Dynamic Functional Connectivity Predicts Treatment Response to Electroconvulsive Therapy in Major Depressive Disorder

Background: Electroconvulsive therapy (ECT) is one of the most effective treatments for major depressive disorder. Recently, there has been increasing attention to evaluate the effect of ECT on resting-state functional magnetic resonance imaging (rs-fMRI). This study aims to compare rs-fMRI of depressive disorder (DEP) patients with healthy participants, investigate whether pre-ECT dynamic functional network connectivity network (dFNC) estimated from patients rs-fMRI is associated with an eventual ECT outcome, and explore the effect of ECT on brain network states.Method: Resting-state functional magnetic resonance imaging (fMRI) data were collected from 119 patients with depression or depressive disorder (DEP) (76 females), and 61 healthy (HC) participants (34 females), with an age mean of 52.25 (N = 180) years old. The pre-ECT and post-ECT Hamilton Depression Rating Scale (HDRS) were 25.59 ± 6.14 and 11.48 ± 9.07, respectively. Twenty-four independent components from default mode (DMN) and cognitive control network (CCN) were extracted, using group-independent component analysis from pre-ECT and post-ECT rs-fMRI. Then, the sliding window approach was used to estimate the pre-and post-ECT dFNC of each subject. Next, k-means clustering was separately applied to pre-ECT dFNC and post-ECT dFNC to assess three distinct states from each participant. We calculated the amount of time each subject spends in each state, which is called “occupancy rate” or OCR. Next, we compared OCR values between HC and DEP participants. We also calculated the partial correlation between pre-ECT OCRs and HDRS change while controlling for age, gender, and site. Finally, we evaluated the effectiveness of ECT by comparing pre- and post-ECT OCR of DEP and HC participants.Results: The main findings include (1) depressive disorder (DEP) patients had significantly lower OCR values than the HC group in state 2, where connectivity between cognitive control network (CCN) and default mode network (DMN) was relatively higher than other states (corrected p = 0.015), (2) Pre-ECT OCR of state, with more negative connectivity between CCN and DMN components, is linked with the HDRS changes (R = 0.23 corrected p = 0.03). This means that those DEP patients who spent less time in this state showed more HDRS change, and (3) The post-ECT OCR analysis suggested that ECT increased the amount of time DEP patients spent in state 2 (corrected p = 0.03).Conclusion: Our finding suggests that dynamic functional network connectivity (dFNC) features, estimated from CCN and DMN, show promise as a predictive biomarker of the ECT outcome of DEP patients. Also, this study identifies a possible underlying mechanism associated with the ECT effect on DEP patients.

A digital intervention targeting cognitive control network dysfunction in middle age and older adults with major depression

Nonpharmacological interventions targeting putative network mechanisms of major depressive disorder (MDD) may represent novel treatments. This mechanistic study investigates how a video game-like intervention, designed to improve cognitive control network (CCN) functioning by targeting multitasking, influences the CCN of middle-aged and older adults with MDD. The sample consisted of 34 adults aged 45–75 with SCID-defined diagnosis of MDD, Hamilton depression rating scale scores ≥20, and a deficit in cognitive control. Participants were instructed to play at home for 20–25 min per day, at least 5 times per week, for 4 weeks. Evidence of target engagement was defined a priori as >2/3 of participants showing CCN improvement. CCN engagement was defined as a change in a Z score of ≥0.5 on functional magnetic resonance imaging (fMRI) in activation and functional connectivity of the CCN during task-based and resting-state fMRI, respectively. 74% of participants showed a change in activation of the CCN, and 72% showed an increase in resting-state functional connectivity. Sixty-eight percent demonstrated improved cognitive control function, measured as either improvement on sustained attention or working memory performance or reduced self-reported symptoms of apathy on the frontal systems behavioral scale (FrsBe). Participants also reported a significant reduction in mood symptoms measured by PHQ-9. A remotely deployed neuroscience-informed video game-like intervention improves both CCN functions and mood in middle-aged and older adults with MDD. This easily-disseminated intervention may rescue CCN dysfunction present in a substantial subset of middle-aged and older adults with MDD.

Disrupted dynamic functional network connectivity among cognitive control networks in the progression of Alzheimer’s disease

