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Lechner S, Northoff G. Abnormal resting-state EEG phase dynamics distinguishes major depressive disorder and bipolar disorder. J Affect Disord 2024; 359:269-276. [PMID: 38795776 DOI: 10.1016/j.jad.2024.05.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/22/2024] [Accepted: 05/18/2024] [Indexed: 05/28/2024]
Abstract
Changes in EEG have been reported in both major depressive disorder (MDD) and bipolar disorder (BD). Specifically, power changes in EEG alpha and theta frequency bands during rest and task are known in both disorders. This leaves open whether there are changes in yet another component of the electrophysiological EEG signal, namely phase-related processes that may allow for distinguishing MDD and BD. For that purpose, we investigate EEG-based spontaneous phase in the resting state of MDD, BD and healthy controls. Our main findings show: (i) decreased spontaneous phase variability in frontal theta of both MDD and BD compared to HC; (ii) decreased spontaneous phase variability in central-parietal alpha in MDD compared to both BD and HC; (iii) increased delays or lags of alpha phase cycles in MDD (but not in BD), which (iv) correlate with the decreased phase variability in MDD. Together, we show similar (decreased frontal theta variability) and distinct (decreased central-parietal alpha variability with increased lags or delays) findings in the spontaneous phase dynamics of MDD and BD. This suggests potential relevance of theta and alpha phase dynamics in distinguishing MDD and BD in clinical differential-diagnosis.
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Affiliation(s)
- Stephan Lechner
- The Royal's Institute of Mental Health Research, Brain and Mind Research Institute, University of Ottawa, Ottawa, ON K1Z 7K4, Canada; Research Group Neuroinformatics, Faculty of Computer Science, University of Vienna, 1010 Vienna, Austria; Vienna Doctoral School Cognition, Behavior and Neuroscience, University of Vienna, 1030 Vienna, Austria.
| | - Georg Northoff
- The Royal's Institute of Mental Health Research, Brain and Mind Research Institute, University of Ottawa, Ottawa, ON K1Z 7K4, Canada
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Vacca S, Porcu M, Piga M, Mannelli L, Chessa E, Suri JS, Balestrieri A, Cauli A, Saba L. Structural Brain MR Imaging Alterations in Patients with Systemic Lupus Erythematosus with and without Neuropsychiatric Events. AJNR Am J Neuroradiol 2024; 45:802-808. [PMID: 38637023 DOI: 10.3174/ajnr.a8200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/18/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND AND PURPOSE Systemic lupus erythematosus is a complex autoimmune disease known for its diverse clinical manifestations, including neuropsychiatric systemic lupus erythematosus, which impacts a patient's quality of life. Our aim was to explore the relationships among brain MR imaging morphometric findings, neuropsychiatric events, and laboratory values in patients with systemic lupus erythematosus, shedding light on potential volumetric biomarkers and diagnostic indicators for neuropsychiatric systemic lupus erythematosus. MATERIALS AND METHODS Twenty-seven patients with systemic lupus erythematosus (14 with neuropsychiatric systemic lupus erythematosus, 13 with systemic lupus erythematosus), 24 women and 3 men (average age, 43 years, ranging from 21 to 62 years) were included in this cross-sectional study, along with 10 neuropsychiatric patients as controls. An MR imaging morphometric analysis, with the VolBrain online platform, to quantitatively assess brain structural features and their differences between patients with neuropsychiatric systemic lupus erythematosus and systemic lupus erythematosus, was performed. Correlations and differences between MR imaging morphometric findings and laboratory values, including disease activity scores, such as the Systemic Lupus Erythematosus Disease Activity Index and the Systemic Lupus International Collaborating Clinics Damage Index, were explored. An ordinary least squares regression analysis further explored the Systemic Lupus Erythematosus Disease Activity Index and Systemic Lupus International Collaborating Clinics Damage Index relationship with MR imaging features. RESULTS For neuropsychiatric systemic lupus erythematosus and non-neuropsychiatric systemic lupus erythematosus, the brain regions with the largest difference in volumetric measurements were the insular central operculum volume (P value = .003) and the occipital cortex thickness (P = .003), which were lower in neuropsychiatric systemic lupus erythematosus. The partial correlation analysis showed that the most correlated morphometric features with neuropsychiatric systemic lupus erythematosus were subcallosal area thickness asymmetry (P < .001) and temporal pole thickness asymmetry (P = .011). The ordinary least squares regression analysis yielded an R 2 of 0.725 for the Systemic Lupus Erythematosus Disease Activity Index score, with calcarine cortex volume as a significant predictor, and an R 2 of 0.715 for the Systemic Lupus International Collaborating Clinics Damage Index score, with medial postcentral gyrus volume as a significant predictor. CONCLUSIONS The MR imaging volumetric analysis, along with the correlation study and the ordinary least squares regression analysis, revealed significant differences in brain regions and their characteristics between patients with neuropsychiatric systemic lupus erythematosus and those with systemic lupus erythematosus, as well as between patients with different Systemic Lupus Erythematosus Disease Activity Index and Systemic Lupus International Collaborating Clinics Damage Index scores.
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Affiliation(s)
- Sebastiano Vacca
- From the School of Medicine and Surgery (S.V.), University of Cagliari, Cagliari, Italy
| | - Michele Porcu
- Department of Radiology (M. Piga, A.B., L.S.), Azienda Ospedaliero-Universitaria, Cagliari, Italy
| | - Matteo Piga
- Department of Medical Science and Public Health (M. Porcu, A.B., A.C.), University of Calgiari, Cagliari, Italy
- Rheumatology Unit (M. Piga, E.C., A.C.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato, Italy
| | - Lorenzo Mannelli
- Institute for Hospitalization and Healthcare (L.M.), SDN, Napoli, Italy
| | - Elisabetta Chessa
- Rheumatology Unit (M. Piga, E.C., A.C.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato, Italy
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division (J.S.S.), AtheroPoint, Roseville, California
| | - Antonella Balestrieri
- Department of Radiology (M. Piga, A.B., L.S.), Azienda Ospedaliero-Universitaria, Cagliari, Italy
- Department of Medical Science and Public Health (M. Porcu, A.B., A.C.), University of Calgiari, Cagliari, Italy
| | - Alberto Cauli
- Department of Medical Science and Public Health (M. Porcu, A.B., A.C.), University of Calgiari, Cagliari, Italy
- Rheumatology Unit (M. Piga, E.C., A.C.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato, Italy
| | - Luca Saba
- Department of Radiology (M. Piga, A.B., L.S.), Azienda Ospedaliero-Universitaria, Cagliari, Italy
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Wang Y, Li Z, Cao X. Investigating the network structure and causal relationships among bridge symptoms of comorbid depression and anxiety: A Bayesian network analysis. J Clin Psychol 2024; 80:1271-1285. [PMID: 38366938 DOI: 10.1002/jclp.23663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND The network analysis method emphasizes the interaction between individual symptoms to identify shared or bridging symptoms between depression and anxiety to understand comorbidity. However, the network analysis and community detection approach have limitations in identifying causal relationships among symptoms. This study aims to address this gap by applying Bayesian network (BN) analysis to investigate potential causal relationships. METHOD Data were collected from a sample of newly enrolled college students. The network structure of depression and anxiety was estimated using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) Scale measures, respectively. Shared symptoms between depression and anxiety were identified through network analysis and clique percolation (CP) method. The causal relationships among symptoms were estimated using BN. RESULTS The strongest bridge symptoms, as indicated by bridge strength, include sad mood (PHQ2), motor (PHQ8), suicide (PHQ9), restlessness (GAD5), and irritability (GAD6). These bridge symptoms formed a distinct community using the CP algorithm. Sad mood (PHQ2) played an activating role, influencing other symptoms. Meanwhile, restlessness (GAD5) played a mediating role with reciprocal influences on both anxiety and depression symptoms. Motor (PHQ8), suicide (PHQ9), and irritability (GAD6) assumed recipient positions. CONCLUSION BN analysis presents a valuable approach for investigating the complex interplay between symptoms in the context of comorbid depression and anxiety. It identifies two activating symptoms (i.e., sadness and worry), which serve to underscore the fundamental differences between these two disorders. Additionally, psychomotor symptoms and suicidal ideations are recognized as recipient roles, being influenced by other symptoms within the network.
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Affiliation(s)
- Yu Wang
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Zhongquan Li
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Xing Cao
- Mental Health Education Center, Southeast University, Nanjing, China
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Mohammadgholi-Beiki A, Sheibani M, Jafari-Sabet M, Motevalian M, Rahimi-Moghaddam P. Anti-inflammatory and protective effects of Aripiprazole on TNBS-Induced colitis and associated depression in rats: Role of kynurenine pathway. Int Immunopharmacol 2024; 133:112158. [PMID: 38691917 DOI: 10.1016/j.intimp.2024.112158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/08/2024] [Accepted: 04/23/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND The prevalence of depression is higher in patients with inflammatory bowel disease (IBD) than in the general population. Inflammatory cytokines and the kynurenine pathway (KP) play important roles in IBD and associated depression. Aripiprazole (ARP), an atypical antipsychotic, shows various anti-inflammatory properties and may be useful in treating major depressive disorder. This study aimed to evaluate the protective effects of ARP on TNBS-induced colitis and subsequent depression in rats, highlighting the role of the KP. MATERIAL AND METHODS Fifty-six male Wistar rats were used, and all groups except for the normal and sham groups received a single dose of intra-rectal TNBS. Three different doses of ARP and dexamethasone were injected intraperitoneally for two weeks in treatment groups. On the 15th day, behavioral tests were performed to evaluate depressive-like behaviors. Colon ulcer index and histological changes were assessed. The tissue levels of inflammatory cytokines, KP markers, lipopolysaccharide (LPS), nuclear factor-kappa-B (NF-κB), and zonula occludens (ZO-1) were evaluated in the colon and hippocampus. RESULTS TNBS effectively induced intestinal damages and subsequent depressive-like symptoms in rats. TNBS treatment significantly elevated the intestinal content of inflammatory cytokines and NF-κB expression, dysregulated the KP markers balance in both colon and hippocampus tissues, and increased the serum levels of LPS. However, treatment with ARP for 14 days successfully reversed these alterations, particularly at higher doses. CONCLUSION ARP could alleviate IBD-induced colon damage and associated depressive-like behaviors mainly via suppressing inflammatory cytokines activity, serum LPS concentration, and affecting the NF-κB/kynurenine pathway.
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Affiliation(s)
| | - Mohammad Sheibani
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Razi Drug Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Majid Jafari-Sabet
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Razi Drug Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Manijeh Motevalian
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Razi Drug Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Meinke C, Lueken U, Walter H, Hilbert K. Predicting treatment outcome based on resting-state functional connectivity in internalizing mental disorders: A systematic review and meta-analysis. Neurosci Biobehav Rev 2024; 160:105640. [PMID: 38548002 DOI: 10.1016/j.neubiorev.2024.105640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 02/29/2024] [Accepted: 03/21/2024] [Indexed: 04/07/2024]
Abstract
Predicting treatment outcome in internalizing mental disorders prior to treatment initiation is pivotal for precision mental healthcare. In this regard, resting-state functional connectivity (rs-FC) and machine learning have often shown promising prediction accuracies. This systematic review and meta-analysis evaluates these studies, considering their risk of bias through the Prediction Model Study Risk of Bias Assessment Tool (PROBAST). We examined the predictive performance of features derived from rs-FC, identified features with the highest predictive value, and assessed the employed machine learning pipelines. We searched the electronic databases Scopus, PubMed and PsycINFO on the 12th of December 2022, which resulted in 13 included studies. The mean balanced accuracy for predicting treatment outcome was 77% (95% CI: [72%- 83%]). rs-FC of the dorsolateral prefrontal cortex had high predictive value in most studies. However, a high risk of bias was identified in all studies, compromising interpretability. Methodological recommendations are provided based on a comprehensive exploration of the studies' machine learning pipelines, and potential fruitful developments are discussed.
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Affiliation(s)
- Charlotte Meinke
- Department of Psychology, Humboldt-Universität zu Berlin, Germany.
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Germany; German Center for Mental Health (DZPG), partner site Berlin/Potsdam, Germany.
| | - Henrik Walter
- Charité Universtätsmedizin Berlin, corporate member of FU Berlin and Humboldt Universität zu Berlin, Department of Psychiatrie and Psychotherapy, CCM, Germany.
| | - Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, Germany; Department of Psychology, Health and Medical University Erfurt, Germany.
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Belvederi Murri M, Triolo F, Coni A, Nerozzi E, Maietta Latessa P, Fantozzi S, Padula N, Escelsior A, Assirelli B, Ermini G, Bagnoli L, Zocchi D, Cabassi A, Tedeschi S, Toni G, Chattat R, Tripi F, Neviani F, Bertolotti M, Cremonini A, Bertakis KD, Amore M, Chiari L, Zanetidou S. The body of evidence of late-life depression: the complex relationship between depressive symptoms, movement, dyspnea and cognition. Exp Aging Res 2024; 50:296-311. [PMID: 37035934 DOI: 10.1080/0361073x.2023.2196504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 03/24/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Physical symptoms play an important role in late-life depression and may contribute to residual symptomatology after antidepressant treatment. In this exploratory study, we examined the role of specific bodily dimensions including movement, respiratory functions, fear of falling, cognition, and physical weakness in older people with depression. METHODS Clinically stable older patients with major depression within a Psychiatric Consultation-Liaison program for Primary Care underwent comprehensive assessment of depressive symptoms, instrumental movement analysis, dyspnea, weakness, activity limitations, cognitive function, and fear of falling. Network analysis was performed to explore the unique adjusted associations between clinical dimensions. RESULTS Sadness was associated with worse turning and walking ability and movement transitions from walking to sitting, as well as with worse general cognitive abilities. Sadness was also connected with dyspnea, while neurovegetative depressive burden was connected with activity limitations. DISCUSSION Limitations of motor and cognitive function, dyspnea, and weakness may contribute to the persistence of residual symptoms of late-life depression.
