Major depressive disorder (MDD) is common and disabling, but its neuropathophysiology remains unclear. Most studies of functional brain networks in MDD have had limited statistical power and data analysis approaches have varied widely. The REST-meta-MDD Project of resting-state fMRI (R-fMRI) addresses these issues. Twenty-five research groups in China established the REST-meta-MDD Consortium by contributing R-fMRI data from 1,300 patients with MDD and 1,128 normal controls (NCs). Data were preprocessed locally with a standardized protocol before aggregated group analyses. We focused on functional connectivity (FC) within the default mode network (DMN), frequently reported to be increased in MDD. Instead, we found decreased DMN FC when we compared 848 patients with MDD to 794 NCs from 17 sites after data exclusion. We found FC reduction only in recurrent MDD, not in first-episode drug-naïve MDD. Decreased DMN FC was associated with medication usage but not with MDD duration. DMN FC was also positively related to symptom severity but only in recurrent MDD. Exploratory analyses also revealed alterations in FC of visual, sensory-motor, and dorsal attention networks in MDD. We confirmed the key role of DMN in MDD but found reduced rather than increased FC within the DMN. Future studies should test whether decreased DMN FC mediates response to treatment. All R-fMRI indices of data contributed by the REST-meta-MDD consortium are being shared publicly via the R-fMRI Maps Project.
Accumulating evidence suggests that early improvement after two-week antidepressant treatment is predictive of later outcomes of patients with major depressive disorder (MDD); however, whether this early improvement is associated with baseline neural architecture remains largely unknown.Utilizing resting-state functional MRI data and graph-based network approaches, this study calculated voxel-wise degree centrality maps for 24 MDD patients at baseline and linked them with changes in the Hamilton Rating Scale for Depression (HAMD) scores after two weeks of medication.Six clusters exhibited significant correlations of their baseline degree centrality with treatment-induced HAMD changes for the patients, which were mainly categorized into the posterior default-mode network (i.e., the left precuneus, supramarginal gyrus, middle temporal gyrus, and right angular gyrus) and frontal regions.Receiver operating characteristic curve and logistic regression analyses convergently revealed excellent performance of these regions in discriminating the early improvement status
Abstract Background: Bone destruction is the key and difficult point in the treatment of RA. Studies have found that the use of traditional Chinese medicine Qingre Huoxue Decoction (QRHXD) can effectively reduce disease activity and delay bone destruction. Magnetic resonance imaging (MRI) is one of the effective ways to evaluate bone destruction in RA in real time, which is helpful to the early evaluation and discovery of synovitis and bone destruction. Therefore, we designed a multicenter, randomized, double-blinded, controlled clinical trial to assess the improvement of the bone destruction of QRHXD in treating RA using MRI. Methods: This study aimed to assess the definitive evidence that the traditional Chinese medicine QRHXD slows bone destruction in RA using MRI. A total of 204 adult participants with RA will be enrolled, with balanced treatment allocation (1:1). The experimental intervention will be QRHXD plus MTX and the control intervention will be QRHXD placebo plus MTX for 24 weeks. The primary outcome measure will be RA MRI score at screening period and 24 weeks. Secondary outcome measures will include the ACR20, ACR50 and ACR70, DAS28, patient report outcome(PRO), health assessment questionnaire(HAQ) and X-ray sharp score of both hands. In addition, the vital signs and adverse reactions of the subjects will be recorded. Discussion: The purpose of this study is to use MRI to confirm that QRHXD can effectively slow the imaging progress of active RA. To provide evidence for the efficacy of Chinese medicine in delaying bone destruction in RA, and help to carry out more clinical research on Chinese medicine prescriptions. Trial registration number Clinical Trials.gov ID: NCT04170504.
Abstract Neuroimaging studies have shown topological disruptions of both functional and structural whole-brain networks in major depressive disorder (MDD). This study examined common and specific alterations between these two types of networks and whether the alterations were differentially involved in the two hemispheres. Multimodal MRI data were collected from 35 MDD patients and 35 healthy controls, whose functional and structural hemispheric networks were constructed, characterized, and compared. We found that functional brain networks were profoundly altered at multiple levels, while structural brain networks were largely intact in patients with MDD. Specifically, the functional alterations included decreases in intra-hemispheric (left and right) and inter-hemispheric (heterotopic) functional connectivity; decreases in local, global and normalized global efficiency for both hemispheric networks; increases in normalized local efficiency for the left hemispheric networks; and decreases in intra-hemispheric integration and inter-hemispheric communication in the dorsolateral superior frontal gyrus, anterior cingulate gyrus and hippocampus. Regarding hemispheric asymmetry, largely similar patterns were observed between the functional and structural networks: the right hemisphere was over-connected and more efficient than the left hemisphere globally; the occipital and partial regions exhibited leftward asymmetry, and the frontal and temporal sites showed rightward lateralization with regard to regional connectivity profiles locally. Finally, the functional–structural coupling of intra-hemispheric connections was significantly decreased and correlated with the disease severity in the patients. Overall, this study demonstrates modality- and hemisphere-dependent and invariant network alterations in MDD, which are helpful for understanding elaborate and characteristic patterns of integrative dysfunction in this disease.
