154 research outputs found
Narcissistic dimensions and depressive symptoms in patients across mental disorders in cognitive behavioural therapy and in psychoanalytic interactional therapy in Germany: a prospective cohort study
No full textEffective in-patient treatment with ECT is associated with an increase in structural brain connectivity in severely depressed patients
No full textBackground: This study investigates (1) whether alterations in magnetic resonance imaging (MRI)-based structural global network organization is impaired in patients with major depressive disorder (MDD), (2) whether in-patient treatment including pharmacological, psychological and neurostimulation interventions is linked to changes in structural brain connectivity and (3) whether brain structural changes relate to changes in depression symptomatology.
Methods: One hundred seventy-eight subjects – 109 subjects diagnosed with current MDD and 55 healthy controls (HC) - participated in the present study (baseline + 6-weeks follow up). Fifty-six depressed patients were treated with electroconvulsive therapy (ECT) and 67 received in-patient treatment without ECT. Here, grey matter T1-weighted MRI was used to define nodes and DWI-based tractography to define the connections – or edges – between the nodes creating a structural connectome. Changes over time in depressions symptom severity was measured with the Hamilton Depression Ratings Scale.
Results: MDD patients showed reduced connectivity strength at baseline compared to healthy controls. MDD patients showed a significant increase of connectivity strength over time, an effect that was not detected in HC. An increase of connectivity strength was associated with a decrease in depression symptom severity. These effects were independent of treatment choice, suggesting a nonspecific effect that cannot be traced back to ECT.
Conclusion: We demonstrate an alleviation of structural brain dysconnectivity in MDD patients after successful antidepressive treatment, which is most prominent in those patients that show the greatest reduction in depressive symptomatology. This pattern of results suggests neuroplastic mechanisms involved in the successful treatment of depression and should be investigated as a potential treatment target in future studies.
Research Category and Technology and Methods: Clinical Research: 2. Electroconvulsive Therapy (ECT
SAP - Identifying the effects of cognitive-behavioral therapy on the structural connectome in depression
No full textDepression is widely recognized as one of the most debilitating conditions worldwide (James et al., 2018; Vos et al., 2020). Although various treatment approaches, including pharmacotherapy and psychotherapy, are available and provide relief to many (Bundesärztekammer (BÄK) et al., 2022), a substantial portion of patients either fail to respond or experience relapse, highlighting the limited stability of remission and the frequent need for multiple treatment attempts (Malhi & Mann, 2018). Improving treatment outcomes and developing more personalized therapeutic strategies require a deeper understanding of the underlying mechanisms through which these treatments exert their effects.
Emerging evidence suggests that alterations in the brain’s structural network, or structural connectome, may represent a key pathophysiological mechanism underlying depression (Korgaonkar et al., 2014; Repple et al., 2020). Considering the brain as a connectome conceptualizes it as a network composed of nodes, representing distinct brain regions, and edges, representing the white matter fiber tracts connecting these regions. In practice, nodes are typically defined by parcellation of T1-weighted structural MRI, whereas edges are derived from diffusion-weighted imaging (Hagmann, 2005; Sporns et al., 2005). This approach enables the use of graph metrics to investigate the architecture of the brain's structural network (Rubinov & Sporns, 2010) as well as the identification of specific subnetworks associated with effects of interest (Zalesky et al., 2010). Previous cross-sectional studies on the structural connectome have reported lower structural brain connectivity in patients with MDD compared to HC (Korgaonkar et al., 2014; Myung et al., 2016; Yao et al., 2019), with more pronounced deficits observed in patients with earlier onset and more severe depressive symptoms (Repple et al., 2020, 2023). These findings are further corroborated by microstructural analyses in MDD showing lowered white matter integrity (van Velzen et al., 2020) as well as a decline in white matter integrity over time compared to HC (Flinkenflügel et al., 2024). These results support the notion that depression may be characterized by disrupted information processing within the connectome (Sporns et al., 2005).
