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Ko Y, Kim HE, Kim BH, Ham K, Lee S, Park B, Kim JJ. Neural dynamics of social anxiety during and after anxiety-provoking and relaxation-inducing: A task and resting-state fMRI study. J Affect Disord 2025; 380:655-665. [PMID: 40122256 DOI: 10.1016/j.jad.2025.03.104] [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: 11/15/2023] [Revised: 03/12/2025] [Accepted: 03/19/2025] [Indexed: 03/25/2025]
Abstract
BACKGROUND Social anxiety disorder (SAD) is marked by intense fear of social situations and negative evaluation. This study investigated neural effects of SAD-specific imagery scripts and their relationships with Brief Fear of Negative Evaluation (BFNE). METHODS Thirty-six SAD and 32 healthy controls underwent four five-minute fMRI runs: anxiety-provoking imagery, rest, relaxing imagery, and rest. The order of imageries was counterbalanced. Functional connectivity analysis and connectome-based predictive modeling with respect to BFNE were performed using six seed regions, including the bilateral amygdala, left hypothalamus, bilateral dorsomedial prefrontal cortex (DMPFC), left ventromedial PFC (VMPFC), and left posterior cingulate cortex (PCC). RESULTS Group × task interaction effects were found in connectivity of left amygdala-right cerebellum, left PCC-bilateral superior frontal gyrus, and left PCC-right posterior middle temporal gyrus, and group × engagement effects were discovered in left hypothalamus-bilateral DMPFC and left VMPFC-right DMPFC couplings. Group × task × engagement interactions highlighted aberrant functional connections of right amygdala-left VMPFC, DMPFC-left DLPFC, and left VMPFC-bilateral supplementary motor area in SAD. Patterns of connectivity predicted the BFNE scores in various segments of imagery conditions. LIMITATIONS Patient's medication, physiological measures were not considered. Noisy nature of fMRI could have interfered participants from focusing. CONCLUSIONS Our results revealed disrupted functional connections associated with emotion dysregulation and overly self-referent thinking in SAD. Markedly, patients showed maladaptive responses related to relaxation-inducing blocks, challenging the expected relaxation response. Overall findings emphasized inappropriate engagements of various processes in relaxing circumstances that do not overtly involve social anxiety to be associated with symptomatology.
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Affiliation(s)
- Yujin Ko
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Republic of Korea
| | - Hesun Erin Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
| | - Byung-Hoon Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Kyunghee Ham
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Seungmin Lee
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Bohyun Park
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jae-Jin Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
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Qi J, Hu WL. Altered hypothalamic functional connectivity after partial sleep deprivation in young and elderly adults. Behav Brain Res 2025; 488:115587. [PMID: 40228717 DOI: 10.1016/j.bbr.2025.115587] [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: 01/12/2025] [Revised: 03/12/2025] [Accepted: 04/08/2025] [Indexed: 04/16/2025]
Abstract
BACKGROUND The hypothalamus plays a critical role in sleep-wake regulation and attention control. However, few studies explored the alterations of hypothalamic functional connectivity after sleep deprivation. The purpose of the study is to investigate the influence of partial sleep deprivation on hypothalamic functional connectivity in young and elderly adults and to determine whether age modulates the interactions between partial sleep deprivation and hypothalamic functional connectivity. METHODS Data for this study were collected as part of the Stockholm Sleepy Brain Project. Forty-one young adults (aged 20-30) and thirty-six elderly adults (aged 65-75) were finally recruited in the study. Participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans following full sleep and partial sleep deprivation (3 h of sleep) in a crossover design. Seed-based functional connectivity analyses were performed for the bilateral hypothalamus using rs-fMRI data. RESULTS For young adults, partial sleep deprivation caused enhanced hypothalamic functional connectivity with the inferior frontal gyrus and precuneus. For elderly adults, reduced functional connectivity was observed between the hypothalamus and frontal, parietal, temporal, occipital regions, and cingulate gyrus following partial sleep deprivation. Further, a significant interactive effect between age and partial sleep deprivation on the hypothalamic functional connectivity was observed. Age-related abnormalities of hypothalamic functional connectivity were observed in frontoparietal regions, pallidum, rectus, and superior occipital gyrus. CONCLUSION Partial sleep deprivation led to increased hypothalamic functional connectivity in young adults, while decreased hypothalamic functional connectivity in elderly adults. Our results indicate that age modulates the influence of sleep deprivation on intrinsic brain functional connectivity.
