The subgenual anterior cingulate cortex(sgACC)plays a central role in the pathophysiology of major depressive disorder(MDD).Its functional interactive profile with the left dorsal lateral prefrontal cortex(DLPFC)is as...The subgenual anterior cingulate cortex(sgACC)plays a central role in the pathophysiology of major depressive disorder(MDD).Its functional interactive profile with the left dorsal lateral prefrontal cortex(DLPFC)is associated with transcranial magnetic stimulation(TMS)treatment outcomes.Previous research on sgACC functional connectivity(FC)in MDD has yielded inconsistent results,partly due to small sample sizes and limited statistical power.Furthermore,calculating sgACC-FC to target TMS individually is challenging.We used a large multi-site cross-sectional sample(1660 patients with MDD vs.1341 healthy controls)from Phase Ⅱ of the Depression Imaging REsearch ConsorTium(DIRECT)to systematically delineate case-control difference maps of sgACC-FC.We explored the potential impact of group-level abnormality profiles on TMS target localization and clinical efficacy.Next,we developed an MDD big data-guided,individualized TMS targeting algorithm to integrate group-level statistical maps with individual-level brain activity to individually localize TMS targets.We found enhanced sgACCDLPFC FC in patients with MDD compared with healthy controls(HC).These group differences altered the position of the sgACC anti-correlation peak in the left DLPFC.We showed that the magnitude of case-control differences in the sgACC-FC was related to clinical improvement in two independent clinical samples.This targeting algorithm may generate targets demonstrating stronger associations with clinical efficiency than group-level targets.We reliably delineated MDD-related abnormalities of sgACC-FC profiles in a large,independently ascertained sample and demonstrated the potential impact of such casecontrol differences on FC-guided localization of TMS targets.展开更多
基金the Beijing Nova Program of Science and Technology(20230484465)the Beijing Natural Science Foundation(J230040)+12 种基金the National Natural Science Foundation of China(82122035,81671774,81630031,and 32300933)the Sci-Tech Innovation 2030–Major Project of Brain Science and Braininspired Intelligence Technology(2021ZD0200600)the National Key R&D Program of China(2017YFC1309902)the Key Research Program of the Chinese Academy of Sciences(ZDBS-SSW-JSC006)the Scientific Foundation of Institute of Psychology,Chinese Academy of Sciences(E2CX4425YZ,E3CX1315,and Y9CX422005)the China Postdoctoral Science Foundation(2019M660847)the China National Postdoctoral Program for Innovative Talents(BX20200360)the Special Research Assistant Program of the Chinese Academy of Sciences(E2CX0624)the Key R&D Program of Sichuan Province(2023YFS0076)the Canadian Institutes of Health Research(CIHR),the National Institutes of Health–US(NIH)the Brain Canada Foundationthe Temerty Family through the Centre for Addiction and Mental Health(CAMH)Foundation and the Campbell Family Research Institutethe China Scholarship Council(202104910248)during a visit of Xiao Chen to the Centre for Addiction and Mental Health is acknowledged.
文摘The subgenual anterior cingulate cortex(sgACC)plays a central role in the pathophysiology of major depressive disorder(MDD).Its functional interactive profile with the left dorsal lateral prefrontal cortex(DLPFC)is associated with transcranial magnetic stimulation(TMS)treatment outcomes.Previous research on sgACC functional connectivity(FC)in MDD has yielded inconsistent results,partly due to small sample sizes and limited statistical power.Furthermore,calculating sgACC-FC to target TMS individually is challenging.We used a large multi-site cross-sectional sample(1660 patients with MDD vs.1341 healthy controls)from Phase Ⅱ of the Depression Imaging REsearch ConsorTium(DIRECT)to systematically delineate case-control difference maps of sgACC-FC.We explored the potential impact of group-level abnormality profiles on TMS target localization and clinical efficacy.Next,we developed an MDD big data-guided,individualized TMS targeting algorithm to integrate group-level statistical maps with individual-level brain activity to individually localize TMS targets.We found enhanced sgACCDLPFC FC in patients with MDD compared with healthy controls(HC).These group differences altered the position of the sgACC anti-correlation peak in the left DLPFC.We showed that the magnitude of case-control differences in the sgACC-FC was related to clinical improvement in two independent clinical samples.This targeting algorithm may generate targets demonstrating stronger associations with clinical efficiency than group-level targets.We reliably delineated MDD-related abnormalities of sgACC-FC profiles in a large,independently ascertained sample and demonstrated the potential impact of such casecontrol differences on FC-guided localization of TMS targets.
