Mapping Neural Circuit Biotypes to Symptoms and Behavioral Dimensions of Depression and Anxiety.
Anxiety
Biotype
Clinical translation
Depression
Functional brain circuit imaging
Precision mental health
Journal
Biological psychiatry
ISSN: 1873-2402
Titre abrégé: Biol Psychiatry
Pays: United States
ID NLM: 0213264
Informations de publication
Date de publication:
15 03 2022
15 03 2022
Historique:
received:
30
10
2020
revised:
25
06
2021
accepted:
28
06
2021
pubmed:
7
9
2021
medline:
20
4
2022
entrez:
6
9
2021
Statut:
ppublish
Résumé
Despite tremendous advances in characterizing human neural circuits that govern emotional and cognitive functions impaired in depression and anxiety, we lack a circuit-based taxonomy for depression and anxiety that captures transdiagnostic heterogeneity and informs clinical decision making. We developed and tested a novel system for quantifying 6 brain circuits reproducibly and at the individual patient level. We implemented standardized circuit definitions relative to a healthy reference sample and algorithms to generate circuit clinical scores for the overall circuit and its constituent regions. In new data from primary and generalizability samples of depression and anxiety (N = 250), we demonstrated that overall disconnections within task-free salience and default mode circuits map onto symptoms of anxious avoidance, loss of pleasure, threat dysregulation, and negative emotional biases-core characteristics that transcend diagnoses-and poorer daily function. Regional dysfunctions within task-evoked cognitive control and affective circuits may implicate symptoms of cognitive and valence-congruent emotional functions. Circuit dysfunction scores also distinguished response to antidepressant and behavioral intervention treatments in an independent sample (n = 205). Our findings articulate circuit dimensions that relate to transdiagnostic symptoms across mood and anxiety disorders. Our novel system offers a foundation for deploying standardized circuit assessments across research groups, trials, and clinics to advance more precise classifications and treatment targets for psychiatry.
Sections du résumé
BACKGROUND
Despite tremendous advances in characterizing human neural circuits that govern emotional and cognitive functions impaired in depression and anxiety, we lack a circuit-based taxonomy for depression and anxiety that captures transdiagnostic heterogeneity and informs clinical decision making.
METHODS
We developed and tested a novel system for quantifying 6 brain circuits reproducibly and at the individual patient level. We implemented standardized circuit definitions relative to a healthy reference sample and algorithms to generate circuit clinical scores for the overall circuit and its constituent regions.
RESULTS
In new data from primary and generalizability samples of depression and anxiety (N = 250), we demonstrated that overall disconnections within task-free salience and default mode circuits map onto symptoms of anxious avoidance, loss of pleasure, threat dysregulation, and negative emotional biases-core characteristics that transcend diagnoses-and poorer daily function. Regional dysfunctions within task-evoked cognitive control and affective circuits may implicate symptoms of cognitive and valence-congruent emotional functions. Circuit dysfunction scores also distinguished response to antidepressant and behavioral intervention treatments in an independent sample (n = 205).
CONCLUSIONS
Our findings articulate circuit dimensions that relate to transdiagnostic symptoms across mood and anxiety disorders. Our novel system offers a foundation for deploying standardized circuit assessments across research groups, trials, and clinics to advance more precise classifications and treatment targets for psychiatry.
Identifiants
pubmed: 34482948
pii: S0006-3223(21)01437-2
doi: 10.1016/j.biopsych.2021.06.024
pmc: PMC9511971
mid: NIHMS1738043
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
561-571Subventions
Organisme : NIMH NIH HHS
ID : T32 MH019938
Pays : United States
Organisme : NIMH NIH HHS
ID : U01 MH109985
Pays : United States
Organisme : NIDA NIH HHS
ID : P50 DA042012
Pays : United States
Organisme : NIMH NIH HHS
ID : F32 MH108299
Pays : United States
Organisme : NHLBI NIH HHS
ID : UH2 HL132368
Pays : United States
Organisme : NIMH NIH HHS
ID : K23 MH113708
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH101496
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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