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Mindfulness Meditation and Network Neuroscience: Review, Synthesis, and Future Directions. 正念冥想与网络神经科学:回顾、综述和未来方向》。
Pub Date : 2024-11-17 DOI: 10.1016/j.bpsc.2024.11.005
Ruchika S Prakash, Anita Shankar, Vaibhav Tripathi, Winson F Z Yang, Megan Fisher, Clemens C C Bauer, Richard Betzel, Matthew D Sacchet

Network neuroscience is an interdisciplinary field, which can be used to understand the brain by examining the connections between its constituent elements. In recent years, the application of network neuroscience approaches to study the intricate nature of the structural and functional relationships within the human brain has yielded unique insights into its organization. In this review, we begin by defining network neuroscience and providing an overview of the common metrics that describe the topology of human structural and functional brain networks. We then present a detailed overview of a limited but growing body of literature that leverages network neuroscience metrics to demonstrate the impact of mindfulness meditation on modulating the fundamental structural and functional network properties of segregation, integration, and influence. Although preliminary, results across studies suggest that mindfulness meditation results in a shift in connector hubs, such as the anterior cingulate cortex, the thalamus, and the mid-insula. Although there is mixed evidence regarding the impact of mindfulness training on global metrics of connectivity, the default mode network exhibits reduced intra-connectivity following mindfulness training. Our review also underscores essential directions for future research, including a more comprehensive examination of mindfulness training and its potential to influence structural and functional connections at the nodal, network, and whole-brain levels. Furthermore, we emphasize the importance of open science, adoption of rigorous study designs to improve the internal validity of studies, and the inclusion of diverse samples in neuroimaging studies to comprehensively characterize the impact of mindfulness on brain organization.

网络神经科学是一个跨学科领域,可通过研究大脑组成元素之间的联系来了解大脑。近年来,应用网络神经科学方法研究人脑内部错综复杂的结构和功能关系,对大脑的组织结构产生了独特的见解。在这篇综述中,我们首先定义了网络神经科学,并概述了描述人类大脑结构和功能网络拓扑结构的常用指标。然后,我们详细概述了数量有限但不断增加的文献,这些文献利用网络神经科学指标来证明正念冥想对调节分离、整合和影响等基本结构和功能网络特性的影响。尽管是初步研究,但各项研究结果表明,正念冥想会导致前扣带回皮层、丘脑和中半岛等连接器枢纽发生转移。虽然关于正念训练对全球连通性指标的影响证据不一,但默认模式网络在正念训练后表现出内部连通性降低。我们的综述还强调了未来研究的重要方向,包括更全面地研究正念训练及其在结点、网络和全脑水平上影响结构和功能连接的潜力。此外,我们还强调了开放科学的重要性,采用严格的研究设计来提高研究的内部有效性,并在神经影像学研究中纳入不同的样本,以全面描述正念对大脑组织的影响。
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引用次数: 0
Increased Amygdala Activation During Symptom Provocation Predicts Response to Combined Repetitive Transcranial Magnetic Stimulation and Exposure Therapy in Obsessive-Compulsive Disorder in a Randomized Controlled Trial. 在一项随机对照试验中,症状激发时杏仁核激活的增加可预测强迫症患者对重复经颅磁刺激和暴露疗法的反应。
Pub Date : 2024-11-14 DOI: 10.1016/j.bpsc.2024.10.020
Milan Houben, Tjardo S Postma, Sophie M D D Fitzsimmons, Chris Vriend, Neeltje M Batelaan, Adriaan W Hoogendoorn, Ysbrand D van der Werf, Odile A van den Heuvel

Background: Repetitive transcranial magnetic stimulation (rTMS) combined with exposure and response prevention is a promising treatment modality for treatment-refractory obsessive-compulsive disorder (OCD). However, not all patients respond sufficiently to this treatment. We investigated whether brain activation during a symptom provocation task could predict treatment response.

Methods: Sixty-one adults with OCD (39 female/22 male) underwent symptom provocation with OCD- and fear-related visual stimuli during functional magnetic resonance imaging prior to an 8-week combined rTMS and exposure and response prevention treatment regimen. Participants received one of the following 3 rTMS treatments as part of a randomized controlled trial: 1) 10-Hz rTMS (110% resting motor threshold) to the left dorsolateral prefrontal cortex, 2) 10-Hz rTMS (110% resting motor threshold) to the left presupplementary motor area, or 3) 10-Hz control rTMS (60% resting motor threshold) to the vertex. Multiple regression and correlation were used to examine the predictive value of task-related brain activation for treatment response in the following regions of interest: the dorsomedial prefrontal cortex, amygdala, dorsolateral prefrontal cortex, and left presupplementary motor area.

