Enhanced default mode network functional connectivity links with electroconvulsive therapy response in major depressive disorder

Pang, Yajing; Wei, Qiang; Zhao, Shanshan; Li, Nan; Li, Zhihui; Lu, Fengmei; Pang, Jianyue; Zhang, Rui; Wang, Kai; Chu, Congying; Tian, Yanghua; Wang, Jiaojian

doi:10.1016/j.jad.2022.03.035

Cited by 45 publications

(37 citation statements)

References 47 publications

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“…Dysfunction in the mPFC may result in hallucinations and delusions [ 26 ]. Several postmortem and fMRI studies have provided evidence for abnormal anatomical and FC of the mPFC, which is implicated in psychiatric symptoms and impaired cognitive function in SZ and MDD patients [ 99 , 100 ]. For example, previous studies found that hyperconnectivity between the mPFC and default mode network was correlated with more serious positive symptoms in SZ patients [ 101 ].…”

Section: Discussionmentioning

confidence: 99%

Neural substrates of reward anticipation and outcome in schizophrenia: a meta-analysis of fMRI findings in the monetary incentive delay task

et al. 2022

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Dysfunction of the mesocorticolimbic dopaminergic reward system is a core feature of schizophrenia (SZ), yet its precise contributions to different stages of reward processing and their relevance to disease symptomology are not fully understood. We performed a coordinate-based meta-analysis, using the monetary incentive delay task, to identify which brain regions are implicated in different reward phases in functional magnetic resonance imaging in SZ. A total of 17 studies (368 SZ and 428 controls) were included in the reward anticipation, and 10 studies (229 SZ and 281 controls) were included in the reward outcome. Our meta-analysis revealed that during anticipation, patients showed hypoactivation in the striatum, anterior cingulate cortex, median cingulate cortex (MCC), amygdala, precentral gyrus, and superior temporal gyrus compared with controls. Striatum hypoactivation was negatively associated with negative symptoms and positively associated with the proportion of second-generation antipsychotic users (percentage of SGA users). During outcome, patients displayed hyperactivation in the striatum, insula, amygdala, hippocampus, parahippocampal gyrus, cerebellum, postcentral gyrus, and MCC, and hypoactivation in the dorsolateral prefrontal cortex (DLPFC) and medial prefrontal cortex (mPFC). Hypoactivity of mPFC during outcome was negatively associated with positive symptoms. Moderator analysis showed that the percentage of SGA users was a significant moderator of the association between symptom severity and brain activity in both the anticipation and outcome stages. Our findings identified the neural substrates for different reward phases in SZ and may help explain the neuropathological mechanisms underlying reward processing deficits in the disorder.

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Section: Discussionmentioning

confidence: 99%

Neural substrates of reward anticipation and outcome in schizophrenia: a meta-analysis of fMRI findings in the monetary incentive delay task

et al. 2022

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“…Therefore, our findings indicated that OFC impairment may be correlated with brain function in MDD, SZ, and BD. Previous functional connectivity studies have reported that the default mode network (DMN) plays an important role in psychiatric disorders (Meda et al, 2014;Cheng et al, 2022;Pang et al, 2022). Since the OFC is located in the DMN, further research needs to explore the functional abnormalities of the OFC in these three psychiatric disorders.…”

Section: Discussionmentioning

confidence: 99%

Reduced Gray Matter Volume in Orbitofrontal Cortex Across Schizophrenia, Major Depressive Disorder, and Bipolar Disorder: A Comparative Imaging Study

Yang

Cui

et al. 2022

Front. Neurosci.

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Schizophrenia (SZ), major depressive disorder (MDD), and bipolar disorder (BD) are severe psychiatric disorders and share common characteristics not only in clinical symptoms but also in neuroimaging. The purpose of this study was to examine common and specific neuroanatomical features in individuals with these three psychiatric conditions. In this study, 70 patients with SZ, 85 patients with MDD, 42 patients with BD, and 95 healthy controls (HCs) were recruited. Voxel-based morphometry (VBM) analysis was used to explore brain imaging characteristics. Psychopathology was assessed using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Young Mania Rating Scale (YMRS), and the Positive and Negative Syndrome Scale (PANSS). Cognition was assessed using the digit symbol substitution test (DSST), forward-digital span (DS), backward-DS, and semantic fluency. Common reduced gray matter volume (GMV) in the orbitofrontal cortex (OFC) region was found across the SZ, MDD, and BD. Specific reduced GMV of brain regions was also found. For patients with SZ, we found reduced GMV in the frontal lobe, temporal pole, occipital lobe, thalamus, hippocampus, and cerebellum. For patients with MDD, we found reduced GMV in the frontal and temporal lobes, insular cortex, and occipital regions. Patients with BD had reduced GMV in the medial OFC, inferior temporal and fusiform regions, insular cortex, hippocampus, and cerebellum. Furthermore, the OFC GMV was correlated with processing speed as assessed with the DSST across four groups (r = 0.17, p = 0.004) and correlated with the PANSS positive symptoms sub-score in patients with SZ (r = − 0.27, p = 0.026). In conclusion, common OFC alterations in SZ, MDD, and BD provided evidence that this region dysregulation may play a critical role in the pathophysiology of these three psychiatric disorders.

