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BACKGROUND: Numerous studies have shown that major depressive disorder (MDD) is characterized by a range of impairments in emotional and cognitive functions that are closely related to abnormalities in brain structure and function. Cognitive behavioral therapy (CBT) can be used as treatment for mild to moderate MDD, which can assist with ameliorating the symptoms. Previous studies have assumed that the internal fluctuations throughout the entire scan are static. However, it has recently been suggested that the brain connectivity is dynamic and relative to continuous rhythmic activity. The effect of dynamic changes in CBT on MDD patients is unknown. METHODS: Nineteen first-episode, unmedicated MDD patients and twenty-two healthy controls (HC) participated in the study. The patients received early CBT treatment once a week for 6 weeks. Symptom examinations and magnetic resonance imaging (MRI) scans were performed pre and post treatment. Degree centrality (DC) was used to investigate the whole-brain connectivity differences between patients with MDD and healthy controls, and sliding window correlation analysis was applied to investigate the dynamic changes of functional connectivity among MDD patients treated with CBT. The variance of dynamic functional connectivity (dFC) was calculated to evaluate the temporal variability along the time. RESULTS: Patients with MDD showed abnormal DC in dorsolateral prefrontal cortex (dlPFC), insula and postcentral gyrus. Correlation analysis revealed that degree centrality of dlPFC was negatively correlated with the course of disease in patients with MDD. Results of dynamic functional connectivity showed that, compared to HC, MDD patients-remained excessively stable in dlPFC and precuneus connectivity, which is associated with emotional cognitive symptoms. After CBT, patients showed increased dFC variability in dlPFC and precuneus (p < 0.01, GRF corrected). CONCLUSION: DLPFC plays an important role in pathophysiological mechanism of MDD. CBT helped patients suppress redundant thoughts and negative self-focus. As a connecting node, dlPFC participates in the mechanism of action of CBT.
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Cognitive Behavioral Therapy , Depressive Disorder, Major , Brain/diagnostic imaging , Brain Mapping , Depressive Disorder, Major/diagnostic imaging , Depressive Disorder, Major/therapy , Humans , Magnetic Resonance ImagingABSTRACT
Objective:To investigate the difference of functional connectivity(FC) between the habenula and other brain regions in the patients with first-episode current depression (fMDD) and remitted depression (rMDD).Methods:Thirty-five patients with first-episode current depression (fMDD), 35 patients with remitted depression (rMDD) and 30 healthy controls (HC) matched with gender, age and education years were scanned by resting-state fMRI. Hamilton Depression Scale (HAMD 17) was used to assess the severity of the patients. After preprocessing, seed-based FC analysis was performed on the habenula. Pearson correlation analysis was performed between the FC values and HAMD 17 and duration of disease. Results:(1) Compared with the HC group, FC decreased between the habenula and left middle occipital gyrus(l-MOG) in fMDD group (x, y, z=-48, -84, 3, t=-4.335, P<0.05), while FC increased between the habenula and left supramarginal gyrus (x, y, z=-66, -30, 36, t=4.876, P<0.05), left superior frontal gyrus(l-SFG) (x, y, z=-6, -33, 51, t=4.402, P<0.05), left inferior parietal lobe(l-IPL)( t=3.300, P<0.05) and right inferior parietal lobe(r-IPL) ( t=3.557, P<0.05) in fMDD group. Compared with the HC, FC decreased between the habenula and l-MOG (x, y, z=-48, -84, 3, t=-4.321, P<0.05) and left thalamus (x, y, z=-9, 3, 3, t=-3.971, P<0.05) in rMDD group, while FC increased between the habenula and left middle temporal gyrus(l-MTG)( x, y, z=-48, -39, 9, t=4.062, P<0.05), left supramarginal gyrus (x, y, z=-51, -15, 45, t=2.906, P<0.05), l-SFG (x, y, z=-24, -21, 39, t=3.044, P<0.05), l-IPL ( t=2.880, P<0.05) and r-IPL ( t=3.512, P<0.05) in rMDD group. (2) FC decreased in fMDD group between the habenula and right orbitofrontal cortex(r-OFC) ( t=-3.899, P<0.05) and l-MTG ( t=-4.023, P<0.05) than rMDD group, while FC increased between the habenula and left supramarginal gyrus ( t=4.157, P<0.05), l-SFG( t=3.327, P<0.05), left thalamus ( t=3.316, P<0.05) and l-IPL ( t=3.909, P<0.05) than rMDD group. (3)There was no significantly correlation between the HAMD 17 and the FC value changes among the different regions, and was marginal significantly correlation between duration of disease and the FC values from the habenula and l-MOG( r=0.328, P=0.063). Conclusion:Both fMDD and rMDD show abnormal FC between the habenula and default mode network, visual network and reward network, which may be related to the pathogenesis of depression. The FC of the habenula in rMDD still had not recovered to normal.
