Microstructural deficits of the thalamus in major depressive disorder

Effects of depression and anxiety symptoms on cognitive inhibition: A cross-sectional study of structural and functional MRI evidence

Evidence shows that depression and anxiety symptoms are associated with reduced cognitive inhibition. Nevertheless, the neural substrates responsible for the effects of depression and anxiety symptoms on cognitive inhibition are yet to be determined. This cross-sectional study adhered to the strengthening the reporting of observational studies in epidemiology (STROBE) checklist. Data from 242 participants from the Iranian brain imaging database were used in this study. To address the neural substrates of depression and anxiety responsible for inhibition, voxel-based morphometry (VBM) analysis and resting-state functional magnetic resonance imaging (RS-fMRI) were used. The depression anxiety stress scale was used to evaluate symptoms of depression and anxiety, and the Stroop test was used for cognitive inhibition. The behavioral results demonstrated that inhibition was significantly negatively correlated with depression and anxiety. The VBM results showed that depression was negatively correlated with gray matter (GM) volume in the left pallidum and the right cerebellum cortex. Additionally, anxiety negatively correlated with GM volume in the left and right cerebellum cortex. RS-fMRI results showed that the thalamus network was positively correlated with depression and anxiety. more importantly, mediation analysis revealed that the right cerebellum cortex and thalamic resting-state network through depression and anxiety had a total indirect effect on inhibition. Clarifying the neural substrates responsible for how depression and anxiety symptoms affect cognitive inhibition could have important implications for interventions aimed at supporting individuals' cognitive health.

Differential impact of cerebral small vessel disease on thalamic regulation of anxiety: insights from 7T MRI

Little is known about how thalamic vascular patterns interact with small vessel diseases (SVDs) to influence affective symptoms. Here we collected 7-Telsa magnetic resonance imaging (MRI) data from 84 individuals with SVD and analyzed the influences of thalamic vascular pattern on affective symptoms, aiming to elucidate the underlying mechanisms driven by brain structure and function in the context of SVD. Subjects with a combined arterial supply by tuberothalamic and paramedian arteries to the right thalamus exhibited a lower Hamilton Anxiety scale (HAMA) score. When grouped by SVD burden, the same correlation remained in subjects with low SVD burden, whereas no difference was observed in the high SVD burden group. Interestingly, interaction effects of SVD and thalamic vascular pattern were also found affecting thalamic volume and resting-state brain activity in ventromedial prefrontal cortex (vmPFC). With moderated mediation analysis, right thalamic vascular pattern was indicated to affect anxiety through both direct (vascular pattern → HAMA score) and indirect (vascular pattern → thalamic volume → HAMA score) pathways. But high SVD burden interrupted the effects of right thalamic vascular pattern on HAMA score and thalamic volume. The finding that subjects with a combined arterial supply to the right thalamus exhibited a lower level of anxiety may suggest a novel vascular resilience for regulating anxiety. However, this vascular compensation mechanism was found to be impaired by elevated SVD burden and the disrupted inhibitory vmPFC activity caused by impaired thalamus. The findings of the present study provide a new underlying mechanism for affective disorders with SVD involved.

Scientific psychiatry within technical reach

This is an invited commentary on the paper by Zou et al, accepted for publication in World Journal of Psychiatry. It reflects the findings of the authors in the broader context of the search for scientifically sound and evidence based nomothetic system for diagnosis and treatment in psychiatry, with a special focus on the application of translational neuroimaging in that effort.

Structural connectivity of thalamic subnuclei in major depressive disorder: An ultra-high resolution diffusion MRI study at 7-Tesla

BACKGROUND

The thalamus serves as a central relay station within the brain, and thalamic connectional anomalies are increasingly thought to be present in major depressive disorder (MDD). However, the use of conventional MRI scanners and acquisition techniques has prevented a thorough examination of the thalamus and its subnuclear connectional profile. We combined ultra-high field diffusion MRI acquired at 7.0 Tesla to map the white matter connectivity of thalamic subnuclei.