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Affiliation(s)
| | - Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Alice Coni
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Bologna, Italy
| | - Erika Nerozzi
- Department for Life Quality Studies, University of Bologna, Bologna, Italy
| | | | - Silvia Fantozzi
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Bologna, Italy
| | - Nicola Padula
- Association for Research on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
| | - Andrea Escelsior
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Barbara Assirelli
- Department of Primary Care, Azienda Unita' Locale Sanita', Bologna, Italy
| | - Giuliano Ermini
- Department of Primary Care, Azienda Unita' Locale Sanita', Bologna, Italy
| | - Luigi Bagnoli
- Department of Primary Care, Azienda Unita' Locale Sanita', Bologna, Italy
| | - Donato Zocchi
- Department of Primary Care, Azienda Unita' Locale Sanita', Bologna, Italy
| | - Aderville Cabassi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Stefano Tedeschi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Giulio Toni
- Association for Research on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
| | - Rabih Chattat
- Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy
| | - Ferdinando Tripi
- Association for Research on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
| | - Francesca Neviani
- Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy
| | - Marco Bertolotti
- Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy
| | - Alessandro Cremonini
- Association for Research on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
| | - Klea D Bertakis
- Department of Family and Community Medicine, University of California, Davis, California, United States
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Lorenzo Chiari
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Bologna, Italy
| | - Stamatula Zanetidou
- Association for Research on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
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Greco C, Raimo G, Amorese T, Cuciniello M, Mcconvey G, Cordasco G, Faundez-Zanuy M, Vinciarelli A, Callejas-Carrion Z, Esposito A. Discriminative Power of Handwriting and Drawing Features in Depression. Int J Neural Syst 2024; 34:2350069. [PMID: 38009869 DOI: 10.1142/s0129065723500697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
This study contributes knowledge on the detection of depression through handwriting/drawing features, to identify quantitative and noninvasive indicators of the disorder for implementing algorithms for its automatic detection. For this purpose, an original online approach was adopted to provide a dynamic evaluation of handwriting/drawing performance of healthy participants with no history of any psychiatric disorders ([Formula: see text]), and patients with a clinical diagnosis of depression ([Formula: see text]). Both groups were asked to complete seven tasks requiring either the writing or drawing on a paper while five handwriting/drawing features' categories (i.e. pressure on the paper, time, ductus, space among characters, and pen inclination) were recorded by using a digitalized tablet. The collected records were statistically analyzed. Results showed that, except for pressure, all the considered features, successfully discriminate between depressed and nondepressed subjects. In addition, it was observed that depression affects different writing/drawing functionalities. These findings suggest the adoption of writing/drawing tasks in the clinical practice as tools to support the current depression detection methods. This would have important repercussions on reducing the diagnostic times and treatment formulation.
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Affiliation(s)
- Claudia Greco
- Department of Psychology, Università della Campania "Luigi Vanvitelli", Viale Ellittico 31 Caserta, 81000, Italy
| | - Gennaro Raimo
- Department of Psychology, Università della Campania "Luigi Vanvitelli", Viale Ellittico 31 Caserta, 81000, Italy
| | - Terry Amorese
- Department of Psychology, Università della Campania "Luigi Vanvitelli", Viale Ellittico 31 Caserta, 81000, Italy
| | - Marialucia Cuciniello
- Department of Psychology, Università della Campania "Luigi Vanvitelli", Viale Ellittico 31 Caserta, 81000, Italy
| | - Gavin Mcconvey
- Action Mental Health, 27 Jubilee Rd, BT23 4YH, Newtownards, UK
| | - Gennaro Cordasco
- Department of Psychology, Università della Campania "Luigi Vanvitelli", Viale Ellittico 31 Caserta, 81000, Italy
| | - Marcos Faundez-Zanuy
- Tecnocampus Universitat Pompeu Fabra, Carrer d'Ernest Lluch 32 Mataro, Barcelona 08302, Spain
| | - Alessandro Vinciarelli
- University of Glasgow, School of Computing Science, 18 Lilybank Gardens Glasgow, G12,8RZ, Scotland
| | - Zoraida Callejas-Carrion
- Department of Languages and Computer Systems, Universidad de Granada, Periodista Daniel Saucedo Aranda Granada, 18071, Spain
| | - Anna Esposito
- Department of Psychology, Università della Campania "Luigi Vanvitelli", Viale Ellittico 31 Caserta, 81000, Italy
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Tao Z, Sun N, Yuan Z, Chen Z, Liu J, Wang C, Li S, Ma X, Ji B, Li K. Research on a New Intelligent and Rapid Screening Method for Depression Risk in Young People Based on Eye Tracking Technology. Brain Sci 2023; 13:1415. [PMID: 37891784 PMCID: PMC10605395 DOI: 10.3390/brainsci13101415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/27/2023] [Accepted: 10/03/2023] [Indexed: 10/29/2023] Open
Abstract
Depression is a prevalent mental disorder, with young people being particularly vulnerable to it. Therefore, we propose a new intelligent and rapid screening method for depression risk in young people based on eye tracking technology. We hypothesized that the "emotional perception of eye movement" could characterize defects in emotional perception, recognition, processing, and regulation in young people at high risk for depression. Based on this hypothesis, we designed the "eye movement emotional perception evaluation paradigm" and extracted digital biomarkers that could objectively and accurately evaluate "facial feature perception" and "facial emotional perception" characteristics of young people at high risk of depression. Using stepwise regression analysis, we identified seven digital biomarkers that could characterize emotional perception, recognition, processing, and regulation deficiencies in young people at high risk for depression. The combined effectiveness of an early warning can reach 0.974. Our proposed technique for rapid screening has significant advantages, including high speed, high early warning efficiency, low cost, and high intelligence. This new method provides a new approach to help effectively screen high-risk individuals for depression.
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Affiliation(s)
- Zhanbo Tao
- Police Sports Department, Zhejiang Police College, Hangzhou 310053, China
- Joint Laboratory of Police Health Smart Surveillance, Zhejiang Police College, Hangzhou 310053, China
| | - Ningxia Sun
- Department of Reproductive Medicine, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Zhen Yuan
- Centre for Cognitive and Brain Sciences, University of Macau, Macau SAR 999078, China
| | - Zeyuan Chen
- Joint Laboratory of Police Health Smart Surveillance, Zhejiang Police College, Hangzhou 310053, China
| | - Jiakang Liu
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Chen Wang
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Shuwu Li
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Xiaowen Ma
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Bin Ji
- Department of Radiopharmacy and Molecular Imaging, School of Pharmacy, Fudan University, Shanghai 200032, China
| | - Kai Li
- Joint Laboratory of Police Health Smart Surveillance, Zhejiang Police College, Hangzhou 310053, China
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou 310053, China
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9
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Cohen J, Richter V, Neumann M, Black D, Haq A, Wright-Berryman J, Ramanarayanan V. A multimodal dialog approach to mental state characterization in clinically depressed, anxious, and suicidal populations. Front Psychol 2023; 14:1135469. [PMID: 37767217 PMCID: PMC10520716 DOI: 10.3389/fpsyg.2023.1135469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 08/14/2023] [Indexed: 09/29/2023] Open
Abstract
Background The rise of depression, anxiety, and suicide rates has led to increased demand for telemedicine-based mental health screening and remote patient monitoring (RPM) solutions to alleviate the burden on, and enhance the efficiency of, mental health practitioners. Multimodal dialog systems (MDS) that conduct on-demand, structured interviews offer a scalable and cost-effective solution to address this need. Objective This study evaluates the feasibility of a cloud based MDS agent, Tina, for mental state characterization in participants with depression, anxiety, and suicide risk. Method Sixty-eight participants were recruited through an online health registry and completed 73 sessions, with 15 (20.6%), 21 (28.8%), and 26 (35.6%) sessions screening positive for depression, anxiety, and suicide risk, respectively using conventional screening instruments. Participants then interacted with Tina as they completed a structured interview designed to elicit calibrated, open-ended responses regarding the participants' feelings and emotional state. Simultaneously, the platform streamed their speech and video recordings in real-time to a HIPAA-compliant cloud server, to compute speech, language, and facial movement-based biomarkers. After their sessions, participants completed user experience surveys. Machine learning models were developed using extracted features and evaluated with the area under the receiver operating characteristic curve (AUC). Results For both depression and suicide risk, affected individuals tended to have a higher percent pause time, while those positive for anxiety showed reduced lip movement relative to healthy controls. In terms of single-modality classification models, speech features performed best for depression (AUC = 0.64; 95% CI = 0.51-0.78), facial features for anxiety (AUC = 0.57; 95% CI = 0.43-0.71), and text features for suicide risk (AUC = 0.65; 95% CI = 0.52-0.78). Best overall performance was achieved by decision fusion of all models in identifying suicide risk (AUC = 0.76; 95% CI = 0.65-0.87). Participants reported the experience comfortable and shared their feelings. Conclusion MDS is a feasible, useful, effective, and interpretable solution for RPM in real-world clinical depression, anxiety, and suicidal populations. Facial information is more informative for anxiety classification, while speech and language are more discriminative of depression and suicidality markers. In general, combining speech, language, and facial information improved model performance on all classification tasks.
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Affiliation(s)
| | | | | | | | - Allie Haq
- Clarigent Health, Mason, OH, United States
| | - Jennifer Wright-Berryman
- Department of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Vikram Ramanarayanan
- Modality.AI, Inc., San Francisco, CA, United States
- Otolaryngology - Head and Neck Surgery (OHNS), University of California, San Francisco, San Francisco, CA, United States
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10
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Tran I, Gellner AK. Long-term effects of chronic stress models in adult mice. J Neural Transm (Vienna) 2023; 130:1133-1151. [PMID: 36786896 PMCID: PMC10460743 DOI: 10.1007/s00702-023-02598-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/28/2023] [Indexed: 02/15/2023]
Abstract
Neuropsychiatric disorders, such as major depression, anxiety disorders, and post-traumatic stress disorder, tend to be long-term conditions in whose development and maintenance stress are central pathogenic factors. Translational mouse models are widely used in neuropsychiatric research, exploiting social and non-social stressors to investigate the mechanisms underlying their detrimental effects. However, most studies focus on the short-term consequences of chronic stress, whereas only a few are interested in the long-term course. This is counterintuitive given the human conditions that preclinical models are designed to mimic. In this review, we have summarized the limited work to date on long-term effects of chronic stress in mice models. First, the different models are presented and a definition of short- vs. long-term sequelae is proposed. On this basis, behavioral, endocrine, and vegetative effects are addressed before examining data on cellular and molecular alterations in the brain. Finally, future directions for research on the long-term effects of stress are discussed.
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Affiliation(s)
- Inès Tran
- Institute of Physiology II, Medical Faculty, University of Bonn, Bonn, Germany
| | - Anne-Kathrin Gellner
- Institute of Physiology II, Medical Faculty, University of Bonn, Bonn, Germany.
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
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11
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Kent L. Mental Gravity: Depression as Spacetime Curvature of the Self, Mind, and Brain. ENTROPY (BASEL, SWITZERLAND) 2023; 25:1275. [PMID: 37761574 PMCID: PMC10528036 DOI: 10.3390/e25091275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/09/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023]
Abstract
The principle of mental gravity contends that the mind uses physical gravity as a mental model or simulacrum to express the relation between the inner self and the outer world in terms of "UP"-ness and "DOWN"-ness. The simulation of increased gravity characterises a continuum of mental gravity which states includes depression as the paradigmatic example of being down, low, heavy, and slow. The physics of gravity can also be used to model spacetime curvature in depression, particularly gravitational time dilation as a property of MG analogous to subjective time dilation (i.e., the slowing of temporal flow in conscious experience). The principle has profound implications for the Temporo-spatial Theory of Consciousness (TTC) with regard to temporo-spatial alignment that establishes a "world-brain relation" that is centred on embodiment and the socialisation of conscious states. The principle of mental gravity provides the TTC with a way to incorporate the structure of the world into the structure of the brain, conscious experience, and thought. In concert with other theories of cognitive and neurobiological spacetime, the TTC can also work towards the "common currency" approach that also potentially connects the TTC to predictive processing frameworks such as free energy, neuronal gauge theories, and active inference accounts of depression. It gives the up/down dimension of space, as defined by the gravitational field, a unique status that is connected to both our embodied interaction with the physical world, and also the inverse, reflective, emotional but still embodied experience of ourselves.
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Affiliation(s)
- Lachlan Kent
- Mental Wellbeing Initiatives, Royal Melbourne Institute of Technology, Melbourne, VIC 3001, Australia
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12
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Indirli R, Lanzi V, Arosio M, Mantovani G, Ferrante E. The association of hypogonadism with depression and its treatments. Front Endocrinol (Lausanne) 2023; 14:1198437. [PMID: 37635965 PMCID: PMC10449581 DOI: 10.3389/fendo.2023.1198437] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023] Open
Abstract
According to World Health Organization estimates, 5% of the adult population worldwide suffers from depression. In addition to the affective, psychomotor and cognitive symptoms which characterize this mood disorder, sexual dysfunction has been frequently reported among men suffering from depression. The most common sexual manifestations are decreased libido, erectile dysfunction and orgasmic disorder. In addition, epidemiological studies have documented a reduction of testosterone concentrations in men with depression and, for these reasons, depressive disorders appear as one possible cause of male functional hypogonadism. Moreover, some largely used antidepressant medications can cause or worsen sexual complaints, thus depression and its treatments rise several andrological-relevant issues. The other way round, men with hypogonadism can manifest depressed mood, anxiety, insomnia, memory impairment which, if mild, may respond to testosterone replacement therapy (TRT). However, the prevalence of functional hypogonadism in depression, and of depressive symptoms in hypogonadal men, is not known. Severe depressive symptoms do not respond to TRT, while the effect of treating major depression on functional hypogonadism, has not been investigated. Overall, the clinical relevance of each condition to the other, as well as the physiopathological underpinnings of their relationship, are still to be clarified. The present review summarizes current evidence on the influence of testosterone on mood and of depression on the hypothalamic-pituitary-testis axis; the clinical association between male hypogonadism and depression; and the reciprocal effects of respective treatments.
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Affiliation(s)
- Rita Indirli
- Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Valeria Lanzi
- Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Maura Arosio
- Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giovanna Mantovani
- Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Emanuele Ferrante
- Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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13
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Wang Y, Liang L, Zhang Z, Xu X, Liu R, Fang H, Zhang R, Wei Y, Liu Z, Zhu R, Zhang X, Wang F. Fast and accurate assessment of depression based on voice acoustic features: a cross-sectional and longitudinal study. Front Psychiatry 2023; 14:1195276. [PMID: 37415683 PMCID: PMC10320390 DOI: 10.3389/fpsyt.2023.1195276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/02/2023] [Indexed: 07/08/2023] Open
Abstract
Background Depression is a widespread mental disorder that affects a significant portion of the population. However, the assessment of depression is often subjective, relying on standard questions or interviews. Acoustic features have been suggested as a reliable and objective alternative for depression assessment. Therefore, in this study, we aim to identify and explore voice acoustic features that can effectively and rapidly predict the severity of depression, as well as investigate the potential correlation between specific treatment options and voice acoustic features. Methods We utilized voice acoustic features correlated with depression scores to train a prediction model based on artificial neural network. Leave-one-out cross-validation was performed to evaluate the performance of the model. We also conducted a longitudinal study to analyze the correlation between the improvement of depression and changes in voice acoustic features after an Internet-based cognitive-behavioral therapy (ICBT) program consisting of 12 sessions. Results Our study showed that the neural network model trained based on the 30 voice acoustic features significantly correlated with HAMD scores can accurately predict the severity of depression with an absolute mean error of 3.137 and a correlation coefficient of 0.684. Furthermore, four out of the 30 features significantly decreased after ICBT, indicating their potential correlation with specific treatment options and significant improvement in depression (p < 0.05). Conclusion Voice acoustic features can effectively and rapidly predict the severity of depression, providing a low-cost and efficient method for screening patients with depression on a large scale. Our study also identified potential acoustic features that may be significantly related to specific treatment options for depression.
