsfMRI) is often used to investigate brain abnormalities in psychiatric disorders. This approach assumes implicitly that FC can recover reliable maps of the functional architecture of the brain and that these profiles of connectivity reflect trait differences underlying pathology. However, evidence of FC related to self-generated thoughts (mind-wandering) stands in contrast with these assumptions, as FC may reflect thought patterns rather than functional architecture.

METHODS

Multi-factor analysis (MFA) was used to investigate the reported content of self-generated thoughts during high-field (7T) rsfMRI in a repeated sample of 22 healthy individuals. To investigate the relationship between these experiences and FC, individual scores for each of these dimensions were compared with whole-brain connectivity using the network-based statistic (NBS) method.

RESULTS

This analysis revealed three dimensions of thought content: self-referential thought, negative thoughts about one's surroundings, and thoughts in the form of imagery. A network of connections within the sensorimotor cortices negatively correlated with self-generated thoughts concerning the self was observed (p = .0081, .0486 FDR).

CONCLUSION

These results suggest a potentially confounding relationship between self-generated thoughts and FC, and contribute to the body of research concerning the functional representation of mind-wandering.

Amplitude of low frequency fluctuations (ALFF) of spontaneous and induced rumination in major depression: An fNIRS study

In the current study, we investigated the amplitude of low frequency fluctuations (ALFF) at rest and during a rumination induction. Specifically, we explored the differences of cortical blood oxygenation using fNIRS in subjects with Major Depressive Disorder (MDD) and healthy controls (HC). Rumination was assessed as state and trait measure, as well as with a qualitative semi-structured interview. Qualitative and quantitative measures of rumination indicated that the MDD group showed elevated rumination regarding state and trait measures. Furthermore, rumination differed qualitatively between the groups. The MDD group showed higher levels of general rumination and increased rumination during the rumination induction. However, the MDD group did not show a carry-over effect of elevated rumination after the induction paradigm to the following resting-state measurement. On a neuronal level, we observed a general hypoactivity in the MDD group compared to the HC group. Moreover, both groups showed increased ALFF during the rumination induction compared to the rest phase, especially in temporo-parietal areas. However, no interaction effect of MDD status and rumination induction was found. The current findings are discussed with respect to the literature of paradigms used in the investigation of rumination and suggestions on general improvements in rumination research are given.

Classification of Schizophrenia by Functional Connectivity Strength Using Functional Near Infrared Spectroscopy

Functional near-infrared spectroscopy (fNIRS) has been widely employed in the objective diagnosis of patients with schizophrenia during a verbal fluency task (VFT). Most of the available methods depended on the time-domain features extracted from the data of single or multiple channels. The present study proposed an alternative method based on the functional connectivity strength (FCS) derived from an individual channel. The data measured 100 patients with schizophrenia and 100 healthy controls, who were used to train the classifiers and to evaluate their performance. Different classifiers were evaluated, and support machine vector achieved the best performance. In order to reduce the dimensional complexity of the feature domain, principal component analysis (PCA) was applied. The classification results by using an individual channel, a combination of several channels, and 52 ensemble channels with and without the dimensional reduced technique were compared. It provided a new approach to identify schizophrenia, improving the objective diagnosis of this mental disorder. FCS from three channels on the medial prefrontal and left ventrolateral prefrontal cortices rendered accuracy as high as 84.67%, sensitivity at 92.00%, and specificity at 70%. The neurophysiological significance of the change at these regions was consistence with the major syndromes of schizophrenia.

Neural correlates of mindful emotion regulation in high and low ruminators

Depressive rumination is considered a prominent risk factor for the occurrence, severity, and duration of depressive episodes. A variety of treatment options have been developed to treat depressive rumination of which mindfulness based programs are especially promising. In the current study, we investigated the neural underpinnings of a short mindfulness intervention and mindful emotion regulation in high and low trait ruminators in an ecologically valid environment using functional near-infrared spectroscopy (fNIRS). Participants were randomly assigned to a mindfulness instruction (MT) group or an instructed thinking (IT) group. Participants in the MT group were trained to either focus their attention mindfully on their breath or their emotions, while the IT group focused their attention on the past or future. Afterwards, all participants underwent an emotion regulation paradigm in which they either watched negative or neutral movie clips. During both paradigms cortical hemodynamic changes were assessed by means of fNIRS. Participants in the MT group showed lower activity in the cognitive control network (CCN) during the focus on breath condition in comparison to the focus on emotion condition. Additionally, oxygenated hemoglobin in the MT group tended to be lower than in the IT group. Further, self-reports of emotional distress during the instruction paradigm were reduced in the MT group. During the emotion regulation paradigm, we observed reduced emotional reactivity in terms of emotional distress and avoidance in the MT group in comparison to the IT group. Furthermore, on a neural level, we observed higher CCN activity in the MT group in comparison to the IT group. We did not find any effect of rumination, neither on the intervention nor on the emotion regulation task. The results of this pilot study are discussed in light of the present literature on the neural correlates of mindfulness based interventions in rumination and emphasize the use of fNIRS to track neural changes in situ over the course of therapy.

