A first-principles study on the multiferroicity of semi-modified X2M (X = C, Si; M = F, Cl) monolayers.

The research of two-dimensional multiferroic materials has attracted extensive attention in recent years. In this work, we systematically investigated the multiferroic properties of semi-fluorinated and semi-chlorinated graphene and silylene X2M (X = C, Si; M = F, Cl) monolayers under strain using first principles calculations based on density functional theory. We find that the X2M monolayer has a frustrated antiferromagnetic order, and a large polarization with a high reversal potential barrier. When increasing the applied biaxial tensile strain, the magnetic order remains unchanged, but the polarization flipping potential barrier of X2M gradually decreases. When the strain increases to 35%, although the energy required to flip the fluorine and chlorine atoms is still very high in the C2F and C2Cl monolayers, it goes down to 312.5 meV and 260 meV in unit cells of the Si2F and Si2Cl monolayers, respectively. At the same time, both semi-modified silylenes exhibit metallic ferroelectricity with a band gap of at least 0.275 eV in the direction perpendicular to the plane. The results of these studies show that Si2F and Si2Cl monolayers may become a new generation of information storage materials with magnetoelectric multifunctional properties.

Theoretical investigation of the magnetic and optical properties in a transition metal-doped GaTeCl monolayer.

We investigate the structural, magnetic, electronic and optical properties of a transition metal-doped GaTeCl monolayer, denoted as M@GaTeCl (M = V, Cr, Mn, Fe and Co), by using first-principles calculations. It is found that the magnetic ground state can be regulated by different M elements. In the meantime, the electronic structure is different with the doping of different M metal atoms, and thus the optical absorption changes correspondingly. The electronic calculations of M@GaTeCl suggest that V@GaTeCl, Cr@GaTeCl, Mn@GaTeCl and Fe@GaTeCl are semiconductors and the magnetic ground states are G-type antiferromagnetic (AFM), C-type AFM, A-type AFM and C-type AFM order, respectively, while Co@GaTeCl is a metal and the ground state is ferromagnetic (FM) order. The different magnetic ground states are discussed with the Heisenberg model. The rough estimation of the ferroelectric polarization value of M@GaTeCl suggests that M@GaTeCl still exhibits multiferroicity. The electronic structure is explained by the projected density of states, band structure and decomposed charge of the valence band maximum (VBM) and conduction band minimum (CBM). Simultaneously, the absorption coefficient calculations indicate that M@GaTeCl absorption shows anisotropic properties, as the same as in a pure GaTeCl monolayer, there exists enhanced visible light absorption in these M@GaTeCl monolayers relative to the pure GaTeCl one, which can be interpreted by the anisotropic structure and by the peculiar electronic structure. Thus, we found that the magnetic ground state, the electronic structure, and the absorption coefficient of M@GaTeCl can be tuned by doping different transition metal M atoms, and the ferroelectricity is still retained, which makes M@GaTeCl a potential multifunctional material in spintronics and optics.

Improving the reproducibility of proton magnetic resonance spectroscopy brain thermometry: Theoretical and empirical approaches.

In proton magnetic resonance spectroscopy (1 H MRS)-based thermometry of brain, averaging temperatures measured from more than one reference peak offers several advantages, including improving the reproducibility (i.e., precision) of the measurement. This paper proposes theoretically and empirically optimal weighting factors to improve the weighted average of temperatures measured from three references. We first proposed concepts of equivalent noise and equivalent signal-to-noise ratio in terms of frequency measurement and a concept of relative frequency that allows the combination of different peaks in a spectrum for improving the precision of frequency measurement. Based on these, we then derived a theoretically optimal weighting factor and proposed an empirical weighting factor, both involving equivalent noise levels, for a weighted average of temperatures measured from three references (i.e., the singlets of NAA, Cr, and Ch in the 1 H MR spectrum). We assessed these two weighting factors by comparing their errors in measurement of temperatures with the errors of temperatures measured from individual references; we also compared these two new weighting factors with two previously proposed weighting factors. These errors were defined as the standard deviations in repeated measurements or in Monte Carlo studies. Both the proposed theoretical and empirical weighting factors outperformed the two previously proposed weighting factors as well as the three individual references in all phantom and in vivo experiments. In phantom experiments with 4- or 10-Hz line broadening, the theoretical weighting factor outperformed the empirical one, but the latter was superior in all other repeated and Monte Carlo tests performed on phantom and in vivo data. The proposed weighting factors are superior to the two previously proposed weighting factors and can improve the reproducibility of temperature measurement using 1 H MRS-based thermometry.