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Affiliation(s)
- Jing Qi
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Wen-Li Hu
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
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Fasiello E, Galbiati A, Ferini-Strambi L. Impact of sleep deprivation on dynamic functional connectivity states. HANDBOOK OF CLINICAL NEUROLOGY 2025; 206:27-36. [PMID: 39864929 DOI: 10.1016/b978-0-323-90918-1.00012-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2025]
Abstract
Sleep deprivation (SD) is an experimental procedure to study the effects of sleep loss on the human brain. Neuroimaging techniques, such as functional magnetic resonance imaging (fMRI) and electroencephalography (EEG), have been pivotal in studying these effects. The present chapter aims to retrace the state of the art regarding the literature that examines the SD effects on the brain through functional connectivity (FC) evaluated in fMRI and EEG settings, separately. Specifically, we focused on the cognitive domains mainly affected by sleep loss and the underlying brain connectivity alterations. SD disrupts homeostatic and circadian processes, negatively affecting cognitive and cerebral functionality explored through FC. All evidence confirms the detrimental role of SD on brain connectivity impacting several resting-state networks and resulting in cognitive impairments. To conclude, SD may offer useful insights into pathogenic mechanisms likely resembling those induced by chronic sleep loss that might find their application in the clinical context.
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Affiliation(s)
- Elisabetta Fasiello
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy; Department of Neurology, Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Galbiati
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy; Department of Neurology, Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luigi Ferini-Strambi
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy; Department of Neurology, Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Byrne H, Knight SJ, Josev EK, Scheinberg A, Beare R, Yang JYM, Oldham S, Rowe K, Seal ML. Hypothalamus Connectivity in Adolescent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. J Neurosci Res 2024; 102:e25392. [PMID: 39431934 DOI: 10.1002/jnr.25392] [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: 01/22/2024] [Revised: 07/18/2024] [Accepted: 09/29/2024] [Indexed: 10/22/2024]
Abstract
Adolescent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disabling illness of unknown etiology. Increasing evidence suggests hypothalamic involvement in ME/CFS pathophysiology, which has rarely been explored using magnetic resonance imaging (MRI) in the condition. This work aimed to use MRI to examine hypothalamus connectivity in adolescents with ME/CFS and explore how this relates to fatigue severity and illness duration. 25 adolescents with ME/CFS and 23 healthy controls completed a neuroimaging protocol consisting of structural and multishell diffusion-weighted imaging sequences, in addition to the PedsQL Multidimensional Fatigue Scale to assess fatigue severity. Information about illness duration was acquired at diagnosis. Preprocessing and streamlines tractography was performed using QSIPrep combined with a custom parcellation scheme to create structural networks. The number (degree) and weight (strength) of connections between lateralized hypothalamus regions and cortical and subcortical nodes were extracted, and relationships between connectivity measures, fatigue severity, and illness duration were performed using Bayesian regression models. We observed weak-to-moderate evidence of increased degree, but not strength, of connections from the bilateral anterior-inferior (left: pd [%] = 99.18, median [95% CI] = -22.68[-40.96 to 4.45]; right: pd [%] = 99.86, median [95% CI] = -23.35[-38.47 to 8.20]), left anterior-superior (pd [%] = 99.33, median [95% CI] = -18.83[-33.45 to 4.07]) and total left hypothalamus (pd [%] = 99.44, median [95% CI] = -47.18[-83.74 to 11.03]) in the ME/CFS group compared with controls. Conversely, bilateral posterior hypothalamus degree decreased with increasing ME/CFS illness duration (left: pd [%] = 98.13, median [95% CI]: -0.47[-0.89 to 0.03]; right: pd [%] = 98.50, median [95% CI]:-0.43[-0.82 to 0.05]). Finally, a weak relationship between right intermediate hypothalamus connectivity strength and fatigue severity was identified in the ME/CFS group (pd [%] = 99.35, median [95% CI] = -0.28[-0.51 to 0.06]), which was absent in controls. These findings suggest changes in hypothalamus connectivity may occur in adolescents with ME/CFS, warranting further investigation.