METHODS

Fifty-three MDD patients and 12 healthy controls (HCs) were involved in the final analysis. FreeSurfer was used to segment the thalamic subnuclei, and MRtrix was used to perform the preprocessing and tractography. Fractional anisotropy, axial diffusivity, mean diffusivity, radial diffusivity, and streamline count of thalamic subnuclear tracts were measured as proxies of white matter microstructure. Bayesian multilevel model was used to assess group differences in white matter metrics for each thalamic subnuclear tract and the association between these white matter metrics and clinical features in MDD.

RESULTS

Evidence was found for reduced whiter matter metrics of the tracts spanning from all thalamic subnuclei among MDD versus HC participants. Moreover, evidence was found that white matter in various thalamic subnuclear tracts is related to medication status, age of onset and recurrence in MDD.

CONCLUSIONS

Structural connectivity was generally reduced in thalamic subnuclei in MDD participants. Several clinical characteristics are related to perturbed subnuclear thalamic connectivity with cortical and subcortical circuits that govern sensory processing, emotional function, and goal-directed behavior.

Neural Modulation Alteration to Positive and Negative Emotions in Depressed Patients: Insights from fMRI Using Positive/Negative Emotion Atlas

BACKGROUND

Although it has been noticed that depressed patients show differences in processing emotions, the precise neural modulation mechanisms of positive and negative emotions remain elusive. FMRI is a cutting-edge medical imaging technology renowned for its high spatial resolution and dynamic temporal information, making it particularly suitable for the neural dynamics of depression research.

METHODS

To address this gap, our study firstly leveraged fMRI to delineate activated regions associated with positive and negative emotions in healthy individuals, resulting in the creation of the positive emotion atlas (PEA) and the negative emotion atlas (NEA). Subsequently, we examined neuroimaging changes in depression patients using these atlases and evaluated their diagnostic performance based on machine learning.

RESULTS

Our findings demonstrate that the classification accuracy of depressed patients based on PEA and NEA exceeded 0.70, a notable improvement compared to the whole-brain atlases. Furthermore, ALFF analysis unveiled significant differences between depressed patients and healthy controls in eight functional clusters during the NEA, focusing on the left cuneus, cingulate gyrus, and superior parietal lobule. In contrast, the PEA revealed more pronounced differences across fifteen clusters, involving the right fusiform gyrus, parahippocampal gyrus, and inferior parietal lobule.

CONCLUSIONS

These findings emphasize the complex interplay between emotion modulation and depression, showcasing significant alterations in both PEA and NEA among depression patients. This research enhances our understanding of emotion modulation in depression, with implications for diagnosis and treatment evaluation.

Gray Matter Volume Correlates of Co-Occurring Depression in Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) involves neurodevelopmental syndromes with significant deficits in communication, motor behaviors, emotional and social comprehension. Often, individuals with ASD exhibit co-occurring depression characterized by a change in mood and diminished interest in previously enjoyable activities. Due to communicative challenges and a lack of appropriate assessments in this cohort, co-occurring depression can often go undiagnosed during routine clinical examinations and, thus, its management neglected. The literature on co-occurring depression in adults with ASD is limited. Therefore, understanding the neural basis of the co-occurring psychopathology of depression in ASD is crucial for identifying brain-based markers for its timely and effective management. Using structural MRI and phenotypic data from the Autism Brain Imaging Data Exchange (ABIDE II) repository, we examined the pattern of relationship regional grey matter volume (rGMV) has with co-occurring depression and autism severity within regions of a priori interest in adults with ASD (n = 44; age = 17-28 years). Further, we performed an exploratory analysis of the rGMV differences between ASD and matched typically developed (TD, n = 39; age = 18-31 years) samples. The severity of co-occurring depression correlated negatively with the rGMV of the right thalamus. Additionally, a significant interaction was evident between the severity of co-occurring depression and core ASD symptoms towards explaining the rGMV in the left cerebellum crus II. The results further the understanding of the neurobiological underpinnings of co-occurring depression in adults with ASD towards exploring neuroimaging-based biomarkers in the same cohort.