Proton magnetic resonance spectroscopy thermometry: Impact of separately acquired full water or partially suppressed water data on quantification and measurement error.

In proton magnetic resonance spectroscopy (1 H MRS) thermometry, separately acquired full water and partially suppressed water are commonly used for measuring temperature. This paper compares these two approaches. Single-voxel 1 H MRS data were collected on a 3-T GE scanner from 26 human subjects. Every subject underwent five continuous MRS sessions, each separated by a 2-min phase. Each MRS session lasted 13 min and consisted of two free induction decays (FIDs) without water suppression (with full water [FW or w]) and 64 FIDs with partial water suppression (with partially suppressed water [PW or w']). Frequency differences between the two FWs, the first two PWs, the second FW and the first PW (FW2 , PW1 ), or between averaged water ( wav' ) and N-acetylaspartate (NAA), were measured. Intrasubject and intersubject variations of the frequency differences were used as a metric for the error in temperature measurement. The intrasubject variations of frequency differences between FW2 and PW1fw2-fw1' , calculated from the five MRS sessions for each subject, were larger than those between the two FWs or between the first two PWs (p = 1.54 x 10-4 and p = 1.72 x 10-4 , respectively). The mean values of intrasubject variations of fw2-fw1' for all subjects were 4.7 and 4.5 times those of fw2-fw1 and fw2'-fw1' , respectively. The intrasubject variations of the temperatures based on frequency differences, fw2-fNAA or ( fw1'-fNAA ), were about 2.5 times greater than those based on averaged water and NAA frequencies (fwav'-fNAA ). The mean temperature measured from (fwav'-fNAA ) (n = 26) was 0.29°C lower than that measured from fw2-fNAA and was 0.83°C higher than that from ( fw1'-fNAA ). It was concluded that the use of separately acquired unsuppressed or partially suppressed water signals may result in large errors in frequency and, consequently, temperature measurement.

Prediction of two-dimensional monolayer C2O2Fe with chiral magnetic and ferroelectric orders.

Low-dimensional multiferroics are highly desired for applications and contain exotic physical properties. Here we predict a two-dimensional material, C2O2Fe monolayer, through Fe intercalation in the graphene oxide monolayer. The crystal stable texture, chiral spin order, and ferroelectric polarization of the C2O2Fe monolayer are theoretically studied by considering the electron on-site Coulomb interaction and spin orbit coupling, which also manifests the ferroelectric polarization and reversal barrier at 30% biaxial tensile strain comparable with the other two-dimensional ferroelectric materials, such as GeS and GeSe. Moreover, first-principles calculations show that the polarization flipping is accompanied by spin orientation reversal, when the ferroelectric polarization is upward to the plane, a clockwise chiral antiferromagnetic ground state is obtained, while when the polarization is downward, the monolayer shows the anticlockwise chiral antiferromagnetic structure. In this sense, a strong electrically controlled magnetism exists in the designed C2O2Fe monolayer film.

A study on the multiferroic properties of semi-hydrogenated X2H (X = C, Si, and Ge) monolayer films.

