Centre for Youth Mental Health - Research Publications

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Author: Han, Laura × Author: van Velzen, Laura × End date: 2019 × Start date: 2018 ×

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    Meta-Analysis of Hippocampal Subfields: Results From the ENIGMA-MDD Working Group
    Saemann, P ; Czisch, M ; Jahanshad, N ; Whelan, CD ; van Velzen, L ; Hibar, D ; Han, L ; Veer, IM ; Walter, H ; Veltman, D ; Schmaal, L (ELSEVIER SCIENCE INC, 2019-05-15)
    Background Hippocampal volume reductions in major depressive disorder (MDD) represent a robust finding in retrospective meta-analyses. Subregional specificity of this finding has been suspected from several smaller previous studies. Given the complex role of the hippocampus both for stress response regulation and its vulnerability to chronic disease, we aim at finer mapping of this result using FreeSurfer based, automated subfield segmentation. Methods Twenty-three centers with MDD/control samples contributed. Results reported here stem from 2522 patients and 4244 controls. After segmentation and standardized QC, local statistical were run for 25 models in total. Key models were: Cases vs. controls (covarying for age, age squared, sex-by-age, sex-by-age-squared, ICV and scanner/site); recurrent vs. controls, first episode vs. controls, early onset (EO, <22 years) vs. controls, late onset (LO) vs. controls. Eventually, inverse variance-weighted random-effect meta-analysis model in R (metafor package) with FDR correction for 14 phenotypes was performed. Results Regional specificity of volume deficits were detected in MDD as a whole (2522 patients, 4244 controls) (CA3>whole>CA1>GC.ML.DG>CA4>molecular layer). No robust effects were found in first episode patients (743 patients, 3812 controls) except for nominal effects. In recurrent MDD, only CA1 effects were robust. EO depression showed unexpectedly strong effects (836 patients, 3472 controls). Similarly, patients with current AD treatment showed strong effects, similarly distributed as in MDD except for CA1. No correlation with depression severity was detected. Conclusions Hippocampal structural changes in MDD show subregion specificity. While first episode status seems less critical and first/recurrent episode patients are similar, early onset appears as key predictor of structural abnormalities.
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    The impact of depression and anxiety treatment on biological aging and metabolic stress: study protocol of the Mood treatment with antidepressants or running (MOTAR) study
    Lever-van Milligen, BA ; Verhoeven, JE ; Schmaal, L ; van Velzen, LS ; Revesz, D ; Black, CN ; Han, LKM ; Horsfall, M ; Batelaan, NM ; van Balkom, AJLM ; van Schaik, DJF ; van Oppen, P ; Penninx, BWJH (BMC, 2019-12-30)
    BACKGROUND: Depressive and anxiety disorders have shown to be associated to premature or advanced biological aging and consequently to adversely impact somatic health. Treatments with antidepressant medication or running therapy are both found to be effective for many but not all patients with mood and anxiety disorders. These interventions may, however, work through different pathophysiological mechanisms and could differ in their impact on biological aging and somatic health. This study protocol describes the design of an unique intervention study that examines whether both treatments are similarly effective in reducing or reversing biological aging (primary outcome), psychiatric status, metabolic stress and neurobiological indicators (secondary outcomes). METHODS: The MOod Treatment with Antidepressants or Running (MOTAR) study will recruit a total of 160 patients with a current major depressive and/or anxiety disorder in a mental health care setting. Patients will receive a 16-week treatment with either antidepressant medication or running therapy (3 times/week). Patients will undergo the treatment of their preference and a subsample will be randomized (1:1) to overcome preference bias. An additional no-disease-no-treatment group of 60 healthy controls without lifetime psychopathology, will be included as comparison group for primary and secondary outcomes at baseline. Assessments are done at week 0 for patients and controls, and at week 16 and week 52 for patients only, including written questionnaires, a psychiatric and medical examination, blood, urine and saliva collection and a cycle ergometer test, to gather information about biological aging (telomere length and telomerase activity), mental health (depression and anxiety disorder characteristics), general fitness, metabolic stress-related biomarkers (inflammation, metabolic syndrome, cortisol) and genetic determinants. In addition, neurobiological alterations in brain processes will be assessed using structural and functional Magnetic Resonance Imaging (MRI) in a subsample of at least 25 patients per treatment arm and in all controls. DISCUSSION: This intervention study aims to provide a better understanding of the impact of antidepressant medication and running therapy on biological aging, metabolic stress and neurobiological indicators in patients with depressive and anxiety disorders in order to guide a more personalized medicine treatment. TRIAL REGISTRATION: Trialregister.nl Number of identification: NTR3460, May 2012.