Elsevier

NeuroImage: Clinical

Volume 20, 2018, Pages 1001-1009
NeuroImage: Clinical

Cognitive control neuroimaging measures differentiate between those with and without future recurrence of depression

https://doi.org/10.1016/j.nicl.2018.10.004Get rights and content
Under a Creative Commons license
open access

Highlights

  • Tools are needed to increase identification of MDD recurrence

  • Cognitive control behavior and depression symptoms have been predictive of recurrence in prior studies, but with low accuracy

  • In remitted Major Depressive Disorder, those who will go on to have future depressive episodes differed in cognitive control activation and connectivity

  • Symptoms, performance, task activation, and seed-based connectivity can contribute to identification of risk for recurrence

Abstract

Background

Major Depressive Disorder (MDD) is a prevalent, disruptive illness. A majority of those with MDD are at high risk for recurrence and increased risk for morbidity and mortality. This study examined whether multimodal baseline (and retest) Cognitive Control performance and neuroimaging markers (task activation and neural connectivity between key brain nodes) could differentiate between those with and without future recurrence of a major depressive (MD) episode within one year. We hypothesized that performance and neuroimaging measures of Cognitive Control would identify markers that differ between these two groups.

Methods

A prospective cohort study of young adults (ages 18–23) with history (h) of early-onset MDD (N = 60), now remitted, and healthy young adults (N = 49). Baseline Cognitive Control measures of performance, task fMRI and resting state connectivity (and reliability retest 4–12 weeks later) were used to compare those with future recurrence of MDD (N = 21) relative to those without future recurrence of MDD (N = 34 with resilience). The measures tested were (1) Parametric Go/No-Go (PGNG) performance, and task activation for (2) PGNG Correct Rejections, (3) PGNG Commission errors, and (4 & 5), resting state connectivity analyses of Cognitive Control Network to and from subgenual anterior cingulate.

Results

Relative to other groups at baseline, the group with MDD Recurrence had less bilateral middle frontal gyrus activation during commission errors. MDD Recurrence exhibited greater connectivity of right middle frontal gyrus to subgenual anterior cingulate (SGAC). SGAC connectivity was also elevated in this group to numerous regions in the Cognitive Control Network. Moderate to strong ICCs were present from test to retest, and highest for rs-fMRI markers. There were modest, significant correlations between task, connectivity and behavioral markers that distinguished between groups.

Conclusion

Markers of Cognitive Control function could identify those with early course MD who are at risk for depression recurrence. Those at high risk for recurrence would benefit from maintenance or preventative treatments. Future studies could test and validate these markers as potential predictors, accounting for sample selection and bias in feature detection.

Acronyms

CC
CCN
Cognitive Control
Cognitive Control Network
SEN
Salience and Emotion Network
hMDD
history of Major Depressive Disorder
PGNG
Parametric Go/No-Go Test
ICC
Intraclass Correlation Coefficient
ROI
region of interest
SGAC
subgenual anterior cingulate
rs-fMRI
resting state functional magnetic resonance imaging
MFG
middle frontal gyrus
UM
University of Michigan
UIC
University of Illinois at Chicago
PCIT
Percent Correct Inhibition Trials
HDRS
Hamilton Depression Rating Scale

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