In recent years, the research on the physical properties of two-dimensional (2D) materials has attracted much attention. In this paper, the magnetic and ferroelectric (FE) properties of semi-hydrogenated graphene, silylene and germanene X2H (X = C, Si, and Ge) under strain are systematically investigated. The results have shown that X2H is a magnetic FE semiconductor with ferromagnetic (FM) and FE structures, both perpendicular to the plane, a large energy gap, and a high polarization reversal barrier. It is found that both the polarization reversal barrier and the magnitude of FE polarization gradually decrease, but the FM state remains the same, upon gradually increasing the tensile strain. As the tensile strain is increased to 19%, the barriers of the Si2H and Ge2H monolayer films to flip a single valence bond are decreased to 1.123 eV and 0.768 eV, respectively, and the systems still maintain semiconductor characteristics. When the strain is increased to 20%, the films begin to show metallicity in the plane of films, but still have the polarity perpendicular to the plane because of the anisotropy of the band structure. These research results suggest that the magnetoelectric properties of Si2H and Ge2H monolayer films provide the possibility for achieving a new generation of information storage materials.

Magnetism and spin exchange coupling in strained monolayer CrOCl.

The magnetism and spin exchange coupling of monolayer CrOCl with different strains are investigated systematically using first principles. It is found that the magnetic ground state can be changed from ferromagnetic (FM) to antiferromagnetic (AFM), and the Curie temperature (TC) is enhanced significantly by applying the uniaxial strain along a- or b-axis direction. The variations of spin exchange coupling are explained according to the Goodenough-Kanamori-Anderson (GKA) and Bethe-Slater Interaction (BSI) rules. The strain-dependent magnetic state is mainly attributed to the competition between direct exchange interactions of cation-cation and indirect superexchange ones of cation-anion-cation in monolayer CrOCl. The different competitions in a- and b-axis direction determine the different critical intervals R of magnetic transitions, where R is the distance of the two nearest-neighbor (NN) Cr3+ ions. The AFM-FM transition occurs at R/r3d = 2.9 and 3.75 in a-axis direction, while it happens at R/r3d = 2.65 along b-axis direction. These results indicate that the sensitive relevancy between the external strain and magnetic coupling makes monolayer CrOCl a promising candidate for spintronics.

Emergent multiferroicity and strain-driven metal-semiconductor transitions in LaMnO3/RMnO3 superlattices (R = Pr, Pm, Sm and Gd).

It is known that rare-earth manganites LnMnO3 with Ln = La to Gd are typical Mott insulators favoring the A-type antiferromagnetic (A-AFM) state. Certainly no ferroelectricity can be possible although the alternatively stacked LnO layers are both polar. Nevertheless, under the inspiration that one plus one is more than two, it is appreciated that by combining two components of this manganite series into a superlattice functionality is added. In this work, we construct a (001)-oriented LaMnO3/RMnO3 (R = Pr, Pm, Sm and Gd) superlattice and investigate the possible emergent ferroelectricity by means of first-principles calculations. It is revealed that the lattice matching in these superlattices may generate lattice distortions to each component based on the scenario of hybrid improper ferroelectricity, resulting in spontaneous ferroelectric polarization, which is larger than the traditional type II Ln'MnO3 (Ln' radius is smaller than that of Gd) polarization. In the meantime, the A-AFM state remains the magnetic ground state of these superlattices. Furthermore, it is predicted that the externally imposed in-plane compressive strain can trigger the semiconductor to half-metal transitions accompanying the A-AFM to ferromagnetic (FM) transitions. The present work sheds light on the possibility to design multiferroic materials and functionality by tailoring artificial superlattices/heterostructures from those non-ferroelectric systems, and to design electronic devices by utilizing the electronic transport properties under epitaxial strain.

Advances in multimodal data fusion in neuroimaging: Overview, challenges, and novel orientation.

Multimodal fusion in neuroimaging combines data from multiple imaging modalities to overcome the fundamental limitations of individual modalities. Neuroimaging fusion can achieve higher temporal and spatial resolution, enhance contrast, correct imaging distortions, and bridge physiological and cognitive information. In this study, we analyzed over 450 references from PubMed, Google Scholar, IEEE, ScienceDirect, Web of Science, and various sources published from 1978 to 2020. We provide a review that encompasses (1) an overview of current challenges in multimodal fusion (2) the current medical applications of fusion for specific neurological diseases, (3) strengths and limitations of available imaging modalities, (4) fundamental fusion rules, (5) fusion quality assessment methods, and (6) the applications of fusion for atlas-based segmentation and quantification. Overall, multimodal fusion shows significant benefits in clinical diagnosis and neuroscience research. Widespread education and further research amongst engineers, researchers and clinicians will benefit the field of multimodal neuroimaging.

