Changed brain entropy and functional connectivity patterns induced by electroconvulsive therapy in majoy depression disorder

OBJECTIVE

Our objective is to innovatively integrate both linear and nonlinear characteristics of brain signals in Electroconvulsive Therapy (ECT) research, with the goal of uncovering deeper insights into the pathogenesis of Major Depressive Disorder (MDD) and identifying novel targets for other physical intervention therapies.

METHODS

We measured brain entropy (BEN) in 42 MDD patients and 42 matched healthy controls (HC) using rs-fMRI data. Brain regions that differed significantly in patients with MDD before and after ECT were extracted. Then, we use these brain regions as seed points to investigate the differences in whole-brain resting-state functional connectivity (RSFC) patterns before and after ECT.

RESULTS

Compared to HCs, patients had higher BEN levels in the right precuneus (PCUN.R) and right angular gyrus (ANG.R). After ECT, patients had lower BEN levels in the PCUN.R and ANG.R. Compared with before ECT, patients showed significantly increased RSFC after ECT between the PCUN.R and right middle temporal gyrus and ANG.R. Significantly increased RSFC was observed between the ANG.R and right middle frontal gyrus and right supramarginal gyrus after ECT.

CONCLUSION

Combining the linear and nonlinear characteristics of brain signals can effectively explore the pathogenesis of depression and provide new targets for ECT.

Common hyper-entropy patterns identified in nicotine smoking, marijuana use, and alcohol use based on uni-drug dependence cohorts

Substance use disorders present similar behaviors and psychopathologies related to impaired decision making/inhibition control and information processing, suggesting common alterations in frontal and limbic brain areas. To test this hypothesis, we identified three uni-substance use cohorts with dependence to only one type of substance from the Human Connectome Project: marijuana dependence, nicotine dependence, and alcohol dependence. Fifty-nine marijuana uses, 34 nicotine smokers, 35 alcohol drinkers, and their age and sex-matched non-substance use controls were identified. We used brain entropy mapping to probe brain alterations in substance use disorders. Compared to non-substance use individuals, all three substance use disorder cohorts had increased brain entropy. Marijuana dependence and nicotine dependence showed overlapped hyper-brain entropy in bilateral dorso-lateral prefrontal cortex, anterior cingulate cortex, and right insula. Hyper-brain entropy in marijuana dependence and alcohol dependence overlap in left insula, left doso-lateral prefrontal cortex, and posterior cingulate. Hyper-brain entropy in nicotine dependence and alcohol dependence overlap only in left dorso-lateral prefrontal cortex. Hyper-brain entropy in those areas was correlated with increased impulsivity or reduced inhibition control in substance use disorder but not in controls. Drug dependence is associated with hyper-brain entropy in the prefrontal cortex and the meso-limbic system, independent of a specific addictive drug. Brain entropy in this circuit provides a sensitive marker to detect brain and behavioral alterations in substance user disorders.

Immediate visual reproduction negatively correlates with brain entropy of parahippocampal gyrus and inferior occipital gyrus in bipolar II disorder adolescents

BACKGROUND

Brain entropy reveals complexity and irregularity of brain, and it has been proven to reflect brain complexity alteration in disease states. Previous studies found that bipolar disorder adolescents showed cognitive impairment. The relationship between complexity of brain neural activity and cognition of bipolar II disorder (BD-II) adolescents remains unclear.

METHODS

Nineteen BD-II patients (14.63 ±1.57 years old) and seventeen age-gender matched healthy controls (HCs) (14.18 ± 1.51 years old) were enlisted. Entropy values of all voxels of the brain in resting-state functional MRI data were calculated and differences of them between BD-II and HC groups were evaluated. After that, correlation analyses were performed between entropy values of brain regions showing significant entropy differences and clinical indices in BD-II adolescents.

RESULTS

Significant differences were found in scores of immediate visual reproduction subtest (VR-I, p = 0.003) and Stroop color-word test (SCWT-1, p = 0.015; SCWT-2, p = 0.004; SCWT-3, p = 0.003) between the two groups. Compared with HCs, BD-II adolescents showed significant increased brain entropy in right parahippocampal gyrus and right inferior occipital gyrus. Besides, significant negative correlations between brain entropy values of right parahippocampal gyrus, right inferior occipital gyrus and immediate visual reproduction subtest scores were observed in BD-II adolescents.

CONCLUSIONS

The findings of the present study suggested that the disrupted function of corticolimbic system is related with cognitive abnormality of BD-II adolescents. And from the perspective temporal dynamics of brain system, the current study, brain entropy may provide available evidences for understanding the underlying neural mechanism in BD-II adolescents.