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Objective To explore the developmental characteristics of white matter volume in autism spectrum disorder (ASD) children longitudinal.Methods From May 2011 to September 2014,37 ASD children (ASD group)and 27 developmental delays (DD) children (control group) were treated at the Child Mental Health Research Center,Nanjing Brian Hospital Affiliated of Nanjing Medical University,and the children whose age,gender and developmental quotient matched with the ASD children were scanned by structure magnetic resonance imaging (sMRI) at the age of 2-3 years old and 4-5 years old respectively.Region of interest (ROI) technology was adopted to investigate the change of the cerebrum white and the sub-lobes structure white matter volume with time.Then the correlation between clinical symptoms and brain white matter volume changes was analyzed.Results Among the 2-3 years old,compared with the control group,the white matter volume of the total brain[(383 521.84 ±6 427.57) mm3 vs.(364 014.06 ±6 856.97) mm3],the left cerebral hemisphere [(191 609.35 ± 3 206.60) mm3 vs.(181 695.89 ± 3 389.54)mm3],temporal lobe [(41 860.49 ±816.38) mm3 vs.(39 444.18 ± 834.85) mm3] and the right temporal lobe [(21 312.79 ± 414.07) mm3 vs.(20 084.22 ± 412.13) mm3] were significantly larger in the ASD group,and the differences were statistically significant (all P ＜ 0.05).With the analysis of covariance with age or the total brain volume as the covariate,the differences disappeared(all P ＞ 0.05).Among the 4-5 years old,compared with the control group,the white matter volumes of the total brain[(417 651.42 ± 6 443.86) mm3 vs.(394 317.27 ± 6 404.86)mm3],left cerebral hemisphere [(208 714.16 ±3 214.61) mm3 vs.(197 192.82 ±3 262.02) mm3],right cerebral hemisphere [(208937.26±3242.09) mm3 vs.(7 124.45 ±3 193.13) mm3],frontal lobe [(107 107.46±1 681.99) mm3 vs.(100 326.19 ± 1 883.24) mm3],left frontal lobe [(54 569.63 ± 846.85) mm3 vs.(51 177.25 ±979.09) mm3],right frontal lobe [(52 537.83 ± 841.99) mm3 vs.(49 148.94 ±928.31) mm3],temporal lobe [(45 189.75 ± 833.29) mm3 vs.(42 487.73 ± 786.27) mm3],left temporal lobe [(22 204.21 ±411.77) mm3 vs.(20 922.90 ± 418.46) mm3],and right temporal lobe [(22 985.54 ± 426.93) mm3 vs.(21 564.83 ± 378.78) mm3]were significantly larger in the ASD group,and the differences were statistically significant (all P ＜ 0.05).With the analysis of covariance with age as the covariate,the differences still existed (all P ＜ 0.05).With the analysis of covariance with the total brain volume as the covariate,the differences disappeared (all P ＞ 0.05).For longitudinal analysis,there was a significant difference in the white matter volume between the whole brain,left cerebral hemisphere,right cerebral hemisphere,frontal lobe,left frontal lobe,fight frontal lobe,temporal lobe,left temporal lobe,right temporal lobe and the differences were statistically significant (F =5.521,5.533,5.459,5.830,5.800,5.723,4.857,4.418,5.159,all P ＜0.05).There was a positive correlation between the changes of the volume of whole brain,the white matter volume in the whole brain,bilateral cerebral hemisphere,frontal lobe,parietal lobe,right parietal lobe and Childhood Autism Rating Scale (r =0.367,0.343,0.321,0.349,0.296,0.308,0.351,all P ＜ 0.05).Conclusions Among the 2-3 years old,the white matter volume of the brain regions have been increased significantly in ASD.Among the 4-5 years old,the increase of the white matter volume of the brain regions implicated more widely which mainly concentrated in the frontal and temporal lobe in ASD.The severity of the clinical symptoms of ASD may be associated with the white matter volume of the total brain,bilateral cerebral hemisphere,frontal lobe,parietal lobe and right parietal lobe.