Results: The different treatment groups responded equally to treatment. Higher pretreatment task-related activation of the right amygdala to OCD-related stimuli showed a positive association with treatment response in all groups. Exploratory whole-brain analyses showed positive associations between activation in multiple task-relevant regions and treatment response. Only dorsal anterior cingulate cortex activation to fear-related stimuli showed a negative association with treatment outcome.

Conclusions: Higher pretreatment right amygdala activation during symptom provocation predicts better treatment response to combined rTMS and exposure and response prevention in OCD.

背景:重复经颅磁刺激(rTMS)与暴露和反应预防(ERP)相结合,是治疗难治性强迫症(OCD)的一种很有前景的治疗方式。然而,并非所有患者都对这种治疗方法有足够的反应。我们研究了在症状激惹任务中大脑激活是否能预测治疗反应:61名成人强迫症患者(22名男性/39名女性)在接受为期8周的经颅磁刺激和ERP联合治疗之前,在fMRI中接受了强迫症和恐惧相关视觉刺激的症状刺激。作为随机对照试验的一部分,参与者接受了以下三种经颅磁刺激治疗之一:(1)左侧背外侧前额叶皮层(DLPFC)10Hz经颅磁刺激(110%静息运动阈值(RMT));(2)左侧前补充运动区(preSMA)10Hz经颅磁刺激(110% RMT);或(3)顶点10Hz对照经颅磁刺激(60% RMT)。利用多元回归和相关性研究了任务相关脑激活对以下ROI的治疗反应的预测价值:背内侧前额叶皮层、杏仁核、DLPFC和preSMA:结果:不同治疗组对治疗的反应相同。在所有治疗组中,右侧杏仁核对强迫症相关刺激的较高治疗前任务相关激活与治疗反应呈正相关。探索性全脑分析显示,多个任务相关区域的激活与治疗反应呈正相关。只有背侧前扣带回皮层对恐惧相关刺激的激活与治疗结果呈负相关:结论:在症状激发时,治疗前较高的右杏仁核激活可预测强迫症患者对经颅磁刺激和ERP联合治疗的较好治疗反应。
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引用次数: 0
Aperiodic (1/f) neural activity robustly tracks symptom severity changes in treatment-resistant depression. 非周期性(1/f)神经活动可有力追踪耐药性抑郁症的症状严重程度变化。
Pub Date : 2024-11-13 DOI: 10.1016/j.bpsc.2024.10.019
Carl Hacker, Madaline M Mocchi, Jiayang Xiao, Brian Metzger, Joshua Adkinson, Bailey Pascuzzi, Raissa Mathura, Denise Oswalt, Andrew Watrous, Eleonora Bartoli, Anusha Allawala, Victoria Pirtle, Xiaoxu Fan, Isabel Danstrom, Ben Shofty, Garrett Banks, Yue Zhang, Michelle Armenta-Salas, Koorosh Mirpour, Sanjay Mathew, Jeff Cohn, David Borton, Wayne Goodman, Nader Pouratian, Sameer Anil Sheth, Kelly R Bijanki

Background: A reliable physiological biomarker for Major Depressive Disorder is essential for developing and optimizing neuromodulatory treatment paradigms. This study investigates a passive electrophysiologic biomarker that tracks changes in depressive symptom severity on the order of minutes to hours.

Methods: We analyze brief recordings from intracranial electrodes implanted deep in the brain during a clinical trial of deep brain stimulation for treatment-resistant depression in 5 human subjects (nfemale= 3, nmale = 2). This surgical setting allows for precise temporal and spatial sensitivity in the ventromedial prefrontal cortex, a challenging area to measure. We focused on the aperiodic slope of the power spectral density, a metric reflecting the balance of activity across all frequency bands and serving as a proxy for excitatory/inhibitory balance in the brain.

Results: Our findings demonstrate that shifts in aperiodic slope correlate with depression severity, with flatter (less negative) slopes indicating reduced depression severity. This significant correlation was observed in all N=5 subjects, particularly in the ventromedial prefrontal cortex.

Conclusions: This biomarker offers a new way to track patient responses to Major Depressive Disorder treatment, paving the way for individualized therapies in both intracranial and non-invasive monitoring contexts.