Effects and neural mechanisms of different physical activity on major depressive disorder based on cerebral multimodality monitoring: a narrative review

Major depressive disorder (MDD) is currently the most common psychiatric disorder in the world. It characterized by a high incidence of disease with the symptoms like depressed mood, slowed thinking, and reduced cognitive function. Without timely intervention, there is a 20-30% risk of conversion to treatment-resistant depression (TRD) and a high burden for the patient, family and society. Numerous studies have shown that physical activity (PA) is a non-pharmacological treatment that can significantly improve the mental status of patients with MDD and has positive effects on cognitive function, sleep status, and brain plasticity. However, the physiological and psychological effects of different types of PA on individuals vary, and the dosage profile of PA in improving symptoms in patients with MDD has not been elucidated. In most current studies of MDD, PA can be categorized as continuous endurance training (ECT), explosive interval training (EIT), resistance strength training (RST), and mind-body training (MBT), and the effects on patients' depressive symptoms, cognitive function, and sleep varied. Therefore, the present study was based on a narrative review and included a large number of existing studies to investigate the characteristics and differences in the effects of different PA interventions on MDD. The study also investigated the characteristics and differences of different PA interventions in MDD, and explained the neural mechanisms through the results of multimodal brain function monitoring, including the intracranial environment and brain structure. It aims to provide exercise prescription and theoretical reference for future research in neuroscience and clinical intervention in MDD.

GABAergic imbalance in Parkinson's disease-related depression determined with MEGA-PRESS

OBJECTIVE

The pathogenesis of depression in patients with Parkinson's disease (PD) is poorly understood. Therefore, this study aimed to explore the changes in γ-aminobutyric acid (GABA) and glutamate plus glutamine (Glx) levels in patients with PD with or without depression determined using MEscher-GArwood Point Resolved Spectroscopy (MEGA-PRESS).

MATERIALS AND METHODS

A total of 83 patients with primary PD and 24 healthy controls were included. Patients with PD were categorized into depressed PD (DPD, n = 19) and nondepressed PD (NDPD, n = 64) based on the 17-item Hamilton Depression Rating Scale. All participants underwent T1-weighted imaging and MEGA-PRESS sequence to acquire GABA+ and Glx values. The MEGA-PRESS sequence was conducted using 18.48 mL voxels in the left thalamus and medial frontal cortex. The GABA+, Glx, and creatine values were quantified using Gannet 3.1 software.

RESULTS

The GABA+ and Glx values were not significantly disparate between patients with PD and controls in the thalamus and medial frontal cortex. However, the levels of N-acetyl aspartate/creatine and choline/creatine in the left thalamus were significantly lower in patients with PD than in controls (P = .031, P = .009). The GABA+/Water and GABA+/Creatine in the medial frontal cortex were higher in DPD than in NDPD (P = .001, P = .004). The effects of depression on Glx or other metabolite levels were not evident, and no significant difference in metabolite values was noted in the left thalamus among all groups (P > .05).

CONCLUSIONS

GABA+ levels increased in the medial frontal cortex in DPD, which may be more closely related to depressive pathology. Thus, alterations in GABAergic function in special brain structures may be related to the clinical manifestations of PD symptoms, and hence mediating this function might help in treating depression in PD.

A comprehensive hierarchical comparison of structural connectomes in Major Depressive Disorder cases v. controls in two large population samples

BACKGROUND

The brain can be represented as a network, with nodes as brain regions and edges as region-to-region connections. Nodes with the most connections (hubs) are central to efficient brain function. Current findings on structural differences in Major Depressive Disorder (MDD) identified using network approaches remain inconsistent, potentially due to small sample sizes. It is still uncertain at what level of the connectome hierarchy differences may exist, and whether they are concentrated in hubs, disrupting fundamental brain connectivity.