Spent pickle liquor is a kind of perilous liquid rubbish containing of zinc, iron ions and other environmentally harmful elements. Therefore, the discharging of solution is limited due to the ecological environment issues. A novel cleaning process for the recovery of zinc from spent pickle liquor using solvent extraction is proposed. The extraction system is composed of secondary carboprimary amine(N1923), isooctanol and kerosene. The spent pickle liquor after ultrasonic enhanced reduction pretreatment is studied experimentally, and the effective parameters such as the concentration of extractant, organic phase composition and phase ratio on the extraction are investigated. The concentration of zinc ions in raffinate is only 0.01 g/L by three-stage counter-current extraction, and the raffinate can be used to prepare iron salt water purifier. H2SO4 solution is used to strip the loaded organic phase to obtain zinc-rich solution with 5.39 mol/L zinc, and the zinc-rich solution from the process can be used to prepare zinc oxide. The stripping unloaded organic phase can be recirculated and no emulsification or scale accumulation is observed during the process. Kinetic, slope method, FT-IR, HRMS and Raman are used in combination with density functional theory (DFT) to analyze the extraction mechanism and the structure of the extraction complexes, the results showed that the extraction mechanism of N1923 is in accordance with the pseudo primary kinetic model, the stoichiometric ratio of the extraction reaction is 1, which is anion-exchange, and the extraction complex is [(RNH3)ZnCl3]. An efficient, low-consumption, convenient, safe and sustainable treatment method was provided for the recovery of zinc from pickling waste streams, and lays the foundation for industrialization.
Background The risk of major depressive disorder (MDD) and insomnia is higher in patients with coronary heart disease (CHD) than in the general population. In addition, immune inflammation may be a shared aetiological factor for mental disorders and CHD. However, it is unclear whether MDD is associated with poor sleep quality and cell-mediated immune function in patients with CHD. Aims This study investigated the impact of depression on sleep quality and cell-mediated immune functions in patients with CHD and examined discriminative factors in patients with CHD with and without MDD. Methods This cross-sectional retrospective study was conducted at the Zhejiang University School of Medicine affiliated with Sir Run Run Shaw Hospital. The study population consisted of 84 patients with CHD assigned to two groups based on their Hamilton Depression Rating Scale (HAMD) score (CHD with MDD (HAMD score of ≥10) vs without MDD). Subjective sleep quality, systemic inflammatory response and cell-mediated immune functions were assessed in patients with CHD with (n=50) and without (n=34) MDD using the Pittsburgh Sleep Quality Index (PSQI), routine blood tests and flow cytometry. The relationships between variables were ascertained using Pearson’s product–moment, and linear discriminant analysis was used to explore the discriminative factors between groups. Results Patients with CHD with MDD had significantly poorer sleep quality than those without MDD (Z=−6.864, p<0.001). The Systemic Inflammation Index (SII) and CD4 + /CD8 + T-cell ratios were higher in patients with CHD with MDD than in those without MDD (Z=−3.249, p=0.001). Patients with CHD with MDD had fewer CD3 + CD8 + and CD3 + T cells (Z=3.422, p=0.001) than those without MDD (t=2.032, p=0.045). Furthermore, patients with CHD with MDD may be differentiated from those without MDD using the PSQI, SII and T-cell levels, as these variables correctly classified the depressed and non-depressed groups with an accuracy of 96.4%. Conclusions MDD may be responsible for poor sleep quality, increased cell-mediated immunity and SII in patients with CHD, which are discriminative factors for CHD in the depressive state. Clinicians should be aware of these interactions, as treatment for depressive symptoms may also improve CHD prognosis.
Background: Major Depressive Disorder (MDD) is common and disabling, but its neural pathophysiology remains unclear. Functional brain network studies in MDD have largely had limited statistical power and data analysis approaches have varied widely. The REST-meta-MDD Project of resting-state fMRI (R-fMRI) addresses these issues. Methods: The 25 research groups in China composing the REST-meta-MDD Project contributed R-fMRI data of 1,300 patients with MDD and 1,128 normal controls (NCs). The data were preprocessed locally with a standardized protocol prior to aggregated group analyses. We focused on functional connectivity (FC) within the default mode network (DMN), frequently reported to show increased FC in MDD. Outcomes: We found decreased instead of increased DMN FC in MDD compared to NCs. We found FC reduction only in recurrent MDD, not in first-episode drug-naive MDD. Decreased DMN FC was associated with medication usage but not with MDD duration or severity. Exploratory analyses also revealed alterations of local intrinsic activity in MDD. Interpretation: We confirmed the key role of DMN in MDD but found reduced rather than increased FC within the DMN. Future studies should test whether decreased DMN FC mediates treatment response. The REST-meta-MDD model can be generalized to longitudinal MDD studies and to other psychiatric disorders. Funding: National Key R&D Program of China, National Natural Science Foundation of China and Chinese Academy of Sciences.
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