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Affiliation(s)
- Hollie Byrne
- Developmental Imaging, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Sarah J Knight
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Elisha K Josev
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Adam Scheinberg
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Richard Beare
- Developmental Imaging, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- National Centre for Healthy Ageing and Peninsula Clinical School, Monash University, Melbourne, Australia
| | - Joseph Y M Yang
- Developmental Imaging, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Neurosurgery, Neuroscience Advanced Clinical Imaging Service (NACIS), The Royal Children's Hospital, Melbourne, Australia
- Neuroscience Research, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Stuart Oldham
- Developmental Imaging, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Katherine Rowe
- Department of General Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Marc L Seal
- Developmental Imaging, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
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Chen Y, Chaudhary S, Li G, Fucito LM, Bi J, Li CSR. Deficient sleep, altered hypothalamic functional connectivity, depression and anxiety in cigarette smokers. NEUROIMAGE. REPORTS 2024; 4:100200. [PMID: 38605733 PMCID: PMC11008573 DOI: 10.1016/j.ynirp.2024.100200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Background Deficient sleep is implicated in nicotine dependence as well as depressive and anxiety disorders. The hypothalamus regulates the sleep-wake cycle and supports motivated behavior, and hypothalamic dysfunction may underpin comorbid nicotine dependence, depression and anxiety. We aimed to investigate whether and how the resting state functional connectivities (rsFCs) of the hypothalamus relate to cigarette smoking, deficient sleep, depression and anxiety. Methods We used the data of 64 smokers and 198 age- and sex-matched adults who never smoked, curated from the Human Connectome Project. Deficient sleep and psychiatric problems were each assessed with Pittsburgh Sleep Quality Index (PSQI) and Achenbach Adult Self-Report. We processed the imaging data with published routines and evaluated the results at a corrected threshold, all with age, sex, and the severity of alcohol use as covariates. Results Smokers vs. never smokers showed poorer sleep quality and greater severity of depression and anxiety. In smokers only, the total PSQI score, indicating more sleep deficits, was positively associated with hypothalamic rsFCs with the right inferior frontal/insula/superior temporal and postcentral (rPoCG) gyri. Stronger hypothalamus-rPoCG rsFCs were also associated with greater severity of depression and anxiety in smokers but not never smokers. Additionally, in smokers, the PSQI score completely mediated the relationships of hypothalamus-rPoCG rsFCs with depression and anxiety severity. Conclusions These findings associate hypothalamic circuit dysfunction to sleep deficiency and severity of depression and anxiety symptoms in adults who smoke. Future studies may investigate the roles of the hypothalamic circuit in motivated behaviors to better characterize the inter-related neural markers of smoking, deficient sleep, depression and anxiety.
