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Altered development of the Hurst Exponent in medial prefrontal cortex in preschoolers with autism. 自闭症学龄前儿童内侧前额叶皮层赫斯特指数的发展变化。
Pub Date : 2024-09-16 DOI: 10.1016/j.bpsc.2024.09.003
Annika C Linke, Bosi Chen, Lindsay Olson, Michaela Cordova, Molly Wilkinson, Tiffany Wang, Meagan Herrera, Madison Salmina, Adriana Rios, Judy Mahmalji, Tess Do, Jessica Vu, Michelle Budman, Alexis Walker, Inna Fishman

Background: Atypical balance of excitation (E) and inhibition (I) in the brain is thought to contribute to the emergence and symptomatology of autism spectrum disorders (ASD). E/I ratio can be estimated from resting state functional magnetic resonance imaging (fMRI) using the Hurst Exponent (H). A recent study reported decreased ventromedial prefrontal cortex (vmPFC) H in male adults with ASD. Part of the default mode network (DMN), vmPFC plays an important role in emotion regulation, decision making, and social cognition. It frequently shows altered function and connectivity in autistic individuals.

Methods: The current study presents the first fMRI evidence of altered early development of vmPFC H and its link to DMN functional connectivity (FC) and emotional control in toddlers and preschoolers with ASD. 83 children (n=45 ASD), ages 1½ - 5 years, underwent natural sleep fMRI as part of a longitudinal study.

Results: In a cross-sectional analysis, vmPFC H decreased with age in children with ASD, reflecting increasing E/I ratio, but not in typically developing children. This effect remained significant when controlling for gestational age at birth, socioeconomic status, or ethnicity. The same pattern was also observed in a subset of children with longitudinal fMRI data acquired two years apart on average. Lower vmPFC H was further associated with reduced FC within the DMN as well as with higher emotional control deficits (though only significant transdiagnostically).

Conclusions: These results suggest an early onset of E/I imbalances in vmPFC in ASD with likely consequences for the maturation of the DMN.

背景:大脑中异常的兴奋(E)和抑制(I)平衡被认为是导致自闭症谱系障碍(ASD)出现和症状的原因。E/I比率可通过静息状态功能磁共振成像(fMRI)的赫斯特指数(H)来估算。最近的一项研究报告称,患有 ASD 的男性成年人腹内侧前额叶皮层(vmPFC)的 H 值降低。作为默认模式网络(DMN)的一部分,vmPFC 在情绪调节、决策制定和社会认知方面发挥着重要作用。自闭症患者的vmPFC经常出现功能和连接性改变:本研究首次用fMRI技术证明了自闭症幼儿和学龄前儿童vmPFC H早期发育的改变及其与DMN功能连接(FC)和情绪控制的联系。作为纵向研究的一部分,83名1岁半至5岁的儿童(45名患有自闭症)接受了自然睡眠fMRI检查:在一项横断面分析中,随着年龄的增长,ASD儿童的vmPFC H值下降,这反映了E/I比值的增加,但在发育正常的儿童中却没有这种现象。在控制出生胎龄、社会经济地位或种族的情况下,这一效应仍然明显。在平均相隔两年获取纵向 fMRI 数据的儿童子集中也观察到了相同的模式。较低的vmPFC H进一步与DMN内的FC降低以及较高的情绪控制缺陷相关(尽管仅在转诊断中具有显著性):这些结果表明,在ASD患者中,vmPFC的E/I失衡很早就开始出现,并可能对DMN的成熟产生影响。
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引用次数: 0
Symptom Dimensions and Cognitive Impairments in Individuals at Clinical High Risk for Psychosis. 精神病临床高危人群的症状维度和认知障碍。
Pub Date : 2024-09-13 DOI: 10.1016/j.bpsc.2024.09.002
Tian Hong Zhang, Li Hua Xu, Yan Yan Wei, HuiRu Cui, Xiao Chen Tang, Ye Gang Hu, Hai Chun Liu, Zi Xuan Wang, Tao Chen, Zheng Hui Yi, Chun Bo Li, Ji Jun Wang

Objective: Understanding the intricate relationship between symptom dimensions, clusters, and cognitive impairments is crucial for early detection and intervention in individuals at clinical high-risk(CHR) for psychosis. This study delves into this complex interplay within a CHR sample and aims to predict the conversion to psychosis.

