title: Abnormal spontaneous neural activity in the anterior insular and anterior cingulate cortices in anxious depression.
abstract: OBJECTIVE
  Anxious depression is a distinct clinical subtype of major depressive disorder (MDD) characterized by palpitations, somatic complaints, altered interoceptive awareness, high risk of suicide, and poor response to pharmacotherapy. However, the neural mechanisms of anxious depression are still not well understood. In this study we investigated changes in neural oscillation during the resting-state of patients with anxious depression by measuring differences in the amplitude of low-frequency fluctuation (ALFF).
  
  
  METHODS
  Resting-state functional magnetic resonance imaging was acquired in 31 patients with anxious depression, 18 patients with remitted depression, as well as 68 gender- and age-matched healthy participants. We compared the differences both in the ALFF and fractional ALFF (fALFF) among the three groups. We also examined the correlation between the ALFF/fALFF and the severity of anxiety as well as depression.
  
  
  RESULTS
  Anxious depression patients showed increased ALFF/fALFF in the right dorsal anterior insular cortex and decreased ALFF/fALFF in the bilateral lingual gyrus relative to remitted depression patients and healthy controls. The increased ALFF in the dorsal anterior insula was also positively correlated with stronger anxiety in the anxious depression group. Anxious depression patients also displayed increased fALFF in the right ventral anterior cingulate cortex (ACC) compared to remitted depression patients and healthy controls.
  
  
  CONCLUSIONS
  Our results suggest that alterations of the cortico-limbic networks, including the right dorsal anterior insula and right ventral ACC, may play a critical role in the physiopathology of anxious depression.
authors.affiliation: Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Laboratory of Brain Disorders, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China.
authors.forename: Chun-Hong
authors.initials: CH
authors.lastname: Liu
authors.affiliation: Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Laboratory of Brain Disorders, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China. Electronic address: maxinanding@vip.163.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Ma
authors.affiliation: Rehabilitation College of Capital Medical University, China Rehabilitation Research Center, Beijing 100068, China.
authors.forename: Lu-Ping
authors.initials: LP
authors.lastname: Song
authors.affiliation: Department of Psychology, Queens College, The City University of New York, Queens, NY 11367, USA.
authors.forename: Jin
authors.initials: J
authors.lastname: Fan
authors.affiliation: Department of Psychology, Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Wang
authors.affiliation: Department of Psychology, Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
authors.forename: Xue-Yu
authors.initials: XY
authors.lastname: Lv
authors.affiliation: Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Laboratory of Brain Disorders, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Laboratory of Brain Disorders, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.affiliation: Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 10084, China. Electronic address: lihong001@gmail.com.
authors.forename: Lihong
authors.initials: L
authors.lastname: Wang
authors.affiliation: Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Laboratory of Brain Disorders, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China.
authors.forename: Chuan-Yue
authors.initials: CY
authors.lastname: Wang
mesh_terms: D000328:Adult; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology*; D001931:Brain Mapping / Q000379:methods; D016022:Case-Control Studies; D002540:Cerebral Cortex; D003863:Depression / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006179:Gyrus Cinguli; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: Amplitude of low-frequency fluctuation (ALFF); Anxious depression; Fractional amplitude of low-frequency fluctuation (fALFF); Functional magnetic resonance imaging (fMRI); Resting-state