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“…A prior study found that ketamine can reduce FC ( Price et al, 2017 ). Moreover, research has found that changes in FC at baseline could predict the effect of ECT ( Pang et al, 2022a ). In our results, the FC of responders will be toward HCs while non-responders will be far away from HCs if the FC has been reduced.…”

Section: Discussionmentioning

confidence: 99%

The functional connectivity of the middle frontal cortex predicts ketamine’s outcome in major depressive disorder

et al. 2022

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Background: Ketamine, a robust antidepressant, has promising potential in the treatment of major depressive disorder (MDD). However, it does not work for all MDD patients, and the mechanism underlying its anti-depressive effects is unclear. Researchers have explored the mechanisms of ketamine action in MDD patients through MRI, a technique that measures brain activity intuitively. Notably, many MRI results were inconsistent because they selected different brain regions as seeds, particularly with respect to functional connectivity (FC) analysis. To eliminate the influence of prior seeds as much as possible, we used the significantly different results in degree centrality (DC) analysis as seeds to explore the FC changes in MDD patients to identify an imaging biomarker of ketamine's effect.Methods: Forty-four MDD patients and 45 healthy controls (HCs) were included in the study. Patients, aged 18-65, received six intravenous ketamine injections over 12 days. Depressive symptoms were estimated and MRI scans were performed at baseline and the day after the sixth infusion. We estimated FC differences between responders, non-responders and HCs using the region that showed significant differences between responders and nonresponders in DC analysis as the seed. The correlation between the MADRS changes and zFC values was performed, and the potential of zFC values to be a neuroimaging biomarker was explored using the receiver operating characteristic curve.Result: Compared with non-responders, responders had significantly decreased DC values in the right middle frontal gyrus (MFG). In the analysis of FC using the region that showed significant differences in DC as a seed, there was a significant difference in the region of the right supplementary motor area (SMA) among responders, non-responders, and HCs. This region also overlapped with the bilateral median cingulate gyrus. In post hocFrontiers in Neuroscience 01 frontiersin.org analysis, responders had higher FC than non-responders and HCs, and nonresponders had lower FC than HCs. Importantly, the FC between the MFG and SMA (overlapping bilateral median cingulate gyrus) was correlated with the improvement of symptoms, which was estimated by the Mongomery-Asberg Depression Scale (MADRS). FC has the potential to be an imaging biomarker that can predict the ketamine effect in MDD patients according to the receiver operating characteristic curve analysis. Conclusion:Our results revealed that FC between the SMG and SMA and mACC was highly correlated with depressive symptoms and has the potential to be a neuroimaging biomarker to predict the effect of ketamine in MDD.KEYWORDS ketamine, major depressive disorder, degree centrality (DC), functional connectivity, default mode network, biomarker Patients and method Study participantsParticipants were recruited from a clinical trial (ChiCTR-OOC-17012239) in the Affiliated Brain Hospital of Guangzhou Medical University. Two experienced psychiatrists used the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5, SCID) to s...

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Enhanced default mode network functional connectivity links with electroconvulsive therapy response in major depressive disorder

Cited by 45 publications

References 47 publications

Neural substrates of reward anticipation and outcome in schizophrenia: a meta-analysis of fMRI findings in the monetary incentive delay task

Neural substrates of reward anticipation and outcome in schizophrenia: a meta-analysis of fMRI findings in the monetary incentive delay task

Reduced Gray Matter Volume in Orbitofrontal Cortex Across Schizophrenia, Major Depressive Disorder, and Bipolar Disorder: A Comparative Imaging Study

The functional connectivity of the middle frontal cortex predicts ketamine’s outcome in major depressive disorder

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