背景:重度抑郁症的可靠生理生物标志物对于开发和优化神经调节治疗范例至关重要。本研究调查了一种被动电生理生物标志物,它能追踪抑郁症状严重程度在数分钟至数小时内的变化:我们分析了 5 名受试者(女性 3 人,男性 2 人)在接受脑深部刺激治疗耐药抑郁症的临床试验期间从植入大脑深部的颅内电极获得的简短记录。这种手术设置可以精确测量腹内侧前额叶皮层的时间和空间灵敏度,而这是一个具有挑战性的测量区域。我们重点研究了功率谱密度的非周期性斜率,该指标反映了所有频段的活动平衡,可作为大脑兴奋/抑制平衡的替代指标:我们的研究结果表明,非周期性斜率的变化与抑郁症的严重程度有关,斜率越平(负值越小)表明抑郁症的严重程度越低。在所有 5 名受试者中都观察到了这种明显的相关性,尤其是在腹内侧前额叶皮层:这种生物标志物为跟踪患者对重度抑郁障碍治疗的反应提供了一种新方法,为颅内和非侵入性监测背景下的个体化疗法铺平了道路。
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引用次数: 0
Decoding Mindfulness With Multivariate Predictive Models. 用多元预测模型解码正念。
Pub Date : 2024-11-13 DOI: 10.1016/j.bpsc.2024.10.018
Jarrod A Lewis-Peacock, Tor D Wager, Todd S Braver

Identifying the brain mechanisms that underlie the salutary effects of mindfulness meditation and related practices is a critical goal of contemplative neuroscience. Here, we suggest that the use of multivariate predictive models represents a promising and powerful methodology that could be better leveraged to pursue this goal. This approach incorporates key principles of multivariate decoding, predictive classification, and model-based analyses, all of which represent a strong departure from conventional brain mapping approaches. We highlight 2 such research strategies-state induction and neuromarker identification-and provide illustrative examples of how these approaches have been used to examine central questions in mindfulness, such as the distinction between internally directed focused attention and mind wandering and the effects of mindfulness interventions on somatic pain and drug-related cravings. We conclude by discussing important issues to be addressed with future research, including key tradeoffs between using a personalized versus population-based approach to predictive modeling.

确定正念冥想和相关练习产生有益影响的大脑机制是沉思神经科学的一个重要目标。在此,我们建议使用多变量预测模型作为一种有前途且强大的方法,以更好地实现这一目标。这种方法融合了多元解码、预测分类和基于模型分析的关键原则,所有这些都与传统的脑图谱方法大相径庭。我们重点介绍了两种这样的研究策略--状态诱导和神经标记物识别--并举例说明了这些方法是如何被用于研究正念的核心问题的,如内部引导的集中注意力和思想游离之间的区别,以及正念干预对躯体疼痛和药物相关渴求的作用。最后,我们讨论了未来研究中需要解决的重要问题,包括使用个性化方法与基于人群的方法进行预测建模之间的关键权衡。
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引用次数: 0
The Reward Positivity As a Predictor of First-Lifetime Onsets of Depression, Anxiety, and Suicidal Ideation in High-Risk Adolescents. 奖励积极性是预测高危青少年抑郁、焦虑和自杀意念终生首次发作的指标。
Pub Date : 2024-11-09 DOI: 10.1016/j.bpsc.2024.10.017
Gia-Huy L Hoang, Kent G Hecker, Connor Maxey, Ford Burles, Olave E Krigolson, Daniel C Kopala-Sibley

Background: Reduced reward positivity (RewP), an electroencephalography marker elicited by feedback indicating reward, has been associated with an increased risk for depression during adolescence. However, the ability of the RewP to predict the first-lifetime onset of depressive disorders, as opposed to anxiety and suicidal ideation in high-risk populations, has not been thoroughly investigated. In this study, we examined whether the RewP predicts the first-lifetime onset of depression, anxiety, and suicidal ideation over 18 months in familial high-risk adolescents.

Methods: The sample included 145 adolescents (64.8% female), ages 11 to 17 years, who had at least 1 parent with a history of mood or anxiety disorders and completed baseline and at least 1 follow-up measurement. At baseline, the RewP was measured using a simple gambling task; current internalizing symptoms were assessed using self-report questionnaires; and the adolescent's psychiatric diagnoses were evaluated with diagnostic interviews. The same interview was administered to the adolescents again 9 months and 18 months later.

Results: Logistic regression models showed that higher RewP scores significantly predicted a lower likelihood of developing a first onset of major depressive disorder over 18 months, even after controlling for sex, age, and baseline internalizing symptoms. In contrast, the RewP did not significantly predict the first onset of anxiety disorders or suicidal ideation.

Conclusions: A reduced RewP precedes the first onset of depression in high-risk adolescents, highlighting the RewP's predictive capability for depression risk in predisposed populations. A blunted RewP could complement self-reported symptoms in screening and prevention.