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Objective To investigate the resting-state functional connectivity of the two hemispheres between multiple system atrophy (Parkinsonian type,MSA-P) and Parkinson's disease (PD).Methods A total of 25 MSA-P,29 PD patients and 29 well-matched healthy controls recruited in the Nanjing Brain Hospital Affiliated to Nanjing Medical University from June 2013 to December 2015 were scanned with resting-state functional magnetic resonance imaging for voxel mirrored homotopic correlation (VMHC) analysis.The Mini Mental State Examination,Montreal Cognitive Assessment,Frontal Assessment Battery and Unified Parkinson's Disease Rating Scale-Ⅲ (UPDRS-Ⅲ) were used to assess the clinical symptom.Then the relationship between the change of VMHC values and severity of clinical symptoms was investigated.Results Compared with healthy controls,MSA-P and PD patients both showed decreased VMHC in bilateral cerebellum posterior lobe,precuneus gyrus,middle temporal gyrus,and postcentral gyrus.Compared with PD or healthy controls,MSA-P patients exhibited lower VMHC in bilateral putamen.Significant negative correlation between VMHC values of putamen and UPDRS-Ⅲ scores was found in MSAP patients (r =-0.607,P =0.001).Conclusion These functional changes suggest that the abnormal interhemispheric synchrony probably plays an important role in pathophysiology of both MSA-P and PD,and abnormal VMHC values in putamen of MSA-P may be helpful in differentiating MSA-P from PD.
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Objectives To investigate MRI patterns of functional connectivity(FC)in different brain areas of the subthalamic nucleus (STN)in Parkinson's Disease (PD)and its correlation with cognition.Methods We used functional magnetic resonance imaging to investigate the difference in whole-brain resting-state FC of STN between 32 patients with PD during the medicatiom ON state and 25 healthy control group(HC)matched for age,gender,and cognition,and examine the correlation between functional connectivity strength and montreal cognitive assessment (MoCA)scores.Results Compared with HC,the PD group showed increased FC in the right lingual gyrus of the left STN and the right STN showed decreased FC in the left superior frontal gyrus and the supplementary motor area(t=4.29,-3.61,and-3.83,respectively,each P ＜ 0.05),while the right STN showed only decreased FC in the right bilateral cingulate gyrus and the precuneus(t=-4.44,4.29,and-4.30,respectively,each P＜ 0.05).In addition,PD patients' connectivity strength between RSTN and the bilateral precuneus was positively correlated with MoCA scores(t =0.58 and 0.57,respectively,each P＜0.05).Conclusions Compared with HC,PD patients exhibit decreased FC between RSTN and the precuneus,with FC strength positively correlated with MOCA scores.The cognitive decline caused by deep brain stimulation in STN may be related to injuries of the precuneus.
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Purpose To study the application of MR diffusion tensor imaging (DTI) quantitative parameters in grading of cerebral glioma on a 3.0T scanner. Materials and Methods DTI mapping of 51 cases of cerebral glioma confirmed by pathology were retrospective analyzed. All the cases were divided into two groups: low-grade gliomas (grade I-II, 18 cases) and high-grade gliomas (grade III-IV, 33 cases). Value of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD),λ1, λ2, and λ3 of the tumor, peritumoral edema and contralateral tissue area were recorded and compared. Results rMDt, rADt, rRDt, λ1t, λ2t and λ3t of tumor in the low-grade glioma group were higher than those in the high-grade glioma group, and the difference was statistically significant (t=-3.235- -2.458, P0.05). rFAe of peritumoral edema in the low-grade glioma group was higher than those in the high-grade group, while rMDe, rADe, rRDe, λ1e, λ2e and λ3e were lower in the low-grade group. All differences were not statistically significant except λ1e (t=2.052, P<0.05). ROC analysis showed the area under the curve (Az) of rMDt, rADt, rRDt, λ1t, λ2t, λ3t and λ1e were 0.746, 0.710, 0.762, 0.735, 0.722, 0.705 and 0.374, respectively. Az value of rMDt, rADt, rRDt,λ1t, λ2t, λ3t were statistically different between the low- and high-grade gliomas (Z=3.287-4.605, P<0.001). Conclusion Among DTI quantitative parameters on glioma grading, rMD, rAD, rRD, λ1, λ2, and λ3 of tumor area are helpful in grading gliomas.
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Objective To investigate the diagnostic value of MRI on Creutzfeldt-Jakob disease(CJD).Methods The imaging data of 15 patients with CJD were analyzed retrospectively.Results In the 15 cases,the diagnosis was clinical probable CJD 10 cases,maybe CJD 5 cases.There was no abnormal signal found by routine T 1WI and T 2WI scanning in the 15 cases.DWI showed that 10 cases had hyperintense abnormalities in both the cerebral cortex and the striatum,5 cases had hyperintense abnormalities only in the cerebral cortex.The hyperintense abnormalities were symmetric in 8 cases,but were asymmetric in the other 7 cases.1H-MRS were applied in the 4 cases and showed that N-acetylas partate(NAA),NAA/creatine(Cr) were decreased to some extent.Choline(Cho),Cho/Cr were decreased in 2 cases and increased in 2 cases.mI peak did not appear in all 4 cases.Conclusion MRI,especially DWI and 1H-MRS give can valuable information in detecting and diagnosing CJD early.