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Affiliation(s)
- Yang Wang
- Psychology Institute, Inner Mongolia Normal University, Hohhot, Inner Mongolia, China
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute, Nanjing Medical University, Nanjing, China
| | - Lijuan Liang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute, Nanjing Medical University, Nanjing, China
- Laboratory of Psychology, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Zhongguo Zhang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute, Nanjing Medical University, Nanjing, China
- The Fourth People’s Hospital of Yancheng, Yancheng, Jiangsu, China
| | - Xiao Xu
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
| | - Rongxun Liu
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute, Nanjing Medical University, Nanjing, China
- College of Medical Engineering, Xinxiang Medical University, Xinxiang, Henan, China
| | - Hanzheng Fang
- School of Computer Science and Engineering, Northeastern University, Shenyang, Liaoning, China
| | - Ran Zhang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute, Nanjing Medical University, Nanjing, China
| | - Yange Wei
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute, Nanjing Medical University, Nanjing, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Rongxin Zhu
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute, Nanjing Medical University, Nanjing, China
| | - Xizhe Zhang
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
| | - Fei Wang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute, Nanjing Medical University, Nanjing, China
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14
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Wang S, Tang Q, Lv Y, Tao Y, Liu X, Zhang L, Liu G. The Temporal Relationship between Depressive Symptoms and Loneliness: The Moderating Role of Self-Compassion. Behav Sci (Basel) 2023; 13:472. [PMID: 37366723 DOI: 10.3390/bs13060472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023] Open
Abstract
Loneliness and depression are significant mental health challenges among college students; however, the intricate relationship between these phenomena remains unclear, particularly in the context of self-compassion. In this comprehensive study, we employ a cross-lagged panel network (CLPN) analysis to investigate the symptom-level association between depression and loneliness while exploring the potential moderating influence of self-compassion. Our sample consisted of 2785 college students, who were categorized into high- and low-self-compassion groups based on scores from the Self-Compassion Scale. Depressive symptoms were assessed using the Patient Health Questionnaire-9, while the UCLA Loneliness Scale-8 measured loneliness expressions. Our findings indicate that self-compassion plays a crucial role in the relationship between depression and loneliness. Specifically, we observed distinctive patterns within the high and low-self-compassion groups. In the low-self-compassion group, "energy" emerged as the most influential symptom, whereas "motor function" exhibited the highest influence in the high-self-compassion group. Furthermore, among individuals with high self-compassion, the pathway from depression to loneliness was characterized by "guilt-being alone when desired," while the reverse path from loneliness to depression encompassed "left out-feeling sad" and "left out-anhedonia." Conversely, in the low-self-compassion group, depression and loneliness demonstrated a more intricate mutual triggering relationship, suggesting that self-compassion effectively moderates the association between these variables. This study provides valuable insights into the underlying mechanisms driving the interplay between depression and loneliness, shedding light on the pivotal role of self-compassion in this intricate dynamic.
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Affiliation(s)
- Shujian Wang
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing 100875, China
| | - Qihui Tang
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing 100875, China
| | - Yichao Lv
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing 100875, China
| | - Yanqiang Tao
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing 100875, China
| | - Xiangping Liu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing 100875, China
| | - Liang Zhang
- College Students' Mental Health Education Center, Northeast Agricultural University, Harbin 150030, China
| | - Gang Liu
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
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15
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Xia Y, Hua L, Dai Z, Han Y, Du Y, Zhao S, Zhou H, Wang X, Yan R, Wang X, Zou H, Sun H, Huang Y, Yao Z, Lu Q. Attenuated post-movement beta rebound reflects psychomotor alterations in major depressive disorder during a simple visuomotor task: a MEG study. BMC Psychiatry 2023; 23:395. [PMID: 37270511 DOI: 10.1186/s12888-023-04844-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 05/04/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Psychomotor alterations are a common symptom in patients with major depressive disorder (MDD). The primary motor cortex (M1) plays a vital role in the mechanism of psychomotor alterations. Post-movement beta rebound (PMBR) in the sensorimotor cortex is abnormal in patients with motor abnormalities. However, the changes in M1 beta rebound in patients with MDD remain unclear. This study aimed to primarily explore the relationship between psychomotor alterations and PMBR in MDD. METHODS One hundred thirty-two subjects were enrolled in the study, comprising 65 healthy controls (HCs) and 67 MDD patients. All participants performed a simple right-hand visuomotor task during MEG scanning. PMBR was measured in the left M1 at the source reconstruction level with the time-frequency analysis method. Retardation factor scores and neurocognitive test performance, including the Digit Symbol Substitution Test (DSST), the Making Test Part A (TMT-A), and the Verbal Fluency Test (VFT), were used to measure psychomotor functions. Pearson correlation analyses were used to assess relationships between PMBR and psychomotor alterations in MDD. RESULTS The MDD group showed worse neurocognitive performance than the HC group in all three neurocognitive tests. The PMBR was diminished in patients with MDD compared to HCs. In a group of MDD patients, the reduced PMBR was negatively correlated with retardation factor scores. Further, there was a positive correlation between the PMBR and DSST scores. PMBR is negatively associated with the TMT-A scores. CONCLUSION Our findings suggested that the attenuated PMBR in M1 could illustrate the psychomotor disturbance in MDD, possibly contributing to clinical psychomotor symptoms and deficits of cognitive functions.
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Affiliation(s)
- Yi Xia
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Lingling Hua
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zhongpeng Dai
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing, 210096, China
| | - Yinglin Han
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yishan Du
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Shuai Zhao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Hongliang Zhou
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xiaoqin Wang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Rui Yan
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, China
| | - Xumiao Wang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - HaoWen Zou
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, China
| | - Hao Sun
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, China
| | - YingHong Huang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, China
| | - ZhiJian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China.
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China.
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing, 210096, China.
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Alon Y, Azriel O, Pine DS, Bar-Haim Y. A randomized controlled trial of supervised remotely-delivered attention bias modification for posttraumatic stress disorder. Psychol Med 2023; 53:3601-3610. [PMID: 35132952 PMCID: PMC10248784 DOI: 10.1017/s003329172200023x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/03/2022] [Accepted: 01/17/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Many individuals with posttraumatic stress disorder (PTSD) have limited access to first-line treatments, warranting the development of remotely-delivered treatments. Attention bias modification (ABM), targeting perturbed threat-related attentional patterns, shows promise when delivered in-person. However, previous studies found ABM to be ineffective when delivered remotely. Randomized clinical trials usually applied two variations of ABM: ABM away from threat or attention control training (ACT) balancing attention between threat-related and neutral stimuli. We tested remotely-delivered ACT/ABM with tighter supervision and video-based interactions that resemble in-clinic protocols. We expected to replicate the results of in-clinic trials, in which ACT outperformed ABM for PTSD. METHODS In this double-blinded, parallel-group randomized controlled trial, 60 patients diagnosed with PTSD were randomized (ABM n = 30; ACT n = 30). Patients performed eight bi-weekly remotely-delivered supervised ABM/ACT sessions. Symptoms were assessed pre- and post-treatment with Clinician-Administered PTSD Scale 5 (CAPS-5) severity score and PTSD diagnosis as the primary outcomes. Current depressive episode, current anxiety-related comorbidity, and time elapsed since the trauma were examined as potential moderators of treatment outcome. RESULTS Significant decrease in CAPS-5 severity scores and PTSD diagnosis was observed following both ACT and ABM with no between-group difference. Patients without depression or whose trauma occurred more recently had greater symptom reduction in the ACT than the ABM group. CONCLUSIONS Contrary to our expectation, symptoms decreased similarly following ACT and ABM. Moderator analyses suggest advantage for ACT in non-depressed patients and patients whose trauma occurred more recently. Further refinements in remotely-delivered ABM/ACT may be needed.
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Affiliation(s)
- Yaron Alon
- School of Psychological Sciences, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Omer Azriel
- School of Psychological Sciences, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Daniel S. Pine
- Section on Developmental Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel-Aviv University, Tel Aviv-Yafo, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv-Yafo, Israel
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17
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Bogdanova D. Gait disorders in unipolar and bipolar depression. Heliyon 2023; 9:e15864. [PMID: 37305515 PMCID: PMC10256928 DOI: 10.1016/j.heliyon.2023.e15864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 04/15/2023] [Accepted: 04/25/2023] [Indexed: 06/13/2023] Open
Abstract
Objectives Bipolar and unipolar depressions have a similar clinical picture, but different neurological and psychological mechanisms. These misleading similarities can lead to overdiagnosis and increased suicide risk. Recent studies show that gait is a sensitive objective marker for distinguishing the type of depression. The present study aims to compare psychomotor reactivity disorders and gait activity in unipolar and bipolar depression. Methods A total of 636 people aged 40.7 ± 11.2 years are studied with an ultrasound cranio-corpo-graph. They are divided into three groups - patients with unipolar depression, with bipolar depression and healthy controls. Each person performs three psychomotor tasks - a classic Unterberger task, a simplified version with open eyes and a complex version with an additional cognitive task. Results We find significant differences in psychomotor activity and reactivity between the three groups. Bipolar patients have more inhibited psychomotor skills than unipolar and they are both more inhibited than the norms. The simplified variant of the equilibriometric task is the most sensitive one and psychomotor reactivity is a more precise marker than psychomotor activity. Conclusion Both psychomotor activity and reactivity in gait could be sensitive markers for distinguishing similar psychiatric conditions. The application of the cranio-corpo-graph and the possible development of similar devices could lead to new diagnostic and therapeutic approaches, including early detection and prediction of the type of depression.
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18
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Ali FZ, Parsey RV, Lin S, Schwartz J, DeLorenzo C. Circadian rhythm biomarker from wearable device data is related to concurrent antidepressant treatment response. NPJ Digit Med 2023; 6:81. [PMID: 37120493 PMCID: PMC10148831 DOI: 10.1038/s41746-023-00827-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/11/2023] [Indexed: 05/01/2023] Open
Abstract
Major depressive disorder (MDD) is associated with circadian rhythm disruption. Yet, no circadian rhythm biomarkers have been clinically validated for assessing antidepressant response. In this study, 40 participants with MDD provided actigraphy data using wearable devices for one week after initiating antidepressant treatment in a randomized, double-blind, placebo-controlled trial. Their depression severity was calculated pretreatment, after one week and eight weeks of treatment. This study assesses the relationship between parametric and nonparametric measures of circadian rhythm and change in depression. Results show significant association between a lower circadian quotient (reflecting less robust rhythmicity) and improvement in depression from baseline following first week of treatment (estimate = 0.11, F = 7.01, P = 0.01). There is insufficient evidence of an association between circadian rhythm measures acquired during the first week of treatment and outcomes after eight weeks of treatment. Despite this lack of association with future treatment outcome, this scalable, cost-effective biomarker may be useful for timely mental health care through remote monitoring of real-time changes in current depression.
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Affiliation(s)
- Farzana Z Ali
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA.
| | - Ramin V Parsey
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Radiology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Shan Lin
- Department of Electrical and Computer Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Joseph Schwartz
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Christine DeLorenzo
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
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19
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Ricka N, Pellegrin G, Fompeyrine DA, Lahutte B, Geoffroy PA. Predictive biosignature of major depressive disorder derived from physiological measurements of outpatients using machine learning. Sci Rep 2023; 13:6332. [PMID: 37185788 PMCID: PMC10130089 DOI: 10.1038/s41598-023-33359-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
Major Depressive Disorder (MDD) has heterogeneous manifestations, leading to difficulties in predicting the evolution of the disease and in patient's follow-up. We aimed to develop a machine learning algorithm that identifies a biosignature to provide a clinical score of depressive symptoms using individual physiological data. We performed a prospective, multicenter clinical trial where outpatients diagnosed with MDD were enrolled and wore a passive monitoring device constantly for 6 months. A total of 101 physiological measures related to physical activity, heart rate, heart rate variability, breathing rate, and sleep were acquired. For each patient, the algorithm was trained on daily physiological features over the first 3 months as well as corresponding standardized clinical evaluations performed at baseline and months 1, 2 and 3. The ability of the algorithm to predict the patient's clinical state was tested using the data from the remaining 3 months. The algorithm was composed of 3 interconnected steps: label detrending, feature selection, and a regression predicting the detrended labels from the selected features. Across our cohort, the algorithm predicted the daily mood status with 86% accuracy, outperforming the baseline prediction using MADRS alone. These findings suggest the existence of a predictive biosignature of depressive symptoms with at least 62 physiological features involved for each patient. Predicting clinical states through an objective biosignature could lead to a new categorization of MDD phenotypes.
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Affiliation(s)
| | | | | | - Bertrand Lahutte
- Psychiatry Department, Bégin Military Hospital, 94160, Saint-Mandé, France
| | - Pierre A Geoffroy
- Psychiatry and Addictology Service, Assistance Publique-Hôpitaux de Paris, GHU Paris Nord, DMU Neurosciences, Hopital Bichat-Claude Bernard, 75018, Paris, France
- GHU Paris-Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université de Paris, 75019, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 67000, Strasbourg, France
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Schwefel MK, Kaufmann C, Gutmann G, Henze R, Fydrich T, Rapp MA, Ströhle A, Heissel A, Heinzel S. Physical fitness is associated with neural activity during working memory performance in major depressive disorder. Neuroimage Clin 2023; 38:103401. [PMID: 37060626 PMCID: PMC10133876 DOI: 10.1016/j.nicl.2023.103401] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 03/17/2023] [Accepted: 04/07/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Deficits in cognition like working memory (WM) are highly prevalent symptoms related to major depressive disorder (MDD). Neuroimaging studies have described frontoparietal abnormalities in patients with MDD as a basis for these deficits. Based on research in healthy adults, it is hypothesized that increased physical fitness might be a protective factor for these deficits in MDD. However, the relationship between physical fitness and WM-related neural activity and performance has not been tested in MDD, to date. Understanding these associations could inform the development of physical exercise interventions in MDD. METHODS Within a larger project, 111 (53female) MDD outpatients and 56 (34female) healthy controls performed an n-back task (0-, 1-, 2-, 3-back) during functional Magnetic Resonance Imaging. Physical fitness from a graded exercise test on a cycle ergometer was performed by 106 MDD patients. RESULTS Patients showed reduced performance particularly at high loads of the n-back WM task and prolonged reaction times at all n-back loads. A whole-brain interaction analysis of group by WM load revealed reduced neural activity in six frontoparietal clusters at medium and high WM loads in MDD patients compared to healthy controls. Analysis of covariance within the MDD sample showed that physical fitness was associated with neural activity in right and left superior parietal lobules. Externally defined Regions of Interest confirmed this analysis. CONCLUSIONS Results indicate frontoparietal hypoactivity in MDD at high demands, arguing for decreased WM capacity. We demonstrate a parietal fitness correlate which could be used to guide future research on effects of exercise on cognitive functioning in MDD.
