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Zhang Y, Peng B, Chen S, Liang Q, Zhang Y, Lin S, Xu Z, Zhang J, Hou G, Qiu Y. Reduced coupling between global signal and cerebrospinal fluid inflow in patients with depressive disorder: A resting state functional MRI study. J Affect Disord 2024; 354:136-142. [PMID: 38484877 DOI: 10.1016/j.jad.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Depressed patients often suffer from sleep disturbance, which has been recognized to be responsible for glymphatic dysfunction. The purpose of this study was to investigate the coupling strength of global blood‑oxygen-level-dependent (gBOLD) signals and cerebrospinal fluid (CSF) inflow dynamics, which is a biomarker for glymphatic function, in depressed patients and to explore its potential relationship with sleep disturbance by using resting-state functional MRI. METHODS A total of 138 depressed patients (112 females, age: 34.70 ± 13.11 years) and 84 healthy controls (29 females, age: 36.6 ± 11.75 years) participated in this study. The gBOLD-CSF coupling strength was calculated to evaluate glymphatic function. Sleep disturbance was evaluated using the insomnia items (item 4 for insomnia-early, item 5 for insomnia-middle, and item 6 for insomnia-late) of The 17-item Hamilton Depression Rating Scale for depressed patients, which was correlated with the gBOLD-CSF coupling strength. RESULTS The depressed patients exhibited weaker gBOLD-CSF coupling relative to healthy controls (p = 0.022), possibly due to impairment of the glymphatic system. Moreover, the gBOLD-CSF coupling strength correlated with insomnia-middle (r = 0.097, p = 0.008) in depressed patients. Limitations This study is a cross-sectional study. CONCLUSION Our findings shed light on the pathophysiology of depression, indicating that cerebral waste clearance system deficits are correlated with poor sleep quality in depressed patients.
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Affiliation(s)
- Yanyu Zhang
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Duobao AVE 56, Liwan district, Guangzhou 510145, People's Republic of China
| | - Bo Peng
- Department of Depressive Disorder, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong 518020, People's Republic of China
| | - Shengli Chen
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, People's Republic of China
| | - Qunjun Liang
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, People's Republic of China
| | - Yingli Zhang
- Department of Depressive Disorder, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong 518020, People's Republic of China
| | - Shiwei Lin
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, People's Republic of China
| | - Ziyun Xu
- Neuropsychiatry Imaging Center, Department of Radiology, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong 518020, People's Republic of China
| | - Jiayun Zhang
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Duobao AVE 56, Liwan district, Guangzhou 510145, People's Republic of China
| | - Gangqiang Hou
- Neuropsychiatry Imaging Center, Department of Radiology, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong 518020, People's Republic of China.
| | - Yingwei Qiu
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518000, People's Republic of China.
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Li Y, Yin Y, Yu Y, Hu X, Liu X, Wu S. The potential predictors for treatment-resistance depression after selective serotonin reuptake inhibitors therapy in Han Chinese: A resting-state functional magnetic resonance imaging study. Early Interv Psychiatry 2024. [PMID: 38320861 DOI: 10.1111/eip.13509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/26/2023] [Accepted: 01/24/2024] [Indexed: 02/08/2024]
Abstract
AIM Selective serotonin reuptake inhibitors (SSRIs) are among the most important antidepressants. However, there is limited research on predicting the occurrence of treatment-resistant depression (TRD) after 5 years. Examining the predictive effect of TRD occurrence using resting-state fMRI in patients initiating SSRIs treatment at the onset of major depressive disorder (MDD) could potentially enhance TRD management. METHODS A total of 60 first-episode drug-naive MDD patients who met the criteria, along with 41 healthy controls of Han Chinese ethnicity, were recruited. All MDD patients received SSRIs as the initial treatment for relieving depressive symptoms. Resting-state fMRI scans were conducted for all subjects. Follow-up assessments were conducted over a period of five years, during which MDD patients were categorized into treatment-resistant depression (TRD) and non-treatment-resistant depression (NRD) groups based on disease progression. Amplitude of low-frequency fluctuations (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and Regional Homogeneity (ReHo) values were calculated and compared among the three groups. Additionally, receiver operating characteristic (ROC) curves were employed to identify potential predictors. RESULTS After 5 years of follow-up, it was found that 43 MDD patients were classified as NRD, while 17 were classified as TRD. In comparison to TRD, NRD exhibited decreased ALFF in the left middle cingulum gyrus (MCG.L) and in the right middle frontal gyrus (MFG.R), as well as decreased ReHo in MCG.L. Furthermore, NRD showed increased fALFF in the left precuneus (PCUN.L). The area under the curve (AUC) values were as follows: 0.724 (MCG.L by ALFF), 0.732 (MFG.R), 0.767 (PCUN.L), 0.774 (MCG.L by ReHo), 0.878 (combined), 0.547 (HAMD), and 0.408 (HAMA) respectively. CONCLUSION The findings suggest that PCUN.L, MFG.R, MCG.L, and the combined measures may indicate the possibility of developing TRD after 5 years when SSRIs are used as the initial therapy for relieving depressive symptoms in MDD patients.
