Frequency-Specific Changes in the Fractional Amplitude of the Low-Frequency Fluctuations in the Default Mode Network in Medication-Free Patients With Bipolar II Depression: A Longitudinal Functional MRI Study

Author(s): Jun Zhou ¹ ^, ² ^, ³ ^, ⁴ ^, ⁵ , Xiaoqian Ma ¹ ^, ² ^, ³ ^, ⁴ ^, ⁵ , Chunwang Li ⁶ , Aijun Liao ¹ ^, ² ^, ³ ^, ⁴ ^, ⁵ , Zihao Yang ¹ ^, ² ^, ³ ^, ⁴ ^, ⁵ , Honghong Ren ¹ ^, ² ^, ³ ^, ⁴ ^, ⁵ , Jinsong Tang ⁷ , Jinguang Li ¹ ^, ² ^, ³ ^, ⁴ ^, ⁵ , Zongchang Li ¹ ^, ² ^, ³ ^, ⁴ ^, ⁵ , Ying He ¹ ^, ² ^, ³ ^, ⁴ ^, ⁵ ^, ^* , Xiaogang Chen ¹ ^, ² ^, ³ ^, ⁴ ^, ⁵ ^, ^*

Publication date (Electronic): 08 January 2021

Journal: Frontiers in Psychiatry

Publisher: Frontiers Media S.A.

Keywords: fractional amplitude of low-frequency fluctuations, bipolar depression, resting state functional magnetic resonance imaging, default-mode Network, escitalopram, lithium

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Abstract

Objective: This study aimed to examine the treatment-related changes of the fractional amplitude of low-frequency fluctuations (fALFF) in the default mode network (DMN) across different bands after the medication-free patients with bipolar II depression received a 16-week treatment of escitalopram and lithium.

Methods: A total of 23 medication-free patients with bipolar II depression and 29 healthy controls (HCs) were recruited. We evaluated the fALFF values of slow 4 (0.027–0.073 Hz) band and slow 5 (0.01–0.027 Hz) band of the patients and compared the results with those of the 29 HCs at baseline. After 16-week treatment of escitalopram with lithium, the slow 4 and slow 5 fALFF values of the patients were assessed and compared with the baselines of patients and HCs. The depressive symptoms of bipolar II depression in patients were assessed with a 17-item Hamilton Depression Rating Scale (HDRS) before and after treatment.

Results: Treatment-related effects showed increased slow 5 fALFF in cluster D (bilateral medial superior frontal gyrus, bilateral superior frontal gyrus, right middle frontal gyrus, and bilateral anterior cingulate), cluster E (bilateral precuneus/posterior cingulate, left cuneus), and cluster F (left angular, left middle temporal gyrus, left superior temporal gyrus, and left supramarginal gyrus) in comparison with the baseline of the patients. Moreover, a positive association was found between the increase in slow 5 fALFF values (follow-up value minus the baseline values) in cluster D and the decrease in HDRS scores (baseline HDRS scores minus follow-up HDRS scores) at follow-up, and the same association between the increase in slow 5 fALFF values and the decrease in HDRS scores was found in cluster E.

Conclusions: The study reveals that the hypoactivity of slow 5 fALFF in the DMN is related to depression symptoms and might be corrected by the administration of escitalopram with lithium, implying that slow 5 fALFF of the DMN plays a key role in bipolar depression.

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Most cited references 85

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M. Hamilton (1960)

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The brain's default network: anatomy, function, and relevance to disease.

Randy L. Buckner, Jessica Andrews-Hanna, Daniel Schacter (2008)

