Large-scale network dysfunction in major depressive disorder: metaanalysis of resting-state functional connectivity. JAMA Psychiatry.

Obsessive-compulsive disorder (OCD) is a serious and often chronically disabling condition. The current dominant model of OCD focuses on abnormalities in prefrontal-striatal circuits that support executive function (EF). While there is growing evidence for EF impairments associated with OCD, results have been inconsistent, making the nature and magnitude of these impairments controversial. The current meta-analysis uses random-effects models to synthesize 110 previous studies that compared participants with OCD to healthy control participants on at least one neuropsychological measure of EF. The results indicate that individuals with OCD are impaired on tasks measuring most aspects of EF, consistent with broad impairment in EF. EF deficits were not explained by general motor slowness or depression. Effect sizes were largely stable across variation in demographic and clinical characteristics of samples, although medication use, age, and gender moderated some effects.

Major depressive disorder (MDD) is characterized by abnormal resting-state functional connectivity (RSFC), especially in medial prefrontal cortical (MPFC) regions of the default network. However, prior research in MDD has not examined dynamic changes in functional connectivity as networks form, interact, and dissolve over time. We compared unmedicated individuals with MDD (n=100) to control participants (n=109) on dynamic RSFC (operationalized as SD in RSFC over a series of sliding windows) of an MPFC seed region during a resting-state functional magnetic resonance imaging scan. Among participants with MDD, we also investigated the relationship between symptom severity and RSFC. Secondary analyses probed the association between dynamic RSFC and rumination. Results showed that individuals with MDD were characterized by decreased dynamic (less variable) RSFC between MPFC and regions of parahippocampal gyrus within the default network, a pattern related to sustained positive connectivity between these regions across sliding windows. In contrast, the MDD group exhibited increased dynamic (more variable) RSFC between MPFC and regions of insula, and higher severity of depression was related to increased dynamic RSFC between MPFC and dorsolateral prefrontal cortex. These patterns of highly variable RSFC were related to greater frequency of strong positive and negative correlations in activity across sliding windows. Secondary analyses indicated that increased dynamic RSFC between MPFC and insula was related to higher levels of recent rumination. These findings provide initial evidence that depression, and ruminative thinking in depression, are related to abnormal patterns of fluctuating communication among brain systems involved in regulating attention and self-referential thinking.

A core aspect of human cognition involves overcoming the constraints of the present environment by mentally simulating another time, place, or perspective. Although these self-generated processes confer many benefits, they can come at an important cost, and this cost is greater for some individuals than for others. Here we explore the possibility that the costs and benefits of self-generated thought depend, in part, upon its phenomenological content. To test these hypotheses, we first developed a novel thought sampling paradigm in which a large sample of young adults recalled several recurring thoughts and rated each thought on multiple content variables (i.e., valence, specificity, self-relevance, etc.). Next, we examined multi-level relationships among these content variables and used a hierarchical clustering approach to partition self-generated thought into distinct dimensions. Finally, we investigated whether these content dimensions predicted individual differences in the costs and benefits of the experience, assessed with questionnaires measuring emotional health and wellbeing. Individuals who characterized their thoughts as more negative and more personally significant scored higher on constructs associated with Depression and Trait Negative Affect, whereas those who characterized their thoughts as less specific scored higher on constructs linked to Rumination. In contrast, individuals who characterized their thoughts as more positive, less personally significant, and more specific scored higher on constructs linked to improved wellbeing (Mindfulness). Collectively, these findings suggest that the content of people’s inner thoughts can (1) be productively examined, (2) be distilled into several major dimensions, and (3) account for a large portion of variability in their functional outcomes.

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Objective Major Depressive Disorder is characterized by reduced reward-related striatal activation and dysfunctional reward learning, putatively reflecting decreased dopaminergic signaling. The goal of this study was to test whether a pharmacological challenge designed to facilitate dopaminergic transmission can enhance striatal responses to reward and improve reward learning among depressed individuals. Method In a double-blind placebo-controlled design, 46 unmedicated depressed participants and 43 healthy controls were randomized to receive either placebo or a single low dose (50 mg) of the D2/D3 antagonist amisulpride, which was believed to increase dopamine signaling through presynaptic autoreceptor blockade. To investigate the effects of increased dopaminergic transmission on reward-related striatal function and behavior, a monetary incentive delay task (in conjunction with functional magnetic resonance imaging) and a probabilistic reward learning task were administered at absorption peaks of amisulpride. Results Depressed participants selected previously rewarded stimuli less frequently than controls, indicating reduced reward learning, but this effect was not modulated by amisulpride. Relative to depressed participants receiving placebo (and controls receiving amisulpride), depressed participants receiving amisulpride exhibited increased striatal activation and potentiated corticostriatal functional connectivity between the nucleus accumbens and midcingulate cortex in response to monetary rewards. Stronger corticostriatal connectivity in response to rewards predicted better reward learning among depressed individuals receiving amisulpride as well as among controls receiving placebo. Conclusions Acute enhancement of dopaminergic transmission potentiated reward-related striatal activation and corticostriatal functional connectivity in depressed individuals (but had no behavioral effects), suggesting that targeted pharmacological treatments may normalize neural correlates of reward processing in depression. Thus, despite acute effects on neural function, behavioral modification may require more chronic exposure, fitting prior reports that antidepressant effects of amisulpride in depression emerged after sustained administration. ClinicalTrials.gov Protocol 2010-P001568

Previous studies have shown that depressed individuals have difficulty directing attention away from negative distractors, a phenomenon known as affective interference. However, findings are mixed regarding the neural mechanisms and network dynamics of affective interference. The present study addressed these issues by comparing neural activation during emotion-word and color-word Stroop tasks in participants with varying levels of (primarily subclinical) depression. Depressive symptoms predicted increased activation to negative distractors in areas of dorsal anterior cingulate cortex (dACC) and posterior cingulate cortex (PCC), regions implicated in cognitive control and internally directed attention, respectively. Increased dACC activity was also observed in the group-average response to incongruent distractors, suggesting that dACC activity during affective interference is related to overtaxed cognitive control. In contrast, regions of PCC were deactivated across the group in response to incongruent distractors, suggesting that PCC activity during affective interference represents task-independent processing. A psychophysiological interaction emerged in which higher depression predicted more positively correlated activity between dACC and PCC during affective interference, i.e. greater connectivity between cognitive control and internal-attention systems. These findings suggest that, when individuals high in depression are confronted by negative material, increased attention to internal thoughts and difficulty shifting resources to the external world interfere with goal-directed behavior.

Threat-related ELS was associated with RSFC within lateral corticolimbic circuits, which in turn was related to blunted physiological response to acute stress. Notably, increased flexibility between the amygdala and rACC compensated for this static disruption, suggesting that more dynamic medial corticolimbic circuits might be key to restoring healthy stress response.