A randomized proof-of-mechanism trial of TNF antagonism for motivational anhedonia and related corticostriatal circuitry in depressed patients with high inflammation.

Chronic, low-grade inflammation has been associated with motivational deficits in patients with major depression (MD). In turn, impaired motivation has been linked to poor quality of life across psychiatric disorders. We thus determined effects of the anti-inflammatory drug infliximab-a potent tumor necrosis factor (TNF) antagonist-on behavioral and neural measures of motivation in 42 medically stable, unmedicated MD patients with a C-reactive protein > 3mg/L. All patients underwent a double-blind, placebo-controlled, single-dose, randomized clinical trial with infliximab (5mg/kg) versus placebo. Behavioral performance on an effort-based decision-making task, self-report questionnaires, and neural responses during event-related functional magnetic resonance imaging were assessed at baseline and 2 weeks following infusion. We found that relative to placebo, patients receiving infliximab were more willing to expend effort for rewards. Moreover, increase in effortful choices was associated with reduced TNF signaling as indexed by decreased soluble TNF receptor type 2 (sTNFR2). Changes in effort-based decision-making and sTNFR2 were also associated with changes in task-related activity in a network of brain areas, including dmPFC, ventral striatum, and putamen, as well as the functional connectivity between these regions. Changes in sTNFR2 also mediated the relationships between drug condition and behavioral and neuroimaging measures. Finally, changes in self-reported anhedonia symptoms and effort-discounting behavior were associated with greater responses of an independently validated whole-brain predictive model (aka "neural signature") sensitive to monetary rewards. Taken together, these data support the use of anti-inflammatory treatment to improve effort-based decision-making and associated brain circuitry in depressed patients with high inflammation.

Effects of acute stress and depression on functional connectivity between prefrontal cortex and the amygdala.

Stress is known to be a significant risk factor for the development of Major Depressive Disorder (MDD), yet the neural mechanisms that underlie this risk are poorly understood. Prior work has heavily implicated the corticolimbic system in the pathophysiology of MDD. In particular, the prefrontal cortex (PFC) and amygdala play a central role in regulating the response to stress, with dorsal PFC and ventral PFC exhibiting reciprocal excitatory and inhibitory influences on amygdala subregions. However, it remains unclear how best to disentangle the impact of stress from the impact of current MDD symptoms on this system. Here, we examined stress-induced changes in resting state functional connectivity (rsFC) within an a priori corticolimbic network in MDD patients and healthy controls (total n = 80) before and after an acute stressor or a "no stress" control condition. Using graph theoretic analysis, we found that connectivity between basolateral amygdala and dorsal prefrontal nodes of the corticolimbic network had a negative association with individual differences in chronic perceived stress at baseline. Following the acute stressor, healthy individuals showed a reduction of the amygdala node strength, while MDD patients exhibited little change. Finally, dorsal PFC-particularly dorsomedial PFC- connectivity to the basolateral amygdala was associated with the strength of the basolateral amygdala responses to loss feedback during a reinforcement learning task. These findings highlight attenuated connectivity between basolateral amygdala and prefrontal cortex in patients with MDD. In healthy individuals, acute stress exposure was found to push the corticolimbic network to a "stress-phenotype" that may be chronically present in patients with current depression and high levels of perceived stress. In sum, these results help to identify circuit mechanisms underlying the effects of acute stress and their role in mood disorders.

Reduced adaptation of glutamatergic stress response is associated with pessimistic expectations in depression.

Stress is a significant risk factor for the development of major depressive disorder (MDD), yet the underlying mechanisms remain unclear. Preclinically, adaptive and maladaptive stress-induced changes in glutamatergic function have been observed in the medial prefrontal cortex (mPFC). Here, we examine stress-induced changes in human mPFC glutamate using magnetic resonance spectroscopy (MRS) in two healthy control samples and a third sample of unmedicated participants with MDD who completed the Maastricht acute stress task, and one sample of healthy control participants who completed a no-stress control manipulation. In healthy controls, we find that the magnitude of mPFC glutamate response to the acute stressor decreases as individual levels of perceived stress increase. This adaptative glutamate response is absent in individuals with MDD and is associated with pessimistic expectations during a 1-month follow-up period. Together, this work shows evidence for glutamatergic adaptation to stress that is significantly disrupted in MDD.

The psychometric properties of the Personality Assessment Inventory-Adolescent's Borderline Features Scale across two high-risk samples.

The present study sought to assess the performance of the Borderline Features (BOR) Scale of the adolescent version of the Personality Assessment Inventory (Morey, 2007b) in 2 high-risk samples: inpatient and justice-involved adolescents. This study is the first to evaluate the BOR scale in high-risk adolescent samples, outside the initial standardization studies. Across both samples (NClinical = 327, NForensic = 151), results indicated good internal consistency. Confirmatory factor analysis indicated poor fit of the 4-factor structure proposed by the measure's authors. Convergent validity and receiver-operating characteristics analyses, conducted in the clinical sample, indicated that the adolescent version of the Personality Assessment Inventory BOR scale had good diagnostic accuracy for predicting a borderline personality disorder diagnosis (via structured interview). Findings suggest that the BOR scale has adequate internal consistency, convergent validity, and clinical utility, although areas for future measure evaluation (including factor structure) remain. Still, the BOR scale may partially address the current hesitation to assess borderline personality disorder features in high-risk youth because it is embedded within a broadband psychopathology measure. (PsycINFO Database Record

Symmetry in critical random Boolean network dynamics.

Using Boolean networks as prototypical examples, the role of symmetry in the dynamics of heterogeneous complex systems is explored. We show that symmetry of the dynamics, especially in critical states, is a controlling feature that can be used both to greatly simplify analysis and to characterize different types of dynamics. Symmetry in Boolean networks is found by determining the frequency at which the various Boolean output functions occur. There are classes of functions that consist of Boolean functions that behave similarly. These classes are orbits of the controlling symmetry group. We find that the symmetry that controls the critical random Boolean networks is expressed through the frequency by which output functions are utilized by nodes that remain active on dynamical attractors. This symmetry preserves canalization, a form of network robustness. We compare it to a different symmetry known to control the dynamics of an evolutionary process that allows Boolean networks to organize into a critical state. Our results demonstrate the usefulness and power of using the symmetry of the behavior of the nodes to characterize complex network dynamics, and introduce an alternative approach to the analysis of heterogeneous complex systems.