Despite evidence of structural connectome alterations in depression, it remains uncer-tain whether these abnormalities can be modified by particular treatments and whether such modifications are linked to treatment outcomes in depression. Cognitive-behavioral therapy (CBT) is a first-line treatment for depression (Bundesärztekammer (BÄK) et al., 2022) that focuses on actively restructuring maladaptive schemas, fostering more realistic and reflective beliefs, and promoting cognitive flexibility (Beck, 1979, 2008). While previous MRI studies have demonstrated CBT-associated changes in both functional activity and connectivity (Borgers et al., 2025; Jamieson et al., 2024; König et al., 2025; Li et al., 2022) as well as CBT-associated changes in white matter microstructure and gray matter volume (Flinkenflügel et al., 2025; Zwiky et al., 2025), the effect of CBT on the structural connectome in depression has yet to be elucidated.
To address these gaps, this prospective, naturalistic study aims to investigate the as-sociation between longitudinal changes in the structural connectome and treatment outcome following CBT in patients with depression.
In the present study, we aim to investigate changes in measures of brain structural connectivity in patients with depression following CBT, as compared to healthy controls (HC).
Specifically, we expect (1) significant group-specific, time-dependent effects (group × time interactions) in brain structural connectivity, characterized by a longitudinal increase in structural connectivity in patients undergoing CBT, whereas healthy controls are expected to show no comparable change. Furthermore, we hypothesize (2) that increases in structural connectivity in the patient group will be significantly associated with reductions in depressive symptom severity following CBT
Are the Big Five mirrored in the structural connectome of the brain? An exploratory study
No full textThis research seeks to explore the question of whether personality (i.e. the factors and facets of the Big Five) is linked to the structural connectome of the brain (i.e. the structural network of cortical brain regions and the white matter fibre tracts connecting those cortical brain regions). The structural connectome will be estimated using structural and diffusion-weighted MRI. The structural connectome will be examined regarding its topology and connectivity strength. It will be explored whether its topology and connectivity are linked to personality factors and facets, measured by a personality questionnaire
An international conceptualization of Major Depressive Disorder: a Delphi method-based consensus guideline
No full textWe propose a Delphi method-based consensus approach to obtain consensus on internationally agreed, valid, consistent and clinically useful operationalisation of the concept of depression. We will address:
• What are relevant depression dimensions/domains to consider in our future work in depression (e.g. anhedonia,
melancholia, anxious distress, atypical symptoms, etc.)?
• For each dimension/domain:
- How do we measure this dimension/domain and is there a validated relevant cut-off
- What is the -possible- link to pre-clinical evidence/relevance of etiology/neurobiology to consider this
dimension/domain,
- How does this dimension/domain of depression translate to transdiagnostic approaches
Are the Big Five mirrored in the structural connectome of the brain? An exploratory study
No full textThis research seeks to explore the question of whether personality (i.e. the factors and facets of the Big Five) is linked to the structural connectome of the brain (i.e. the structural network of cortical brain regions and the white matter fibre tracts connecting those cortical brain regions). The structural connectome will be estimated using structural and diffusion-weighted MRI. The structural connectome will be examined regarding its topology and connectivity strength. It will be explored whether its topology and connectivity are linked to personality factors and facets, measured by a personality questionnaire
Are the Big Five mirrored in the structural connectome of the brain? An exploratory study
No full textThis research seeks to explore the question of whether personality (i.e. the factors and facets of the Big Five) is linked to the structural connectome of the brain (i.e. the structural network of cortical brain regions and the white matter fibre tracts connecting those cortical brain regions). The structural connectome will be estimated using structural and diffusion-weighted MRI. The structural connectome will be examined regarding its topology and connectivity strength. It will be explored whether its topology and connectivity are linked to personality factors and facets, measured by a personality questionnaire
Association of brain cortical changes with relapse in patients with major depressive disorder
No full textImportance: More than half of all patients with major depressive disorder (MDD) experience a relapse within 2 years after recovery. It is unclear how relapse affects brain morphologic features during the course of MDD.
