1.Cortical thickness abnormalities in drug-naive first-episode adult depression: a Meta-analysis
Liangliang PING ; Shan SUN ; Cong ZHOU ; Mengxin HE ; Jianyu QUE ; Qi ZHENG ; Zonglin SHEN ; Xiufeng XU ; Yuqi CHENG
Chinese Journal of Psychiatry 2024;57(8):512-519
Objective:This meta-analysis aims to explore the most consistent changes in cortical thickness in drug-naive first-episode patients with major depressive disorder (DF-MDD).Methods:Systematic and comprehensive searches were conducted to acquire relevant literature from the PubMed and Web of Science databases for the studies published from inception to July 23, 2023, by using the keywords ("depression" OR "depressive disorder" OR "unipolar depression") AND ("cortical thickness"OR"thickness"). The SDM (signed differential mapping) software was used to perform whole-brain voxel-wise meta-analysis, heterogeneity test, and assess publication bias. Meta-regression analysis was employed to examine the impact of disease severity on cortical thickness in depression, and heterogeneity was tested, along with an assessment of publication bias.Results:Eight studies were ultimately included, encompassing 417 DF-MDD patients and 409 healthy controls. Compared to the healthy control group, DF-MDD patients exhibited significantly decreased cortical thickness in multiple brain regions, including the supplementary motor area ( Z=-2.471, P<0.000 5) and the rolandic operculum ( Z=-2.190, P<0.000 5). Further regression analysis found that the disease severity was positively correlated with the cortical thickness in the supplementary motor area ( Z=2.265, P<0.000 5) and the rolandic operculum ( Z=1.56, P<0.000 5). Additionally, the average depressive duration was positively correlated with cortical thickness in the right opercular part of the inferior frontal gyrus ( Z=1.922, P<0.000 5), and negatively correlated with changes in the right midcingulate cortex ( Z=-3.035, P<0.000 5) in DF-MDD. Conclusion:DF-MDD patients exhibit reduced cortical thickness in the supplementary motor area and the operculum area during the early stages of the disease. And the observed pattern of cortical alterations is associated with both the severity and duration of the disease.
2.Comparison of demographic and clinical characteristics of bipolar Ⅰ disorder and bipolar Ⅱ disorder
Li ZHOU ; Yiling XIE ; Tingting ZHANG ; Yueqin HUANG ; Liang ZHOU ; Yan LIU ; Bo LIU ; Jie ZHANG ; Yuandong GONG ; Zhongcai LI ; Bi LI ; Zhipeng LI ; Qingyuan ZENG ; Zonglin SHEN ; Wenming CHEN ; Zhaorui LIU ; Jin LU
Chinese Mental Health Journal 2024;38(1):33-41
Objective:To compare demographic characteristics,clinical characteristics,therapeutic characteris-tics and physiological indicators of patients with bipolar Ⅰ disorder and bipolar Ⅱ disorder.Methods:A total of 381 patients with bipolar disorder(BD)diagnosed by the Diagnostic and Statistical Manual of Mental Disorders 5 th Edi-tion(DSM-5)were selected,including 302 patients with BD-Ⅰ(79.27%),74 patients with BD-Ⅱ(19.42%)and 5 patients with other specific and related disorders(1.31%).Demographic and clinical characteristics were collected with self-designed clinical information questionnaire.Multivariate logistic regression and multivariate linear regres-sion analysis were used for analysis.Results:Compared with patients with BD-Ⅱ,patients with BD-Ⅰ had more risk to have psychotic features(OR=5.75,95%CI:2.82-11.76),longer disease duration,and more repeated transcra-nial magnetic therapy(OR=3.09,95%CI:1.02-9.35),higher uric acid,total cholesterol and high-density lipo-protein.BD-Ⅰ in Han nationality was more common(OR=11.50,95%CI:1.76-75.30),and had lower education level(OR=10.22,95%CI:1.16-89.77),and less family history of psychosis(OR=2.34,95%CI:1.01-5.42).Conclusion:There are significant differences between BD-Ⅰ and BD-Ⅱ in demographic and clinical charac-teristics,treatment status,and physiological indicators,which could provide clues for exploring the pathogenesis of bipolar disorder.