Effects of attention training technique on brain function in high- and low-cognitive-attentional syndrome individuals: Regional dynamics before, during, and after a single session of ATT

OBJECTIVE

Attention Training Technique (ATT) is a key therapeutic tool in metacognitive therapy. There are numerous studies on the behavioral effects of ATT, however the neural mechanisms at work in the training are yet to be uncovered. To date there have been no controlled fMRI studies of ATT.

METHOD

We conducted a randomized double-blind controlled study of two groups with varying levels of cognitive-attentional syndrome (CAS). Groups with high (n = 43) and low (n = 46) levels of CAS underwent a single session of ATT or a control condition (CON) in an MRI scanner. Participants underwent resting state functional MRI (rsfMRI) sessions and rumination induction sessions both pre- and post-intervention Functional connectivity analyses and inter-subject correlations analyses were computed. We also collected data on emotion and attention functioning pre- and post-intervention.

RESULTS

We did not observe any behavioral effects of ATT. However, direct comparison between ATT and CON sessions revealed greater inter-subject correlations in almost all hubs belonging to the studied functional networks. Moreover, subjects who received ATT showed diminished connectivity in the fronto-parietal network during ruminations and diminished connectivity of the precuneus with lateral occipital cortices and the intraparietal sulcus in abstract thinking and rsfMRI, respectively. Furthermore, some of the observed effects in functional connectivity and inter-subject correlations were specific to different levels of CAS.

CONCLUSIONS

Our results may support a proposed neural mechanism for ATT: disengagement of attention from CAS-type processing in either low- or high-CAS individuals. It is also possible that some neural effects of ATT are specific to individuals with different levels of CAS.

Malleability of rumination: An exploratory model of CBT-based plasticity and long-term reduced risk for depressive relapse among youth from a pilot randomized clinical trial

CLINICAL TRIALS REGISTRATION

NCT01905267, https://clinicaltrials.gov/ct2/show/NCT01905267.

The developmental trajectory of fronto-temporoparietal connectivity as a proxy of the default mode network: a longitudinal fNIRS investigation

The default mode network (DMN) is a network of brain regions that is activated while we are not engaged in any particular task. While there is a large volume of research documenting functional connectivity within the DMN in adults, knowledge of the development of this network is still limited. There is some evidence for a gradual increase in the functional connections within the DMN during the first 2 years of life, in contrast to other functional resting‐state networks that support primary sensorimotor functions, which are online from very early in life. Previous studies that investigated the development of the DMN acquired data from sleeping infants using fMRI. However, sleep stages are known to affect functional connectivity. In the current longitudinal study, fNIRS was used to measure spontaneous fluctuations in connectivity within fronto‐temporoparietal areas—as a proxy for the DMN—in awake participants every 6 months from 11 months till 36 months. This study validates a method for recording resting‐state data from awake infants, and presents a data analysis pipeline for the investigation of functional connections with infant fNIRS data, which will be beneficial for researchers in this field. A gradual development of fronto‐temporoparietal connectivity was found, supporting the idea that the DMN develops over the first years of life. Functional connectivity reached its maximum peak at about 24 months, which is consistent with previous findings showing that, by 2 years of age, DMN connectivity is similar to that observed in adults.

Rumination network dysfunction in major depression: A brain connectome study

BACKGROUND

Rumination is a central feature of major depressive disorder (MDD). Knowledge of the neural structures that underpin rumination offers significant insight into depressive pathophysiology and may help to develop potential intervention strategies for MDD, a mental illness that has become the leading cause of disability worldwide.

METHODS

Using resting-state fMRI and graph theory, this study adopted a connectome approach to examine the functional topological organization of the neural network associated with rumination in MDD. Data from 96 participants were analyzed, including 51 patients with MDD and 45 healthy controls.

RESULTS

We found altered functional integration and segregation of neural networks associated with depressive rumination as indicated by reduced global and local efficiency in MDD patients compared with controls. Interestingly, these metrics correlated positively with depression severity, as measured by the Hamilton Depression Rating Scale. Moreover, mediation analysis indicated that the association between network metrics and depression severity was mediated by the ruminative tendency of patients. Disrupted nodal centralities were located in regions associated with emotional processing, visual mental imagery, and attentional control.

CONCLUSION

Our results highlight rumination as a two-edged sword that reflects a disease-specific neuropathology but also points to a functionality of depressive symptoms with evolutionary meaning.