Magnetism and hybrid improper ferroelectricity in LaMO3/YMO3 superlattices.

Using first-principles calculations, we investigate the structural, electronic, and magnetic properties of perovskite LaMO3/YMO3 superlattices (M = Cr, Mn, Co and Ni). It is found that ferroelectricity can emerge in LaMO3/YMO3 superlattices (M = Cr, Mn, Co), allowing them to be promising multiferroic candidates, while no ferroelectricity is found in the LaNiO3/YNiO3 superlattice. The electronic structure calculations indicate that the LaCrO3/YCrO3, LaMnO3/YMnO3, and LaCoO3/YCoO3 superlattices are insulators, and their magnetic ground states exhibit G-type antiferromagnetic (AFM), A-type AFM, and G-type AFM order, respectively, while the LaNiO3/YNiO3 superlattice is however a half-metallic ferromagnet. The electronic structure and magnetic ground state are discussed, based on the projected density of states data and Heisenberg model, respectively, and the magnetic phase transition temperature is evaluated based on mean-field theory. In the meantime, the spontaneous ferroelectric polarization of the LaMO3/YMO3 superlattices (M = Cr, Mn, Co) is determined respectively using the Born effective charge model and Berry phase method, and their hybrid improper ferroelectric character is predicted, with the net polarization mainly from the different displacements of the LaO layers and YO layers along the b-axis. It is suggested that alternative multiferroic materials can be obtained by properly designing superlattices that consist of two non-polar magnetic materials but exhibit tunable magnetic ground states and transition temperature and hybrid improper ferroelectricity.

MR image features predicting hemorrhagic transformation in acute cerebral infarction: a multimodal study.

INTRODUCTION: The aims of this study were to observe magnetic resonance imaging (MRI) features and the frequency of hemorrhagic transformation (HT) in patients with acute cerebral infarction and to identify the risk factors of HT. METHODS: We first performed multimodal MRI (anatomical, diffusion weighted, and susceptibility weighted) scans on 87 patients with acute cerebral infarction within 24 hours after symptom onset and documented the image findings. We then performed follow-up examinations 3 days to 2 weeks after the onset or whenever the conditions of the patients worsened within 3 days. We utilized univariate statistics to identify the correlations between HT and image features and used multivariate logistical regression to correct for confounding factors to determine relevant independent image features of HT. RESULTS: HT was observed in 17 out of total 87 patients (19.5 %). The infarct size (p = 0.021), cerebral microbleeds (CMBs) (p = 0.004), relative apparent diffusion (rADC) (p = 0.023), and venous anomalies (p = 0.000) were significantly related with HT in the univariate statistics. Multivariate analysis demonstrated that CMBs (odd ratio (OR) = 0.082; 95 % confidence interval (CI) = 0.011-0.597; p = 0.014), rADC (OR = 0.000; 95 % CI = 0.000-0.692; p = 0.041), and venous anomalies (OR = 0.066; 95 % CI = 0.011-0.403; p = 0.003) were independent risk factors for HT. CONCLUSIONS: The frequency of HT is 19.5 % in this study. CMBs, rADC, and venous anomalies are independent risk factors for HT of acute cerebral infarction.

Improving the spectral resolution and spectral fitting of (1) H MRSI data from human calf muscle by the SPREAD technique.