背景:奖赏积极性降低(RewP)是由奖赏反馈引起的脑电图(EEG)标记,它与青少年抑郁症风险增加有关。然而,RewP 在预测高危人群抑郁障碍(而非焦虑和自杀意念)的首次发病方面的预测能力尚未得到深入研究。在本研究中,作者考察了 RewP 是否能预测家族性高危青少年在 18 个月内首次出现抑郁、焦虑和自杀意念的情况:样本包括 145 名青少年(64.8% 为男性),年龄在 11-17 岁之间,父母至少一方有情绪和焦虑症病史,并完成了基线和至少一次随访测量。在基线测量中,使用简单的赌博任务测量 RewP,使用自我报告问卷评估他们当前的内化症状,并通过诊断访谈评估青少年的精神诊断。9个月和18个月后,青少年再次接受了同样的访谈:逻辑回归模型显示,即使在控制了性别、年龄和基线内化症状之后,RewP 分数越高,预测在 18 个月内首次出现重度抑郁症(MDD)的可能性就越低。相比之下,RewP并不能显著预测焦虑症或自杀倾向的首次发病:结论:RewP的降低先于高危青少年抑郁症的首次发病,这凸显了RewP在预测易感人群抑郁症风险方面的预测能力。在筛查和预防过程中,RewP减弱可作为自我报告症状的补充。
{"title":"The Reward Positivity As a Predictor of First-Lifetime Onsets of Depression, Anxiety, and Suicidal Ideation in High-Risk Adolescents.","authors":"Gia-Huy L Hoang, Kent G Hecker, Connor Maxey, Ford Burles, Olave E Krigolson, Daniel C Kopala-Sibley","doi":"10.1016/j.bpsc.2024.10.017","DOIUrl":"10.1016/j.bpsc.2024.10.017","url":null,"abstract":"<p><strong>Background: </strong>Reduced reward positivity (RewP), an electroencephalography marker elicited by feedback indicating reward, has been associated with an increased risk for depression during adolescence. However, the ability of the RewP to predict the first-lifetime onset of depressive disorders, as opposed to anxiety and suicidal ideation in high-risk populations, has not been thoroughly investigated. In this study, we examined whether the RewP predicts the first-lifetime onset of depression, anxiety, and suicidal ideation over 18 months in familial high-risk adolescents.</p><p><strong>Methods: </strong>The sample included 145 adolescents (64.8% female), ages 11 to 17 years, who had at least 1 parent with a history of mood or anxiety disorders and completed baseline and at least 1 follow-up measurement. At baseline, the RewP was measured using a simple gambling task; current internalizing symptoms were assessed using self-report questionnaires; and the adolescent's psychiatric diagnoses were evaluated with diagnostic interviews. The same interview was administered to the adolescents again 9 months and 18 months later.</p><p><strong>Results: </strong>Logistic regression models showed that higher RewP scores significantly predicted a lower likelihood of developing a first onset of major depressive disorder over 18 months, even after controlling for sex, age, and baseline internalizing symptoms. In contrast, the RewP did not significantly predict the first onset of anxiety disorders or suicidal ideation.</p><p><strong>Conclusions: </strong>A reduced RewP precedes the first onset of depression in high-risk adolescents, highlighting the RewP's predictive capability for depression risk in predisposed populations. A blunted RewP could complement self-reported symptoms in screening and prevention.</p>","PeriodicalId":93900,"journal":{"name":"Biological psychiatry. Cognitive neuroscience and neuroimaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mindfulness as a Way of Reducing Automatic Constraints on Thought. 正念是一种减少思维自动限制的方法。
Pub Date : 2024-11-08 DOI: 10.1016/j.bpsc.2024.11.001
Kalina Christoff Hadjiilieva

The number of mindfulness-based wellness promotion programs offered by institutions, by governments, and through mobile apps has grown exponentially in the last decade. However, the scientific understanding of what mindfulness is and how it works is still evolving. Here, I focus on 2 common mindfulness practices: focused attention (FA) and open monitoring (OM). First, I summarize what is known about FA and OM meditation at the psychological level. While they share similar emotion regulation goals, they differ in terms of some of their attention regulation goals. Second, I turn to the neuroscientific literature, showing that FA meditation is associated with consistent activations of cortical control network regions and deactivations of cortical default network regions. In contrast, OM meditation seems to be most consistently associated with changes in the functional connectivity patterns of subcortical structures, including the basal ganglia and cerebellum. Finally, I present a novel account of the mental changes that occur during FA and OM meditation as understood from within the Dynamic Framework of Thought-a conceptual framework that distinguishes between deliberate and automatic constraints on thought. Although deliberate self-regulation processes are often emphasized in scientific and public discourse on mindfulness, here I argue that mindfulness may primarily involve changes in automatic constraints on thought. In particular, I argue that mindfulness reduces the occurrence of automatized sequences of mental states or habits of thought. In this way, mindfulness may increase the spontaneity of thought and reduce automatically constrained forms of thought such as rumination and obsessive thought.