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Affiliation(s)
- Yi Li
- Department of Radiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Yan Yin
- Department of Psychosomatic, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Yingyi Yu
- Department of Radiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Xiwen Hu
- The sixth ward of Psychiatry Department, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, China
| | - XiaoYan Liu
- The fifth ward of Psychiatry Department, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Sha Wu
- Department of intensive care unit, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, China
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Yan H, Han Y, Shan X, Li H, Liu F, Zhao J, Li P, Guo W. Shared and distinctive dysconnectivity patterns underlying pure generalized anxiety disorder (GAD) and comorbid GAD and depressive symptoms. J Psychiatr Res 2024; 170:225-236. [PMID: 38159347 DOI: 10.1016/j.jpsychires.2023.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
The resting-state connectivity features underlying pure generalized anxiety disorder (GAD, G1) and comorbid GAD and depressive symptoms (G2) have not been directly compared. Furthermore, it is unclear whether these features might serve as potential prognostic biomarkers and change with treatment. Degree centrality (DC) in G1 (40 subjects), G2 (58 subjects), and healthy controls (HCs, 54 subjects) was compared before treatment, and the DC of G1 or G2 at baseline was compared with that after 4 weeks of paroxetine treatment. Using support vector regression (SVR), voxel-wise DC across the entire brain and abnormal DC at baseline were employed to predict treatment response. At baseline, G1 and G2 exhibited lower DC in the left mid-cingulate cortex and vermis IV/V compared to HCs. Additionally, compared to HCs, G1 had lower DC in the left middle temporal gyrus, while G2 showed higher DC in the right inferior temporal/fusiform gyrus. However, there was no significant difference in DC between G1 and G2. The SVR based on abnormal DC at baseline could successfully predict treatment response in responders in G2 or in G1 and G2. Notably, the predictive performance based on abnormal DC at baseline surpassed that based on DC across the entire brain. After treatment, G2 responders showed lower DC in the right medial orbital frontal gyrus, while no change in DC was identified in G1 responders. The G1 and G2 showed common and distinct dysconnectivity patterns and they could potentially serve as prognostic biomarkers. Furthermore, DC in patients with GAD could change with treatment.
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Affiliation(s)
- Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yiding Han
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xiaoxiao Shan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingping Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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Mohammadi S, Seyedmirzaei H, Salehi MA, Jahanshahi A, Zakavi SS, Dehghani Firouzabadi F, Yousem DM. Brain-based Sex Differences in Depression: A Systematic Review of Neuroimaging Studies. Brain Imaging Behav 2023; 17:541-569. [PMID: 37058182 PMCID: PMC10102695 DOI: 10.1007/s11682-023-00772-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 04/15/2023]
Abstract
Major depressive disorder (MDD) is a common psychiatric illness with a wide range of symptoms such as mood decline, loss of interest, and feelings of guilt and worthlessness. Women develop depression more often than men, and the diagnostic criteria for depression mainly rely on female patients' symptoms. By contrast, male depression usually manifests as anger attacks, aggression, substance use, and risk-taking behaviors. Various studies have focused on the neuroimaging findings in psychiatric disorders for a better understanding of their underlying mechanisms. With this review, we aimed to summarize the existing literature on the neuroimaging findings in depression, separated by male and female subjects. A search was conducted on PubMed and Scopus for magnetic resonance imaging (MRI), functional MRI (fMRI), and diffusion tensor imaging (DTI) studies of depression. After screening the search results, 15 MRI, 12 fMRI, and 4 DTI studies were included. Sex differences were mainly reflected in the following regions: 1) total brain, hippocampus, amygdala, habenula, anterior cingulate cortex, and corpus callosum volumes, 2) frontal and temporal gyri functions, along with functions of the caudate nucleus and prefrontal cortex, and 3) frontal fasciculi and frontal projections of corpus callosum microstructural alterations. Our review faces limitations such as small sample sizes and heterogeneity in populations and modalities. But in conclusion, it reflects the possible roles of sex-based hormonal and social factors in the depression pathophysiology.
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Affiliation(s)
- Soheil Mohammadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Homa Seyedmirzaei
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Interdisciplinary Neuroscience Research Program (INRP), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Jahanshahi
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyed Sina Zakavi
- School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - David M Yousem
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, MD, USA.
