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      Brain structure alterations in depression: Psychoradiological evidence

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          Abstract

          <p id="d1116437e308">Depression is the leading cause of disability around the world, but little is known about its pathology. Currently, the diagnosis of depression is made based on clinical manifestations, with little objective evidence. Magnetic resonance imaging (MRI) has been used to investigate the pathological changes in brain anatomy associated with this disorder. MRI can identify structural alterations in depressive patients in vivo, which could make considerable contributions to clinical diagnosis and treatment. Numerous studies that focused on gray and white matter have found significant brain region alterations in major depressive disorder patients, such as in the frontal lobe, hippocampus, temporal lobe, thalamus, striatum, and amygdala. The results are inconsistent and controversial because of the different demographic and clinical characteristics. However, some regions overlapped; thus, we think that there may be a “hub” in MDD and that an impairment in these regions contributes to disease severity. Brain connections contain both structural connections and functional connections, which reflect disease from a different view and support that MDD may be caused by the interaction of multiple brain regions. According to previous reports, significant circuits include the frontal‐subcortical circuit, the suicide circuit, and the reward circuit. As has been recognized, the pathophysiology of major depressive disorder is complex and changeable. The current review focuses on the significant alterations in the gray and white matter of patients with the depressive disorder to generate a better understanding of the circuits. Moreover, identifying the nuances of depressive disorder and finding a biomarker will make a significant contribution to the guidance of clinical diagnosis and treatment. </p>

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          Parallel organization of functionally segregated circuits linking basal ganglia and cortex.

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            Rich-club organization of the human connectome.

            The human brain is a complex network of interlinked regions. Recent studies have demonstrated the existence of a number of highly connected and highly central neocortical hub regions, regions that play a key role in global information integration between different parts of the network. The potential functional importance of these "brain hubs" is underscored by recent studies showing that disturbances of their structural and functional connectivity profile are linked to neuropathology. This study aims to map out both the subcortical and neocortical hubs of the brain and examine their mutual relationship, particularly their structural linkages. Here, we demonstrate that brain hubs form a so-called "rich club," characterized by a tendency for high-degree nodes to be more densely connected among themselves than nodes of a lower degree, providing important information on the higher-level topology of the brain network. Whole-brain structural networks of 21 subjects were reconstructed using diffusion tensor imaging data. Examining the connectivity profile of these networks revealed a group of 12 strongly interconnected bihemispheric hub regions, comprising the precuneus, superior frontal and superior parietal cortex, as well as the subcortical hippocampus, putamen, and thalamus. Importantly, these hub regions were found to be more densely interconnected than would be expected based solely on their degree, together forming a rich club. We discuss the potential functional implications of the rich-club organization of the human connectome, particularly in light of its role in information integration and in conferring robustness to its structural core.
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              Frontal-subcortical circuits and human behavior.

              This synthetic review was performed to demonstrate the utility of frontal-subcortical circuits in the explanation of a wide range of human behavioral disorders. Reports of patients with degenerative disorders or focal lesions involving frontal lobe or linked subcortical structures were chosen from the English literature. Individual case reports and group investigations from peer-reviewed journals were evaluated. Studies were included if they described patient behavior in detail or reported pertinent neuropsy-chological findings and had compelling evidence of a disorder affecting frontal-subcortical circuits. Information was used if the report from which it was taken met study selection criteria. Five parallel segregated circuits link the frontal lobe and subcortical structures. Clinical syndromes observed with frontal lobe injury are recapitulated with lesions of subcortical member structures of the circuits. Each prefrontal circuit has a signature behavioral syndrome: executive function deficits occur with lesions of the dorsolateral prefrontal circuit, disinhibition with lesions of the orbitofrontal circuit, and apathy with injury to the anterior cingulate circuit. Depression, mania, and obsessive-compulsive disorder may also be mediated by frontal-subcotical circuits. Movement disorders identify involvement of the basal ganglia component of frontal-subcortical circuits. Frontal-subcortical circuits mediate many aspects of human behavior.
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                Author and article information

                Journal
                CNS Neuroscience & Therapeutics
                CNS Neurosci Ther
                Wiley
                17555930
                November 2018
                November 2018
                March 05 2018
                : 24
                : 11
                : 994-1003
                Affiliations
                [1 ]Huaxi MR Research Center (HMRRC); Department of Radiology; West China Hospital of Sichuan University; Chengdu China
                [2 ]Department of Psychiatry and Behavioral Neuroscience; University of Cincinnati; Cincinnati OH USA
                [3 ]Department of Nuclear Medicine; West China Hospital; Sichuan University; Chengdu China
                [4 ]Department of Psychology; School of Public Administration; Sichuan University; Chengdu China
                Article
                10.1111/cns.12835
                6489983
                29508560
                b450c13c-5d23-43eb-aee8-9fc40052e720
                © 2018

                http://doi.wiley.com/10.1002/tdm_license_1.1

                http://onlinelibrary.wiley.com/termsAndConditions#vor

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