Proton magnetic resonance spectroscopic imaging ((1) H MRSI) has been used for the in vivo measurement of intramyocellular lipids (IMCLs) in human calf muscle for almost two decades, but the low spectral resolution between extramyocellular lipids (EMCLs) and IMCLs, partially caused by the magnetic field inhomogeneity, has hindered the accuracy of spectral fitting. The purpose of this paper was to enhance the spectral resolution of (1) H MRSI data from human calf muscle using the SPREAD (spectral resolution amelioration by deconvolution) technique and to assess the influence of improved spectral resolution on the accuracy of spectral fitting and on in vivo measurement of IMCLs. We acquired MRI and (1) H MRSI data from calf muscles of three healthy volunteers. We reconstructed spectral lineshapes of the (1) H MRSI data based on field maps and used the lineshapes to deconvolve the measured MRS spectra, thereby eliminating the line broadening caused by field inhomogeneities and improving the spectral resolution of the (1) H MRSI data. We employed Monte Carlo (MC) simulations with 200 noise realizations to measure the variations of spectral fitting parameters and used an F-test to evaluate the significance of the differences of the variations between the spectra before SPREAD and after SPREAD. We also used Cramer-Rao lower bounds (CRLBs) to assess the improvements of spectral fitting after SPREAD. The use of SPREAD enhanced the separation between EMCL and IMCL peaks in (1) H MRSI spectra from human calf muscle. MC simulations and F-tests showed that the use of SPREAD significantly reduced the standard deviations of the estimated IMCL peak areas (p < 10(-8) ), and the CRLBs were strongly reduced (by ~37%).

Multimodal magnetic resonance imaging: The coordinated use of multiple, mutually informative probes to understand brain structure and function.

Differing imaging modalities provide unique channels of information to probe differing aspects of the brain's structural or functional organization. In combination, differing modalities provide complementary and mutually informative data about tissue organization that is more than their sum. We acquired and spatially coregistered data in four MRI modalities--anatomical MRI, functional MRI, diffusion tensor imaging (DTI), and magnetic resonance spectroscopy (MRS)--from 20 healthy adults to understand how interindividual variability in measures from one modality account for variability in measures from other modalities at each voxel of the brain. We detected significant correlations of local volumes with the magnitude of functional activation, suggesting that underlying variation in local volumes contributes to individual variability in functional activation. We also detected significant inverse correlations of NAA (a putative measure of neuronal density and viability) with volumes of white matter in the frontal cortex, with DTI-based measures of tissue organization within the superior longitudinal fasciculus, and with the magnitude of functional activation and default-mode activity during simple visual and motor tasks, indicating that substantial variance in local volumes, white matter organization, and functional activation derives from an underlying variability in the number or density of neurons in those regions. Many of these imaging measures correlated with measures of intellectual ability within differing brain tissues and differing neural systems, demonstrating that the neural determinants of intellectual capacity involve numerous and disparate features of brain tissue organization, a conclusion that could be made with confidence only when imaging the same individuals with multiple MRI modalities.

An MR brain images classifier system via particle swarm optimization and kernel support vector machine.

Automated abnormal brain detection is extremely of importance for clinical diagnosis. Over last decades numerous methods had been presented. In this paper, we proposed a novel hybrid system to classify a given MR brain image as either normal or abnormal. The proposed method first employed digital wavelet transform to extract features then used principal component analysis (PCA) to reduce the feature space. Afterwards, we constructed a kernel support vector machine (KSVM) with RBF kernel, using particle swarm optimization (PSO) to optimize the parameters C and σ . Fivefold cross-validation was utilized to avoid overfitting. In the experimental procedure, we created a 90 images dataset brain downloaded from Harvard Medical School website. The abnormal brain MR images consist of the following diseases: glioma, metastatic adenocarcinoma, metastatic bronchogenic carcinoma, meningioma, sarcoma, Alzheimer, Huntington, motor neuron disease, cerebral calcinosis, Pick's disease, Alzheimer plus visual agnosia, multiple sclerosis, AIDS dementia, Lyme encephalopathy, herpes encephalitis, Creutzfeld-Jakob disease, and cerebral toxoplasmosis. The 5-folded cross-validation classification results showed that our method achieved 97.78% classification accuracy, higher than 86.22% by BP-NN and 91.33% by RBF-NN. For the parameter selection, we compared PSO with those of random selection method. The results showed that the PSO is more effective to build optimal KSVM.