Objective: To use structural magnetic resonance imaging to identify morphologic brain changes associated with relapse in MDD. Design, Setting, and Participants: In this longitudinal case-control study, patients with acute MDD at baseline and healthy controls were recruited from the University of Münster Department of Psychiatry from March 21, 2010, to November 14, 2014, and were reassessed from November 11, 2012, to October 28, 2016. Depending on patients’ course of illness during follow-up, they were subdivided into groups of patients with and without relapse. Whole-brain gray matter volume and cortical thickness of the anterior cingulate cortex, orbitofrontal cortex, middle frontal gyrus, and insula were assessed via 3-T magnetic resonance imaging at baseline and 2 years later. Main Outcomes and Measures: Gray matter was analyzed via group (no relapse, relapse, and healthy controls) by time (baseline and follow-up) analysis of covariance, controlling for age and total intracranial volume. Confounding factors of medication and depression severity were assessed. Results: This study included 37 patients with MDD and a relapse (19 women and 18 men; mean [SD] age, 37.0 [12.7] years), 23 patients with MDD and without relapse (13 women and 10 men; mean [SD] age, 32.5 [10.5] years), and 54 age- and sex-matched healthy controls (24 women and 30 men; mean [SD] age, 37.5 [8.7] years). A significant group-by-time interaction controlling for age and total intracranial volume revealed that patients with relapse showed a significant decline of insular volume (difference, −0.032; 95% CI, −0.063 to −0.002; P = .04) and dorsolateral prefrontal volume (difference, −0.079; 95% CI, −0.113 to −0.045; P < .001) from baseline to follow-up. In patients without relapse, gray matter volume in these regions did not change significantly (insula: difference, 0.027; 95% CI, −0.012 to 0.066; P = .17; and dorsolateral prefrontal volume: difference, 0.023; 95% CI, −0.020 to 0.066; P = .30). Volume changes were not correlated with psychiatric medication or with severity of depression at follow-up. Additional analysis of cortical thickness showed an increase in the anterior cingulate cortex (difference, 0.073 mm; 95% CI, 0.023-0.123 mm; P = .005) and orbitofrontal cortex (difference, 0.089 mm; 95% CI, 0.032-0.147 mm; P = .003) from baseline to follow-up in patients without relapse. Conclusion and Relevance: A distinct association of relapse in MDD with brain morphologic features was revealed using a longitudinal design. Relapse is associated with brain structures that are crucial for regulation of emotions and thus needs to be prevented. This study might be a step to guide future prognosis and maintenance treatment in patients with recurrent MDD.Dario Zaremba, Katharina Dohm, Ronny Redlich, Dominik Grotegerd, Robert Strojny, Susanne Meinert, Christian Bürger, Verena Enneking, Katharina Förster, Jonathan Repple, Nils Opel, Bernhard T. Baune, Pienie Zwitserlood, Walter Heindel, Volker Arolt, Harald Kugel, Udo Dannlowsk
Structural connectomic signatures of childhood maltreatment across affective and psychotic disorders
No full textExperimentally Assessed Reactive Aggression in Borderline Personality Disorder
No full textApproximately 73% of patients suffering from Borderline personality disorder (BPD) exhibit aggressive behaviour, which severely hinders therapeutic work and clinical improvement. Because the underlying mechanisms of aggression in BPD are not yet completely understood, additional research in this domain has a high clinical and scientific relevance. We employed a modified version of the Taylor Aggression Paradigm (mTAP), in order to examine for the first time whether this task can be used to differentiate between BPD patients and healthy controls with regard to reactive aggression. In the mTAP, the amount of money subtracted by a virtual opponent was categorized into ‘low’ (10–20 cents) and ‘high’ (80–100 cents) provocations, enabling us to compare how much money BPD patients and healthy controls subtracted (i.e., how aggressively participants responded) following high and low provocation trials. Our results showed that, compared to healthy controls, BPD patients showed higher overall aggression, higher aggression after high provocation trials, as well as a larger difference between high and low provocation trials. This finding was corroborated by a neuropsychological assessment, demonstrating higher levels of aggression and impulsivity in BPD patients. Interestingly, reactive aggression in the mTAP was positively correlated with symptom severity and impulsivity in BPD patients. We suggest that the mTAP provides a valuable tool allowing psychiatrists to quantify reactive aggression in BPD. Therefore, clinicians and researchers might consider this task, as a short experimental measure of reactive aggression, either in future studies or to aid diagnostic assessment during clinical practice
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