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Affiliation(s)
- Yu Chen
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Shefali Chaudhary
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Guangfei Li
- Department of Biomedical Engineering, College of Chemistry and Life Science, Beijing University of Technology, Beijing, China
- Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing, China
| | - Lisa M. Fucito
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06520, USA
| | - Jinbo Bi
- Department of Computer Science and Engineering, School of Engineering, University of Connecticut, Storrs, CT, USA
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06520, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06520, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06520, USA
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Lutfy RH, Salam SA, Mohammed HS, Shakweer MM, Essawy AE. Photomodulatory effects in the hypothalamus of sleep-deprived young and aged rats. Behav Brain Res 2024; 458:114731. [PMID: 37898350 DOI: 10.1016/j.bbr.2023.114731] [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: 09/12/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023]
Abstract
Insufficient sleep is associated with impaired hypothalamic activity and declined attentional performance. In this study, alterations in the hypothalamus of REM sleep-deprived (SD) young and aged rats, and the modulatory effect of near-infrared (NIR) laser were investigated. Forty-eight male Wistar rats (24 young at 2 months and 24 senile at 14 months) were divided into three groups: the control, the SD group subjected to 72 hr of sleep deprivation, and the transcranial-NIR laser-treated (TLT) group subjected to SD for 72 hr and irradiated with 830 nm laser. The hypothalamic levels of oxidative stress, inflammatory biomarkers, antioxidant enzymes, mitochondrial cytochrome C oxidase (CCO), apoptotic markers (BAX, BCL-2), and neuronal survival-associated genes (BDNF, GLP-1) were evaluated. Furthermore, the hypothalamic tissue alterations were analyzed via histological examination. The results revealed that TLT treatment has enhanced the antioxidant status, prevented oxidative insults, suppressed neuroinflammation, regulated CCO activity, reduced apoptotic markers, and tuned the survival genes (BDNF & GLP-1) in hypothalamic tissue of SD young and aged rats. Microscopically, TLT treatment has ameliorated the SD-induced alterations and restored the normal histological features of hypothalamus tissue. Moreover, the obtained data showed that SD and NIR laser therapy are age-dependent. Altogether, our findings emphasize the age-dependent adverse effects of SD on the hypothalamus and suggest the use of low-laser NIR radiation as a potential non-invasive and therapeutic approach against SD-induced adverse effects in young and aged animals.
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Affiliation(s)
- Radwa H Lutfy
- Zoology Department, Faculty of Science, Alexandria University, Egypt; School of Biotechnology, Badr University in Cairo, Badr City, Cairo 11829, Egypt
| | | | - Haitham S Mohammed
- Biophysics Department, Faculty of Science, Cairo University, Giza, Egypt.
| | - Marwa M Shakweer
- Department of Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Department of Pathology, Faculty of Medicine, Badr University in Cairo (BUC), Cairo, Egypt
| | - Amina E Essawy
- Zoology Department, Faculty of Science, Alexandria University, Egypt
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An X, Lian J, Xu L, Peng Z, Chen S, Cheng MY, Shao Y. Changes in electroencephalography microstates are associated with reduced levels of vigilance after sleep deprivation. Brain Res 2024; 1825:148729. [PMID: 38128810 DOI: 10.1016/j.brainres.2023.148729] [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: 09/02/2023] [Revised: 11/30/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
Total sleep deprivation (TSD) negatively affects cognitive functions, especially vigilance attention, but studies on vigilance changes in terms of electroencephalography (EEG) microstates after TSD are limited. This study investigates the impact of TSD on vigilance attention, EEG microstates and its relationship. Thirty healthy adult males completed a psychomotor vigilance task (PVT) before, 24 h after, and 36 h after TSD while their EEG was recorded during rest. Microstate analysis revealed significant changes in the occurrence and contribution of microstate class B after TSD. Moreover, changes in the probability of transitioning between microstate classes A and D were observed, correlating with decreased vigilance. Specifically, a positive correlation was found between transitioning from class B to class C and vigilance, while a trend of negative correlation was observed between transitioning between classes A and D and vigilance. These findings indicate abnormal activity in the salience network and dorsal attention network following sleep deprivation. TSD impairs vigilance attention, as demonstrated by the effects on EEG microstate class B and the transitions between classes A and D. The study suggests its potential as an early warning indicator for predicting vigilance attention after sleep deprivation.
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Affiliation(s)
- Xin An
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Jie Lian
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Lin Xu
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Ziyi Peng
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Shufang Chen
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Ming-Yang Cheng
- School of Psychology, Beijing Sport University, Beijing 100084, China.
| | - Yongcong Shao
- School of Psychology, Beijing Sport University, Beijing 100084, China.
