Repetitive Negative Thinking-Specific and -Nonspecific White Matter Tracts Engaged by Historical Psychosurgical Targets for Depression

Stella M Sanchez; Aki Tsuchiyagaito; Rayus Kuplicki; Heekyeong Park; Ivan Postolski; Michael Rohan; Martin P Paulus; Salvador M Guinjoan

doi:10.1016/j.biopsych.2023.03.012

Repetitive Negative Thinking-Specific and -Nonspecific White Matter Tracts Engaged by Historical Psychosurgical Targets for Depression

Biol Psychiatry. 2023 Oct 15;94(8):661-671. doi: 10.1016/j.biopsych.2023.03.012. Epub 2023 Mar 23.

Authors

Stella M Sanchez¹, Aki Tsuchiyagaito², Rayus Kuplicki¹, Heekyeong Park³, Ivan Postolski⁴, Michael Rohan¹, Martin P Paulus⁵, Salvador M Guinjoan⁶

Affiliations

¹ Laureate Institute for Brain Research, Tulsa, Oklahoma.
² Laureate Institute for Brain Research, Tulsa, Oklahoma; Research Center for Child Mental Development, Chiba University, Chiba, Japan.
³ Laureate Institute for Brain Research, Tulsa, Oklahoma; Department of Psychology, University of North Texas, Dallas, Texas.
⁴ Institute for Research in Computational Sciences, National Scientific and Technical Research Council-University of Buenos Aires, Buenos Aires, Argentina.
⁵ Laureate Institute for Brain Research, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma.
⁶ Laureate Institute for Brain Research, Tulsa, Oklahoma; Department of Psychiatry, Oklahoma University Health Sciences Center, Tulsa, Oklahoma. Electronic address: SGuinjoan@laureateinstitute.org.

PMID: 36965550
PMCID: PMC10517085 (available on 2024-10-15)
DOI: 10.1016/j.biopsych.2023.03.012

Abstract

Background: Repetitive negative thinking (RNT) is a frequent symptom of major depressive disorder (MDD) that is associated with poor outcomes and treatment resistance. While most studies on RNT have focused on structural and functional characteristics of gray matter, this study aimed to examine the association between white matter (WM) tracts and interindividual variability in RNT.

Methods: A probabilistic tractography approach was used to characterize differences in the size and anatomical trajectory of WM fibers traversing psychosurgery targets historically useful in the treatment of MDD (anterior capsulotomy, anterior cingulotomy, and subcaudate tractotomy) in patients with MDD and low (n = 53) or high (n = 52) RNT, and healthy control subjects (n = 54). MDD samples were propensity matched on depression and anxiety severity and demographics.

Results: WM tracts traversing left hemisphere targets and reaching the ventral anterior body of the corpus callosum (thus extending to contralateral regions) were larger in the high-RNT MDD group compared with low-RNT (effect size D = 0.27, p = .042) and healthy control (D = 0.23, p = .02) groups. MDD was associated with greater size of tracts that converge onto the right medial orbitofrontal cortex regardless of RNT intensity. Other RNT-nonspecific findings in MDD involved tracts reaching the left primary motor and right primary somatosensory cortices.

Conclusions: This study provides the first evidence to our knowledge that WM connectivity patterns, which could become targets of intervention, differ between high- and low-RNT participants with MDD. These WM differences extend to circuits that are not specific to RNT, possibly subserving reward mechanisms and psychomotor activity.

Trial registration: ClinicalTrials.gov NCT02450240.

Keywords: Depression; Diffusion tensor imaging; Probabilistic tractography; Psychosurgery; Repetitive negative thinking; White matter tracts.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Anxiety
Depression
Depressive Disorder, Major* / surgery
Humans
Pessimism*
White Matter* / diagnostic imaging

Associated data

ClinicalTrials.gov/NCT02450240

Grants and funding

P20 GM121312/GM/NIGMS NIH HHS/United States