Task-induced changes in brain entropy

Entropy indicates irregularity of a dynamic system with higher entropy indicating higher irregularity and more transit states. In the human brain, regional entropy has been increasingly assessed using resting state fMRI. Response of regional entropy to task has been scarcely studied. The purpose of this study is to characterize task-induced regional brain entropy (BEN) alterations using the large Human Connectome Project (HCP) data. To control the potential modulation by the block-design, BEN of task-fMRI was calculated from the fMRI images acquired during the task conditions only and then compared to BEN of rsfMRI. Compared to resting state, task-performance unanimously induced BEN reduction in the peripheral cortical area including both the task activated regions and task non-specific regions such as the task negative area and BEN increase in the centric part of the sensorimotor and perception networks. Task control condition showed large residual task effects. After controlling the task non-specific effects using the control BEN vs task BEN comparison, regional BEN showed task specific effects in target regions.

The neurocognitive correlates of brain entropy estimated by resting state fMRI

Resting state brain activity consumes most of brain energy, likely creating and maintaining a reserve of general brain functionality. The latent reserve if it exists may be reflected by the profound long-range fluctuations of resting brain activity. The long-range temporal coherence (LRTC) can be characterized by resting state fMRI (rsfMRI)-based brain entropy (BEN) mapping. While BEN mapping results have shown sensitivity to neuromodulations or disease conditions, the underlying neuromechanisms especially the associations of BEN or LRTC to neurocognition still remain unclear. To address this standing question and to test a novel hypothesis that resting BEN reflects a latent functional reserve through the link to general functionality, we mapped resting BEN of 862 young adults and comprehensively examined its associations to neurocognitions using data from the Human Connectome Project (HCP). Our results unanimously highlighted two brain circuits: the default mode network (DMN) and executive control network (ECN) through their negative associations of BEN to general functionality, which is independent of age and sex. While BEN in DMN/ECN increases with age, it decreases with education years. These results demonstrated the neurocognitive correlates of resting BEN in DMN/ECN and suggest resting BEN in DMN/ECN as a potential proxy of the latent functional reserve that facilitates general brain functionality and may be enhanced by education.

Associations of brain entropy (BEN) to cerebral blood flow and fractional amplitude of low-frequency fluctuations in the resting brain

Entropy is a fundamental trait of human brain. Using fMRI-based brain entropy (BEN) mapping, interesting findings have been increasingly revealed in normal brain and neuropsychiatric disorders. As BEN is still relatively new, an often-raised question is how much new information can this measure tell about the brain compared to other more established brain activity measures. The study aimed to address that question by examining the relationship between BEN and cerebral blood flow (CBF) and the fractional amplitude of low-frequency fluctuations (fALFF), two widely used resting state brain state measures. fMRI data acquired from a large cohort of normal subjects were used to calculate the three metrics; inter-modality associations were assessed at each voxel through the Pearson correlation analysis. A moderate to high positive BEN-CBF and BEN-fALFF correlations were found in orbito-frontal cortex (OFC) and posterior inferior temporal cortex (ITC); Strong negative BEN-fALFF correlations were found in visual cortex (VC), anterior ITC, striatum, motor network, precuneus, and lateral parietal cortex. Positive CBF-fALFF correlations were found in medial OFC (MOFC), medial prefrontal cortex (MPFC), left angular gyrus, and left precuneus. Significant gender effects were observed for all three metrics and their correlations. Our data clearly demonstrated that BEN provides unique information that cannot be revealed by CBF and fALFF.

Reduced brain entropy by repetitive transcranial magnetic stimulation on the left dorsolateral prefrontal cortex in healthy young adults

Entropy indicates system irregularity and the capacity for information processing. Recent research has identified interesting voxel-wise entropy distribution patterns in normal brain and its changes due to aging and brain disorders. A question of great scientific and clinical importance is whether brain entropy (BEN) can be modulated using non-invasive neuromodulations. The purpose of this study was to address this open question using high-frequency repetitive transcranial magnetic stimulation (rTMS). BEN was calculated from resting state fMRI at each voxel acquired before and after applying 20 Hz rTMS or SHAM (control) stimulation. As compared to SHAM, 20 Hz rTMS reduced BEN in medial orbito-frontal cortex and subgenial anterior cingulate cortex (MOFC/sgACC), suggesting a reduced information processing therein, probably as a result of the enhanced top-down regulation by the left DLPFC rTMS. No significant changes were observed to the functional connectivity (FC) between the left DLPFC (the target site) to the rest of the brain, suggesting that rTMS may not affect FC though it might use FC to transfer its effects or the ad hoc information. Our data proved that rTMS can modulate BEN and BEN can be used to monitor rTMS effects.