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Affiliation(s)
- M K Schwefel
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
| | - C Kaufmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - G Gutmann
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - R Henze
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - T Fydrich
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - M A Rapp
- Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - A Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - A Heissel
- Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - S Heinzel
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
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21
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Zhu H, Zhu H, Liu X, Wei F, Li H, Guo Z. The Characteristics of Entorhinal Cortex Functional Connectivity in Alzheimer's Disease Patients with Depression. Curr Alzheimer Res 2023; 19:CAR-EPUB-129980. [PMID: 36872356 DOI: 10.2174/1567205020666230303093112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Depression is one of the most common neuropsychiatric symptoms of Alzheimer's disease (AD) which decreases the life quality of both patients and caregivers. There are currently no effective drugs. It is therefore important to explore the pathogenesis of depression in AD patients. OBJECTIVE The present study aimed to investigate the characteristics of the entorhinal cortex (EC) functional connectivity (FC) in the whole brain neural network of AD patients with depression (D-AD). METHODS Twenty-four D-AD patients, 14 AD patients without depression (nD-AD), and 20 healthy controls underwent resting-state functional magnetic resonance imaging. We set the EC as the seed and used FC analysis. One-way analysis of variance was used to examine FC differences among the three groups. RESULTS Using the left EC as the seed point, there were FC differences among the three groups in the left EC-inferior occipital gyrus. Using the right EC as the seed point, there were FC differences among the three groups in the right EC-middle frontal gyrus, -superior parietal gyrus, -superior medial frontal gyrus, and -precentral gyrus. Compared with the nD-AD group, the D-AD group had increased FC between the right EC and right postcentral gyrus. CONCLUSION Asymmetry of FC in the EC and increased FC between the EC and right postcentral gyrus may be important in the pathogenesis of depression in AD.
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Affiliation(s)
- Haokai Zhu
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Zhejiang 310000, China
| | - Hong Zhu
- Tongde Hospital of Zhejiang Province, Zhejiang Mental Health Center, Hangzhou, Zhejiang 310012, China
| | - Xiaozheng Liu
- Department of Radiology of the Second Affiliated Hospital, China-USA Neuroimaging Research Institute, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Fuquan Wei
- Tongde Hospital of Zhejiang Province, Zhejiang Mental Health Center, Hangzhou, Zhejiang 310012, China
| | - Huichao Li
- Tongde Hospital of Zhejiang Province, Zhejiang Mental Health Center, Hangzhou, Zhejiang 310012, China
| | - Zhongwei Guo
- Tongde Hospital of Zhejiang Province, Zhejiang Mental Health Center, Hangzhou, Zhejiang 310012, China
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22
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Mills-Finnerty C, Staggs H, Hogoboom N, Naparstek S, Harvey T, Beaudreau SA, O’Hara R. Association between mental health symptoms and behavioral performance in younger vs. older online workers. Front Psychiatry 2023; 14:995445. [PMID: 37065893 PMCID: PMC10090330 DOI: 10.3389/fpsyt.2023.995445] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/25/2023] [Indexed: 04/18/2023] Open
Abstract
Background The COVID-19 pandemic has been associated with increased rates of mental health problems, particularly in younger people. Objective We quantified mental health of online workers before and during the COVID-19 pandemic, and cognition during the early stages of the pandemic in 2020. A pre-registered data analysis plan was completed, testing the following three hypotheses: reward-related behaviors will remain intact as age increases; cognitive performance will decline with age; mood symptoms will worsen during the pandemic compared to before. We also conducted exploratory analyses including Bayesian computational modeling of latent cognitive parameters. Methods Self-report depression (Patient Health Questionnaire 8) and anxiety (General Anxiety Disorder 7) prevalence were compared from two samples of Amazon Mechanical Turk (MTurk) workers ages 18-76: pre-COVID 2018 (N = 799) and peri-COVID 2020 (N = 233). The peri-COVID sample also completed a browser-based neurocognitive test battery. Results We found support for two out of three pre-registered hypotheses. Notably our hypothesis that mental health symptoms would increase in the peri-COVID sample compared to pre-COVID sample was not supported: both groups reported high mental health burden, especially younger online workers. Higher mental health symptoms were associated with negative impacts on cognitive performance (speed/accuracy tradeoffs) in the peri-COVID sample. We found support for two hypotheses: reaction time slows down with age in two of three attention tasks tested, whereas reward function and accuracy appear to be preserved with age. Conclusion This study identified high mental health burden, particularly in younger online workers, and associated negative impacts on cognitive function.
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Affiliation(s)
- Colleen Mills-Finnerty
- Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Veterans Administration Palo Alto Health Care System, Palo Alto, CA, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
- *Correspondence: Colleen Mills-Finnerty,
| | - Halee Staggs
- Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Veterans Administration Palo Alto Health Care System, Palo Alto, CA, United States
- Shiley-Marcos School of Engineering, University of San Diego, San Diego, CA, United States
| | - Nichole Hogoboom
- Department of Psychology, San Jose State University, San Jose, CA, United States
| | - Sharon Naparstek
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Tiffany Harvey
- Department of Biochemistry, University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Sherry A. Beaudreau
- Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Veterans Administration Palo Alto Health Care System, Palo Alto, CA, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Ruth O’Hara
- Sierra Pacific Mental Illness, Research, Education, and Clinical Center, Veterans Administration Palo Alto Health Care System, Palo Alto, CA, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
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23
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Ali FZ, Wengler K, He X, Nguyen MH, Parsey RV, DeLorenzo C. Gradient boosting decision-tree-based algorithm with neuroimaging for personalized treatment in depression. NEUROSCIENCE INFORMATICS 2022; 2:100110. [PMID: 36699194 PMCID: PMC9873411 DOI: 10.1016/j.neuri.2022.100110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction Pretreatment positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) and magnetic resonance spectroscopy (MRS) may identify biomarkers for predicting remission (absence of depression). Yet, no such image-based biomarkers have achieved clinical validity. The purpose of this study was to identify biomarkers of remission using machine learning (ML) with pretreatment FDG-PET/MRS neuroimaging, to reduce patient suffering and economic burden from ineffective trials. Methods This study used simultaneous PET/MRS neuroimaging from a double-blind, placebo-controlled, randomized antidepressant trial on 60 participants with major depressive disorder (MDD) before initiating treatment. After eight weeks of treatment, those with ≤ 7 on 17-item Hamilton Depression Rating Scale were designated a priori as remitters (free of depression, 37%). Metabolic rate of glucose uptake (metabolism) from 22 brain regions were acquired from PET. Concentrations (mM) of glutamine and glutamate and gamma-aminobutyric acid (GABA) in anterior cingulate cortex were quantified from MRS. The data were randomly split into 67% train and cross-validation (n = 40), and 33% test (n = 20) sets. The imaging features, along with age, sex, handedness, and treatment assignment (selective serotonin reuptake inhibitor or SSRI vs. placebo) were entered into the eXtreme Gradient Boosting (XGBoost) classifier for training. Results In test data, the model showed 62% sensitivity, 92% specificity, and 77% weighted accuracy. Pretreatment metabolism of left hippocampus from PET was the most predictive of remission. Conclusions The pretreatment neuroimaging takes around 60 minutes but has potential to prevent weeks of failed treatment trials. This study effectively addresses common issues for neuroimaging analysis, such as small sample size, high dimensionality, and class imbalance.
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Affiliation(s)
- Farzana Z. Ali
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Kenneth Wengler
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Xiang He
- Department of Radiology, Stony Brook Medicine, Stony Brook, NY, USA
- Department of Radiology, Northshore University Hospital, Manhasset, NY, USA
| | - Minh Hoai Nguyen
- Department of Computer Science, Stony Brook University, Stony Brook, NY, USA
| | - Ramin V. Parsey
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
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24
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Elkjær E, Mikkelsen MB, Michalak J, Mennin DS, O'Toole MS. Motor alterations in depression and anxiety disorders: A systematic review and meta-analysis. J Affect Disord 2022; 317:373-387. [PMID: 36037990 DOI: 10.1016/j.jad.2022.08.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 05/19/2022] [Accepted: 08/21/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Psychomotor retardation has long been recognized as a major feature of depression, and anxiety disorders have been linked with freeze and flight motor responses. This systematic review and meta-analysis aimed a) to synthesize available evidence of motor alterations comparing individuals with depression and anxiety disorders to healthy individuals and b) to evaluate the effect of experimental manipulations of motor displays within these clinical groups. METHOD The databases PubMed and PsycINFO were searched for studies either assessing motor differences between clinical and healthy control groups or manipulating the motor system within a clinical group. RESULTS The literature search yielded 87 relevant papers, comprising 82 studies comparing a clinical group to a healthy group and 5 studies investigating motor manipulations within a clinical sample. The results of the meta-analysis (K = 71) indicated a statistically significant combined estimate of differences between healthy and clinical groups (g = 0.38 [0.31, 0.45], adjusted for publication bias g = 0.26 [0.19, 0.33]) of a small size. This effect did not vary according to type of disorder (anxiety vs. depression, p = .468). From a narrative review of experimental studies within clinical groups, four out of five studies reported statistically significant effects of manipulating the motor system on affective outcomes. DISCUSSION This synthesis adds to the accumulating empirical evidence of motor alterations in depression and anxiety disorders. Future research will need to investigate how individuals suffering from depression or anxiety disorders could benefit from psychological, behavioral, and physical interventions directly aimed at the motor system.
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Affiliation(s)
- Emma Elkjær
- Department for Psychology and Behavioral Sciences, Aarhus University, Denmark.
| | - Mai B Mikkelsen
- Department for Psychology and Behavioral Sciences, Aarhus University, Denmark
| | - Johannes Michalak
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Germany
| | - Douglas S Mennin
- Department of Psychology, Teachers College, Columbia University, New York, NY, United States of America
| | - Mia S O'Toole
- Department for Psychology and Behavioral Sciences, Aarhus University, Denmark.
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25
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Zhao YJ, Bai W, Cai H, Sha S, Zhang Q, Lei SM, Lok KI, Chow IHI, Cheung T, Su Z, Balbuena L, Xiang YT. The backbone symptoms of depression: a network analysis after the initial wave of the COVID-19 pandemic in Macao. PeerJ 2022; 10:e13840. [PMID: 36128195 PMCID: PMC9482773 DOI: 10.7717/peerj.13840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 07/14/2022] [Indexed: 01/21/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic disrupted the working lives of Macau residents, possibly leading to mental health issues such as depression. The pandemic served as the context for this investigation of the network structure of depressive symptoms in a community sample. This study aimed to identify the backbone symptoms of depression and to propose an intervention target. Methods This study recruited a convenience sample of 975 Macao residents between 20th August and 9th November 2020. In an electronic survey, depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9). Symptom relationships and centrality indices were identified using directed and undirected network estimation methods. The undirected network was constructed using the extended Bayesian information criterion (EBIC) model, and the directed network was constructed using the Triangulated Maximally Filtered Graph (TMFG) method. The stability of the centrality indices was evaluated by a case-dropping bootstrap procedure. Wilcoxon signed rank tests of the centrality indices were used to assess whether the network structure was invariant between age and gender groups. Results Loss of energy, psychomotor problems, and guilt feelings were the symptoms with the highest centrality indices, indicating that these three symptoms were backbone symptoms of depression. The directed graph showed that loss of energy had the highest number of outward projections to other symptoms. The network structure remained stable after randomly dropping 50% of the study sample, and the network structure was invariant by age and gender groups. Conclusion Loss of energy, psychomotor problems and guilt feelings constituted the three backbone symptoms during the pandemic. Based on centrality and relative influence, loss of energy could be targeted by increasing opportunities for physical activity.
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Affiliation(s)
- Yan-Jie Zhao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China,Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
| | - Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China,Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
| | - Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China,Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing An Ding Hospital, Beijing, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing An Ding Hospital, Beijing, China
| | - Si Man Lei
- Faculty of Education, University of Macau, Macau SAR, China
| | - Ka-In Lok
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Ines Hang Iao Chow
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China,Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, Texas, US
| | - Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China,Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
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26
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Multimodal multi-center analysis of electroconvulsive therapy effects in depression: Brainwide gray matter increase without functional changes. Brain Stimul 2022; 15:1065-1072. [DOI: 10.1016/j.brs.2022.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
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Paquet A, Lacroix A, Calvet B, Girard M. Psychomotor semiology in depression: a standardized clinical psychomotor approach. BMC Psychiatry 2022; 22:474. [PMID: 35841086 PMCID: PMC9287955 DOI: 10.1186/s12888-022-04086-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/23/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Although psychomotor symptoms are associated with the clinical symptomatology of depression, they are rarely assessed and standardized clinical evaluation tools are lacking. Psychomotor retardation is sometimes assessed through direct patient observations by clinicians or through a clinical observation grid, in the absence of a standardized psychomotor assessment. In this pilot study, we evaluated the feasibility of standardized psychomotor examination of patients with major depressive disorder (MDD) and detailed a psychomotor semiology in these patients. METHODS We used a standardized psychomotor assessment to examine 25 patients with MDD and 25 age- and sex-matched healthy controls (HC) and compared their psychomotor profiles. Using standardized tests, we assessed muscle tone and posture, gross motor skills, perceptual-motor skills, and body image/organization. Clinical assessments of depressive symptoms (levels of psychomotor retardation, anxiety, and self-esteem) comprised this detailed psychomotor examination. RESULTS All participants were examined using the standardized psychomotor assessment. The main results of the psychomotor examination highlighted low body image of MDD participants (p < 0.001). Significant differences between groups were found in passive muscle tone, posture, emotional control, jumping, manual dexterity, walking, and praxis. Among these psychomotor variables, body image, passivity, jumping and rhythm scores predicted an MDD diagnosis. CONCLUSIONS Beyond the psychomotor retardation known to be present in MDD patients, this examination revealed an entire psychomotor symptomatology characterized by elevated muscle tone, poor body image associated with poor self-esteem, slowness in global motor skills and manual praxis, and poor rhythmic adaptation. In light of these results, we encourage clinicians to consider using a standardized tool to conduct detailed psychomotor examination of patients with depressive disorders. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04031937 , 24/07/2019.