在过去十年中,由机构、政府以及通过移动应用程序提供的以正念为基础的健康促进计划的数量呈指数级增长。然而,人们对正念是什么以及正念如何发挥作用的科学认识仍在不断发展。在此,我将重点介绍两种常见的正念练习:集中注意力(FA)和开放式监控(OM)。首先,我从心理学层面总结了目前对正念冥想和开放式监控冥想的了解。虽然它们有着相似的情绪调节目标,但在某些注意力调节目标方面却有所不同。其次,我转向神经科学文献,这些文献表明,FA 冥想与大脑皮层 "控制 "网络区域的持续激活和大脑皮层 "默认 "网络区域的失活有关。相比之下,OM 冥想似乎与皮层下结构(包括基底神经节和小脑)功能连接模式的变化最为一致。最后,我对FA冥想和OM冥想过程中的心理变化进行了新颖的阐述,这是从思维动态框架(DFT)--一种区分思维的刻意约束和自动约束的概念框架--中理解的。尽管在关于正念的科学和公共讨论中,人们经常强调有意的自我调节过程,但在这里,我认为正念可能主要涉及对思维的自动约束的变化。特别是,我认为正念会减少心理状态自动化序列或思维习惯的发生。因此,正念可以增加思维的自发性,减少反刍和强迫性思维等自动约束的思维形式。
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引用次数: 0
ENIGMA-Meditation: Worldwide Consortium for Neuroscientific Investigations of Meditation Practices. ENIGMA-冥想:全球冥想实践神经科学研究联盟。
Pub Date : 2024-11-06 DOI: 10.1016/j.bpsc.2024.10.015
Saampras Ganesan, Fernando A Barrios, Ishaan Batta, Clemens C C Bauer, Todd S Braver, Judson A Brewer, Kirk Warren Brown, Rael Cahn, Joshua A Cain, Vince D Calhoun, Lei Cao, Gaël Chetelat, Christopher R K Ching, J David Creswell, Paulina Clara Dagnino, Svend Davanger, Richard J Davidson, Gustavo Deco, Janine M Dutcher, Anira Escrichs, Lisa T Eyler, Negar Fani, Norman A S Farb, Suruchi Fialoke, David M Fresco, Rahul Garg, Eric L Garland, Philippe Goldin, Danella M Hafeman, Neda Jahanshad, Yoona Kang, Sahib S Khalsa, Namik Kirlic, Sara W Lazar, Antoine Lutz, Timothy J McDermott, Giuseppe Pagnoni, Camille Piguet, Ruchika S Prakash, Hadley Rahrig, Nicco Reggente, Luigi F Saccaro, Matthew D Sacchet, Greg J Siegle, Yi-Yuan Tang, Sophia I Thomopoulos, Paul M Thompson, Alyssa Torske, Isaac N Treves, Vaibhav Tripathi, Aki Tsuchiyagaito, Matthew D Turner, David R Vago, Sofie Valk, Fadel Zeidan, Andrew Zalesky, Jessica A Turner, Anthony P King

Meditation is a family of ancient and contemporary contemplative mind-body practices that can modulate psychological processes, awareness, and mental states. Over the last 40 years, clinical science has manualized meditation practices and designed various meditation interventions that have shown therapeutic efficacy for disorders including depression, pain, addiction, and anxiety. Over the past decade, neuroimaging has been used to examine the neuroscientific basis of meditation practices, effects, states, and outcomes for clinical and nonclinical populations. However, the generalizability and replicability of current neuroscientific models of meditation have not yet been established, because they are largely based on small datasets entrenched with heterogeneity along several domains of meditation (e.g., practice types, meditation experience, clinical disorder targeted), experimental design, and neuroimaging methods (e.g., preprocessing, analysis, task-based, resting-state, structural magnetic resonance imaging). These limitations have precluded a nuanced and rigorous neuroscientific phenotyping of meditation practices and their potential benefits. Here, we present ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis)-Meditation, the first worldwide collaborative consortium for neuroscientific investigations of meditation practices. ENIGMA-Meditation will enable systematic meta- and mega-analyses of globally distributed neuroimaging datasets of meditation using shared, standardized neuroimaging methods and tools to improve statistical power and generalizability. Through this powerful collaborative framework, existing neuroscientific accounts of meditation practices can be extended to generate novel and rigorous neuroscientific insights that account for multidomain heterogeneity. ENIGMA-Meditation will inform neuroscientific mechanisms that underlie therapeutic action of meditation practices on psychological and cognitive attributes, thereby advancing the field of meditation and contemplative neuroscience.