Diagnostic and Predictive Applications of Functional Near-Infrared Spectroscopy for Major Depressive Disorder: A Systematic Review

INTRODUCTION

Major depressive disorder (MDD) is a global psychiatric disorder with no established biomarker. There is growing evidence that functional near-infrared spectroscopy (fNIRS) has the ability to aid in the diagnosis and prediction of the treatment response of MDD. The aim of this review was to systematically review, and gather the evidence from existing studies that used fNIRS signals in the diagnosis of MDD, correlations with depression symptomatology, and the monitoring of treatment response.

METHODS

PubMed, EMBASE, ScienceDirect, and Cochrane Library databases were searched for published English articles from 1980 to June 2019 that focused on the application of fNIRS for (i) differentiating depressed versus nondepressed individuals, (ii) correlating with depression symptomatology, and in turn (iii) monitoring treatment responses in depression. Studies were included if they utilized fNIRS to evaluate cerebral hemodynamic variations in patients with MDD of any age group. The quality of the evidence was assessed using the Newcastle-Ottawa quality assessment scale.

RESULTS

A total of 64 studies were included in this review, with 12 studies being longitudinal, while the rest were cross-sectional. More than two-thirds of the studies (n = 49) had acceptable quality. fNIRS consistently demonstrated attenuated cerebral hemodynamic changes in depressed compared to healthy individuals. fNIRS signals have also shown promise in correlating with individual symptoms of depression and monitoring various treatment responses.

CONCLUSIONS

This review provides comprehensive updated evidence of the diagnostic and predictive applications of fNIRS in patients with MDD. Future studies involving larger sample sizes, standardized methodology, examination of more brain regions in an integrative approach, and longitudinal follow-ups are needed.

Disinhibited Revenge - An fNIRS Study on Forgiveness and Cognitive Control

The ability to reconcile is a key factor for a cooperative and successful life. Among the many factors that have an impact on how people negotiate social contracts, poor cognitive control (which is inversely linked to impulsivity) may exert negative effects on forgiveness. To investigate the neurobiological basis of this proposition, subjects with high vs. low impulsivity scores completed an ultimatum game (UG) and a dictator game (DG). First, the participants played an UG where they had to accept or reject offers from fair or unfair opponents. Afterward, the roles changed, and a DG was played. Here, subjects had the opportunity to forgive or take revenge on unfair opponents by the allocation of a fair/unfair amount of money. During this task, activity of the dorsolateral prefrontal cortex (DLPFC) was assessed via functional near-infrared spectroscopy (fNIRS). Highly impulsive subjects were significantly more revenge-seeking than individuals with a low impulsivity. This behavioral difference was reflected in the activation pattern of the left DLPFC, where higher activation in trials with unfair opponents was found, but only in the highly impulsive group. This result is discussed as an indicator of more revenge-driven behavior in highly impulsive individuals, since activity in the left DLPFC is associated with retaliation.

Functional connectivity of reflective and brooding rumination in depressed and healthy women

Ruminative thinking is related to an increased risk for major depressive disorder (MDD) and perpetuates negative mood states. Rumination, uncontrollable negative thoughts about the self, may comprise both reflective and brooding components. However, only brooding rumination is consistently associated with increased negativity bias and negative coping styles, while reflective rumination has a less clear relationship with negative outcomes in healthy and depressed participants. The current study examined seed-to-voxel (S2.V) resting-state functional connectivity (FC) in a sample of healthy (HC) and depressed (MDD) adult women (HC: n=50, MDD: n=33). The S2V FC of six key brain regions, including the left and right amygdala, anterior and posterior cingulate cortex (ACC, PCC), and medial and dorsolateral prefrontal cortices (mPFC, dlPFC), was correlated with self-reported reflective and brooding rumination. Results indicate that HC and MDD participants had increased brooding rumination associated with decreased FC between the left amygdala and the right temporal pole. Moreover, reflective rumination was associated with distinct FC of the mPFC, PCC, and ACC with parietal, occipital, and cingulate regions. Depressed participants, compared with HC, exhibited decreased FC between the PCC and a region in the right middle frontal gyrus. The results of the current study add to the understanding of the neural underpinnings of different forms of self-related cognition-brooding and reflective rumination-in healthy and depressed women.

Fronto-temporoparietal connectivity and self-awareness in 18-month-olds: A resting state fNIRS study

How and when a concept of the 'self' emerges has been the topic of much interest in developmental psychology. Self-awareness has been proposed to emerge at around 18 months, when toddlers start to show evidence of physical self-recognition. However, to what extent physical self-recognition is a valid indicator of being able to think about oneself, is debated. Research in adult cognitive neuroscience has suggested that a common network of brain regions called Default Mode Network (DMN), including the temporo-parietal junction (TPJ) and the medial prefrontal cortex (mPFC), is recruited when we are reflecting on the self. We hypothesized that if mirror self-recognition involves self-awareness, toddlers who exhibit mirror self-recognition might show increased functional connectivity between frontal and temporoparietal regions of the brain, relative to those toddlers who do not yet show mirror self-recognition. Using fNIRS, we collected resting-state data from 18 Recognizers and 22 Non-Recognizers at 18 months of age. We found significantly stronger fronto-temporoparietal connectivity in Recognizers compared to Non-Recognizers, a finding which might support the hypothesized relationship between mirror-self recognition and self-awareness in infancy.