Methods: A comprehensive cognitive assessment was performed among 744 CHR individuals. The study included a three-year follow-up period to assess conversion to psychosis. Symptom profiles were determined using the Structured Interview for Prodromal Syndromes. By applying factor analysis, symptom dimensions were categorized as dominant negative symptoms(NS), positive symptoms-stressful(PS-S), and positive symptoms-odd(PS-O). The factor scores were used to define three dominant symptom groups. Latent class analysis(LCA) and factor mixture model(FMM) were employed to identify discrete clusters based on symptom patterns. The three-class solution was chosen for the LCA and FMM analysis.

Results: Individuals in the dominant NS group exhibited significantly higher conversion rates to psychosis than those in the other groups. Specific cognitive variables, including performance in the Brief Visuospatial Memory Test-Revised(Odd ratio, OR=0.702, p=0.001) and Neuropsychological Assessment Battery mazes(OR=0.776, p=0.024), significantly predicted conversion to psychosis. Notably, cognitive impairments associated with NS and PS-S affected different cognitive domains. LCA- and FMM-Cluster 1, characterized by severe NS and PS-O, exhibited more impairments in cognitive domains than other clusters. No significant difference in the conversion rate was observed among LCA and FMM clusters.

Conclusions: These findings highlight the importance of NS in the development of psychosis and suggest specific cognitive domains that are affected by symptom dimensions.

目的:了解症状维度、症状群和认知障碍之间错综复杂的关系,对于早期发现和干预精神病临床高危(CHR)人群至关重要。本研究深入探讨了临床高危人群样本中这种复杂的相互作用,并旨在预测其向精神病的转化:方法:对 744 名临床高危人群进行了全面的认知评估。研究包括为期三年的随访,以评估向精神病的转化情况。采用前驱综合征结构化访谈法确定症状特征。通过因子分析,症状维度被分为占主导地位的阴性症状(NS)、阳性症状-紧张(PS-S)和阳性症状-特殊(PS-O)。因子得分被用来定义三个主要症状组。采用潜类分析(LCA)和因子混合模型(FMM)来识别基于症状模式的离散群组。LCA 和 FMM 分析选择了三类解决方案:结果:NS显性组患者的精神病转化率明显高于其他组。特定的认知变量,包括简明视觉空间记忆测验(Brief Visuospatial Memory Test-Revised)(奇数比,OR=0.702,P=0.001)和神经心理评估测试(Neuropsychological Assessment Battery mazes)(OR=0.776,P=0.024)中的表现,可显著预测向精神病的转化。值得注意的是,与 NS 和 PS-S 相关的认知障碍会影响不同的认知领域。以严重 NS 和 PS-O 为特征的 LCA-1 和 FMM-1 群组比其他群组在认知领域表现出更多的障碍。LCA和FMM群组之间的转换率没有明显差异:这些发现强调了 NS 在精神病发展过程中的重要性,并提出了受症状影响的特定认知领域。
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引用次数: 0
Multitrait analysis to decipher the intertwined genetic architecture of neuroanatomical phenotypes and psychiatric disorders. 通过多特征分析,破解神经解剖表型和精神疾病相互交织的遗传结构。
Pub Date : 2024-09-09 DOI: 10.1016/j.bpsc.2024.08.018
Antoine Auvergne, Nicolas Traut, Léo Henches, Lucie Troubat, Arthur Frouin, Christophe Boetto, Sayeh Kazem, Hanna Julienne, Roberto Toro, Hugues Aschard

Background: There is increasing evidence of shared genetic factors between psychiatric disorders and brain magnetic resonance imaging (MRI) phenotypes. However, deciphering the joint genetic architecture of these outcomes has proven challenging, and new approaches are needed to infer potential genetic structure underlying those phenotypes. Multivariate analyses is arising as a meaningful approach to reveal links between MRI phenotypes and psychiatric disorders missed by univariate approaches.

Methods: We first conducted univariate and multivariate genome-wide association studies (GWAS) for nine MRI-derived brain volume phenotypes in 20K UK Biobank participants. We next performed various complementary enrichment analyses to assess whether and how univariate and multitrait approaches can distinguish disorder-associated and non-disorder-associated variants from six psychiatric disorders: bipolarity, attention-deficit/hyperactivity disorder (ADHD), autism, schizophrenia, obsessive-compulsive disorder, and major depressive disorder. Finally, we conducted a clustering analysis of top associated variants based on their MRI multitrait association using an optimized k-medoids approach.