3.Comparison of clinically relevant factors in bipolar disorder patients with different age of onset
Yan MA ; Xiaoyi TIAN ; Yueqin HUANG ; Zhaorui LIU ; Yongyan DENG ; Liang ZHOU ; Yan LIU ; Bo LIU ; Jie ZHANG ; Yuandong GONG ; Xiang FU ; Qiongxian ZHAO ; Jin LU ; Wannian SHA ; Hao HE ; Zonglin SHEN ; Tingting ZHANG ; Wenming CHEN
Chinese Mental Health Journal 2024;38(1):42-49
Objective:To compare clinical characteristics,treatment patterns and physiological indicators in bipolar disorder(BD)patients with different age of onset.Methods:Totally 380 patients with DSM-5 BD were se-lected in this study.Psychiatrists diagnosed the patients using the Mini International Neuropsychiatric Interview.The clinical information questionnaire and the Global Assessment of Functioning scale were utilized to collected clinical characteristics,treatment status,and physiological indicators.The onset age of BD was divided into 21 and 35 years as cut-off points.Multivariate logistic regression and linear regression were used to analyze related factors.Results:Among the 380 patients with BD,199 cases were early-onset group(52.4%),121 cases were middle-onset group(31.8%),and 60 cases were late-onset group(15.8%).There were 26.6%of patients in the early-onset group in-itially diagnosed as depression,23.1%in the middle-onset group,and 11.7%in the late-onset group.Multivariate analysis revealed that compared to the early-onset group of BD,the middle-onset(OR=2.22)and late-onset(OR=4.99)groups had more risk to experience depressive episodes,and the late-onset group(OR=6.74)had 6.74 times of risk to suffer from bipolar Ⅱ disorder.Additionally,patients in the middle-onset(β=-1.52)and late-on-set(β=-4.29)groups had shorter durations of delayed treatment,and those in the middle-onset(β=-1.62)and late-onset(β=-3.14)groups had fewer hospitalizations.Uric acid levels were lower in both the middle-onset(β=-28.39)and late-onset(β=-31.47)groups,and total cholesterol level was lower in the middle-onset group(β=-0.23).Conclusion:Patients with BD in different age of onset show significant differences in clinical charac-teristics,treatment conditions and physiological indicators.
4.Cortical thickness abnormalities in drug-naive first-episode adult depression: a Meta-analysis
Liangliang PING ; Shan SUN ; Cong ZHOU ; Mengxin HE ; Jianyu QUE ; Qi ZHENG ; Zonglin SHEN ; Xiufeng XU ; Yuqi CHENG
Chinese Journal of Psychiatry 2024;57(8):512-519
Objective:This meta-analysis aims to explore the most consistent changes in cortical thickness in drug-naive first-episode patients with major depressive disorder (DF-MDD).Methods:Systematic and comprehensive searches were conducted to acquire relevant literature from the PubMed and Web of Science databases for the studies published from inception to July 23, 2023, by using the keywords ("depression" OR "depressive disorder" OR "unipolar depression") AND ("cortical thickness"OR"thickness"). The SDM (signed differential mapping) software was used to perform whole-brain voxel-wise meta-analysis, heterogeneity test, and assess publication bias. Meta-regression analysis was employed to examine the impact of disease severity on cortical thickness in depression, and heterogeneity was tested, along with an assessment of publication bias.Results:Eight studies were ultimately included, encompassing 417 DF-MDD patients and 409 healthy controls. Compared to the healthy control group, DF-MDD patients exhibited significantly decreased cortical thickness in multiple brain regions, including the supplementary motor area ( Z=-2.471, P<0.000 5) and the rolandic operculum ( Z=-2.190, P<0.000 5). Further regression analysis found that the disease severity was positively correlated with the cortical thickness in the supplementary motor area ( Z=2.265, P<0.000 5) and the rolandic operculum ( Z=1.56, P<0.000 5). Additionally, the average depressive duration was positively correlated with cortical thickness in the right opercular part of the inferior frontal gyrus ( Z=1.922, P<0.000 5), and negatively correlated with changes in the right midcingulate cortex ( Z=-3.035, P<0.000 5) in DF-MDD. Conclusion:DF-MDD patients exhibit reduced cortical thickness in the supplementary motor area and the operculum area during the early stages of the disease. And the observed pattern of cortical alterations is associated with both the severity and duration of the disease.