Thirty years of brain imaging research has converged to define the brain's default network-a novel and only recently appreciated brain system that participates in internal modes of cognition. Here we synthesize past observations to provide strong evidence that the default network is a specific, anatomically defined brain system preferentially active when individuals are not focused on the external environment. Analysis of connectional anatomy in the monkey supports the presence of an interconnected brain system. Providing insight into function, the default network is active when individuals are engaged in internally focused tasks including autobiographical memory retrieval, envisioning the future, and conceiving the perspectives of others. Probing the functional anatomy of the network in detail reveals that it is best understood as multiple interacting subsystems. The medial temporal lobe subsystem provides information from prior experiences in the form of memories and associations that are the building blocks of mental simulation. The medial prefrontal subsystem facilitates the flexible use of this information during the construction of self-relevant mental simulations. These two subsystems converge on important nodes of integration including the posterior cingulate cortex. The implications of these functional and anatomical observations are discussed in relation to possible adaptive roles of the default network for using past experiences to plan for the future, navigate social interactions, and maximize the utility of moments when we are not otherwise engaged by the external world. We conclude by discussing the relevance of the default network for understanding mental disorders including autism, schizophrenia, and Alzheimer's disease.

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Functional connectivity in the motor cortex of resting human brain using echo-planar MRI.

B. Biswal, F Z Yetkin, V M Haughton … (1995)

An MRI time course of 512 echo-planar images (EPI) in resting human brain obtained every 250 ms reveals fluctuations in signal intensity in each pixel that have a physiologic origin. Regions of the sensorimotor cortex that were activated secondary to hand movement were identified using functional MRI methodology (FMRI). Time courses of low frequency (< 0.1 Hz) fluctuations in resting brain were observed to have a high degree of temporal correlation (P < 10(-3)) within these regions and also with time courses in several other regions that can be associated with motor function. It is concluded that correlation of low frequency fluctuations, which may arise from fluctuations in blood oxygenation or flow, is a manifestation of functional connectivity of the brain.

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Author and article information

Contributors

Jun Zhou: URI : http://loop.frontiersin.org/people/982540/overview

Jinguang Li: URI : http://loop.frontiersin.org/people/956080/overview

Xiaogang Chen: URI : http://loop.frontiersin.org/people/531554/overview

Journal

Journal ID (nlm-ta): Front Psychiatry

Journal ID (iso-abbrev): Front Psychiatry

Journal ID (publisher-id): Front. Psychiatry

Title: Frontiers in Psychiatry

Publisher: Frontiers Media S.A.

ISSN (Electronic): 1664-0640

Publication date (Electronic): 08 January 2021

Publication date Collection: 2020

Volume: 11

Electronic Location Identifier: 574819

Affiliations

[1] ¹Department of Psychiatry, The Second Xiangya Hospital, Central South University , Changsha, China

[2] ²National Clinical Research Center for Mental Disorders , Changsha, China

[3] ³National Technology Institute on Mental Disorders , Changsha, China

[4] ⁴Hunan Key Laboratory of Psychiatry and Mental Health , Changsha, China

[5] ⁵Mental Health Institute of Central South University , Changsha, China

[6] ⁶Department of Radiology, Hunan Children's Hospital , Changsha, China

[7] ⁷Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University , Hangzhou, China

Author notes

Edited by: Joaquim Radua, Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Spain

Reviewed by: Ruiyang Ge, University of British Columbia, Canada; Ning Sun, First Hospital of Shanxi Medical University, China; Kerang Zhang, First Hospital of Shanxi Medical University, China

*Correspondence: Ying He yinghe@ 123456csu.edu.cn

Xiaogang Chen chenxiaogang@ 123456csu.edu.cn

This article was submitted to Mood and Anxiety Disorders, a section of the journal Frontiers in Psychiatry

Article

DOI: 10.3389/fpsyt.2020.574819

PMC ID: 7819893

PubMed ID: 33488415

SO-VID: 889bf45e-745f-400b-9487-ad6f29f2485f

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 21 June 2020

Date accepted : 24 November 2020

Page count

Figures: 4, Tables: 2, Equations: 0, References: 85, Pages: 12, Words: 8593

Funding

Funded by: National Natural Science Foundation of China 10.13039/501100001809

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Frequency-Specific Changes in the Fractional Amplitude of the Low-Frequency Fluctuations in the Default Mode Network in Medication-Free Patients With Bipolar II Depression: A Longitudinal Functional MRI Study

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Abstract

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Most cited references 85

A RATING SCALE FOR DEPRESSION

The brain's default network: anatomy, function, and relevance to disease.

Functional connectivity in the motor cortex of resting human brain using echo-planar MRI.

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