BackgroundAlzheimer’s disease (AD) is the most common age-related dementia that promotes a decline in memory, thinking, and social skills. The initial stages of dementia can be associated with mild symptoms, and symptom progression to a more severe state is heterogeneous across patients. Recent work has demonstrated the potential for functional network mapping to assist in the prediction of symptomatic progression. However, this work has primarily used static functional connectivity (sFC) from rs-fMRI. Recently, dynamic functional connectivity (dFC) has been recognized as a powerful advance in functional connectivity methodology to differentiate brain network dynamics between healthy and diseased populations.MethodsGroup independent component analysis was applied to extract 17 components within the cognitive control network (CCN) from 1385 individuals across varying stages of AD symptomology. We estimated dFC among 17 components within the CCN, followed by clustering the dFCs into 3 recurring brain states and then estimated a hidden Markov model and the occupancy rate for each subject. Finally, we investigated the link between CCN dFC connectivity features with AD progression.ResultsProgression of AD symptoms were associated with increases in connectivity within the middle frontal gyrus. Also, the AD with mild and severer symptoms showed less connectivity within the inferior parietal lobule and between this region with the rest of CCN. Finally, comparing with mild dementia, we found that the normal brain spends significantly more time in a state with lower within middle frontal gyrus connectivity and higher connectivity between the hippocampus and the rest of CCN, highlighting the importance of assessing the dynamics of brain connectivity in this disease.ConclusionOur results suggest that AD progress not only alters the CCN connectivity strength but also changes the temporal properties in this brain network. This suggests the temporal and spatial pattern of CCN as a biomarker that differentiates different stages of AD.Impact StatementBy assuming that functional connectivity is static over time, many of previous studies have ignored the brain dynamic in Alzheimer’s disease progression. Here, a longitudinal resting-state functional magnetic resonance imaging data are used to explore the temporal changes of functional connectivity in the cognitive control network in Alzheimer’s disease progression. The result of this study would increase our understanding about the underlying mechanisms of Alzheimer’s Disease and help in finding future treatment of this neurological disorder.

Symmetric and Asymmetric Causal Neural Firing Interactions across Striatum, Anterior Cingulate and Prefrontal Cortex during Cognitive Control

Generally, successful performance of complex cognitive tasks depends on the function of interacting regions, including anterior cingulate cortex (ACC), lateral prefrontal cortex (LPFC) and ventral striatum (VS). During task performance, markers of communication amongst regions in the cognitive control network are frequently observed. Typically, however, these markers are agnostic with respect to the direction in which information passes through the system – although firing rate correlations and enhanced synchrony between regions are suggestive of causal interactions, these approaches are not sufficient for determining the influence of on region on another. In this manuscript, we apply a novel approach to investigate the causal dynamics of regions in the cognitive control network during correct and incorrect performance. Using experiment-averaged time courses recorded from ACC, LPFC, and VS, we identify neurons within each region exhibiting task-sensitive response dynamics and calculate Granger causality for each pair of neurons during salient task events. Cluster analysis of causality time courses identifies significant, bidirectional causality between regions following stimulus and feedback onset.

Common abnormality of gray matter integrity in substance use disorder and obsessive-compulsive disorder: A comparative voxel-based meta-analysis

Aim: To determine robust transdiagnostic brain structural markers for compulsivity by capitalizing on the increasing number of case-control studies examining gray matter alterations in substance use disorders (SUD) and obsessive-compulsive disorder (OCD). Design: Pre-registered voxel-based meta-analysis of grey matter volume (GMV) changes through seed-based d Mapping (SDM), follow-up functional, and network-level characterization of the identified transdiagnostic regions by means of co-activation and Granger Causality (GCA) analysis. Participants: Literature search resulted in 31 original VBM studies comparing SUD (n=1191, mean-age=40.03, SD=10.87) and 30 original studies comparing OCD (n=1293, mean-age=29.18, SD=10.34) patients with healthy controls (SUD: n=1585, mean-age=42.63, SD=14.27, OCD: n=1374, mean-age=28.97, SD=9.96). Measurements: Voxel-based meta-analysis within the individual disorders as well as conjunction analysis were employed to reveal common GMV alterations between SUDs and OCD. Meta-analytic coordinates and signed brain volumetric maps determining directed (reduced or increased) brain volumetric alterations between the disorder groups and controls served as the primary outcome. Meta-analytic results employed statistical significance thresholding (FWE<0.05). Findings: Separate meta-analysis demonstrated that SUD (cocaine, alcohol, and nicotine) as well as OCD patients exhibited widespread GMV reductions in frontocortical regions including prefrontal, cingulate, and insular regions. Conjunction analysis revealed that the left inferior frontal gyrus (IFG) consistently exhibited decreased GMV across all disorders. Functional characterization suggests that the IFG represents a core hub in the cognitive control network and exhibits bidirectional (Granger) causal interactions with the striatum. Only OCD showed increased GMV in the dorsal striatum with higher changes being associated with more severe OCD symptomatology. Conclusions: Findings demonstrate robustly decreased GMV across the disorders in the left IFG, suggesting a transdiagnostic brain structural marker. The functional characterization as a key hub in the cognitive control network and casual interactions with the striatum suggest that deficits in inhibitory control mechanisms may promote compulsivity and loss of control that characterize both disorders.

Supramodal Mechanisms of the Cognitive Control Network in Uncertainty Processing

Information processing under conditions of uncertainty requires the involvement of cognitive control. Despite behavioral evidence of the supramodal function (i.e., independent of sensory modality) of cognitive control, the underlying neural mechanism needs to be directly tested. This study used functional magnetic imaging together with visual and auditory perceptual decision-making tasks to examine brain activation as a function of uncertainty in the two stimulus modalities. The results revealed a monotonic increase in activation in the cortical regions of the cognitive control network (CCN) as a function of uncertainty in the visual and auditory modalities. The intrinsic connectivity between the CCN and sensory regions was similar for the visual and auditory modalities. Furthermore, multivariate patterns of activation in the CCN predicted the level of uncertainty within and across stimulus modalities. These findings suggest that the CCN implements cognitive control by processing uncertainty as abstract information independent of stimulus modality.