5.Correlation between personality traits and clinical symptoms in patients with anxious depression
Zhaosong CHU ; Xin WANG ; Mengxin HE ; Yuqi CHENG ; Xiufeng XU ; Zonglin SHEN
Chinese Journal of Behavioral Medicine and Brain Science 2022;31(1):31-36
Objective:To investigate the personality traits of patients with anxious depression and the relationship between personality traits and clinical symptoms.Methods:From December 2011 to October 2014, 177 first-episode untreated patients with depression from the psychiatric department of the First Affiliated Hospital of Kunming Medical University and 185 healthy controls(HC group) recruited by the community were included.All patients were divided into anxious depression group ( n=92) and non-anxious depression group ( n=85) according to whether the anxiety/somatization factor score ≥7.The simplified version of Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI) and the Hamilton depression scale-17 (HAMD-17) were used to assess all the subjects.Statistical analyses were conducted in SPSS 21.0.Analysis of covariance was used to compare the differences of the scores on personality dimensions among the three groups.The relationship between personality dimensions and anxious depression was confirmed by Logistic regression, linear regression analysis and generalized linear models. Results:The differences of the scores on the four dimensions of neuroticism ( F=108.863, P<0.01), extraversion ( F=86.357, P<0.01), agreeableness ( F=50.615, P<0.01), and conscientiousness ( F=24.730, P<0.01) among the three groups were statistically significant.Further pairwise comparision showed, the score of neuroticisms was higher in the anxious depression group(43.05±8.92) and non-anxious depression group(39.85±7.21) than that in the HC group (30.16±6.25)( P<0.01, Bonferroni corrected). The scores of extroversion (31.22±6.33, 32.61±6.83), agreeableness (38.66±5.80, 39.46±6.19) and conscientiousness (39.75±6.89, 38.85±7.26) were lower in the anxious depression group and non-anxious depression group than those in the HC group (40.29±5.37, 44.79±4.68, 44.09±5.66, all P<0.01, Bonferroni corrected). The score of neuroticisms in anxious depression group was higher than that in non-anxious depression group, and the difference was statistically significant ( P<0.01, Bonferroni corrected). Logistic regression analysis with age, gender and years of education controlled showed that the score of neuroticism ( B=0.082, OR=1.085, 95% CI=1.020-1.154, P=0.009) and conscientiousness ( B=0.060, OR=1.062, 95% CI=1.006-1.120, P=0.028) were risk factors for anxiety symptoms in patients with depression.Linear regression analysis showed that the scores on neuroticism had positive predictive effects on the anxiety/somatization factor score ( B=0.055, 95% CI=0.021-0.089, P=0.002) and cognitive impairment factor score ( B=0.074, 95% CI=0.023-0.125, P=0.005) in the anxious depression group. Conclusion:Compared to non-anxious depression, patients with anxious depression show higher level of neuroticism, and the level of neuroticism can positively predict the symptoms of anxiety and cognitive impairment.The high level of neuroticism and conscientiousness may be risk factors for the occurrence of anxiety symptoms in patients with depressed.
6.Analysis of mitochondrial genome variation in patients with early-onset familial Alzheimer′s disease
Hongyan JIANG ; Zonglin SHEN ; Rui BI ; Yuqi CHENG ; Xiufeng XU
Chinese Journal of Psychiatry 2021;54(5):325-330
Objectives:To explore the mutations in mitochondrial DNA (mtDNA) and the risk of developing early-onset Alzheimer′s disease(AD).Methods:From March 2014 to April 2020, four pedigrees with maternal inherited characteristics of AD were recruited from the collected pedigree samples of early-onset familial AD. The entire mtDNA sequence was sequenced and compared with the modified Cambridge reference sequence. The latest version of mtDNA classification system database was used to classify mitochondrial haplotypes. Variation analysis method: the phylogenetic tree was used to find out the branch end private variation sites of each family sample proband, the MitoTool was used to analyze the conservatism of variation, and the PhyloTree was used to check whether these mutations were the identification variation of other haplotype groups. The pathogenicity of these variants was predicted by literature and database search, and SIFT pathogenicity prediction (2015). I-TASSER was used to predict the protein structure and Pymol was used to visualize the protein structure homology and to simulate the tertiary protein structure for analysis of the protein structural change.Results:A rare and non-synonymous variation m.8978T>C was detected. The conservative coefficient of this site was 1.0, and the pathogenicity score was high. The tertiary structure of MT-ATP6 protein was simulated by homology analysis, which showed the structural changes of the branched chain residues.Conclusion:Mutation m.8978T>C of mtDNA may have potential pathogenicity and affect the onset of AD through the decline of mitochondrial function.