Results: Univariate MRI GWAS displayed only negligible genetic correlation with psychiatric disorders, while multitrait GWAS identified multiple new associations and showed significant enrichment for variants related to both ADHD and schizophrenia. Clustering analyses further detected two clusters displaying not only enrichment for association with ADHD and schizophrenia, but also consistent direction of effects. Functional annotation analyses of those clusters pointed to multiple potential mechanisms, suggesting in particular a role of neurotrophins pathways on both MRI and schizophrenia.

Conclusions: Our results show that multitrait association signature can be used to infer genetically-driven latent MRI variables associated with psychiatric disorders, opening paths for future biomarker development.

背景:越来越多的证据表明,精神疾病和脑磁共振成像(MRI)表型之间存在共同的遗传因素。然而,破译这些结果的共同遗传结构已被证明具有挑战性,需要新的方法来推断这些表型的潜在遗传结构。多变量分析是揭示单变量方法所遗漏的 MRI 表型与精神疾病之间联系的一种有意义的方法:我们首先对 20K 名英国生物库参与者的九种 MRI 衍生脑容量表型进行了单变量和多变量全基因组关联研究(GWAS)。接下来,我们进行了各种互补性富集分析,以评估单变量和多特征方法是否以及如何区分六种精神疾病(双相情感障碍、注意缺陷/多动障碍(ADHD)、自闭症、精神分裂症、强迫症和重度抑郁障碍)中的障碍相关变异和非障碍相关变异。最后,我们使用优化的 k-medoids 方法,根据磁共振成像多特征相关性对顶级相关变异进行了聚类分析:结果:单变量核磁共振成像基因组学分析(Univariate MRI GWAS)显示出与精神疾病的遗传相关性微乎其微,而多特征基因组学分析(multitrait GWAS)则发现了多种新的关联,并显示出与多动症和精神分裂症相关的变异具有显著的富集性。聚类分析进一步发现了两个聚类,它们不仅富集了与多动症和精神分裂症相关的变异,而且效应方向一致。对这些聚类的功能注释分析表明了多种潜在机制,特别是神经营养素通路在核磁共振成像和精神分裂症中的作用:我们的研究结果表明,多特征关联特征可用于推断与精神疾病相关的基因驱动的潜在 MRI 变量,为未来生物标记物的开发开辟了道路。
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引用次数: 0
Multivariate Association between Functional Connectivity Gradients and Cognition in Schizophrenia Spectrum Disorders. 精神分裂症谱系障碍的功能连接梯度与认知之间的多变量关联
Pub Date : 2024-09-09 DOI: 10.1016/j.bpsc.2024.09.001
Ju-Chi Yu, Colin Hawco, Lucy Bassman, Lindsay D Oliver, Miklos Argyelan, James M Gold, Sunny X Tang, George Foussias, Robert W Buchanan, Anil K Malhotra, Stephanie H Ameis, Aristotle N Voineskos, Erin W Dickie

Background: Schizophrenia Spectrum Disorders (SSDs), which are characterized by social cognitive deficits, have been associated with dysconnectivity in "unimodal" (e.g., visual, auditory) and "multimodal" (e.g., default-mode and frontoparietal) cortical networks. However, little is known regarding how such dysconnectivity relates to social and non-social cognition, and how such brain-behavioral relationships associate with clinical outcomes of SSDs.

Methods: We analyzed cognitive (non-social and social) measures and resting-state functional magnetic resonance imaging data from the 'Social Processes Initiative in Neurobiology of the Schizophrenia(s) (SPINS)' study (247 stable participants with SSDs and 172 healthy controls, ages 18-55). We extracted gradients from parcellated connectomes and examined the association between the first 3 gradients and the cognitive measures using partial least squares correlation (PLSC). We then correlated the PLSC dimensions with functioning and symptoms in the SSDs group.

