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Improved Interhemispheric Functional Connectivity in Postpartum Depression Disorder: Associations With Individual Target-Transcranial Magnetic Stimulation Treatment Effects

Postpartum depression (PPD) is a depressive condition that is associated with a high risk of stressful life events, poor marital relationships, and even suicide. Neuroimaging techniques have enriched our understanding of cerebral mechanisms underlying PPD; namely, abnormalities in the amygdala-insul...

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Autores principales: Zhang, Yao, Mu, Yunfeng, Li, Xiang, Sun, Chuanzhu, Ma, Xiaowei, Li, Sanzhong, Li, Li, Zhang, Zhaohui, Qi, Shun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964485/
https://www.ncbi.nlm.nih.gov/pubmed/35370853
http://dx.doi.org/10.3389/fpsyt.2022.859453
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author Zhang, Yao
Mu, Yunfeng
Li, Xiang
Sun, Chuanzhu
Ma, Xiaowei
Li, Sanzhong
Li, Li
Zhang, Zhaohui
Qi, Shun
author_facet Zhang, Yao
Mu, Yunfeng
Li, Xiang
Sun, Chuanzhu
Ma, Xiaowei
Li, Sanzhong
Li, Li
Zhang, Zhaohui
Qi, Shun
author_sort Zhang, Yao
collection PubMed
description Postpartum depression (PPD) is a depressive condition that is associated with a high risk of stressful life events, poor marital relationships, and even suicide. Neuroimaging techniques have enriched our understanding of cerebral mechanisms underlying PPD; namely, abnormalities in the amygdala-insula-frontal circuit might contribute to the pathogenesis of PPD. Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) is a recently validated neuroscience-informed accelerated intermittent theta-burst stimulation repetitive transcranial magnetic stimulation (rTMS) protocol. It has been shown to be effective, safe, tolerable, and rapid acting for treating treatment-resistant depression, and may be a valuable tool in the treatment of PPD. The purpose of the current study was to detect inter-hemispheric connectivity changes and their relationship with the clinical treatment effects of rTMS. Resting-state fMRI data from 32 patients with PPD treated with SAINT were collected and compared with findings from 32 age matched healthy controls. Voxel-mirrored homotopic connectivity (VMHC) was used to analyze the patterns of interhemispheric intrinsic functional connectivity in patients with PPD. Scores on the 17-item Hamilton Depression Rating Scale, Edinburgh Postnatal Depression Scale (EPDS) scores, and the relationships between these clinical characteristics and VMHC were the primary outcomes. Patients with PPD at baseline showed reduced VMHC in the amygdala, insula, and medial frontal gyrus compared with the HCs. These properties showed a renormalization after individualized rTMS treatment. Furthermore, increased connectivity between the left and right insula after SAINT was significantly correlated with the improvement of EPDS scores. Our results reveal the disruptions in the intrinsic functional architecture of interhemispheric communication in patients with PPD, and provide evidence for the pathophysiological mechanisms and the effects of rTMS.
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spelling pubmed-89644852022-03-31 Improved Interhemispheric Functional Connectivity in Postpartum Depression Disorder: Associations With Individual Target-Transcranial Magnetic Stimulation Treatment Effects Zhang, Yao Mu, Yunfeng Li, Xiang Sun, Chuanzhu Ma, Xiaowei Li, Sanzhong Li, Li Zhang, Zhaohui Qi, Shun Front Psychiatry Psychiatry Postpartum depression (PPD) is a depressive condition that is associated with a high risk of stressful life events, poor marital relationships, and even suicide. Neuroimaging techniques have enriched our understanding of cerebral mechanisms underlying PPD; namely, abnormalities in the amygdala-insula-frontal circuit might contribute to the pathogenesis of PPD. Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) is a recently validated neuroscience-informed accelerated intermittent theta-burst stimulation repetitive transcranial magnetic stimulation (rTMS) protocol. It has been shown to be effective, safe, tolerable, and rapid acting for treating treatment-resistant depression, and may be a valuable tool in the treatment of PPD. The purpose of the current study was to detect inter-hemispheric connectivity changes and their relationship with the clinical treatment effects of rTMS. Resting-state fMRI data from 32 patients with PPD treated with SAINT were collected and compared with findings from 32 age matched healthy controls. Voxel-mirrored homotopic connectivity (VMHC) was used to analyze the patterns of interhemispheric intrinsic functional connectivity in patients with PPD. Scores on the 17-item Hamilton Depression Rating Scale, Edinburgh Postnatal Depression Scale (EPDS) scores, and the relationships between these clinical characteristics and VMHC were the primary outcomes. Patients with PPD at baseline showed reduced VMHC in the amygdala, insula, and medial frontal gyrus compared with the HCs. These properties showed a renormalization after individualized rTMS treatment. Furthermore, increased connectivity between the left and right insula after SAINT was significantly correlated with the improvement of EPDS scores. Our results reveal the disruptions in the intrinsic functional architecture of interhemispheric communication in patients with PPD, and provide evidence for the pathophysiological mechanisms and the effects of rTMS. Frontiers Media S.A. 2022-03-15 /pmc/articles/PMC8964485/ /pubmed/35370853 http://dx.doi.org/10.3389/fpsyt.2022.859453 Text en Copyright © 2022 Zhang, Mu, Li, Sun, Ma, Li, Li, Zhang and Qi. https://creativecommons.org/licenses/by/4.0/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.
spellingShingle Psychiatry
Zhang, Yao
Mu, Yunfeng
Li, Xiang
Sun, Chuanzhu
Ma, Xiaowei
Li, Sanzhong
Li, Li
Zhang, Zhaohui
Qi, Shun
Improved Interhemispheric Functional Connectivity in Postpartum Depression Disorder: Associations With Individual Target-Transcranial Magnetic Stimulation Treatment Effects
title Improved Interhemispheric Functional Connectivity in Postpartum Depression Disorder: Associations With Individual Target-Transcranial Magnetic Stimulation Treatment Effects
title_full Improved Interhemispheric Functional Connectivity in Postpartum Depression Disorder: Associations With Individual Target-Transcranial Magnetic Stimulation Treatment Effects
title_fullStr Improved Interhemispheric Functional Connectivity in Postpartum Depression Disorder: Associations With Individual Target-Transcranial Magnetic Stimulation Treatment Effects
title_full_unstemmed Improved Interhemispheric Functional Connectivity in Postpartum Depression Disorder: Associations With Individual Target-Transcranial Magnetic Stimulation Treatment Effects
title_short Improved Interhemispheric Functional Connectivity in Postpartum Depression Disorder: Associations With Individual Target-Transcranial Magnetic Stimulation Treatment Effects
title_sort improved interhemispheric functional connectivity in postpartum depression disorder: associations with individual target-transcranial magnetic stimulation treatment effects
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964485/
https://www.ncbi.nlm.nih.gov/pubmed/35370853
http://dx.doi.org/10.3389/fpsyt.2022.859453
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