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Yan H, Han Y, Shan X, Li H, Liu F, Xie G, Li P, Guo W. Common and exclusive spontaneous neural activity patterns underlying pure generalized anxiety disorder and comorbid generalized anxiety disorder and depression. J Affect Disord 2023; 331:82-91. [PMID: 36958484 DOI: 10.1016/j.jad.2023.03.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/05/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND This study aimed to identify common and exclusive neural substrates underlying pure generalized anxiety disorder (GAD, G0) and comorbid GAD and depression (G1), assess whether they could assist in diagnosis and prediction of treatment response, and determine whether comorbid depression in GAD patients would change their neural plasticity. METHODS A longitudinal study was conducted, involving 98 patients (40 in the G0 group and 58 in the G1 group) and 54 healthy controls (HCs). The fractional amplitude of low-frequency fluctuations (fALFF), support vector machine, and support vector regression were employed. RESULTS The shared neural underpinnings across the two subtypes of GAD were hyperactivity in the right cerebellar Crus II and inferior temporal gyrus and hypoactivity in the right postcentral gyrus. The G1 group showed hypoactivity in the frontal gyrus, compared with HCs, and hyperactivity in the middle temporal gyrus, compared with the G0 group or HCs. These alterations could aid in diagnosis and the prediction of treatment response with high accuracy. After treatment, both the G1 and G0 groups showed higher fALFF than those before treatment but were located in different brain regions. LIMITATIONS The study was performed in a single center and subjects showed a fairly homogeneous ethnicity. CONCLUSIONS Common and exclusive neural substrates underlying the two subtypes of GAD were identified, which could assist in diagnosis and the prediction of treatment response. Pharmacotherapy for the two subtypes of GAD recruited different pathways, suggesting that comorbid depression in GAD patients would change their neural plasticity.
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Affiliation(s)
- Haohao Yan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yiding Han
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xiaoxiao Shan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Guojun Xie
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan 528000, Guangdong, China
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang 161006, China
| | - Wenbin Guo
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Pawlak M, Bray S, Kopala-Sibley DC. Resting state functional connectivity as a marker of internalizing disorder onset in high-risk youth. Sci Rep 2022; 12:21337. [PMID: 36494495 DOI: 10.1038/s41598-022-25805-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
While research has linked alterations in functional connectivity of the default mode (DMN), cognitive control (CCN), and salience networks (SN) to depression and anxiety, little research has examined whether these alterations may be premorbid vulnerabilities. This study examined resting state functional connectivity (RSFC) of the CCN, DMN, and SN as markers of risk for developing an onset of a depressive or anxiety disorder in adolescents at high familial risk for these disorders. At baseline, 135 participants aged 11-17 completed resting-state functional magnetic resonance imaging, measures of internalizing symptoms, and diagnostic interviews to assess history of depressive and anxiety disorders. Diagnostic assessments were completed again at 9- or 18-month follow-up for 112 participants. At baseline, increased CCN connectivity to areas of the visual network, and decreased connectivity between the left SN and the precentral gyrus, predicted an increased likelihood of a new onset at follow-up. Increased connectivity between the right SN and postcentral gyrus at baseline predicted first episode onsets at follow-up. Altered connectivity between these regions may represent a risk factor for developing a clinically significant onset of an internalizing disorder. Results may have implications for understanding the neural bases of internalizing disorders for early identification and prevention efforts.
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Hou X, Mei B, Wang F, Guo H, Li S, Wu G, Zang C, Cao B. Neural activity in adults with major depressive disorder differs from that in healthy individuals: A resting-state functional magnetic resonance imaging study. Front Psychiatry 2022; 13:1028518. [PMID: 36465288 PMCID: PMC9712791 DOI: 10.3389/fpsyt.2022.1028518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Currently, findings regarding resting-state functional magnetic resonance imaging studies of major depressive disorder (MDD) are inconsistent. In contrast to the previously used a priori seed-based functional connectivity analyses, this study employed whole-brain exploratory analyses and aimed to explore neural activity patterns in Chinese adults with MDD. MATERIALS AND METHODS Specifically, this study examined the amplitude of low-frequency fluctuations within the whole brain and adopted a large-scale brain network template to explore the core dysfunctional brain regions in individuals with MDD. RESULTS Overall, 32 individuals with MDD and 32 healthy controls were evaluated. Compared to healthy controls, individuals with MDD showed more profound alterations in the amplitude of low-frequency fluctuations in the temporolimbic affective circuit (e.g., middle temporal gyrus and parahippocampus) and default mode network (e.g., precuneus and thalamus). Moreover, functional connectivity between the left mid-insula and parietal regions within the sensorimotor network was weaker in individuals with MDD than in healthy controls. CONCLUSION In conclusion, the neural characteristics of MDD correspond to cognitive deficits in self-referential processing and emotional processing and are related to a risk of sensory disorders or psychomotor retardation. These findings present neural markers that may be used to identify MDD, contributing to clinical diagnosis.
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Affiliation(s)
- Xiaofang Hou
- Laboratory of Magnetic Resonance, Zhumadian Second People's Hospital, Zhumadian, Henan, China
| | - Bohui Mei
- Laboratory of Magnetic Resonance, Zhumadian Second People's Hospital, Zhumadian, Henan, China
| | - Fukun Wang
- General Committee Office, Zhumadian Second People's Hospital, Zhumadian, Henan, China
| | - Hua Guo
- Committee Office, Zhumadian Second People's Hospital, Zhumadian, Henan, China
| | - Shilong Li
- Department of Medical, Zhumadian Second People's Hospital, Zhumadian, Henan, China
| | - Gang Wu
- Laboratory of Computed Tomography, Zhumadian Second People's Hospital, Zhumadian, Henan, China
| | - Chen Zang
- Laboratory of Magnetic Resonance, Zhumadian Second People's Hospital, Zhumadian, Henan, China
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
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