Results: The SSDs group showed significantly lower differentiation on all three gradients. The first PLSC dimension explained 68.53% (p<.001) of the covariance and showed a significant difference between SSDs and Controls (bootstrap p<.05). PLSC showed that all cognitive measures were associated with gradient scores of unimodal and multimodal networks (Gradient 1), auditory, sensorimotor, and visual networks (Gradient 2), and perceptual networks and striatum (Gradient 3), which were less differentiated in SSDs. Furthermore, the first dimension was positively correlated with negative symptoms and functioning in the SSDs group.

Conclusions: These results suggest a potential role of lower differentiation of brain networks in cognitive and functional impairments in SSDs.

背景:以社会认知缺陷为特征的精神分裂症谱系障碍(SSDs)与 "单模态"(如视觉、听觉)和 "多模态"(如默认模式和额顶叶)皮层网络的连接障碍有关。然而,人们对这种连接失调与社会认知和非社会认知之间的关系,以及这种大脑行为关系与 SSD 临床结果之间的关系知之甚少:我们分析了 "精神分裂症神经生物学中的社会过程倡议(SPINS)"研究(247 名患有 SSD 的稳定参与者和 172 名健康对照者,年龄在 18-55 岁之间)中的认知(非社会和社会)测量和静息状态功能磁共振成像数据。我们从细胞旁连接组中提取梯度,并使用偏最小二乘法相关性(PLSC)检验了前三个梯度与认知测量之间的关联。然后,我们将偏最小二乘法相关性与 SSDs 组的功能和症状相关联:SSDs 组在所有三个梯度上的分化程度都明显较低。PLSC的第一个维度解释了68.53%(pConclusions:这些结果表明,大脑网络分化程度较低可能与 SSD 患者的认知和功能障碍有关。
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引用次数: 0
Beyond the Descriptive: A Comprehensive, Multi-domain Validation of Symptom Trajectories for Individuals at Clinical High Risk for Psychosis. 超越描述:针对精神病临床高危人群的症状轨迹的综合、多领域验证。
Pub Date : 2024-09-09 DOI: 10.1016/j.bpsc.2024.08.020
Wisteria Deng, Benjamin Chong, Jean Addington, Carrie E Bearden, Kristin S Cadenhead, Barbara A Cornblatt, Matcheri Keshavan, Daniel H Mathalon, Diana O Perkins, William Stone, Elaine F Walker, Scott W Woods, Tyrone D Cannon

Background: Although the Clinical High-Risk for Psychosis (CHR-P) criteria are widely used to ascertain individuals at heightened risk for imminent onset of psychosis, it remains controversial whether CHR-P status define a diagnostic construct in its own right. In a prior study, CHR-P non-converters were observed to follow three distinct trajectories in symptoms and functioning: remission, partial remission, and maintenance of symptoms and functional impairments at subthreshold levels of intensity.

Methods: Here, we utilized the North American Prodrome Longitudinal Study Phase 3 (NAPLS3) sample (N = 806) to determine whether: 1) the same trajectory groups can be detected when assessing symptoms at 2-month intervals over an 8-month period and 2) the resulting trajectory groups differ from each other and from healthy controls and converting CHR-P cases in terms of risk factors, comorbidities, and functional outcomes.

Results: Three distinctive subgroups within the CHR non-converters were identified, largely paralleling those previously observed. Importantly, these extracted groups, along with non-CHR controls and CHR converters, differ from each other significantly with respect to putative etiological risk factors (e.g., predicted risk scores, physiological and self-report measures of stress), affective comorbidities, as well as functional outcomes, providing converging evidence supporting the validity of the identified trajectory groups.

Conclusions: This pattern, along with the fact that even the subgroup of CHR-P nonconverters showing a remission trajectory deviated from healthy controls, supports treating the CHR-P syndrome not just as a status that denotes risk for onset of full psychosis, but also as a marker of ongoing distress for a population in need of interventions.