METHODS

We utilized two large cohorts, UK Biobank (UKB, N = 5104) and Generation Scotland (GS, N = 725), to investigate MDD case-control differences in brain network properties. Network analysis was done across four hierarchical levels: (1) global, (2) tier (nodes grouped into four tiers based on degree) and rich club (between-hub connections), (3) nodal, and (4) connection.

RESULTS

In UKB, reductions in network efficiency were observed in MDD cases globally (d = -0.076, pFDR = 0.033), across all tiers (d = -0.069 to -0.079, pFDR = 0.020), and in hubs (d = -0.080 to -0.113, pFDR = 0.013-0.035). No differences in rich club organization and region-to-region connections were identified. The effect sizes and direction for these associations were generally consistent in GS, albeit not significant in our lower-N replication sample.

CONCLUSION

Our results suggest that the brain's fundamental rich club structure is similar in MDD cases and controls, but subtle topological differences exist across the brain. Consistent with recent large-scale neuroimaging findings, our findings offer a connectomic perspective on a similar scale and support the idea that minimal differences exist between MDD cases and controls.

Alterations in subcortical magnetic susceptibility and disease-specific relationship with brain volume in major depressive disorder and schizophrenia

Quantitative susceptibility mapping is a magnetic resonance imaging technique that measures brain tissues' magnetic susceptibility, including iron deposition and myelination. This study examines the relationship between subcortical volume and magnetic susceptibility and determines specific differences in these measures among patients with major depressive disorder (MDD), patients with schizophrenia, and healthy controls (HCs). This was a cross-sectional study. Sex- and age- matched patients with MDD (n = 49), patients with schizophrenia (n = 24), and HCs (n = 50) were included. Magnetic resonance imaging was conducted using quantitative susceptibility mapping and T1-weighted imaging to measure subcortical susceptibility and volume. The acquired brain measurements were compared among groups using analyses of variance and post hoc comparisons. Finally, a general linear model examined the susceptibility-volume relationship. Significant group-level differences were found in the magnetic susceptibility of the nucleus accumbens and amygdala (p = 0.045). Post-hoc analyses indicated that the magnetic susceptibility of the nucleus accumbens and amygdala for the MDD group was significantly higher than that for the HC group (p = 0.0054, p = 0.0065, respectively). However, no significant differences in subcortical volume were found between the groups. The general linear model indicated a significant interaction between group and volume for the nucleus accumbens in MDD group but not schizophrenia or HC groups. This study showed susceptibility alterations in the nucleus accumbens and amygdala in MDD patients. A significant relationship was observed between subcortical susceptibility and volume in the MDD group's nucleus accumbens, which indicated abnormalities in myelination and the dopaminergic system related to iron deposition.

A structural equation modeling approach using behavioral and neuroimaging markers in major depressive disorder

Major depressive disorder (MDD) has consistently proven to be a multifactorial and highly comorbid disease. Despite recent depression-related research demonstrating causalities between MDD-related factors and a small number of variables, including brain structural changes, a high-statistical power analysis of the various factors is yet to be conducted. We retrospectively analyzed data from 155 participants (84 healthy controls and 71 patients with MDD). We used magnetic resonance imaging and diffusion tensor imaging data, scales assessing childhood trauma, depression severity, cognitive dysfunction, impulsivity, and suicidal ideation. To simultaneously evaluate the causalities between multivariable, we implemented two types of MDD-specified structural equation models (SEM), the behavioral and neurobehavioral models. Behavioral SEM showed significant results in the MDD group: Comparative Fit Index [CFI] = 1.000, Root Mean Square Error of Approximation [RMSEA]) = 0.000), with a strong correlation in the scales for childhood trauma, depression severity, suicidal ideation, impulsivity, and cognitive dysfunction. Based on behavioral SEM, we established neurobehavioral models showing the best-fit in MDD, especially including the right cingulate cortex, central to the posterior corpus callosum, right putamen, pallidum, whole brainstem, and ventral diencephalon, including the thalamus (CFI >0.96, RMSEA <0.05). Our MDD-specific model revealed that the limbic-associated regions are strongly connected with childhood trauma rather than depression severity, and that they independently affect suicidal ideation and cognitive dysfunction. Furthermore, cognitive dysfunction could affect impulsivity.