冥想是古代和现代沉思式身心练习的一种,可以调节心理过程、意识和精神状态。在过去的 40 年中,临床科学已经将冥想练习手册化,并设计了各种冥想干预方法(MIs),这些方法对抑郁、疼痛、成瘾和焦虑等疾病具有疗效。在过去十年中,神经影像学研究了临床和非临床人群冥想练习、效果、状态和结果的神经科学基础。然而,目前冥想神经科学模型的普适性和可复制性仍有待建立,因为这些模型主要基于小规模数据集,在冥想的多个领域(如练习类型、冥想经验、针对的临床疾病)、实验设计和神经成像方法(如预处理、分析、任务型、静息态、结构性磁共振成像)方面存在异质性。这些局限性阻碍了对冥想练习及其潜在益处进行细致严谨的神经科学表型分析。在此,我们将介绍ENIGMA-冥想,这是首个对冥想练习进行神经科学研究的全球合作联盟。ENIGMA-Meditation 将使用共享的标准化神经成像方法和工具,对全球分布的冥想神经成像数据集进行系统的元分析和超大型分析,以提高统计能力和普适性。通过这一功能强大的合作框架,现有的冥想神经科学描述可以得到扩展,从而产生新颖而严谨的神经科学见解,并考虑到多领域的异质性。ENIGMA-冥想将为冥想实践对心理和认知属性的治疗作用提供神经科学机制信息,推动冥想和沉思神经科学领域的发展。
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引用次数: 0
Comparing the Neurocognitive Effects of Right Unilateral Ultra-Brief Pulse Electroconvulsive Therapy and Magnetic Seizure Therapy for the Treatment of Major Depressive Episode. 比较右侧单侧超短脉冲电休克疗法和磁性发作疗法对治疗重度抑郁发作的神经认知效果。
Pub Date : 2024-11-06 DOI: 10.1016/j.bpsc.2024.10.016
Shawn M McClintock, Zhi-De Deng, Mustafa M Husain, Vishal J Thakkar, Elisabeth Bernhardt, Richard D Weiner, Bruce Luber, Sarah H Lisanby

Background: Magnetic seizure therapy (MST) is under investigation as a treatment for adults with major depression. Previous research has suggested that MST has antidepressant efficacy comparable to that of electroconvulsive therapy (ECT), but with greater cognitive safety. The objective of the study was to compare the neurocognitive outcomes of patients receiving an acute course of MST with the outcomes of those receiving ECT for the treatment of major depressive episode.

Methods: This was a between-subjects, double-masked, randomized, multicenter clinical trial. Seventy-three participants with a severe major depressive episode were enrolled and randomly assigned to treatment with MST (n = 35) or ultra-brief pulse right unilateral ECT (n = 38). The main outcome was change in performance from baseline to the end of acute treatment on multiple neurocognitive measures.

Results: Compared with patients who received ECT, patients who received MST had superior cognitive outcomes up to 72 hours posttreatment. Specifically, following MST treatment, there was significant improvement in fine motor dexterity (p = .017) and no significant change in cognitive domains of attention, verbal fluency, executive function, or verbal learning and memory. In contrast, following treatment with ECT, patients demonstrated significantly worse performance on measures of verbal fluency (p < .001), executive function (p = .038), and verbal memory retention (p < .001). Autobiographical memory consistency decreased significantly following treatment with both ECT (p < .001) and MST, although the magnitude of change was greater for ECT.

Conclusions: The study findings confirm previous work and provide new evidence supporting the enhanced cognitive safety of MST relative to ECT. Future research on MST is warranted to optimize its application to individuals with neuropsychiatric illnesses across the life span.

背景:磁性发作疗法(MST)作为一种治疗成人重度抑郁症的方法正在接受研究。先前的研究表明,磁性发作疗法的抗抑郁疗效与电休克疗法(ECT)相当,但认知安全性更高。本研究的目的是比较接受 MST 急性疗程和接受 ECT 治疗重度抑郁症患者的神经认知结果:这是一项受试者间、双掩蔽、随机、多中心临床试验。73名严重重度抑郁症患者被纳入试验,并随机分配接受MST治疗(38人)或超短脉冲右侧单侧电痉挛治疗(35人)。主要结果是多种神经认知指标从基线到急性治疗结束时的表现变化:结果:接受MST治疗的患者在治疗后72小时内的认知能力优于接受ECT治疗的患者。具体而言,在接受 MST 治疗后,患者的精细动作灵活性有了显著改善(p=0.017),而注意力、语言流畅性、执行功能以及语言学习和记忆等认知领域则无明显变化。相反,在接受电痉挛疗法治疗后,患者在言语流畅性方面的表现明显恶化(p结论:研究结果证实了之前的研究成果,并提供了新的证据,证明相对于电痉挛疗法,MST能提高认知安全性。未来有必要对MST进行研究,以优化其在神经精神疾病患者整个生命周期中的应用:临床试验注册:ClinicalTrials.gov identifier:临床试验注册:ClinicalTrials.gov 标识符:NCT00488748。
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引用次数: 0
Altered Functional Connectivity of Unimodal Sensory and Multisensory Integration Networks Is Related to Symptom Severity in Autism Spectrum Disorder. 单感官和多感官整合网络功能连接的改变与自闭症谱系障碍的症状严重程度有关。
Pub Date : 2024-11-02 DOI: 10.1016/j.bpsc.2024.10.014
Yahui Chen, Chen Yang, Bicheng Gao, Kehui Chen, R Joanne Jao Keehn, Ralph-Axel Müller, Li-Xia Yuan, Yuqi You

Background: Atypical sensory processing is a prevalent feature of autism spectrum disorder (ASD) and constitutes a core diagnostic criterion in DSM-5. However, the neurocognitive underpinnings of atypical unimodal and multimodal sensory processing and their relationships with autism symptoms remain unclear.