背景:尽管临床精神病高危人群(CHR-P)标准被广泛用于确定即将罹患精神病的高危人群,但CHR-P状态本身是否可定义为一种诊断结构仍存在争议。在之前的一项研究中,CHR-P 非转换者在症状和功能方面被观察到遵循三种不同的轨迹:缓解、部分缓解以及症状和功能障碍维持在阈值以下的强度水平。方法:在此,我们利用北美前驱症纵向研究第三阶段(NAPLS3)样本(N = 806)来确定:1)是否存在相同的轨迹分组?1)在 8 个月的时间内,每隔 2 个月对症状进行评估时,是否能检测出相同的轨迹组;2)由此得出的轨迹组在风险因素、合并症和功能结果方面是否彼此不同,是否与健康对照组和转换为 CHR-P 病例的对照组不同:结果:在未转换 CHR 的病例中发现了三个不同的亚组,与之前观察到的亚组基本一致。重要的是,这些被提取出来的群体与非 CHR 对照组和 CHR 转换者在推定的病因风险因素(如预测风险评分、生理和自我报告压力测量)、情感合并症以及功能结果方面存在显著差异,为所识别的轨迹群体的有效性提供了一致的证据:这种模式,以及即使是显示出缓解轨迹的CHR-P非转换者亚组也偏离健康对照组这一事实,都支持将CHR-P综合征不仅作为一种表示全面精神病发病风险的状态,而且作为需要干预的人群的持续困扰的标志。
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引用次数: 0
Neural Basis of Pain Empathy Dysregulations in Mental Disorders - A Pre-registered Neuroimaging Meta-Analysis. 精神障碍患者痛觉共鸣失调的神经基础--一项预先登记的神经影像学元分析。
Pub Date : 2024-09-09 DOI: 10.1016/j.bpsc.2024.08.019
Jingxian He, Mercy Chepngetich Bore, Heng Jiang, Xianyang Gan, Junjie Wang, Jialin Li, Xiaolei Xu, Lan Wang, Kun Fu, Liyuan Li, Bo Zhou, Keith Kendrick, Benjamin Becker

Background: Pain empathy represents a fundamental building block of several social functions, which have been demonstrated to be impaired across various mental disorders by accumulating evidence from case-control functional magnetic resonance imaging (fMRI) studies. However, it remains unclear whether the dysregulations are underpinned by robust neural alterations across mental disorders.

Methods: This study utilized coordinate-based meta-analyses to quantitatively determine robust markers of altered pain empathy across mental disorders. To support the interpretation of the findings exploratory network-level and behavioral meta-analyses were conducted.

Results: Quantitative analysis of eleven case-control fMRI studies with data from 296 patients and 229 controls revealed patients with mental disorders exhibited increased pain empathic reactivity in the left anterior cingulate gyrus, adjacent medial prefrontal cortex, and right middle temporal gyrus, yet decreased activity in the left cerebellum IV/V and left middle occipital gyrus compared to controls. The hyperactive regions showed network-level interactions with the core default mode network (DMN) and were associated with affective and social cognitive domains.

Conclusions: The findings suggest that pain-empathic alterations across mental disorders are underpinned by excessive empathic reactivity in brain systems involved in empathic distress and social processes, highlighting a shared therapeutic target to normalize basal social dysfunctions in mental disorders.

背景:病例对照功能磁共振成像(fMRI)研究积累的证据表明,痛觉移情在各种精神障碍中都会受损。然而,目前仍不清楚在各种精神障碍中,这种失调是否是由神经系统的强健改变所支撑的:本研究利用基于坐标的荟萃分析来定量确定精神障碍患者疼痛移情改变的稳健标记。为了支持对研究结果的解释,还进行了探索性网络水平和行为荟萃分析:对11项病例对照fMRI研究中296名患者和229名对照者的数据进行定量分析后发现,与对照者相比,精神障碍患者在左侧扣带回前部、邻近的内侧前额叶皮层和右侧颞中回表现出更高的疼痛移情反应性,但左侧小脑IV/V和左侧枕中回的活动却有所降低。过度活跃区域与核心默认模式网络(DMN)之间存在网络层面的相互作用,并与情感和社会认知领域相关:研究结果表明,精神障碍患者的痛觉移情改变是由大脑系统中涉及移情痛苦和社会过程的过度移情反应所支撑的,这凸显了一个共同的治疗目标,即使精神障碍患者的基础社会功能障碍恢复正常。
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引用次数: 0
Spatiotemporal Eye Movement Dynamics Reveal Altered Face Prioritization in Early Visual Processing Among Autistic Children. 时空眼动动力学揭示了自闭症儿童早期视觉处理中面部优先性的改变。
Pub Date : 2024-09-03 DOI: 10.1016/j.bpsc.2024.08.017
Jason W Griffin, Adam Naples, Raphael Bernier, Katarzyna Chawarska, Geraldine Dawson, James Dziura, Susan Faja, Shafali Jeste, Natalia Kleinhans, Catherine Sugar, Sara Jane Webb, Frederick Shic, James C McPartland

Background: Reduced social attention - looking at faces - is one of the most common manifestations of social difficulty in autism central to social development. Although reduced social attention is well-characterized in autism, qualitative differences in how social attention unfolds across time remains unknown.