Input-output relation of midbrain connectomics in a rodent model of depression

BACKGROUND

The symptoms associated with depression are believed to arise from disruptions in information processing across brain networks. The ventral tegmental area (VTA) influences reward-based behavior, motivation, addiction, and psychiatric disorders, including depression. Deep brain stimulation (DBS) of the medial forebrain bundle (MFB), is an emerging therapy for treatment-resistant depression. Understanding the depression associated anatomical networks crucial for comprehending its antidepressant effects.

METHODS

Flinders Sensitive Line (FSL), a rodent model of depression and Sprague-Dawley rats (n = 10 each) were used in this study. We used monosynaptic tracing to map inputs of VTA efferent neurons: VTA-to-NAc nucleus accumbens (NAc) (both core and shell) and VTA-to-prefrontal cortex (PFC). Quantitative analysis explored afferent diversity and strengths.

RESULTS

VTA efferent neurons receive a variety of afferents with varying input weights and predominant neuromodulatory representation. Notably, NAc-core projecting VTA neurons showed stronger afferents from dorsal raphe, while NAc shell-projecting VTA neurons displayed lower input strengths from cortex, thalamus, zona incerta and pretectal area in FSL rats. NAc shell-projecting VTA neurons showed the most difference in connectivity across the experimental groups.

LIMITATIONS

Lack of functional properties of the anatomical connections is the major limitation of this study. Incomplete labeling and the cytotoxicity of the rabies virus should be made aware of.

CONCLUSIONS

These findings provide the first characterization of inputs to different VTA ascending projection neurons, shedding light on critical differences in the connectome of the midbrain-forebrain system. Moreover, these differences support potential network effects of these circuits in the context of MFB DBS neuromodulation for depression.

Neuroanatomical dimensions in medication-free individuals with major depressive disorder and treatment response to SSRI antidepressant medications or placebo

Major depressive disorder (MDD) is a heterogeneous clinical syndrome with widespread subtle neuroanatomical correlates. Our objective was to identify the neuroanatomical dimensions that characterize MDD and predict treatment response to selective serotonin reuptake inhibitor (SSRI) antidepressants or placebo. In the COORDINATE-MDD consortium, raw MRI data were shared from international samples (N = 1,384) of medication-free individuals with first-episode and recurrent MDD (N = 685) in a current depressive episode of at least moderate severity, but not treatment-resistant depression, as well as healthy controls (N = 699). Prospective longitudinal data on treatment response were available for a subset of MDD individuals (N = 359). Treatments were either SSRI antidepressant medication (escitalopram, citalopram, sertraline) or placebo. Multi-center MRI data were harmonized, and HYDRA, a semi-supervised machine-learning clustering algorithm, was utilized to identify patterns in regional brain volumes that are associated with disease. MDD was optimally characterized by two neuroanatomical dimensions that exhibited distinct treatment responses to placebo and SSRI antidepressant medications. Dimension 1 was characterized by preserved gray and white matter (N = 290 MDD), whereas Dimension 2 was characterized by widespread subtle reductions in gray and white matter (N = 395 MDD) relative to healthy controls. Although there were no significant differences in age of onset, years of illness, number of episodes, or duration of current episode between dimensions, there was a significant interaction effect between dimensions and treatment response. Dimension 1 showed a significant improvement in depressive symptoms following treatment with SSRI medication (51.1%) but limited changes following placebo (28.6%). By contrast, Dimension 2 showed comparable improvements to either SSRI (46.9%) or placebo (42.2%) (β = -18.3, 95% CI (-34.3 to -2.3), P = 0.03). Findings from this case-control study indicate that neuroimaging-based markers can help identify the disease-based dimensions that constitute MDD and predict treatment response.