7.Analysis of mitochondrial genome variation in patients with early-onset familial Alzheimer′s disease
Hongyan JIANG ; Zonglin SHEN ; Rui BI ; Yuqi CHENG ; Xiufeng XU
Chinese Journal of Psychiatry 2021;54(5):325-330
Objectives:To explore the mutations in mitochondrial DNA (mtDNA) and the risk of developing early-onset Alzheimer′s disease(AD).Methods:From March 2014 to April 2020, four pedigrees with maternal inherited characteristics of AD were recruited from the collected pedigree samples of early-onset familial AD. The entire mtDNA sequence was sequenced and compared with the modified Cambridge reference sequence. The latest version of mtDNA classification system database was used to classify mitochondrial haplotypes. Variation analysis method: the phylogenetic tree was used to find out the branch end private variation sites of each family sample proband, the MitoTool was used to analyze the conservatism of variation, and the PhyloTree was used to check whether these mutations were the identification variation of other haplotype groups. The pathogenicity of these variants was predicted by literature and database search, and SIFT pathogenicity prediction (2015). I-TASSER was used to predict the protein structure and Pymol was used to visualize the protein structure homology and to simulate the tertiary protein structure for analysis of the protein structural change.Results:A rare and non-synonymous variation m.8978T>C was detected. The conservative coefficient of this site was 1.0, and the pathogenicity score was high. The tertiary structure of MT-ATP6 protein was simulated by homology analysis, which showed the structural changes of the branched chain residues.Conclusion:Mutation m.8978T>C of mtDNA may have potential pathogenicity and affect the onset of AD through the decline of mitochondrial function.
8.Relationship between BDNF Val/Met gene polymorphism and gray matter volume in first episode and treatment-naive patients with major depressive disorder
Xiaorui HU ; Zonglin SHEN ; Tianzhu ZHAI ; Yi LU ; Xiaoyan LIU ; Yuqi CHENG ; Xiufeng XU
Chinese Journal of Psychiatry 2020;53(3):221-228
Objective:Numerous studies have shown that neuroplasticity plays an important role in the pathogenesis of depression. This study aimed to investigate the relationship between the brain derived neurotrophic factor (BDNF) (Val66Met, rs6265) genotype and gray matter volume (GMV) in the first episode and treatment-naive patients with major depressive disorder (MDD) and healthy subjects.Methods:This study included 41 first episode and treatment-naive MDD patients (MDD group) and 44 sex and age matched healthy controls (HC group). All participants were arranged to take magnetic resonance imaging (MRI) scan. Meanwhile, BDNF rs6265 polymorphism was detected. Voxel-based morphometry (VBM) method was then performed to test the impact of the diagnosis (MDD vs. HC) and BDNF genotype (Met allele vs. Val/Val homozygous) on GMV. Results:There was no statistically significant difference on BDNF rs 6265 sites alleles frequency and genotype between MDD and HC groups (MDD χ 2=0.004, P>0.05; HC χ2=0.048, P>0.05). Gray matter volume in the left precuneus ( F=3.702, P<0.001), right middle temporal gyrus ( F=4.020, P<0.001) and cerebellum vermis_4_5 ( F=3.836, P<0.001) was larger in MDD patients than in the control group. BDNF genotype had effects on left fusiform gyrus ( F=-4.152, P<0.001). BDNF genotype-diagnosis interaction was found to be associated with left anterior cingulate cortex ( F=-4.775, P<0.001) and right anterior cingulate ( F=-3.795, P<0.001). For participants with Val/Val homozygous, compared to HC group, the volume of left anterior cingulate was reduced in MDD patients ( F=-3.729, P<0.001). For participants with the Met allele, compared to healthy controls, MDD patients showed significantly increased GMV in the left middle frontal gyrus ( F=4.317, P<0.001), right inferior occipital gyrus ( F=4.744, P<0.001), right supramarginal gyrus ( F=3.838, P<0.001), and left median cingulate gyrus( F=4.041, P<0.001). Separately in MDD patients and the control group, the GMV did not differ between the Val/Val homozygous group and the Met allele group. Conclusion:BDNF rs6265 alleles could be related to brain structural abnormalities in MDD patients, and could further explain the pathological mechanism of MDD.