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Affiliation(s)
- A. Paquet
- grid.477071.20000 0000 9883 9701Department of research and innovation, Centre Hospitalier Esquirol, Limoges, France ,grid.9966.00000 0001 2165 4861INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France ,grid.463845.80000 0004 0638 6872University Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France
| | - A. Lacroix
- grid.477071.20000 0000 9883 9701Department of research and innovation, Centre Hospitalier Esquirol, Limoges, France
| | - B. Calvet
- grid.477071.20000 0000 9883 9701Department of research and innovation, Centre Hospitalier Esquirol, Limoges, France ,grid.9966.00000 0001 2165 4861INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - M. Girard
- grid.477071.20000 0000 9883 9701Department of research and innovation, Centre Hospitalier Esquirol, Limoges, France ,grid.9966.00000 0001 2165 4861INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
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Ramadan B, Cabeza L, Cramoisy S, Houdayer C, Andrieu P, Millot JL, Haffen E, Risold PY, Peterschmitt Y. Beneficial effects of prolonged 2-phenylethyl alcohol inhalation on chronic distress-induced anxio-depressive-like phenotype in female mice. Biomed Pharmacother 2022; 151:113100. [PMID: 35597115 DOI: 10.1016/j.biopha.2022.113100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 11/02/2022] Open
Abstract
Chronic distress-induced hypothalamic-pituitary-adrenal axis deregulations have been associated with the development of neuropsychiatric disorders such as anxiety and depression. Currently available drugs treating such pathological conditions have limited efficacy and diverse side effects, revealing the need of new safer strategies. Aromatic plant-based compounds are largely used in herbal medicine due to their therapeutic properties on mood, physiology, and general well-being. The purpose of this study was to investigate the effects of 2-phenylethyl alcohol (PEA), one of the pharmacologically active constituents of rose essential oil, on chronic corticosterone (CORT)-induced behavioral and neurobiological changes in female mice. Animals followed a prolonged PEA inhalation exposure (30 min per day) for 15 consecutive days prior to behavioral evaluation with open-field, forced swim and novelty-suppressed feeding tests. CORT treatment induced an anxio-depressive-like phenotype, evidenced by a reduced locomotor activity in the open-field, and an increased latency to feed in the novelty-suppressed feeding paradigms. To elucidate the neural correlates of our behavioral results, immunohistochemistry was further performed to provide a global map of neural activity based on cerebral cFos expression. The altered feeding behavior was accompanied by a significant decrease in the number of cFos-positive cells in the olfactory bulb, and altered functional brain connectivity as shown by cross-correlation-based network analysis. CORT-induced behavioral and neurobiological alterations were reversed by prolonged PEA inhalation, suggesting a therapeutic action that allows regulating the activity of neural circuits involved in sensory, emotional and feeding behaviors. These findings might contribute to better understand the therapeutic potential of PEA on anxio-depressive symptoms.
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Affiliation(s)
- Bahrie Ramadan
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Université de Franche-Comté, Université de B ourgogne - Franche-Comté, Besançon, France.
| | - Lidia Cabeza
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Université de Franche-Comté, Université de B ourgogne - Franche-Comté, Besançon, France
| | - Stéphanie Cramoisy
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Université de Franche-Comté, Université de B ourgogne - Franche-Comté, Besançon, France
| | - Christophe Houdayer
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Université de Franche-Comté, Université de B ourgogne - Franche-Comté, Besançon, France
| | - Patrice Andrieu
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Université de Franche-Comté, Université de B ourgogne - Franche-Comté, Besançon, France
| | - Jean-Louis Millot
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Université de Franche-Comté, Université de B ourgogne - Franche-Comté, Besançon, France
| | - Emmanuel Haffen
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Université de Franche-Comté, Université de B ourgogne - Franche-Comté, Besançon, France; Service de Psychiatrie de l'Adulte, Centre Hospitalier Universitaire de Besançon CHU, Besançon, France; Centre d'Investigation Clinique, CIC-INSERM-1431, Centre Hospitalier Universitaire de Besançon CHU, Besançon, France
| | - Pierre-Yves Risold
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Université de Franche-Comté, Université de B ourgogne - Franche-Comté, Besançon, France
| | - Yvan Peterschmitt
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Université de Franche-Comté, Université de B ourgogne - Franche-Comté, Besançon, France.
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Wenzel M, Althen H, Veeh J, Reif A. Euthymic patients with predominantly manic polarity avoid happy faces in a dot probe task. Int J Bipolar Disord 2022; 10:16. [PMID: 35739323 PMCID: PMC9226225 DOI: 10.1186/s40345-022-00262-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background Some studies suggest a mood-congruent attentional bias in bipolar patients. However, for euthymic patients, especially in dependence on the predominant polarity, there is little and inconsistent data. A clearer understanding of emotion-related attentional biases and their relationship to dysfunctional emotion regulation could help improving the diagnostics and treatment of bipolar disorder (BD). Twenty bipolar patients in a depressive state (BP-acute-D), 32 euthymic patients with manic (BP-euth-M) or depressive (BP-euth-D) predominant polarity, and 20 healthy control participants (HC) performed a dot-probe task (DPT) with happy and sad faces presented for 250 ms or 1250 ms in two different runs. Emotion regulation strategies were assessed with two questionnaires. Results In the short presentation condition of the DPT, BP-euth-M showed less attention for happy faces than HC (p = .03, r = − 0.48). BP-acute-D scored lower in cognitive reappraisal and putting into perspective and higher in suppression, catastrophizing, and rumination than HC. BP-euth-M scored higher in rumination and BP-euth-D lower in putting into perspective and higher in catastrophizing than HC. In BP-euth-D and HC, bias scores for sad faces in the longer presentation condition and reappraisal scores correlated positively. Conclusions Results of the DPT suggest an avoidance of happy faces for BP-euth-M which we interpret as a protection mechanism for triggers of mania. That individuals who apply more reappraisal show more selective attention to sad faces could on the one hand reflect a mental effort in reevaluating the sad emotional input and on the other hand a greater tolerance for it.
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Affiliation(s)
- Martina Wenzel
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany. .,Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital, University of Würzburg, Würzburg, Germany. .,Department of Neurology, Technical University of Munich (TU), Munich, Germany.
| | - Heike Althen
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Julia Veeh
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital, University of Würzburg, Würzburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital, University of Würzburg, Würzburg, Germany
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Mineo L, Rodolico A, Spedicato GA, Aguglia A, Bolognesi S, Concerto C, Cuomo A, Goracci A, Maina G, Fagiolini A, Amore M, Aguglia E. Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity-Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients. Eur Psychiatry 2022; 65:e30. [PMID: 35638732 PMCID: PMC9158398 DOI: 10.1192/j.eurpsy.2022.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Subthreshold hypomania during a major depressive episode challenges the bipolar-unipolar dichotomy. In our study we employed a cross-diagnostic cluster analysis - to identify distinct subgroups within a cohort of depressed patients. Methods A k-means cluster analysis— based on the domain scores of the Mood Spectrum Self-Report (MOODS-SR) questionnaire—was performed on a data set of 300 adults with either bipolar or unipolar depression. After identifying groups, between-clusters comparisons were conducted on MOODS-SR domains and factors and on a set of sociodemographic, clinical and psychometric variables. Results Three clusters were identified: one with intermediate depressive and poor manic symptomatology (Mild), one with severe depressive and poor manic symptomatology (Moderate), and a third one with severe depressive and intermediate manic symptomatology (Mixed). Across the clusters, bipolar patients were significantly less represented in the Mild one, while the DSM-5 “Mixed features” specifier did not differentiate the groups. When compared to the other patients, those of Mixed cluster exhibited a stronger association with most of the illness-severity, quality of life, and outcomes measures considered. After performing pairwise comparisons significant differences between “Mixed” and “Moderate” clusters were restricted to: current and disease-onset age, psychotic ideation, suicidal attempts, hospitalization numbers, impulsivity levels and comorbidity for Cluster B personality disorder. Conclusions In the present study, a clustering approach based on a spectrum exploration of mood symptomatology led to the identification of three transdiagnostic groups of patients. Consistent with our hypothesis, the magnitude of subthreshold (hypo)manic symptoms was related to a greater clinical severity, regardless of the main categorical diagnosis.
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Affiliation(s)
- Ludovico Mineo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Alessandro Rodolico
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Department of Neurosciences, Genoa, Italy
| | - Simone Bolognesi
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Carmen Concerto
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Arianna Goracci
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Giuseppe Maina
- Rita Levi Montalcini Department of Neuroscience, University of Turin, University Hospital San Luigi Gonzaga, Turin, Italy
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Department of Neurosciences, Genoa, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Karyotaki E, Araya R, Kessler RC, Waqas A, Bhana A, Rahman A, Matsuzaka CT, Miguel C, Lund C, Garman EC, Nakimuli-Mpungu E, Petersen I, Naslund JA, Schneider M, Sikander S, Jordans MJD, Abas M, Slade P, Walters S, Brugha TS, Furukawa TA, Amanvermez Y, Mello MF, Wainberg ML, Cuijpers P, Patel V. Association of Task-Shared Psychological Interventions With Depression Outcomes in Low- and Middle-Income Countries: A Systematic Review and Individual Patient Data Meta-analysis. JAMA Psychiatry 2022; 79:430-443. [PMID: 35319740 PMCID: PMC8943620 DOI: 10.1001/jamapsychiatry.2022.0301] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/02/2022] [Indexed: 01/14/2023]
Abstract
Importance Task sharing, the training of nonspecialist workers with no formal experience in counseling, is a promising strategy for addressing the large gap in treatment for depression in low- and middle-income countries (LMICs). Objective To examine the outcomes and moderators of task-shared psychological interventions associated with depression severity, response, and remission. Data Sources Systematic literature searches in PubMed, Embase, PsycINFO, and Cochrane Library up to January 1, 2021. Study Selection Randomized clinical trials (RCTs) of task-shared psychological interventions compared with control conditions for adults with depressive symptoms in LMICs were included. Data Extraction and Synthesis Two researchers independently reviewed the titles, abstracts, and full text of articles from an existing generic meta-analytic database that includes all RCTs on psychotherapy for depression. A systematic review and individual patient data (IPD) meta-analysis was used to estimate the outcomes of task-shared psychological interventions across patient characteristics using mixed-effects models. Procedures for abstracting data and assessing data quality and validity followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Main Outcomes and Measures Primary outcome was reduction in depression symptom severity measured by the 9-item Patient Health Questionnaire (PHQ-9). Response and remission rates were also estimated. Results Of 13 eligible trials, 11 (4145 participants) contributed IPD. Task-shared psychological interventions were associated with a greater decrease in depressive symptom severity than control conditions (Hedges g, 0.32; 95% CI, -0.26 to -0.38). Participants in the intervention groups had a higher chance of responding (odds ratio, 2.11; 95% CI, 1.60 to 2.80) and remitting (odds ratio, 1.87; 95% CI, 1.20 to 1.99). The presence of psychomotor symptoms was significantly associated with the outcomes of task-shared psychological interventions (β [SE], -1.21 [0.39]; P = .002). No other significant associations were identified. Heterogeneity among the trials with IPD was 74% (95% CI, 53%-86%). Conclusions and Relevance In this meta-analysis of IPD, task-shared psychological interventions were associated with a larger reduction in depressive symptom severity and a greater chance of response and remission than control conditions. These findings show potential for the use of task-sharing of psychological interventions across different groups of patients with depression. Further research would help identify which people are most likely to benefit and strengthen larger-scale implementation of this strategy to address the burden of depression in LMICs.
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Affiliation(s)
- Eirini Karyotaki
- Department of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Ricardo Araya
- Center for Global Mental Health and Primary Care Research, Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Ahmed Waqas
- Institute of Population Health Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Arvin Bhana
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Atif Rahman
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
| | - Camila T. Matsuzaka
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Clara Miguel
- Department of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Crick Lund
- Center for Global Mental Health and Primary Care Research, Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Emily C. Garman
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Inge Petersen
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - Marguerite Schneider
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan
- Health Services Academy, Islamabad, Pakistan
| | - Mark J. D. Jordans
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Melanie Abas
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Pauline Slade
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Stephen Walters
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Traolach S. Brugha
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Toshi A. Furukawa
- Departments of Health Promotion and Human Behaviour and of Clinical Epidemiology, Kyoto University Graduate School of Medicine, School of Public Health, Kyoto, Japan
| | - Yagmur Amanvermez
- Department of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Marcelo F. Mello
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Albert Einstein Israelite Hospital, Medicine School, São Paulo, Brazil
| | - Milton L. Wainberg
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York
| | - Pim Cuijpers
- Department of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
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Soyemi AO, Sowunmi OA, Amosu SM, Babalola EO. Depression and quality of life among pregnant women in first and third trimesters in Abeokuta: A comparative study. S Afr J Psychiatr 2022; 28:1779. [PMID: 35402012 PMCID: PMC8991209 DOI: 10.4102/sajpsychiatry.v28i0.1779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background Pregnancy is a dynamic time during which a woman’s emotional state may undergo extensive change. There have been conflicting views about the magnitude of emotional turmoil that occurs during pregnancy. Some investigators suggest that pregnancy is a time of particularly good psychological adjustment; others have reported high levels of psychological challenge. Aim Our study aimed to compare the prevalence and correlates of depression in the first and third trimesters of pregnancy and to determine the relationship between quality of life and depressive disorder. Setting The antenatal clinic of the State Hospital, Ijaiye. Method A descriptive, comparative study of depressive disorder and the quality of life between first- and third-trimester pregnant women (confirmed through a pregnancy test and an abdominopelvic ultrasound). Result For each trimester, 285 participants were recruited. The prevalence of depression among the pregnant women who participated in the study was 7.2%. In the first trimester of pregnancy, the prevalence of depression was 30 (10.5%), while it was 11 (3.9%) in the third trimester of pregnancy. Collectively, the relationship between depression and QoL was significant in the overall domain, satisfaction with general health domain (t = 2.27; p = 0.03), psychological domain (t = 2.74; p = 0.010, and environmental domain (t = 4.57; p ≤ 0.01). Conclusion Our study also highlights the need to pay closer attention to the psychological well-being and quality of life of all pregnant women and not just on their physical health and the baby’s well-being.