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Li G, Chen Y, Chaudhary S, Li CS, Hao D, Yang L, Li CSR. Sleep dysfunction mediates the relationship between hypothalamic-insula connectivity and anxiety-depression symptom severity bidirectionally in young adults. Neuroimage 2023; 279:120340. [PMID: 37611815 DOI: 10.1016/j.neuroimage.2023.120340] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/03/2023] [Accepted: 08/21/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The hypothalamus plays a crucial role in regulating sleep-wake cycle and motivated behavior. Sleep disturbance is associated with impairment in cognitive and affective functions. However, how hypothalamic dysfunction may contribute to inter-related sleep, cognitive, and emotional deficits remain unclear. METHODS We curated the Human Connectome Project dataset and investigated how hypothalamic resting state functional connectivities (rsFC) were associated with sleep dysfunction, as evaluated by the Pittsburgh Sleep Quality Index (PSQI), cognitive performance, and subjective mood states in 687 young adults (342 women). Imaging data were processed with published routines and evaluated with a corrected threshold. We examined the inter-relationship amongst hypothalamic rsFC, PSQI score, and clinical measures with mediation analyses. RESULTS In whole-brain regressions with age and drinking severity as covariates, men showed higher hypothalamic rsFC with the right insula in correlation with PSQI score. No clusters were identified in women at the same threshold. Both hypothalamic-insula rsFC and PSQI score were significantly correlated with anxiety and depression scores in men. Further, mediation analyses showed that PSQI score mediated the relationship between hypothalamic-insula rsFC and anxiety/depression symptom severity bidirectionally in men. CONCLUSIONS Sleep dysfunction is associated with negative emotions and hypothalamic rsFC with the right insula, a core structure of the interoceptive circuits. Notably, anxiety-depression symptom severity and altered hypothalamic-insula rsFC are related bidirectionally by poor sleep quality. These findings are specific to men, suggesting potential sex differences in the neural circuits regulating sleep and emotional states that need to be further investigated.
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Affiliation(s)
- Guangfei Li
- Department of Biomedical engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China; Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing, China.
| | - Yu Chen
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Shefali Chaudhary
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Clara S Li
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA; Smith College, Northampton MA, USA
| | - Dongmei Hao
- Department of Biomedical engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China; Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing, China
| | - Lin Yang
- Department of Biomedical engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China; Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing, China
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA; Department of Neuroscience, Yale University School of Medicine, New Haven CT, USA; Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven CT, USA; Wu Tsai Institute, Yale University, New Haven CT, USA
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Chaudhary S, Zhornitsky S, Roy A, Summers C, Ahles T, Li CR, Chao HH. The effects of androgen deprivation on working memory and quality of life in prostate cancer patients: The roles of hypothalamic connectivity. Cancer Med 2022; 11:3425-3436. [PMID: 35315585 PMCID: PMC9487881 DOI: 10.1002/cam4.4704] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Androgen deprivation therapy (ADT) has been associated with adverse effects on the brain. ADT alters testosterone levels via its action on the hypothalamus-pituitary-gonadal axis and may influence hypothalamic functions. Given the wide regional connectivity of the hypothalamus and its role in regulating cognition and behavior, we assessed the effects of ADT on hypothalamic resting state functional connectivity (rsFC) and their cognitive and clinical correlates. METHODS In a prospective observational study, 22 men with nonmetastatic prostate cancer receiving ADT and 28 patients not receiving ADT (controls), matched in age, years of education, and Montreal Cognitive Assessment score, participated in N-back task and quality of life (QoL) assessments and brain imaging at baseline and at 6 months. Imaging data were processed with published routines and the results of a group by time flexible factorial analysis were evaluated at a corrected threshold. RESULTS ADT and control groups did not differ in N-back performance or QoL across time points. Relative to controls, patients receiving ADT showed significantly higher hypothalamus-right mid-cingulate cortex (MCC) and precentral gyrus (PCG) rsFC during follow-up versus baseline. Further, the changes in MCC and PCG rsFC were correlated positively with the change in QoL score and 0-back correct response rate, respectively, in patients with undergoing ADT. CONCLUSION Six-month ADT affects hypothalamic functional connectivity with brain regions critical to cognitive motor and affective functions. Elevated hypothalamic MCC and PCG connectivity likely serve to functionally compensate for the effects of ADT and sustain attention and overall QoL. The longer-term effects of ADT remain to be investigated.
