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      Transdiagnostic and disease-specific abnormalities in the default-mode network hubs in psychiatric disorders: A meta-analysis of resting-state functional imaging studies

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          Abstract

          Background.

          The default mode network (DMN) dysfunction has emerged as a consistent biological correlate of multiple psychiatric disorders. Specifically, there is evidence of alterations in DMN cohesiveness in schizophrenia, mood and anxiety disorders. The aim of this study was to synthesize at a fine spatial resolution the intra-network functional connectivity of the DMN in adults diagnosed with schizophrenia, mood and anxiety disorders, capitalizing on powerful meta-analytic tools provided by activation likelihood estimation.

          Methods.

          Results from 70 whole-brain resting-state functional magnetic resonance imaging articles published during the last 15 years were included comprising observations from 2,789 patients and 3,002 healthy controls.

          Results.

          Specific regional changes in DMN cohesiveness located in the anteromedial and posteromedial cortex emerged as shared and trans-diagnostic brain phenotypes. Disease-specific dysconnectivity was also identified. Unmedicated patients showed more DMN functional alterations, highlighting the importance of interventions targeting the functional integration of the DMN.

          Conclusion.

          This study highlights functional alteration in the major hubs of the DMN, suggesting common abnormalities in self-referential mental activity across psychiatric disorders.

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          Most cited references40

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          Situating the default-mode network along a principal gradient of macroscale cortical organization.

          Understanding how the structure of cognition arises from the topographical organization of the cortex is a primary goal in neuroscience. Previous work has described local functional gradients extending from perceptual and motor regions to cortical areas representing more abstract functions, but an overarching framework for the association between structure and function is still lacking. Here, we show that the principal gradient revealed by the decomposition of connectivity data in humans and the macaque monkey is anchored by, at one end, regions serving primary sensory/motor functions and at the other end, transmodal regions that, in humans, are known as the default-mode network (DMN). These DMN regions exhibit the greatest geodesic distance along the cortical surface-and are precisely equidistant-from primary sensory/motor morphological landmarks. The principal gradient also provides an organizing spatial framework for multiple large-scale networks and characterizes a spectrum from unimodal to heteromodal activity in a functional metaanalysis. Together, these observations provide a characterization of the topographical organization of cortex and indicate that the role of the DMN in cognition might arise from its position at one extreme of a hierarchy, allowing it to process transmodal information that is unrelated to immediate sensory input.
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            Remembering the past to imagine the future: the prospective brain.

            A rapidly growing number of recent studies show that imagining the future depends on much of the same neural machinery that is needed for remembering the past. These findings have led to the concept of the prospective brain; an idea that a crucial function of the brain is to use stored information to imagine, simulate and predict possible future events. We suggest that processes such as memory can be productively re-conceptualized in light of this idea.
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              Resting-state functional connectivity in neuropsychiatric disorders.

              This review considers recent advances in the application of resting-state functional magnetic resonance imaging to the study of neuropsychiatric disorders. Resting-state functional magnetic resonance imaging is a relatively novel technique that has several potential advantages over task-activation functional magnetic resonance imaging in terms of its clinical applicability. A number of research groups have begun to investigate the use of resting-state functional magnetic resonance imaging in a variety of neuropsychiatric disorders including Alzheimer's disease, depression, and schizophrenia. Although preliminary results have been fairly consistent in some disorders (for example, Alzheimer's disease) they have been less reproducible in others (schizophrenia). Resting-state connectivity has been shown to correlate with behavioral performance and emotional measures. It's potential as a biomarker of disease and an early objective marker of treatment response is genuine but still to be realized. Resting-state functional magnetic resonance imaging has made some strides in the clinical realm but significant advances are required before it can be used in a meaningful way at the single-patient level.
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                Author and article information

                Journal
                Eur Psychiatry
                Eur. Psychiatry
                EPA
                European Psychiatry
                Cambridge University Press (Cambridge, UK )
                0924-9338
                1778-3585
                2020
                29 May 2020
                : 63
                : 1
                : e57
                Affiliations
                [ 1 ] Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, New York, USA
                [ 2 ] Brain Architecture, Imaging and Cognition Lab, Boys Town National Research Hospital , Omaha, Nebraska, USA
                [ 3 ] Department of Neurology and Psychiatry, Sapienza University of Rome , Rome, Italy
                [ 4 ] Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai , New York, New York, USA
                [ 5 ] Department of Psychology, University of Arizona , Tucson, Arizona, USA
                [ 6 ] Evelyn F. McKnight Brain Institute, University of Arizona , Tucson, Arizona, USA
                [ 7 ] Cognitive Science, University of Arizona , Tucson, Arizona, USA
                [ 8 ] Centre for Brain Health, University of British Columbia , Vancouver, British Columbia, Canada
                Author notes
                Gaelle E. Doucet, E-mail: gaelle.doucet@ 123456boystown.org

                Gaelle E. Doucet and Delfina Janiri contributed equally to this study.

                Author information
                https://orcid.org/0000-0003-4120-0474
                Article
                S0924933820000577
                10.1192/j.eurpsy.2020.57
                7355168
                32466812
                322f7d8b-fff6-4b6a-8be0-ebd607b4e1a4
                © The Author(s) 2020

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 April 2020
                : 19 May 2020
                : 20 May 2020
                Page count
                Figures: 2, Tables: 1, References: 70, Pages: 7
                Categories
                Review/Meta-analyses

                Clinical Psychology & Psychiatry
                default mode network,meta-analysis,psychiatric disorders,resting-state fmri studies

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