A support-based reconstruction for SENSE MRI.

A novel, rapid algorithm to speed up and improve the reconstruction of sensitivity encoding (SENSE) MRI was proposed in this paper. The essence of the algorithm was that it iteratively solved the model of simple SENSE on a pixel-by-pixel basis in the region of support (ROS). The ROS was obtained from scout images of eight channels by morphological operations such as opening and filling. All the pixels in the FOV were paired and classified into four types, according to their spatial locations with respect to the ROS, and each with corresponding procedures of solving the inverse problem for image reconstruction. The sensitivity maps, used for the image reconstruction and covering only the ROS, were obtained by a polynomial regression model without extrapolation to keep the estimation errors small. The experiments demonstrate that the proposed method improves the reconstruction of SENSE in terms of speed and accuracy. The mean square errors (MSE) of our reconstruction is reduced by 16.05% for a 2D brain MR image and the mean MSE over the whole slices in a 3D brain MRI is reduced by 30.44% compared to those of the traditional methods. The computation time is only 25%, 45%, and 70% of the traditional method for images with numbers of pixels in the orders of 10(3), 10(4), and 10(5)-10(7), respectively.

Putamen Structure and Function in Familial Risk for Depression: A Multimodal Imaging Study.

BACKGROUND: The putamen has been implicated in depressive disorders, but how its structure and function increase depression risk is not clearly understood. Here, we examined how putamen volume, neuronal density, and mood-modulated functional activity relate to family history and prospective course of depression. METHODS: The study includes 115 second- and third-generation offspring at high or low risk for depression based on the presence or absence of major depressive disorder in the first generation. Offspring were followed longitudinally using semistructured clinical interviews blinded to their familial risk; putamen structure, neuronal integrity, and functional activation were indexed by structural magnetic resonance imaging (MRI), proton magnetic resonance spectroscopy (N-acetylaspartate/creatine ratio), and functional MRI activity modulated by valence and arousal components of a mood induction task, respectively. RESULTS: After adjusting for covariates, the high-risk individuals had lower putamen volume (standardized betas, ß-left = -0.17, ß-right = -0.15, ps = .002), N-acetylaspartate/creatine ratio (ß-left= -0.40, ß-right= -0.37, ps < .0001), and activation modulated by valence (ß-left = -0.22, ß-right = -0.27, ps < .05) than low-risk individuals. Volume differences were greater at younger ages, and N-acetylaspartate/creatine ratio differences were greater at older ages. Lower putamen volume also predicted major depressive disorder episodes up to 8 years after the scan (ß-left = -0.72, p = .013; ß-right = -0.83, p = .037). Magnetic resonance spectroscopy and task functional MRI measures were modestly correlated (0.27 ≤ r ≤ 0.33). CONCLUSIONS: Findings demonstrate abnormalities in putamen structure and function in individuals at high risk for major depressive disorder. Future studies should focus on this region as a potential biomarker for depressive illness, noting meanwhile that differences attributable to family history may peak at different ages based on which MRI modality is being used to assay them.

Techniques for in utero, longitudinal MRI of fetal brain development in baboons at 3T.

Magnetic Resonance Imaging (MRI) is a promising tool for the noninvasive, longitudinal study of developing primate brains. We developed a protocol to scan pregnant baboons serially at 3T for up to 3h per session. This protocol includes procedures for animal preparation, anesthesia, MRI scanning, and post-scan animal care. We applied this protocol to scan 5 baboons multiple times across the latter 70% of gestation-from as early as 56 days post-conceptional age to as late as 185 days (term approximately 180 days). We successfully acquired high-resolution anatomical images and maps of relaxation times (T(1) and T(2)) of the fetal brains at multiple time points across gestation. These images and maps demonstrated the convergence of gray and white matter contrast near term, and furthermore demonstrated that the convergence of contrast is a consequence of the continuous change in relaxation times during fetal brain development. We estimated the rates of decrease of T(1) and T(2) in white matter and gray matter, respectively. In addition, we measured the volumes of fetal brain at different gestational ages and calculated the growth rates of whole brain (0.91+/-0.08 cm(3)/day) and cortical gray matter (0.40+/-0.04 cm(3)/day). We also measured the mean diffusivity in white matter and deep gray matter using diffusion tensor imaging. In conclusion, in utero MRI of fetal baboon brains greatly enhances the use of nonhuman primate models to study fetal brain development longitudinally.