The superior longitudinal fasciculus and its functional triple-network mechanisms in brooding

Brooding, which refers to a repetitive focus on one's distress, is associated with functional connectivity within Default-Mode, Salience, and Executive-Control networks (DMN; SN; ECN), comprising the so-called "triple-network" of attention. Individual differences in brain structure that might perseverate dysfunctional connectivity of brain networks associated with brooding are less clear, however. Using diffusion and functional Magnetic Resonance Imaging, we explored multimodal relationships between brooding severity, white-matter microstructure, and resting-state functional connectivity in depressed adults (N = 32-44), and then examined whether findings directly replicated in a demographically-similar, independent sample (N = 36-45). Among the fully-replicated results, three core findings emerged. First, brooding severity is associated with functional integration and segregation of the triple-network, particularly with a Precuneal subnetwork of the DMN. Second, microstructural asymmetry of the Superior Longitudinal Fasciculus (SLF) provides a robust structural connectivity basis for brooding and may account for over 20% of its severity (Discovery: adj. R² = 0.18; Replication: adj. R² = 0.22; MSE = 0.06, Predictive R² = 0.22). Finally, microstructure of the right SLF and auxiliary white-matter is associated with the functional connectivity correlates of brooding, both within and between components of the triple-network (Discovery: adj. R² = 0.21; Replication: adj. R² = 0.18; MSE = 0.03, Predictive R² = 0.21-0.22). By cross-validating multimodal discovery with replication, the present findings help to reproducibly unify disparate perspectives of brooding etiology. Based on that synthesis, our study reformulates brooding as a microstructural-functional connectivity neurophenotype.

Cortical Hemodynamic Response and Connectivity Modulated by Sub-threshold High-Frequency Repetitive Transcranial Magnetic Stimulation

Repetitive transcranial magnetic stimulation (rTMS) at sub-threshold intensity is a viable clinical strategy to enhance the sensory and motor functions of extremities by increasing or decreasing motor cortical excitability. Despite this, it remains unclear how sub-threshold rTMS modulates brain cortical excitability and connectivity. In this study, we applied functional near-infrared spectroscopy (fNIRS) to investigate the alterations in hemodynamic responses and cortical connectivity patterns that are induced by high-frequency rTMS at a sub-threshold intensity. Forty high-frequency (10 Hz) trains of rTMS at 90% resting motor threshold (RMT) were delivered through a TMS coil placed over 1–2 cm lateral from the vertex. fNIRS signals were acquired from the frontal and bilateral motor areas in healthy volunteers (n = 20) during rTMS administration and at rest. A significant reduction in oxygenated hemoglobin (HbO) concentration was observed in most defined regions of interest (ROIs) during the stimulation period (p < 0.05). Decreased functional connectivity within prefrontal areas as well as between symmetrical ROI-pairs was also observed in most participants during the stimulation (p < 0.05). Results suggest that fNIRS imaging is able to provide a reliable measure of regional cortical brain activation that advances our understanding of the manner in which sub-threshold rTMS affects cortical excitability and brain connectivity.

The Positive Brain - Resting State Functional Connectivity in Highly Vital and Flourishing Individuals

The World Health Organization has defined health as “complete physical, mental and social well-being and not merely the absence of disease or infirmity” (World Health Organization, 1948). An increasing number of studies have therefore started to investigate “the good life.” However, the underlying variation in brain activity has rarely been examined. The goal of this study was to assess differences in resting state functional connectivity (RSFC) between regular healthy individuals and healthy individuals with a high occurrence of flourishing and subjective vitality. Together, flourishing, a broad measure of psycho-social functioning and subjective vitality, an organismic marker of subjective well-being comprise the phenomenological opposite of a major depressive disorder. Out of a group of 43 participants, 20 high-flourishing (highFl) and 18 high-vital (highSV) individuals underwent a 7-min resting state period, where cortical activity in posterior brain areas was assessed using functional near-infrared spectroscopy (fNIRS). Network-based statistics (NBS) of FC yielded significantly different FC patterns for the highFl and highSV individuals compared to their healthy comparison group. The networks converged at areas of the posterior default mode network and differed in hub nodes in the left middle temporal/fusiform gyrus (flourishing) and the left primary/secondary somatosensory cortex (subjective vitality). The attained networks are discussed with regard to recent neuroscientific findings for other well-being measures and potential mechanisms of action based on social information processing and body-related self-perception.