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Affiliation(s)
- Shefali Chaudhary
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Simon Zhornitsky
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Alicia Roy
- VA Connecticut Healthcare SystemWest HavenConnecticutUSA
| | | | - Tim Ahles
- Department of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Chiang‐Shan R. Li
- Departments of Psychiatry and Neuroscience, Interdepartmental Neuroscience ProgramYale University School of Medicine, Wu Tsai Institute, Yale UniversityNew HavenConnecticutUSA
| | - Herta H. Chao
- VA Connecticut Healthcare SystemWest HavenConnecticutUSA
- Department of Medicine & Yale Comprehensive Cancer CenterYale University School of MedicineNew HavenCTUSA
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Chaudhary S, Roy A, Summers C, Zhornitsky S, Ahles T, Li CSR, Chao HH. Hypothalamic connectivities predict individual differences in ADT-elicited changes in working memory and quality of life in prostate cancer patients. Sci Rep 2022; 12:9567. [PMID: 35688928 PMCID: PMC9187668 DOI: 10.1038/s41598-022-13361-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/24/2022] [Indexed: 11/09/2022] Open
Abstract
Androgen deprivation therapy (ADT) has been associated with adverse effects on cognition. However, we currently lack understanding of the neurobiology and prognostic markers of these effects. Given that ADT acts via the hypothalamus-pituitary-gonadal axis, we assessed whether baseline hypothalamic resting state functional connectivity (rsFC) could predict changes in working memory and quality of life in prostate cancer patients following androgen deprivation. In a prospective observational study, 28 men with non-metastatic prostate cancer receiving ADT and 38 patients not receiving ADT (controls), matched in age, years of education and Montreal Cognitive Assessment score, participated in brain imaging at baseline, and N-back task and quality-of-life (QoL) assessments at baseline and at 6 months follow-up. Imaging data were processed with published routines and evaluated at a corrected threshold. ADT and control groups did not differ in N-back performance or QoL across time points. In ADT, the changes in 0-back correct response rate (follow-up-baseline) were correlated with baseline hypothalamus-precentral gyrus rsFC; the changes in 1-back correct response rate and reaction time were each correlated with hypothalamus-middle frontal gyrus and superior parietal lobule rsFC. The changes in physical well-being subscore of QoL were correlated with baseline hypothalamus-anterior cingulate and cuneus rsFC. The hypothalamus rsFCs predicted N-back and QoL change with an area under the receiver operating characteristic curve of 0.93 and 0.73, respectively. Baseline hypothalamus-frontoparietal and salience network rsFC's predict inter-subject variations in the changes in working-memory and QoL following 6 months of ADT. Whether and how hypothalamic rsFCs may predict the cognitive and QoL effects with longer-term ADT remain to be investigated.
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Affiliation(s)
- Shefali Chaudhary
- Department of Psychiatry, Yale University School of Medicine, CMHC S110, 34 Park Street, New Haven, CT, 06519, USA.
| | - Alicia Roy
- Cancer Center, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA
| | - Christine Summers
- Cancer Center, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, CMHC S110, 34 Park Street, New Haven, CT, 06519, USA
| | - Tim Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University, New Haven, CT, 06520, USA
- Department of Neuroscience, Yale University, New Haven, CT, 06520, USA
- Interdepartmental Neuroscience Program, Yale University School of Medicine, Yale University, New Haven, CT, 06520, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06520, USA
| | - Herta H Chao
- Cancer Center, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA.
- Department of Medicine and Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, 06519, USA.
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