Methods: In this study, we examined intrinsic functional connectivity (FC) patterns among 5 unimodal sensory and multisensory integration (MSI) networks in ASD using a large multisite dataset (N = 646) and investigated the relationships between altered FC, atypical sensory processing, social communicative deficits, and overall autism symptoms using correlation and mediation analyses.

Results: Compared with typically developing control participants, participants in the ASD group demonstrated increased FC of the olfactory network, decreased FC within the MSI network, and decreased FC of the MSI-unimodal sensory networks. Furthermore, altered FC was positively associated with autism symptom severity, and such associations were completely mediated by atypical sensory processing and social communicative deficits.

Conclusions: ASD-specific olfactory overconnectivity and MSI-unimodal sensory underconnectivity lend support to the intense world theory and weak central coherence theory, suggesting olfactory hypersensitivity at the expense of MSI as a potential neural mechanism underlying atypical sensory processing in ASD. These atypical FC patterns suggest potential targets for psychological and neuromodulatory interventions.

背景:非典型感觉处理是自闭症谱系障碍(ASD)的一个普遍特征,也是《精神障碍诊断与统计手册》第五版(DSM-5)的一个核心诊断标准。然而,非典型单模态和多模态感觉处理的神经认知基础及其与自闭症症状的关系仍不清楚:本研究利用大型多站点数据集(n = 646)研究了自闭症患者五种单模态感觉和多感觉统合(MSI)网络的内在功能连接(FC)模式,并通过相关性和中介分析研究了FC改变、非典型感觉处理、社会交往障碍和整体自闭症症状之间的关系:与发育正常(TD)对照组相比,ASD组的嗅觉网络FC增加,MSI网络内的FC减少,MSI-非模态-感觉网络的FC减少。此外,FC的改变与自闭症症状的严重程度呈正相关,而这种关联完全是由非典型感觉处理和社会交往障碍介导的:ASD特异性嗅觉过度连接和MSI-非模态感觉连接不足支持了 "强烈世界理论"(Intense World Theory)和 "弱中枢一致性理论"(Weak Central Coherence Theory),表明以牺牲多感觉整合为代价的嗅觉过敏是ASD非典型感觉处理的潜在神经机制。这些非典型的感觉处理模式进一步提出了心理和神经调节干预的潜在目标。
{"title":"Altered Functional Connectivity of Unimodal Sensory and Multisensory Integration Networks Is Related to Symptom Severity in Autism Spectrum Disorder.","authors":"Yahui Chen, Chen Yang, Bicheng Gao, Kehui Chen, R Joanne Jao Keehn, Ralph-Axel Müller, Li-Xia Yuan, Yuqi You","doi":"10.1016/j.bpsc.2024.10.014","DOIUrl":"10.1016/j.bpsc.2024.10.014","url":null,"abstract":"<p><strong>Background: </strong>Atypical sensory processing is a prevalent feature of autism spectrum disorder (ASD) and constitutes a core diagnostic criterion in DSM-5. However, the neurocognitive underpinnings of atypical unimodal and multimodal sensory processing and their relationships with autism symptoms remain unclear.</p><p><strong>Methods: </strong>In this study, we examined intrinsic functional connectivity (FC) patterns among 5 unimodal sensory and multisensory integration (MSI) networks in ASD using a large multisite dataset (N = 646) and investigated the relationships between altered FC, atypical sensory processing, social communicative deficits, and overall autism symptoms using correlation and mediation analyses.</p><p><strong>Results: </strong>Compared with typically developing control participants, participants in the ASD group demonstrated increased FC of the olfactory network, decreased FC within the MSI network, and decreased FC of the MSI-unimodal sensory networks. Furthermore, altered FC was positively associated with autism symptom severity, and such associations were completely mediated by atypical sensory processing and social communicative deficits.</p><p><strong>Conclusions: </strong>ASD-specific olfactory overconnectivity and MSI-unimodal sensory underconnectivity lend support to the intense world theory and weak central coherence theory, suggesting olfactory hypersensitivity at the expense of MSI as a potential neural mechanism underlying atypical sensory processing in ASD. These atypical FC patterns suggest potential targets for psychological and neuromodulatory interventions.</p>","PeriodicalId":93900,"journal":{"name":"Biological psychiatry. Cognitive neuroscience and neuroimaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Probing Neurophysiological Processes Related to Self-Referential Processing to Predict Improvement in Adolescents With Depression Receiving Cognitive Behavioral Therapy. 探究与自我暗示处理相关的神经生理过程,预测接受认知行为疗法的抑郁青少年的病情改善情况。
Pub Date : 2024-11-02 DOI: 10.1016/j.bpsc.2024.10.010
Nayoung Kim, Paul A Bloom, Anthony J Rosellini, Christian A Webb, Diego A Pizzagalli, Randy P Auerbach