9.Relationship between BDNF Val/Met gene polymorphism and gray matter volume in first episode and treatment-naive patients with major depressive disorder
Xiaorui HU ; Zonglin SHEN ; Tianzhu ZHAI ; Yi LU ; Xiaoyan LIU ; Yuqi CHENG ; Xiufeng XU
Chinese Journal of Psychiatry 2020;53(3):221-228
Objective:Numerous studies have shown that neuroplasticity plays an important role in the pathogenesis of depression. This study aimed to investigate the relationship between the brain derived neurotrophic factor (BDNF) (Val66Met, rs6265) genotype and gray matter volume (GMV) in the first episode and treatment-naive patients with major depressive disorder (MDD) and healthy subjects.Methods:This study included 41 first episode and treatment-naive MDD patients (MDD group) and 44 sex and age matched healthy controls (HC group). All participants were arranged to take magnetic resonance imaging (MRI) scan. Meanwhile, BDNF rs6265 polymorphism was detected. Voxel-based morphometry (VBM) method was then performed to test the impact of the diagnosis (MDD vs. HC) and BDNF genotype (Met allele vs. Val/Val homozygous) on GMV. Results:There was no statistically significant difference on BDNF rs 6265 sites alleles frequency and genotype between MDD and HC groups (MDD χ 2=0.004, P>0.05; HC χ2=0.048, P>0.05). Gray matter volume in the left precuneus ( F=3.702, P<0.001), right middle temporal gyrus ( F=4.020, P<0.001) and cerebellum vermis_4_5 ( F=3.836, P<0.001) was larger in MDD patients than in the control group. BDNF genotype had effects on left fusiform gyrus ( F=-4.152, P<0.001). BDNF genotype-diagnosis interaction was found to be associated with left anterior cingulate cortex ( F=-4.775, P<0.001) and right anterior cingulate ( F=-3.795, P<0.001). For participants with Val/Val homozygous, compared to HC group, the volume of left anterior cingulate was reduced in MDD patients ( F=-3.729, P<0.001). For participants with the Met allele, compared to healthy controls, MDD patients showed significantly increased GMV in the left middle frontal gyrus ( F=4.317, P<0.001), right inferior occipital gyrus ( F=4.744, P<0.001), right supramarginal gyrus ( F=3.838, P<0.001), and left median cingulate gyrus( F=4.041, P<0.001). Separately in MDD patients and the control group, the GMV did not differ between the Val/Val homozygous group and the Met allele group. Conclusion:BDNF rs6265 alleles could be related to brain structural abnormalities in MDD patients, and could further explain the pathological mechanism of MDD.
10.Structural abnormalities in patients with obsessive-compulsive disorder: a multimodal study
Cong ZHOU ; Zonglin SHEN ; Fengrui ZHANG ; Xiufeng XU ; Yuqi CHENG
Chinese Journal of Psychiatry 2020;53(2):117-121
Objective:To explore whether gray matter and white matter presented abnormalities in neural circuit in patients with OCD by using multimodal imaging strategies.Methods:Magnetic resonance imaging (MRI) scans from 54 OCD patients and 54 healthy controls (HC) were acquired. Gray matter volume was compared using the voxel-based morphometry (VBM) approach based on the SPM software. Fractional anisotropy (FA) difference was also evaluated using tract based spatial statistics (TBSS) based on the FSL software.Results:Compared with the HC, Patients with OCD showed decreased gray matter volume in the left middle frontal gyrus, left anterior cingulate and paracingulate gyri, left precental gyrus and right inferior temporal gyrus ( P<0.05, Alphasim corrected); meanwhile, decreased FA values in the body and genu of corpus callosum were found. Conclusions:Patients with OCD demonstrated widespread gray matter and white matter alterations especially in the incortico-striatal-thalamic-cortical (CSTC)circuit. Therefore, Patients with OCD might present altered gray and white matter structures simultaneously.

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