Methods: We used a computational modeling (i.e., hidden Markov modeling) approach to assess and compare the spatiotemporal dynamics of social attention in a large, well-characterized sample of autistic (n = 280) and neurotypical (n = 120) children (ages 6-11) that completed three social eye-tracking assays across three longitudinal time points (Baseline, 6 weeks, 24 weeks).

Results: Our analysis supported the existence of two common eye movement patterns that emerged across three ET assays. A focused pattern was characterized by small face regions of interest, which had high probability of capturing fixations early in visual processing. In contrast, an exploratory pattern was characterized by larger face regions of interest, with lower initial probability of fixation, and more non-social regions of interest. In the context of social perception, autistic children showed significantly more exploratory eye movement patterns than neurotypical children across all social perception assays and all three longitudinal time points. Eye movement patterns were associated with clinical features of autism, including adaptive function, face recognition, and autism symptom severity.

Conclusions: Decreased likelihood of precisely looking to faces early in social visual processing may be an important feature of autism that was associated with autism-related symptomology and may reflect less visual sensitivity to face information.

背景:自闭症患者最常见的社交障碍表现之一就是社交注意力(看脸)减退。虽然自闭症患者的社交注意力减退已被充分描述,但社交注意力在不同时期的定性差异仍是未知数:我们使用计算建模(即隐马尔可夫建模)方法评估并比较了自闭症儿童(n = 280)和神经典型儿童(n = 120)(6-11 岁)社交注意力的时空动态:我们的分析结果表明,在三种 ET 测验中存在两种常见的眼动模式。聚焦模式的特点是感兴趣的面部区域较小,在视觉处理的早期捕捉到定点的概率较高。与此相反,探索型模式的特点是感兴趣的面部区域较大,最初定格的概率较低,而且非社会感兴趣的区域较多。在社交感知方面,自闭症儿童在所有社交感知测试和所有三个纵向时间点上都表现出明显多于神经畸形儿童的探索性眼动模式。眼动模式与自闭症的临床特征有关,包括适应功能、人脸识别和自闭症症状严重程度:结论:自闭症儿童在社交视觉处理早期精确注视人脸的可能性降低,这可能是自闭症的一个重要特征,与自闭症相关症状有关,并可能反映出他们对人脸信息的视觉敏感度较低。
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引用次数: 0
Assessing brain iron and its relationship to cognition and comorbidity in children with ADHD with quantitative susceptibility mapping (QSM). 利用定量易感性图谱 (QSM) 评估多动症儿童的脑铁及其与认知和合并症的关系。
Pub Date : 2024-08-30 DOI: 10.1016/j.bpsc.2024.08.015
Marcel Schulze, David Coghill, Silke Lux, Alexandra Philipsen, Tim Silk

Background: Quantitative susceptibility mapping (QSM) is a neuroimaging technique that detects local changes in magnetic susceptibility induced by brain iron. Brain iron and the dopaminergic system are linked since iron is an important cofactor for dopamine synthesis. ADHD is associated with dysregulation of dopaminergic transmission. Therefore, we applied QSM on subcortical structures, to study potential alterations in brain iron and its impact on cognition and mental health in children with ADHD.

Methods: 3 Tesla QSM-data of 111 participants (nADHD= 58, mean age: 13.2 (0.63); nControls=53, mean age: 13.2 (0.51)) were analyzed. Subcortical regional brain iron values were extracted. ANOVAs examined group differences for each region of interest. For dimensional approaches, Pearson correlation analysis was performed across the cohort examining the association with symptoms, mental health, and cognition.

Results: No significant differences were found in iron susceptibility between ADHD and control, between persistent and remitted ADHD, or between medication use. An unexpected finding was that children with internalising disorder had significantly higher iron susceptibility, but the result did not survive multiple comparison corrections. Higher brain iron was associated with sustained attention, but not on inhibition, IQ, and working memory.