Deep Learning in Medical Image Analysis.

Over recent years, deep learning (DL) has established itself as a powerful tool across a broad spectrum of domains in imaging-e [...].

Ventromedial prefrontal cortex/anterior cingulate cortex Glx, glutamate, and GABA levels in medication-free major depressive disorder.

Glutamate (Glu) and gamma-aminobutyric acid (GABA) are implicated in the pathophysiology of major depressive disorder (MDD). GABA levels or GABAergic interneuron numbers are generally low in MDD, potentially disinhibiting Glu release. It is unclear whether Glu release or turnover is increased in depression. Conversely, a meta-analysis of prefrontal proton magnetic resonance spectroscopy (1H MRS) studies in MDD finds low Glx (combination of glutamate and glutamine) in medicated MDD. We hypothesize that elevated Glx or Glu may be a marker of more severe, untreated MDD. We examined ventromedial prefrontal cortex/anterior cingulate cortex (vmPFC/ACC) Glx and glutamate levels using 1H MRS in 34 medication-free, symptomatic, chronically ill MDD patients and 32 healthy volunteers, and GABA levels in a subsample. Elevated Glx and Glu were observed in MDD compared with healthy volunteers, with the highest levels seen in males with MDD. vmPFC/ACC GABA was low in MDD. Higher Glx levels correlated with more severe depression and lower GABA. MDD severity and diagnosis were both linked to higher Glx in vmPFC/ACC. Low GABA in a subset of these patients is consistent with our hypothesized model of low GABA leading to glutamate disinhibition in MDD. This finding and model are consistent with our previously reported findings that the NMDAR-antagonist antidepressant effect is proportional to the reduction of vmPFC/ACC Glx or Glu levels.

Relationship of Brain Glutamate Response to D-Cycloserine and Lurasidone to Antidepressant Response in Bipolar Depression: A Pilot Study.

N-methyl-D-aspartate glutamate-receptor (NMDAR) antagonists such as ketamine have demonstrated efficacy in both major depressive disorder (MDD) and bipolar disorder depression (BP-D). We have previously reported that reduction in Glx (glutamate + glutamine) in the ventromedial prefrontal cortex/anterior cingulate cortex (vmPFC/ACC), measured by proton magnetic resonance spectroscopy (1H MRS) at 3T during a ketamine infusion, mediates the relationship of ketamine dose and blood level to improvement in depression. In the present study, we assessed the impact of D-cycloserine (DCS), an oral NMDAR antagonist combined with lurasidone in BP-D on both glutamate and Glx. Subjects with DSM-V BP-D-I/II and a Montgomery-Asberg Depression Rating Scale (MADRS) score>17, underwent up to three 1H MRS scans. During Scan 1, subjects were randomized to receive double-blind lurasidone 66 mg or placebo. During Scan 2, all subjects received single-blind DCS 950 mg + lurasidone 66 mg, followed by 4 weeks of open label phase of DCS+lurasidone and an optional Scan 3. Five subjects received lurasidone alone and three subjects received placebo for Scan 1. Six subjects received DCS+lurasidone during Scan 2. There was no significant baseline or between treatment-group differences in acute depression improvement or glutamate response. In Scan 2, after a dose of DCS+lurasidone, peak change in glutamate correlated negatively with improvement from baseline MADRS (r = -0.83, p = 0.04). There were no unexpected adverse events. These preliminary pilot results require replication but provide further support for a link between antidepressant effect and a decrease in glutamate by the NMDAR antagonist class of antidepressants.