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Affiliation(s)
| | | | - Sunday M Amosu
- Neuropsychiatric Hospital Aro, Abeokuta, Ogun State, Nigeria
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Claeys EHI, Mantingh T, Morrens M, Yalin N, Stokes PRA. Resting-state fMRI in depressive and (hypo)manic mood states in bipolar disorders: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2022; 113:110465. [PMID: 34736998 DOI: 10.1016/j.pnpbp.2021.110465] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 10/01/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Abnormalities in spontaneous brain activity, measured with resting-state functional magnetic resonance imaging (rs-fMRI), may be key biomarkers for bipolar disorders. This systematic review compares rs-fMRI findings in people experiencing a bipolar depressive or (hypo)manic episode to bipolar euthymia and/or healthy participants. METHODS Medline, Web of Science and Embase were searched up until April 2021. Studies without control group, or including minors, neurological co-morbidities or mixed episodes, were excluded. Qualitative synthesis was used to report results and risk of bias was assessed using the National Heart, Lung and Blood Institute tool for case-control studies. RESULTS Seventy-one studies were included (3167 bipolar depressed/706 (hypo)manic). In bipolar depression, studies demonstrated default-mode (DMN) and frontoparietal network (FPN) dysfunction, altered baseline activity in the precuneus, insula, striatum, cingulate, frontal and temporal cortex, and disturbed regional homogeneity in parietal, temporal and pericentral areas. Functional connectivity was altered in thalamocortical circuits and between the cingulate cortex and precuneus. In (hypo)mania, studies reported altered functional connectivity in the amygdala, frontal and cingulate cortex. Finally, rs-fMRI disturbances in the insula and putamen correlate with depressive symptoms, cerebellar resting-state alterations could evolve with disease progression and altered amygdala connectivity might mediate lithium effects. CONCLUSIONS Our results suggest DMN and FPN dysfunction in bipolar depression, whereas local rs-fMRI alterations might differentiate mood states. Future studies should consider controlling rs-fMRI findings for potential clinical confounding factors such as medication. Considerable heterogeneity of methodology between studies limits conclusions. Standardised clinical reporting and consistent analysis approaches would increase coherence in this promising field.
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Affiliation(s)
- Eva H I Claeys
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, S.033, Universiteitsplein 1, 2610 Antwerpen, Belgium; Department of Psychiatry, University Psychiatric Centre Duffel, Stationsstraat 22, 2570 Duffel, Belgium
| | - Tim Mantingh
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Manuel Morrens
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, S.033, Universiteitsplein 1, 2610 Antwerpen, Belgium; Department of Psychiatry, University Psychiatric Centre Duffel, Stationsstraat 22, 2570 Duffel, Belgium
| | - Nefize Yalin
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Paul R A Stokes
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Shen Q, Sjölander A, Sloan EK, Walker AK, Fall K, Valdimarsdottir U, Sparén P, Smedby KE, Fang F. NSAID use and unnatural deaths after cancer diagnosis: a nationwide cohort study in Sweden. BMC Cancer 2022; 22:75. [PMID: 35039006 PMCID: PMC8764760 DOI: 10.1186/s12885-021-09120-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/15/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Cancer patients experience increased risk of death from accident and suicide. Cognitive impairment induced by cancer-related inflammation and stress-related psychiatric symptoms may be underlying mechanisms. We therefore studied the association between use of nonsteroidal anti-inflammatory drugs (NSAIDs) and risk of these outcomes. METHODS Following a cohort of 388,443 cancer patients diagnosed between October 2005 and December 2014 in Sweden, we ascertained dispense of aspirin or non-aspirin NSAIDs from 3 months before cancer diagnosis onward and defined the on-medication period as from date of drug dispense until the prescribed dosage was consumed. Follow-up time outside medicated periods and time from unexposed patients were defined as off-medication periods. We used Cox models to estimate hazard ratios (HRs) of death due to suicide or accident, by comparing the on-medication periods with off-medication periods. RESULTS In total, 29.7% of the cancer patients had low-dose aspirin dispensed and 29.1% had non-aspirin NSAIDs dispensed. Patients with aspirin use were more likely to be male than patients without aspirin use. Compared with off-medication periods, there was a 22% lower risk of accidental death (N = 651; HR 0.78, 95% confidence interval [CI]: 0.70 to 0.87) during on-medication periods with aspirin. The use of aspirin was not associated with risk of suicide (N = 59; HR 0.96, 95% CI: 0.66 to 1.39). No association was noted between use of non-aspirin NSAIDs and the risk of suicide (N = 13; HR 0.95, 95% CI: 0.42 to 2.18) or accidental death (N = 59; HR 0.92, 95% CI: 0.68 to 1.26). CONCLUSIONS Intake of low-dose aspirin after cancer diagnosis was associated with a lower risk of unnatural deaths among cancer patients.
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Affiliation(s)
- Qing Shen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Arvid Sjölander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Erica K Sloan
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, 5052, Australia
| | - Adam K Walker
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, 5052, Australia
- Laboratory of ImmunoPsychiatry, Neuroscience Research Australia, Randwick, New South Wales, 2031, Australia
- School of Psychiatry, University of New South Wales, Sydney, 2052, Australia
| | - Katja Fall
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, SE-701 82, Örebro, Sweden
| | - Unnur Valdimarsdottir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden
- Center of Public Health Sciences, University of Iceland, IS-101, Reykjavik, Iceland
- Department of Epidemiology, Harvard T. H. Chan. School of Public Health, Boston, MA, 02115, USA
| | - Pär Sparén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Karin E Smedby
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, SE-171 77, Stockholm, Sweden
- Center for Hematology, Karolinska University Hospital, SE-171 77, Stockholm, Sweden
| | - Fang Fang
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden
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Devita M, De Salvo R, Ravelli A, De Rui M, Coin A, Sergi G, Mapelli D. Recognizing Depression in the Elderly: Practical Guidance and Challenges for Clinical Management. Neuropsychiatr Dis Treat 2022; 18:2867-2880. [PMID: 36514493 PMCID: PMC9741828 DOI: 10.2147/ndt.s347356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
Depression is one of the most common mood disorders in the late-life population and is associated with poor quality of life and increased morbidity, disability and mortality. Nevertheless, in older adults, it often remains undetected and untreated. This narrative review aims at giving an overview on the main definitions, clinical manifestations, risk and protective factors for depression in the elderly, and at discussing the main reasons for its under/misdiagnosis, such as cognitive decline and their overlapping symptomatology. A practical approach for the global and multidisciplinary care of the older adult with depression, derived from cross-checking evidence emerging from the literature with everyday clinical experience, is thus provided, as a short and flexible "pocket" guide to orient clinicians in recognizing, diagnosing and treating depression in the elderly.
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Affiliation(s)
- Maria Devita
- Department of General Psychology (DPG), University of Padua, Padua, Italy.,Geriatrics Division, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Rossella De Salvo
- Department of General Psychology (DPG), University of Padua, Padua, Italy
| | - Adele Ravelli
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Marina De Rui
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Alessandra Coin
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Giuseppe Sergi
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Daniela Mapelli
- Department of General Psychology (DPG), University of Padua, Padua, Italy
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Okon M, Blum B, Nathaniel TI. Risk factors and ambulatory outcome in ischemic stroke patients with pre-stroke depression. JOURNAL OF VASCULAR NURSING 2021; 39:91-99. [PMID: 34865727 DOI: 10.1016/j.jvn.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/25/2021] [Accepted: 07/19/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE It is well known that post-stroke depression might be a negative factor for stroke recovery, however there is limited evidence to establish the link between pre-stroke depression and stroke outcome such motor recovery. The objective is to determine clinical risk factors in ischemic stroke patients with pre-stroke depression that are associated functional ambulatory outcome. METHODS Data from acute ischemic patients from a regional stroke registry were collected for consecutive recombinant tissue plasminogen activator(rtPA)-treated acute ischemic stroke patients between January 2010 and June 2016. Logistic regression model was used to predict risk factors that served as predictive variables, while the increase or reduce odds of improvement in ambulatory outcome was considered as the primary outcome. Multicollinearity and possible interactions among the independent variables were analyzed using the variance inflation factor. RESULTS A total of 1446 patients were eligible for recombinant tissue plasminogen activator (rtPA) and 596 of these patients received rtPA. Of the 596 ischemic stroke patients, 286 patients presented with recent pre-stroke depression, 310 had no pre-stroke depression. Carotid artery stenosis (OR = 11.577, 95% CI, 1.281-104.636, P = 0.029) and peripheral vascular disease (OR = 18.040, 95% CI, 2.956-110.086, P = 0.002) were more likely to be associated with increase odds of improvement in ambulation in patients with no pre-stroke depression treated with rtPA, while antihypertensive medications (OR = 0.192, 95% CI, 0.035-1.067, P = 0.050),previous TIA (OR = 0.177, 95% CI, 0.038-0.818, P = 0.027), and congestive heart failure (OR = 0. 0.160, 95% CI, 0.030-0.846, P = 0.031) were associated with reduced odds of improvement in ambulation. In addition, carotid artery stenosis (OR = 0.078, 95% CI, 0.10-0.614, P = 0.015, congestive heart failure (OR = 0.217, 95% CI, 0.318-0.402, P = 0.030), previous TIA (OR = 0.444, 95% CI, 0.517-0.971, P = 0.012), higher NIHSS scores ((OR = 0.887, 95% CI, 0.830-0.948, P < 0.001), and antihypertensive medications (OR = 0.810, 95% CI, 0.401-0.529, P = 0.019) were associated with the reduced odd of improvement in ambulation in an ischemic stroke population with pre-stroke depression treated with rtPA. CONCLUSION Our findings indicate that more risk factors were associated with the decreased odds of an improvement in ambulation following thrombolytic therapy in an ischemic stroke population with pre-stroke depression when compared with those without pre-stroke depression. This finding maybe helpful in the development of management strategies to increase the use of thrombolytic therapy for pre-stroke depressed ischemic stroke to increased their eligibility for rtPA.
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Affiliation(s)
- Marvin Okon
- Department of Public Health, Clemson University, Clemson, SC 29631
| | - Brice Blum
- University of South Carolina School of Medicine, School of Medicine-Greenville, Greenville, SC 29605, USA
| | - Thomas I Nathaniel
- University of South Carolina School of Medicine, School of Medicine-Greenville, Greenville, SC 29605, USA.
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Walking on the bright side: Associations between affect, depression, and gait. PLoS One 2021; 16:e0260893. [PMID: 34855876 PMCID: PMC8638949 DOI: 10.1371/journal.pone.0260893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/18/2021] [Indexed: 12/04/2022] Open
Abstract
Background Psychomotor change is a core symptom of depression and one of the criteria in diagnosing depressive disorders. Research suggests depressed individuals demonstrate deviations in gait, or walking, compared to non-depressed controls. However, studies are sparse, often limited to older adults and observational gait assessment. It is also unclear if gait changes are due to dysregulation of affect, a core feature of depression. The current study addressed this gap by investigating the relation between positive and negative affect, depressive symptom severity, and gait in young adults. Methods Using three-dimensional motion capture, gait parameters (velocity, stride length, and step time) were attained from 90 young adults during a task where they walked ten meters at their own pace overground in a laboratory for ten minutes. Self-report measures of mood and affect were collected. Results On average, the study population reported high negative and low positive affect. Contrary to our hypotheses, hierarchical regressions demonstrated no significant associations between gait parameters and affective or depressive symptoms (ps>.05). Conclusions Our findings do not support a relation between affective symptoms and gait parameters. The results may indicate age-dependent gait pathology or that other symptoms of depression may influence gait more strongly than affect. They may also reflect an observational bias of gait changes in depressed young adults, one that is unsupported by objective data. Replication is warranted to further examine whether affective symptomology is embodied via gait differences in young adults.
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Nikolin S, Tan YY, Martin D, Moffa A, Loo CK, Boonstra TW. Behavioural and neurophysiological differences in working memory function of depressed patients and healthy controls. J Affect Disord 2021; 295:559-568. [PMID: 34509071 DOI: 10.1016/j.jad.2021.08.083] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is associated with deficits in working memory. Several cognitive subprocesses interact to produce working memory, including attention, encoding, maintenance and manipulation. We sought to clarify the contribution of functional deficits in these subprocesses in MDD by varying cognitive load during a working memory task. METHODS 41 depressed participants and 41 age and gender-matched healthy controls performed the n-back working memory task at three levels of difficulty (0-, 1-, and 2-back) in a pregistered study. We assessed response times, accuracy, and event-related electroencephalography (EEG), including P2 and P3 amplitudes, and frontal theta power (4-8 Hz). RESULTS MDD participants had prolonged response times and more positive frontal P3 amplitudes (i.e., Fz) relative to controls, mainly in the most difficult 2-back condition. Working memory accuracy, P2 amplitudes and frontal theta event-related synchronisation did not differ between groups at any level of task difficulty. CONCLUSIONS Depression is associated with generalized psychomotor slowing of working memory processes, and may involve compensatory hyperactivity in frontal and parietal regions. SIGNIFICANCE These findings provide insights into MDD working memory deficits, indicating that depressed individuals dedicate greater levels of cortical processing and cognitive resources to achieve comparable working memory performance to controls.
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Affiliation(s)
- Stevan Nikolin
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Hospital Road, Sydney, Randwick NSW 2031, Australia.
| | - Yi Yin Tan
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Donel Martin
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Hospital Road, Sydney, Randwick NSW 2031, Australia
| | - Adriano Moffa
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Colleen K Loo
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Hospital Road, Sydney, Randwick NSW 2031, Australia; St. George Hospital, Sydney, Australia
| | - Tjeerd W Boonstra
- School of Psychiatry, University of New South Wales, Sydney, Australia; Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
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Ransing R, Patil P, Patil S, Agrawal S. Comparison of actigraphy indices among patients with depression and schizophrenia: A preliminary study. J Family Med Prim Care 2021; 10:3406-3410. [PMID: 34760765 PMCID: PMC8565142 DOI: 10.4103/jfmpc.jfmpc_1693_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/27/2020] [Accepted: 11/21/2020] [Indexed: 11/21/2022] Open
Abstract
Background: Schizophrenia (SCZ) and depression (MDD) are associated with changes in sleep and activity patterns. However, because of a lack of objective evaluation, the diagnostic or clinical value of these sleep-activity patterns is unknown. In this study, we attempted to assess and compare the sleep and activity patterns using actigraphy. Materials and Methods: We have recruited 35 patients with SCZ (mean age: 29.29 ± 7.54 years) and 42 patients with MDD (mean age: 27.5 ± 5.59 years) in this cross-sectional study. The actigraphy indices [Time in bed (minutes), Onset latency (minutes), Total sleep time (Minutes), Sleep efficiency (%), WASO (minutes), number of awakening, and activity duration (minutes) were compared among the two groups using unpaired t-test and Fisher exact test. Results: In the MDD group, the time in bed (minutes) was significantly higher than in the SCZ group (402.7 ± 41.97 vs. 379.1 ± 40.45, P = 0.01), while the sleep efficiency was lower in the SCZ group than in the MDD group (60.04 ± 9.25 vs. 65.05 ± 7.16, P = 0.0092). An increase in onset latency (minutes) was observed in the SCZ group compared to the MDD group (49.06 ± 16.09 vs. 43.6 ± 10.14, P = 0.074). The difference in WASO (minutes), the number of awakenings, and activity duration (minutes) among the two groups were insignificant. Conclusion: Actigraphy parameters such as sleep efficiency and time in bed may be a useful sleep process, etiological, and prognostic markers in patients with SCZ and MDD. The longitudinal studies are needed to estimate the predictive role of these parameters for therapeutic outcome in these patients.