Conclusion: This is the first study addressing brain iron susceptibility and its association with comorbidities and cognition in ADHD. Alterations in brain iron may not account for the full diagnosis of ADHD but may be an indicator of internalising problems in children. Alterations in brain iron content in children were linked to detrimental sustained attention and may represent developmental variation in cognition.

背景:定量磁感应强度图(QSM)是一种神经成像技术,可检测脑铁引起的局部磁感应强度变化。由于铁是合成多巴胺的重要辅助因子,因此脑铁与多巴胺能系统息息相关。多动症与多巴胺能传导失调有关。因此,我们对皮层下结构进行了 QSM,以研究多动症儿童脑铁的潜在变化及其对认知和心理健康的影响。方法:分析了 111 名参与者(nADHD= 58,平均年龄:13.2 (0.63);nControls= 53,平均年龄:13.2 (0.51))的 3 Tesla QSM 数据。提取了皮层下区域脑铁值。方差分析检验了每个相关区域的组间差异。对于维度方法,在整个群体中进行了皮尔逊相关分析,以研究与症状、心理健康和认知的关联:结果:在多动症与对照组之间、持续性多动症与缓解性多动症之间以及药物使用之间,均未发现铁的易感性有明显差异。一个意想不到的发现是,内化障碍儿童的铁敏感性明显更高,但这一结果经不起多重比较校正。脑铁含量较高与持续注意力有关,但与抑制、智商和工作记忆无关:这是首次针对脑铁易感性及其与多动症合并症和认知能力的关系进行的研究。脑铁的变化可能并不能完全诊断为多动症,但可能是儿童内化问题的一个指标。儿童脑铁含量的变化与不利的持续注意力有关,可能代表了认知能力的发展变化。
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引用次数: 0
The reward positivity mediates the association between adverse childhood experiences and anhedonia in young adults with drug-naïve major depressive disorder. 奖赏积极性在患有药物治疗无效重度抑郁症的年轻成人的童年不良经历和失乐症之间起着中介作用。
Pub Date : 2024-08-27 DOI: 10.1016/j.bpsc.2024.08.014
Ciqing Bao, Qiaoyang Zhang, Haowen Zou, Chen He, Rui Yan, Lingling Hua, Qing Lu, Zhijian Yao

Background: Current clinical studies have indicated that major depressive disorder (MDD) with adverse childhood experiences (ACEs) is associated with greater anhedonia. However, little is known about whether the change in reward sensitivity among young MDD individuals with ACEs are related to anhedonia.

Methods: We evaluated anhedonia and ACEs of each patient. Then, we performed Iowa gambling task during EEG to measure the reward positivity (RewP) and its difference (ΔRewP) in 86 MDD patients (31 with no or one ACE and 55 with two or more ACEs) and 44 healthy controls (HCs). Furthermore, we constructed a mediation model to assessed whether aberrant ΔRewP could mediate the relationship between ACEs and anhedonia.

Results: Compared with healthy controls and MDD patients with no or one ACE, MDD patients with two or more ACEs had the most severe symptoms of anhedonia and impaired decision-making, and showed significantly reduced reward sensitivity (most blunted ΔRewP). More importantly, ΔRewP mediated relationship between ACEs and anhedonia in MDD.

Conclusions: We found that the ΔRewP partially mediates the association between ACEs and anhedonia in MDD patients, which provides evidence for the neurobiological basis of abnormal changes in the reward system in MDD individuals with early adverse experiences.