Low myelin-related values in the fornix and thalamus of 7 Tesla MRI of major depressive disorder patients

Introduction

Abnormalities in myelin are believed to be one of the important causes of major depressive disorder, and it is becoming important to more accurately quantify myelin in in vivo magnetic resonance imaging of major depressive disorder patients. We aimed to investigate the difference in myelin concentration in the white matter and subcortical areas using new quantitative myelin-related maps of high-resolution 7 Tesla (7 T) magnetic resonance imaging between patients with major depressive disorder and healthy controls.

Methods

Myelin-related comparisons of the white matter and nearby subcortical regions were conducted between healthy controls (n = 36) and patients with major depressive disorder (n = 34). Smoothed quantitative ratio (sq-Ratio) myelin-related maps were created using the multi-echo magnetization-prepared two rapid gradient echoes (ME-MP2RAGE) sequence of the T1 and T2* images of 7 T magnetic resonance imaging. Differences in the myelin-related values of the regions of interest between the two groups were analyzed using a two-sample t-test, and multiple comparison corrections were performed using the false discovery rate.

Results

The average sq-Ratio myelin-related values were 2.62% higher in the white matter and 2.26% higher in the subcortical regions of the healthy controls group than in the major depressive disorder group. In the group analysis of the healthy control and major depressive disorder groups, the sq-Ratio myelin-related values were significantly different in the fornix area of the white matter (false discovery rate-corrected p = 0.012). In addition, significant differences were observed in both the left (false discovery rate-corrected p = 0.04) and right thalamus (false discovery rate-corrected p = 0.040) among the subcortical regions.

Discussion

The average sq-ratio myelin-related value and sq-ratio myelin-related values in the fornix of the white matter and both thalami were higher in the healthy controls group than in the major depressive disorder group. We look forward to replicating our findings in other populations using larger sample sizes.

Increased thalamic gray matter volume induced by repetitive transcranial magnetic stimulation treatment in patients with major depressive disorder

Purpose

Repetitive transcranial magnetic stimulation (rTMS) is an effective therapy in improving depressive symptoms in MDD patients, but the intrinsic mechanism is still unclear. In this study, we investigated the influence of rTMS on brain gray matter volume for alleviating depressive symptoms in MDD patients using structural magnetic resonance imaging (sMRI) data.

Methods

Patients with first episode, unmedicated patients with MDD (n = 26), and healthy controls (n = 31) were selected for this study. Depressive symptoms were assessed before and after treatment by using the HAMD-17 score. High-frequency rTMS treatment was conducted in patients with MDD over 15 days. The rTMS treatment target is located at the F3 point of the left dorsolateral prefrontal cortex. Structural magnetic resonance imaging (sMRI) data were collected before and after treatment to compare the changes in brain gray matter volume.

Results

Before treatment, patients with MDD had significantly reduced gray matter volumes in the right fusiform gyrus, left and right inferior frontal gyrus (triangular part), left inferior frontal gyrus (orbital part), left parahippocampal gyrus, left thalamus, right precuneus, right calcarine fissure, and right median cingulate gyrus compared with healthy controls (P < 0.05). After rTMS treatment, significant growth in gray matter volume of the bilateral thalamus was observed in depressed patients (P < 0.05).

Conclusion

Bilateral thalamic gray matter volumes were enlarged in the thalamus of MDD patients after rTMS treatment and may be the underlying neural mechanism for the treatment of rTMS on depression.