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Affiliation(s)
- Ramdas Ransing
- Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Pradeep Patil
- Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Swaroopa Patil
- Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Shruti Agrawal
- Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
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Altered effective connectivity in sensorimotor cortices is a signature of severity and clinical course in depression. Proc Natl Acad Sci U S A 2021; 118:2105730118. [PMID: 34593640 PMCID: PMC8501855 DOI: 10.1073/pnas.2105730118] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 12/24/2022] Open
Abstract
Research into neurobiology of depression primarily focuses on its complex psychological aspects. Here we propose an alternative approach and target sensorimotor alterations—a prominent but often neglected feature of depression. We demonstrated using resting-state functional MRI data and computational modeling that top-down and bottom-up information flow in sensory and motor cortices is altered with increasing depression severity in a way that is consistent with depression symptoms. Depression-associated changes were found to be consistent across sessions, amenable to treatment and of effect size sufficiently large to predict whether somebody has mild or severe depression. These results pave the way for an avenue of research into the neural underpinnings of mental health conditions. Functional neuroimaging research on depression has traditionally targeted neural networks associated with the psychological aspects of depression. In this study, instead, we focus on alterations of sensorimotor function in depression. We used resting-state functional MRI data and dynamic causal modeling (DCM) to assess the hypothesis that depression is associated with aberrant effective connectivity within and between key regions in the sensorimotor hierarchy. Using hierarchical modeling of between-subject effects in DCM with parametric empirical Bayes we first established the architecture of effective connectivity in sensorimotor cortices. We found that in (interoceptive and exteroceptive) sensory cortices across participants, the backward connections are predominantly inhibitory, whereas the forward connections are mainly excitatory in nature. In motor cortices these parities were reversed. With increasing depression severity, these patterns are depreciated in exteroceptive and motor cortices and augmented in the interoceptive cortex, an observation that speaks to depressive symptomatology. We established the robustness of these results in a leave-one-out cross-validation analysis and by reproducing the main results in a follow-up dataset. Interestingly, with (nonpharmacological) treatment, depression-associated changes in backward and forward effective connectivity partially reverted to group mean levels. Overall, altered effective connectivity in sensorimotor cortices emerges as a promising and quantifiable candidate marker of depression severity and treatment response.
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Masse C, Vandel P, Sylvestre G, Noiret N, Bennabi D, Mauny F, Puyraveau M, Barsznica Y, Dartevelle J, Meyer A, Binetruy M, Lavaux M, Ryff I, Giustiniani J, Magnin E, Galmiche J, Haffen E, Chopard G. Cognitive Impairment in Late-Life Depression: A Comparative Study of Healthy Older People, Late-Life Depression, and Mild Alzheimer's Disease Using Multivariate Base Rates of Low Scores. Front Psychol 2021; 12:724731. [PMID: 34675839 PMCID: PMC8525508 DOI: 10.3389/fpsyg.2021.724731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Late-Life Depression (LLD) is often associated with cognitive impairment. However, distinction between cognitive impairment due to LLD and those due to normal aging or mild Alzheimer's Disease (AD) remain difficult. The aim of this study was to present and compare the multivariate base rates of low scores in LLD, mild AD, and healthy control groups on a battery of neuropsychological tests. Participants (ages 60-89) were 352 older healthy adults, 390 patients with LLD, and 234 patients with mild AD (i.e., MMSE ≥ 20). Multivariate base rates of low scores (i.e., ≤ 5th percentile) were calculated for each participant group within different cognitive domains (verbal episodic memory, executive skills, mental processing speed, constructional praxis, and language/semantic memory). Obtaining at least one low score was relatively common in healthy older people controls (from 9.4 to 17.6%), and may thus result in a large number of false positives. By contrast, having at least two low scores was unusual (from 0.3 to 4.6%) and seems to be a more reliable criterion for identifying cognitive impairment in LLD. Having at least three low memory scores was poorly associated with LLD (5.9%) compared to mild AD (76.1%) and may provide a useful way to differentiate between these two conditions [χ ( 1 ) 2 = 329.8, p < 0.001; Odds Ratio = 50.7, 95% CI = 38.2-77.5]. The multivariate base rate information about low scores in healthy older people and mild AD may help clinicians to identify cognitive impairments in LLD patients, improve the clinical decision-making, and target those who require regular cognitive and clinical follow-up.
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Affiliation(s)
- Caroline Masse
- Department of Clinical Psychiatry, Besançon University Hospital, Besançon, France
- Laboratory of Neurosciences and Cognitive Psychology, University of Bourgogne Franche-Comté, Besançon, France
| | - Pierre Vandel
- Department of Clinical Psychiatry, Besançon University Hospital, Besançon, France
- Laboratory of Neurosciences and Cognitive Psychology, University of Bourgogne Franche-Comté, Besançon, France
- Association for the Development of Applied Neuropsychology, Besançon, France
- Clinical Investigation Center 1431-INSERM, Besançon University Hospital, Besançon, France
| | - Géraldine Sylvestre
- Association for the Development of Applied Neuropsychology, Besançon, France
- Department of Neurology, Memory Resource and Research Center (CM2R), Besançon University Hospital, Besançon, France
| | - Nicolas Noiret
- Research Centre on Cognition and Learning (CeRCA), UMR 7295 CNRS, University of Poitiers and University of Tours, Poitiers, France
| | - Djamila Bennabi
- Department of Clinical Psychiatry, Besançon University Hospital, Besançon, France
- Laboratory of Neurosciences and Cognitive Psychology, University of Bourgogne Franche-Comté, Besançon, France
| | - Frédéric Mauny
- Methodology Unit, uMETh, Clinical Investigation Center 1431-INSERM, Besançon, France
- Laboratory of Chrono-Environnement, UMR 6249 CNRS, University of Bourgogne Franche-Comté, Besançon, France
| | - Marc Puyraveau
- Methodology Unit, uMETh, Clinical Investigation Center 1431-INSERM, Besançon, France
| | - Yoan Barsznica
- Department of Clinical Psychiatry, Besançon University Hospital, Besançon, France
- Laboratory of Neurosciences and Cognitive Psychology, University of Bourgogne Franche-Comté, Besançon, France
- Department of Neurology, Memory Resource and Research Center (CM2R), Besançon University Hospital, Besançon, France
| | - Jonathan Dartevelle
- Association for the Development of Applied Neuropsychology, Besançon, France
| | - Agatha Meyer
- Association for the Development of Applied Neuropsychology, Besançon, France
| | - Mickaël Binetruy
- Association for the Development of Applied Neuropsychology, Besançon, France
| | - Marie Lavaux
- Association for the Development of Applied Neuropsychology, Besançon, France
| | - Ilham Ryff
- Department of Clinical Psychiatry, Besançon University Hospital, Besançon, France
- Department of Neurology, Memory Resource and Research Center (CM2R), Besançon University Hospital, Besançon, France
| | - Julie Giustiniani
- Department of Clinical Psychiatry, Besançon University Hospital, Besançon, France
- Laboratory of Neurosciences and Cognitive Psychology, University of Bourgogne Franche-Comté, Besançon, France
| | - Eloi Magnin
- Laboratory of Neurosciences and Cognitive Psychology, University of Bourgogne Franche-Comté, Besançon, France
- Department of Neurology, Memory Resource and Research Center (CM2R), Besançon University Hospital, Besançon, France
| | - Jean Galmiche
- Association for the Development of Applied Neuropsychology, Besançon, France
| | - Emmanuel Haffen
- Department of Clinical Psychiatry, Besançon University Hospital, Besançon, France
- Laboratory of Neurosciences and Cognitive Psychology, University of Bourgogne Franche-Comté, Besançon, France
- Clinical Investigation Center 1431-INSERM, Besançon University Hospital, Besançon, France
| | - Gilles Chopard
- Department of Clinical Psychiatry, Besançon University Hospital, Besançon, France
- Laboratory of Neurosciences and Cognitive Psychology, University of Bourgogne Franche-Comté, Besançon, France
- Association for the Development of Applied Neuropsychology, Besançon, France
- Department of Neurology, Memory Resource and Research Center (CM2R), Besançon University Hospital, Besançon, France
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Dam VH, Stenbæk DS, Köhler-Forsberg K, Ip C, Ozenne B, Sahakian BJ, Knudsen GM, Jørgensen MB, Frokjaer VG. Hot and cold cognitive disturbances in antidepressant-free patients with major depressive disorder: a NeuroPharm study. Psychol Med 2021; 51:2347-2356. [PMID: 32317043 PMCID: PMC8506354 DOI: 10.1017/s0033291720000938] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 02/05/2020] [Accepted: 03/24/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cognitive disturbances are common and disabling features of major depressive disorder (MDD). Previous studies provide limited insight into the co-occurrence of hot (emotion-dependent) and cold (emotion-independent) cognitive disturbances in MDD. Therefore, we here map both hot and cold cognition in depressed patients compared to healthy individuals. METHODS We collected neuropsychological data from 92 antidepressant-free MDD patients and 103 healthy controls. All participants completed a comprehensive neuropsychological test battery assessing hot cognition including emotion processing, affective verbal memory and social cognition as well as cold cognition including verbal and working memory and reaction time. RESULTS The depressed patients showed small to moderate negative affective biases on emotion processing outcomes, moderate increases in ratings of guilt and shame and moderate deficits in verbal and working memory as well as moderately slowed reaction time compared to healthy controls. We observed no correlations between individual cognitive tasks and depression severity in the depressed patients. Lastly, an exploratory cluster analysis suggested the presence of three cognitive profiles in MDD: one characterised predominantly by disturbed hot cognitive functions, one characterised predominantly by disturbed cold cognitive functions and one characterised by global impairment across all cognitive domains. Notably, the three cognitive profiles differed in depression severity. CONCLUSION We identified a pattern of small to moderate disturbances in both hot and cold cognition in MDD. While none of the individual cognitive outcomes mapped onto depression severity, cognitive profile clusters did. Overall cognition-based stratification tools may be useful in precision medicine approaches to MDD.
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Affiliation(s)
- V. H. Dam
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - D. S. Stenbæk
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Denmark
| | - K. Köhler-Forsberg
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Denmark
| | - C. Ip
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- Department of Clinical Pharmacology, H. Lundbeck A/S, Valby, Denmark
| | - B. Ozenne
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Denmark
| | - B. J. Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - G. M. Knudsen
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - M. B. Jørgensen
- Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Denmark
| | - V. G. Frokjaer
- Neurobiology Research Unit, the Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Denmark
- Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Denmark
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Cabeza L, Ramadan B, Cramoisy S, Houdayer C, Haffen E, Risold PY, Fellmann D, Peterschmitt Y. Chronic Distress in Male Mice Impairs Motivation Compromising Both Effort and Reward Processing With Altered Anterior Insular Cortex and Basolateral Amygdala Neural Activation. Front Behav Neurosci 2021; 15:717701. [PMID: 34588963 PMCID: PMC8475760 DOI: 10.3389/fnbeh.2021.717701] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
In humans and mammals, effort-based decision-making for monetary or food rewards paradigms contributes to the study of adaptive goal-directed behaviours acquired through reinforcement learning. Chronic distress modelled by repeated exposure to glucocorticoids in rodents induces suboptimal decision-making under uncertainty by impinging on instrumental acquisition and prompting negative valence behaviours. In order to further disentangle the motivational tenets of adaptive decision-making, this study addressed the consequences of enduring distress on relevant effort and reward-processing dimensions. Experimentally, appetitive and consummatory components of motivation were evaluated in adult C57BL/6JRj male mice experiencing chronic distress induced by oral corticosterone (CORT), using multiple complementary discrete behavioural tests. Behavioural data (from novelty suppressed feeding, operant effort-based choice, free feeding, and sucrose preference tasks) collectively show that behavioural initiation, effort allocation, and hedonic appreciation and valuation are altered in mice exposed to several weeks of oral CORT treatment. Additionally, data analysis from FosB immunohistochemical processing of postmortem brain samples highlights CORT-dependent dampening of neural activation in the anterior insular cortex (aIC) and basolateral amygdala (BLA), key telencephalic brain regions involved in appetitive and consummatory motivational processing. Combined, these results suggest that chronic distress-induced irregular aIC and BLA neural activations with reduced effort production and attenuated reward value processing during reinforcement-based instrumental learning could result in maladaptive decision-making under uncertainty. The current study further illustrates how effort and reward processing contribute to adjust the motivational threshold triggering goal-directed behaviours in versatile environments.
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Affiliation(s)
- Lidia Cabeza
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Bahrie Ramadan
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Stephanie Cramoisy
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Christophe Houdayer
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Emmanuel Haffen
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, Université de Bourgogne - Franche-Comté, Besançon, France.,Clinical Psychiatry, Hôpital Universitaire CHRU, Besançon, France.,CIC-INSERM-1431, Hôpital Universitaire CHRU, Besançon, France
| | - Pierre-Yves Risold
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Dominique Fellmann
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Yvan Peterschmitt
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, Université de Bourgogne - Franche-Comté, Besançon, France
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The think aloud paradigm reveals differences in the content, dynamics and conceptual scope of resting state thought in trait brooding. Sci Rep 2021; 11:19362. [PMID: 34593842 PMCID: PMC8484343 DOI: 10.1038/s41598-021-98138-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/25/2021] [Indexed: 02/08/2023] Open
Abstract
Although central to well-being, functional and dysfunctional thoughts arise and unfold over time in ways that remain poorly understood. To shed light on these mechanisms, we adapted a "think aloud" paradigm to quantify the content and dynamics of individuals' thoughts at rest. Across two studies, external raters hand coded the content of each thought and computed dynamic metrics spanning duration, transition probabilities between affective states, and conceptual similarity over time. Study 1 highlighted the paradigm's high ecological validity and revealed a narrowing of conceptual scope following more negative content. Study 2 replicated Study 1's findings and examined individual difference predictors of trait brooding, a maladaptive form of rumination. Across individuals, increased trait brooding was linked to thoughts rated as more negative, past-oriented and self-focused. Longer negative and shorter positive thoughts were also apparent as brooding increased, as well as a tendency to shift away from positive conceptual states, and a stronger narrowing of conceptual scope following negative thoughts. Importantly, content and dynamics explained independent variance, accounting for a third of the variance in brooding. These results uncover a real-time cognitive signature of rumination and highlight the predictive and ecological validity of the think aloud paradigm applied to resting state cognition.
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Loureiro JRA, Sahib AK, Vasavada M, Leaver A, Kubicki A, Wade B, Joshi S, Hellemann G, Congdon E, Woods RP, Espinoza R, Narr KL. Ketamine's modulation of cerebro-cerebellar circuitry during response inhibition in major depression. Neuroimage Clin 2021; 32:102792. [PMID: 34571429 PMCID: PMC8476854 DOI: 10.1016/j.nicl.2021.102792] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/01/2022]
Abstract
Ketamine modulates cerebellar connectivity during response inhibition in depression. Cerebellar–frontoparietal/sensory connectivity decreases in ketamine remitters. Cerebellar-frontoparietal/salience connectivity predicts treatment outcome. Cerebro-cerebellar loops serve as treatment biomarkers in major depression.