背景:目前的临床研究表明,具有不良童年经历(ACEs)的重度抑郁障碍(MDD)与更严重的失乐症有关。然而,人们对患有ACE的年轻MDD患者奖赏敏感性的变化是否与失乐症有关知之甚少:方法:我们对每位患者的失乐症和ACE进行了评估。然后,我们在脑电图中执行了爱荷华赌博任务,测量了86名MDD患者(31名无ACE或仅有1名ACE,55名有2名或2名以上ACE)和44名健康对照组(HCs)的奖赏积极性(RewP)及其差异(ΔRewP)。此外,我们还构建了一个中介模型,以评估异常ΔRewP是否能中介ACE与失神之间的关系:结果:与健康对照组和没有或只有一种ACE的MDD患者相比,有两种或两种以上ACE的MDD患者的失神症状最严重,决策能力受损,奖赏敏感性显著降低(ΔRewP最迟钝)。更重要的是,ΔRewP介导了ACE与MDD患者失乐症之间的关系:结论:我们发现ΔRewP在一定程度上介导了ACE与MDD患者失乐症之间的关系,这为具有早期不良经历的MDD患者奖赏系统异常变化的神经生物学基础提供了证据。
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引用次数: 0
Efficacy of deep brain stimulation for treatment-resistant depression: systematic review and meta-analysis. 脑深部刺激治疗耐药性抑郁症的疗效:系统回顾和荟萃分析。
Pub Date : 2024-08-26 DOI: 10.1016/j.bpsc.2024.08.013
Sandesh Reddy, Katherine E Kabotyanski, Samad Hirani, Tommy Liu, Zain Naqvi, Nisha Giridharan, Mohammed Hasen, Nicole R Provenza, Garrett P Banks, Sanjay J Mathew, Wayne K Goodman, Sameer A Sheth

Background: Treatment-resistant depression (TRD) affects about 30% of individuals with major depressive disorder. Deep brain stimulation (DBS) is an investigational intervention for TRD with varied results. We undertook this meta-analysis to synthesize outcome data across trial designs, anatomical targets, and institutions to better establish efficacy and side effect profiles.

Methods: We conducted a systematic PubMed review following PRISMA guidelines. Seven randomized-controlled trials (n=198) and eight open-label trials (n=77) were included, spanning 2009-2020. Outcome measures included Hamilton Depression Rating Scale or Montgomery-Åsberg Depression Rating Scale scores, as well as response and remission rates over time. Outcomes were tracked at last follow-up and quantified as a time course using model-based network meta-analysis. Linear mixed models were fit to individual patient data to identify covariates.

Results: DBS achieved 47% improvement in long-term depression scale scores, with an estimated time to reach 50% improvement around 23 months. There were no significant subgroup effects of stimulation target, time of last follow-up, sex, age of disease onset, or duration of disease, but open-label trials showed significantly greater treatment effects compared to randomized controlled trials. Long-term (12-60 month) response and remission rates were 48% and 35%, respectively. The time course of improvement with active stimulation could not be adequately distinguished from that with sham stimulation, when available.

Conclusions: DBS produces significant chronic improvement in symptoms of TRD. The limited sham-controlled data, however, does not demonstrate significant improvement over placebo. Future advancements in stimulation optimization and careful blinding and placebo schemes are important next steps for this therapy.

背景:约有 30% 的重度抑郁症患者会出现治疗耐受性抑郁症(TRD)。脑深部刺激(DBS)是一种针对TRD的研究性干预措施,其结果各不相同。我们进行了这项荟萃分析,以综合不同试验设计、解剖靶点和机构的结果数据,从而更好地确定疗效和副作用情况:我们按照 PRISMA 指南在 PubMed 上进行了系统性综述。共纳入 7 项随机对照试验(n=198)和 8 项开放标签试验(n=77),时间跨度为 2009-2020 年。结果测量包括汉密尔顿抑郁量表或蒙哥马利-奥斯伯格抑郁量表评分,以及随时间变化的反应率和缓解率。在最后一次随访时对结果进行跟踪,并使用基于模型的网络荟萃分析将结果量化为一个时间过程。线性混合模型适用于单个患者数据,以确定协变量:结果:DBS使长期抑郁量表评分提高了47%,估计达到50%的提高需要23个月左右。刺激目标、最后一次随访时间、性别、发病年龄或病程没有明显的亚组效应,但开放标签试验的治疗效果明显高于随机对照试验。长期(12-60 个月)反应率和缓解率分别为 48% 和 35%。在有假性刺激的情况下,活性刺激与假性刺激的改善时间过程无法充分区分:结论:DBS能显著改善TRD的慢性症状。结论:DBS 对 TRD 症状有明显的慢性改善作用,但有限的假性对照数据并未显示出与安慰剂相比有明显改善。未来在刺激优化、仔细盲法和安慰剂方案方面取得进展是该疗法下一步的重要工作。
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引用次数: 0
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Biological psychiatry. Cognitive neuroscience and neuroimaging
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