Background: Cognitive behavioral therapy (CBT) is a gold-standard approach for treating major depressive disorder in adolescents. However, nearly half of adolescents receiving CBT do not improve. To personalize treatment, it is essential to identify objective markers that predict treatment responsiveness. To address this aim, we investigated neurophysiological processes related to self-referential processing that predicted CBT response among female adolescents with depression.

Methods: At baseline, female adolescents ages 13 to 18 years (N = 80) completed a comprehensive clinical assessment, and a self-referential encoding task was administered while electroencephalographic data were recorded. Baseline electroencephalographic data were utilized to identify oscillatory differences between healthy adolescents (n = 42) and adolescents with depression (n = 38). Following the baseline assessment, adolescents with depression received up to 12 weeks of CBT. Baseline differences in electroencephalographic oscillations between healthy adolescents and those with depression were used to guide CBT prediction analysis. Cluster-based event-related spectral perturbation analysis was used to probe theta and alpha event-related synchronization (ERS)/event-related desynchronization (ERD) response to negative and positive words.

Results: Baseline analyses showed that, relative to the healthy adolescents, adolescents with depression exhibited higher levels of frontal theta ERS and greater posterior alpha ERD. Multilevel modeling identified primary neural pretreatment predictors of treatment response: greater theta ERS in the right prefrontal cortex after the onset of negative words and lower alpha ERD in both the right prefrontal cortex and posterior cingulate cortex. ERS and ERD associations with treatment response remained significant, with baseline depressive and anxiety symptoms included as covariates in all analyses.

Conclusions: Consistent with prior research, results highlighted that relative to healthy adolescents, adolescents with depression are characterized by prominent theta synchronization and alpha desynchronization over the prefrontal cortex and posterior cingulate cortex, respectively. Cluster-based event-related spectral perturbation analysis also identified key mechanisms underlying depression-related self-referential processing that predicted improved symptoms during the course of CBT. Ultimately, a better characterization of the neural underpinnings of adolescent depression and its treatment may lead to more personalized interventions.

背景:认知行为疗法(CBT)是治疗青少年重度抑郁障碍(MDD)的金标准方法。然而,近一半的青少年在接受 CBT 治疗后病情并未得到改善。为了实现个性化治疗,必须确定预测治疗反应的客观指标。为实现这一目标,本研究调查了与自我参照处理相关的神经生理过程,这些过程可预测抑郁女性青少年的 CBT 反应:基线时,13-18 岁的女性青少年(人数=80)完成了一项全面的临床评估,并在记录脑电图(EEG)数据的同时执行了一项自我参照编码任务。基线脑电图数据用于识别健康青少年(HC,38 人)和抑郁青少年(MDD,42 人)之间的振荡差异。基线评估后,抑郁青少年接受了长达 12 周的 CBT 治疗。健康和抑郁青少年脑电图振荡的基线差异被用来指导 CBT 预测分析。基于聚类的事件相关频谱扰动分析(ERSP)探测了θ和α事件相关同步/不同步(ERS/ERD)对消极和积极词语的反应:基线分析表明,与健康青少年相比,抑郁青少年表现出更高水平的额叶θ ERS和更高的后部α ERD。多层次建模确定了治疗前预测治疗反应的主要神经因素:在消极词语出现后,右侧前额叶皮层(PFC)的θ ERS更高,右侧前额叶皮层和后扣带回皮层(PCC)的α ERD更低。在将基线抑郁症状和焦虑症状作为协变量纳入所有分析的情况下,ERS和ERD与治疗反应的关系仍然显著:与之前的研究一致,研究结果表明,与健康青少年相比,抑郁青少年的前脑皮层(PFC)和后脑皮层(PCC)分别具有突出的θ同步性和α非同步性。基于ERSP的聚类分析还确定了与抑郁相关的自我参照处理的关键机制,这些机制可预测CBT治疗过程中症状的改善。最终,对青少年抑郁症及其治疗的神经基础进行更好的描述,可能会带来更多个性化的干预措施。
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引用次数: 0
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Biological psychiatry. Cognitive neuroscience and neuroimaging
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