Patients with major depressive disorder (MDD) exhibit impaired control of cognitive and emotional systems, including deficient response selection and inhibition. Though these deficits are typically attributed to abnormal communication between macro-scale cortical networks, altered communication with the cerebellum also plays an important role. Yet, how the circuitry between the cerebellum and large-scale functional networks impact treatment outcome in MDD is not understood. We thus examined how ketamine, which elicits rapid therapeutic effects in MDD, modulates cerebro-cerebellar circuitry during response-inhibition using a functional imaging NoGo/Go task in MDD patients (N = 46, mean age: 39.2, 38.1% female) receiving four ketamine infusions, and healthy controls (N = 32, mean age:35.2, 71.4% female). We fitted psychophysiological-interaction (PPI) models for a functionally-derived cerebellar-seed and extracted average PPI in three target functional networks, frontoparietal (FPN), sensory-motor (SMN) and salience (SN) networks. Time and remission status were then evaluated for each of the networks and their network-nodes. Follow-up tests examined whether PPI-connectivity differed between patient remitter/non-remitters and controls. Results showed significant decreases in PPI-connectivity after ketamine between the cerebellum and FPN (p < 0.001) and SMN networks (p = 0.008) in remitters only (N = 20). However, ketamine-related changes in PPI-connectivity between the cerebellum and the SN (p = 0.003) did not vary with remitter status. Cerebellar-FPN, -SN PPI values at baseline were also associated with treatment outcome. Using novel methodology to quantify the functional coupling of cerebro-cerebellar circuitry during response-inhibition, our findings highlight that these loops play distinct roles in treatment response and could potentially serve as novel biomarkers for fast-acting antidepressant therapies in MDD.
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Affiliation(s)
- Joana R A Loureiro
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA.
| | - Ashish K Sahib
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Megha Vasavada
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Antoni Kubicki
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Benjamin Wade
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Shantanu Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Eliza Congdon
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Roger P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Randall Espinoza
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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Pavlidou A, Viher PV, Bachofner H, Weiss F, Stegmayer K, Shankman SA, Mittal VA, Walther S. Hand gesture performance is impaired in major depressive disorder: A matter of working memory performance? J Affect Disord 2021; 292:81-88. [PMID: 34107424 PMCID: PMC8797922 DOI: 10.1016/j.jad.2021.05.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 05/11/2021] [Accepted: 05/23/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Individuals with depression exhibit numerous interpersonal deficits. As effective use of gestures is critical for social communication, it is possible that depressed individuals' interpersonal deficits may be due to deficits in gesture performance. The present study thus compared gesture performance of depressed patients and controls and examined whether these deficits relate to cognitive and other domains of dysfunction. METHODS Gesture performance was evaluated in 30 depressed patients and 30 controls using the Test of Upper Limb Apraxia (TULIA). Clinical rating scales were assessed to determine if gesture deficits were associated with motor, cognitive or functional outcomes. RESULTS Compared to controls, depressed patients exhibited impaired gesture performance with 2/3 of the patients demonstrating gesture deficits. Within depressed patients, gesture performance was highly correlated with working memory abilities. In contrast, no association between gesture performance and gestural knowledge, psychomotor retardation, depression severity, or frontal dysfunction was observed in patients. LIMITATIONS This is a cross-sectional study and a larger size would have allowed for confident detection of more subtle, but potentially relevant effects. CONCLUSION Gesture performance is impaired in depressed patients, and appears to be related to poor working memory abilities, suggesting a disruption in the retrieval of gestural cues indicative of a distinct clinical phenomenon that might be related to social functioning.
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Affiliation(s)
- Anastasia Pavlidou
- University of Bern, University Hospital of Psychiatry, Translation Research Center, Bern, Switzerland.
| | - Petra V Viher
- University of Bern, University Hospital of Psychiatry, Translation Research Center, Bern, Switzerland
| | - Hanta Bachofner
- University of Bern, University Hospital of Psychiatry, Translation Research Center, Bern, Switzerland
| | - Florian Weiss
- University of Bern, University Hospital of Psychiatry, Translation Research Center, Bern, Switzerland
| | - Katharina Stegmayer
- University of Bern, University Hospital of Psychiatry, Translation Research Center, Bern, Switzerland
| | - Stewart A Shankman
- Northwestern University, Department of Psychology, Evanston, IL, USA; Northwestern University, Department of Psychiatry and Behavioral Sciences, Chicago, IL, USA
| | - Vijay A Mittal
- Northwestern University, Department of Psychology, Evanston, IL, USA; Northwestern University, Department of Psychiatry and Behavioral Sciences, Chicago, IL, USA; Northwestern University, Department of Psychiatry, Institute for Policy Research, Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Evanston, Chicago, IL, USA
| | - Sebastian Walther
- University of Bern, University Hospital of Psychiatry, Translation Research Center, Bern, Switzerland
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Chen H, Lu F, Guo X, Pang Y, He C, Han S, Duan X, Chen H. Dimensional Analysis of Atypical Functional Connectivity of Major Depression Disorder and Bipolar Disorder. Cereb Cortex 2021; 32:1307-1317. [PMID: 34416760 DOI: 10.1093/cercor/bhab296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Literatures have reported considerable heterogeneity with atypical functional connectivity (FC) pattern of psychiatric disorders. However, traditional statistical methods are hard to explore this heterogeneity pattern. We proposed a "brain dimension" method to describe the atypical FC patterns of major depressive disorder and bipolar disorder (BD). The approach was firstly applied to a simulation dataset. It was then utilized to a real resting-state functional magnetic resonance imaging dataset of 47 individuals with major depressive disorder, 32 individuals with BD, and 52 well matched health controls. Our method showed a better ability to extract the FC dimensions than traditional methods. The results of the real dataset revealed atypical FC dimensions for major depressive disorder and BD. Especially, an atypical FC dimension which exhibited decreased FC strength of thalamus and basal ganglia was found with higher severity level of individuals with BD than the ones with major depressive disorder. This study provided a novel "brain dimension" method to view the atypical FC patterns of major depressive disorder and BD and revealed shared and specific atypical FC patterns between major depressive disorder and BD.
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Affiliation(s)
- Heng Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, PR China.,School of Life Science and Technology, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu 611731, PR China.,School of Medicine, Guizhou University, Guizhou 550025, China
| | - Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, PR China
| | - Xiaonan Guo
- School of Information Science and Engineering, Yanshan University, Qinhuangdao 066000, China.,Hebei Key Laboratory of Information Transmission and Signal Processing, Yanshan University, Qinhuangdao 066000, China
| | - Yajing Pang
- Research Center for Intelligent Science and Engineering Technology of Traditional Chinese Medicine, School of Electrical Engineering, Zhengzhou University, Zhengzhou 450001, PR China.,Henan Key Laboratory of Brain Science and Brain-Computer Interface Technology, School of Electrical Engineering, Zhengzhou University, Zhengzhou 450001, PR China
| | - Changchun He
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, PR China.,School of Life Science and Technology, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu 611731, PR China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, PR China
| | - Xujun Duan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, PR China.,School of Life Science and Technology, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu 611731, PR China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, PR China.,School of Life Science and Technology, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu 611731, PR China
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48
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Lee YA, Goto Y. The Habenula in the Link Between ADHD and Mood Disorder. Front Behav Neurosci 2021; 15:699691. [PMID: 34248519 PMCID: PMC8264146 DOI: 10.3389/fnbeh.2021.699691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/25/2021] [Indexed: 12/11/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset, neurodevelopmental disorder, whereas major depressive disorder (MDD) is a mood disorder that typically emerges in adulthood. Accumulating evidence suggests that these seemingly unrelated psychiatric disorders, whose symptoms even appear antithetical [e.g., psychomotor retardation in depression vs. hyperactivity (psychomotor acceleration) in ADHD], are in fact associated with each other. Thus, individuals with ADHD exhibit high comorbidity with MDD later in life. Moreover, genetic studies have shown substantial overlaps of susceptibility genes between ADHD and MDD. Here, we propose a novel and testable hypothesis that the habenula, the epithalamic brain region important for the regulation of monoamine transmission, may be involved in both ADHD and MDD. The hypothesis suggests that an initially hypoactive habenula during childhood in individuals with ADHD may undergo compensatory changes during development, priming the habenula to be hyperactive in response to stress exposure and thereby increasing vulnerability to MDD in adulthood. Moreover, we propose a new perspective on habenular deficits in psychiatric disorders that consider the habenula a neural substrate that could explain multiple psychiatric disorders.
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Affiliation(s)
- Young-A Lee
- Department of Food Science and Nutrition, Daegu Catholic University, Gyeongsan, South Korea
| | - Yukiori Goto
- Primate Research Institute, Kyoto University, Inuyama, Japan
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Cabeza L, Ramadan B, Giustiniani J, Houdayer C, Pellequer Y, Gabriel D, Fauconnet S, Haffen E, Risold PY, Fellmann D, Belin D, Peterschmitt Y. Chronic exposure to glucocorticoids induces suboptimal decision-making in mice. Eur Neuropsychopharmacol 2021; 46:56-67. [PMID: 33531260 DOI: 10.1016/j.euroneuro.2021.01.094] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 12/11/2022]
Abstract
Anxio-depressive symptoms as well as severe cognitive dysfunction including aberrant decision-making (DM) are documented in neuropsychiatric patients with hypercortisolaemia. Yet, the influence of the hypothalamo-pituitary-adrenal (HPA) axis on DM processes remains poorly understood. As a tractable mean to approach this human condition, adult male C57BL/6JRj mice were chronically treated with corticosterone (CORT) prior to behavioural, physiological and neurobiological evaluation. The behavioural data indicate that chronic CORT delays the acquisition of contingencies required to orient responding towards optimal DM performance in a mouse Gambling Task (mGT). Specifically, CORT-treated animals show a longer exploration and a delayed onset of the optimal DM performance. Remarkably, the proportion of individuals performing suboptimally in the mGT is increased in the CORT condition. This variability seems to be better accounted for by variations in sensitivity to negative rather than to positive outcome. Besides, CORT-treated animals perform worse than control animals in a spatial working memory (WM) paradigm and in a motor learning task. Finally, Western blotting neurobiological analyses show that chronic CORT downregulates glucocorticoid receptor expression in the medial Prefrontal Cortex (mPFC). Besides, corticotropin-releasing factor signalling in the mPFC of CORT individuals negatively correlates with their DM performance. Collectively, this study describes how chronic exposure to glucocorticoids induces suboptimal DM under uncertainty in a mGT, hampers WM and motor learning processes, thus affecting specific emotional, motor, cognitive and neurobiological endophenotypic dimensions relevant for precision medicine in biological psychiatry.
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Affiliation(s)
- Lidia Cabeza
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France.
| | - Bahrie Ramadan
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Julie Giustiniani
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France; Clinical Psychiatry, Hôpital Universitaire CHRU, Besançon, France; Hôpital Universitaire CHRU, CIC-INSERM-1431, Besançon, France
| | - Christophe Houdayer
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Yann Pellequer
- PEPITE EA-4267, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Damien Gabriel
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France; Hôpital Universitaire CHRU, CIC-INSERM-1431, Besançon, France
| | - Sylvie Fauconnet
- Hôpital Universitaire CHRU, CIC-INSERM-1431, Besançon, France; Laboratoire de Carcinogenèse associée aux HPV EA-3181, Université de Bourgogne - Franche-Comté, Besançon, France; Urologie, andrologie et transplantation rénale, Hôpital Universitaire CHRU, Besançon, France
| | - Emmanuel Haffen
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France; Clinical Psychiatry, Hôpital Universitaire CHRU, Besançon, France; Hôpital Universitaire CHRU, CIC-INSERM-1431, Besançon, France
| | - Pierre-Yves Risold
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Dominique Fellmann
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France
| | - David Belin
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Yvan Peterschmitt
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France.
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50
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Albuquerque L, Valente ARS, Teixeira A, Figueiredo D, Sa-Couto P, Oliveira C. Association between acoustic speech features and non-severe levels of anxiety and depression symptoms across lifespan. PLoS One 2021; 16:e0248842. [PMID: 33831018 PMCID: PMC8031302 DOI: 10.1371/journal.pone.0248842] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 03/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Several studies have investigated the acoustic effects of diagnosed anxiety and depression. Anxiety and depression are not characteristics of the typical aging process, but minimal or mild symptoms can appear and evolve with age. However, the knowledge about the association between speech and anxiety or depression is scarce for minimal/mild symptoms, typical of healthy aging. As longevity and aging are still a new phenomenon worldwide, posing also several clinical challenges, it is important to improve our understanding of non-severe mood symptoms' impact on acoustic features across lifetime. The purpose of this study was to determine if variations in acoustic measures of voice are associated with non-severe anxiety or depression symptoms in adult population across lifetime. METHODS Two different speech tasks (reading vowels in disyllabic words and describing a picture) were produced by 112 individuals aged 35-97. To assess anxiety and depression symptoms, the Hospital Anxiety Depression Scale (HADS) was used. The association between the segmental and suprasegmental acoustic parameters and HADS scores were analyzed using the linear multiple regression technique. RESULTS The number of participants with presence of anxiety or depression symptoms is low (>7: 26.8% and 10.7%, respectively) and non-severe (HADS-A: 5.4 ± 2.9 and HADS-D: 4.2 ± 2.7, respectively). Adults with higher anxiety symptoms did not present significant relationships associated with the acoustic parameters studied. Adults with increased depressive symptoms presented higher vowel duration, longer total pause duration and short total speech duration. Finally, age presented a positive and significant effect only for depressive symptoms, showing that older participants tend to have more depressive symptoms. CONCLUSIONS Non-severe depression symptoms can be related to some acoustic parameters and age. Depression symptoms can be explained by acoustic parameters even among individuals without severe symptom levels.
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Affiliation(s)
- Luciana Albuquerque
- Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
- Center of Health Technology and Services Research, University of Aveiro, Aveiro, Portugal
- Department of Electronics Telecommunications and Informatics, University of Aveiro, Aveiro, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- * E-mail:
| | - Ana Rita S. Valente
- Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
- Department of Electronics Telecommunications and Informatics, University of Aveiro, Aveiro, Portugal
| | - António Teixeira
- Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
- Department of Electronics Telecommunications and Informatics, University of Aveiro, Aveiro, Portugal
| | - Daniela Figueiredo
- Center of Health Technology and Services Research, University of Aveiro, Aveiro, Portugal
- School of Health Science, University of Aveiro, Aveiro, Portugal
| | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications, University of Aveiro, Aveiro, Portugal
- Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Catarina Oliveira
- Institute of Electronics and Informatics Engineering of Aveiro, University of Aveiro, Aveiro, Portugal
- School of Health Science, University of Aveiro, Aveiro, Portugal
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