Andrea N Goldstein-Piekarski1, Tali M Ball2, Zoe Samara2, Brooke R Staveland2, Arielle S Keller3, Scott L Fleming4, Katherine A Grisanzio2, Bailey Holt-Gosselin2, Patrick Stetz1, Jun Ma5, Leanne M Williams6. 1. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California; Sierra-Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California. 2. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California. 3. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California; Department of Graduate Program in Neurosciences, Stanford University, Stanford, California. 4. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California; Department of Biomedical Informatics, Stanford University, Stanford, California. 5. Department of Medicine, University of Illinois at Chicago, Chicago, Illinois; Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois. 6. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California; Sierra-Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California. Electronic address: leawilliams@stanford.edu.
Abstract
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.
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.
Authors: Katherine S Button; John P A Ioannidis; Claire Mokrysz; Brian A Nosek; Jonathan Flint; Emma S J Robinson; Marcus R Munafò Journal: Nat Rev Neurosci Date: 2013-04-10 Impact factor: 34.870
Authors: Boadie W Dunlop; Mary E Kelley; Callie L McGrath; W Edward Craighead; Helen S Mayberg Journal: J Neuropsychiatry Clin Neurosci Date: 2015-06-12 Impact factor: 2.198
Authors: Leanne M Williams; Adam Pines; Andrea N Goldstein-Piekarski; Lisa G Rosas; Monica Kullar; Matthew D Sacchet; Olivier Gevaert; Jeremy Bailenson; Philip W Lavori; Paul Dagum; Brian Wandell; Carlos Correa; Walter Greenleaf; Trisha Suppes; L Michael Perry; Joshua M Smyth; Megan A Lewis; Elizabeth M Venditti; Mark Snowden; Janine M Simmons; Jun Ma Journal: Behav Res Ther Date: 2017-10-07
Authors: Andrea N Goldstein-Piekarski; Brooke R Staveland; Tali M Ball; Jerome Yesavage; Mayuresh S Korgaonkar; Leanne M Williams Journal: Transl Psychiatry Date: 2018-03-06 Impact factor: 6.222
Authors: Laura Nawijn; Richard Dinga; Moji Aghajani; Marie-José van Tol; Nic J A van der Wee; Andreas Wunder; Dick J Veltman; Brenda W H J Penninx Journal: Depress Anxiety Date: 2022-05-10 Impact factor: 8.128