Giulia Quattrini, Antonino Carcione, Mariangela Lanfredi, Giuseppe Nicolò, Laura Pedrini, Daniele Corbo, Laura R Magni, Andrea Geviti, Clarissa Ferrari, Roberto Gasparotti, Antonio Semerari, Michela Pievani, Roberta Rossi
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Fractional anisotropy (FA), mean, radial, and axial diffusivities maps were computed using FSL toolbox. Microstructural changes were assessed (i) voxel-wise, with tract based spatial statistics (TBSS) and (ii) ROI-wise, in the triple network system (default mode, salience, and executive control networks). The effect of MIT on brain microstructure was assessed with paired tests using FSL PALM (voxel-wise), Linear Mixed-Effect Models or Generalized Linear Mixed Models (ROI-wise). Associations between microstructural and clinical changes were explored with linear regression (voxel-wise) and correlations (ROI-wise).</p><p><strong>Results: </strong>The voxel-wise analysis showed that MIT was associated with increased FA in the bilateral thalamic radiation and left associative tracts (p < .050, family-wise error rate corrected). At network system level, MIT increased FA and both interventions reduced AD in the executive control network (p = .05, uncorrected).</p><p><strong>Limitations: </strong>The DTI metrics can't clarify the nature of axonal changes.</p><p><strong>Conclusions: </strong>Our results indicate that MIT modulates brain structural connectivity in circuits related to associative and executive control functions. These microstructural changes may denote activity-dependent plasticity, possibly representing a neurobiological mechanism underlying MIT effects.</p><p><strong>Trial registration: </strong>ClinicalTrials.govNCT02370316 (https://clinicaltrials.gov/study/NCT02370316).</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":null,"pages":null},"PeriodicalIF":4.9000,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of metacognitive interpersonal therapy on brain structural connectivity in borderline personality disorder: Results from the CLIMAMITHE randomized clinical trial.\",\"authors\":\"Giulia Quattrini, Antonino Carcione, Mariangela Lanfredi, Giuseppe Nicolò, Laura Pedrini, Daniele Corbo, Laura R Magni, Andrea Geviti, Clarissa Ferrari, Roberto Gasparotti, Antonio Semerari, Michela Pievani, Roberta Rossi\",\"doi\":\"10.1016/j.jad.2024.10.107\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Recently, we showed that Metacognitive Interpersonal Therapy (MIT) is effective in improving clinical symptoms in borderline personality disorder (BPD). Here, we investigated whether the effect of MIT on clinical features is associated to microstructural changes in brain circuits supporting core BPD symptoms.</p><p><strong>Methods: </strong>Forty-seven BPD were randomized to MIT or structured clinical management, and underwent a clinical assessment and diffusion-weighted imaging before and after the intervention. Fractional anisotropy (FA), mean, radial, and axial diffusivities maps were computed using FSL toolbox. Microstructural changes were assessed (i) voxel-wise, with tract based spatial statistics (TBSS) and (ii) ROI-wise, in the triple network system (default mode, salience, and executive control networks). The effect of MIT on brain microstructure was assessed with paired tests using FSL PALM (voxel-wise), Linear Mixed-Effect Models or Generalized Linear Mixed Models (ROI-wise). 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These microstructural changes may denote activity-dependent plasticity, possibly representing a neurobiological mechanism underlying MIT effects.</p><p><strong>Trial registration: </strong>ClinicalTrials.govNCT02370316 (https://clinicaltrials.gov/study/NCT02370316).</p>\",\"PeriodicalId\":14963,\"journal\":{\"name\":\"Journal of affective disorders\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2024-10-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of affective disorders\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jad.2024.10.107\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of affective disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jad.2024.10.107","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：最近，我们发现元认知人际关系疗法（MIT）能有效改善边缘型人格障碍（BPD）的临床症状。在此，我们研究了元认知人际关系疗法对临床特征的影响是否与支持边缘型人格障碍核心症状的大脑回路的微观结构变化有关：方法：47 名 BPD 被随机分配到 MIT 或结构化临床管理中，并在干预前后接受了临床评估和弥散加权成像。使用 FSL 工具箱计算分数各向异性（FA）、平均、径向和轴向扩散图。微观结构变化的评估包括：(i) 基于道的空间统计（TBSS）的体素评估；(ii) 基于三重网络系统（默认模式、显著性和执行控制网络）的 ROI 评估。使用 FSL PALM（体表）、线性混合效应模型或广义线性混合模型（ROI）进行配对测试，评估麻省理工学院对大脑微观结构的影响。通过线性回归（体素）和相关性（ROI）探讨了微观结构和临床变化之间的关联：结果：体素范围分析表明，麻省理工学院与双侧丘脑辐射和左侧联想束的 FA 增加有关（p 局限性：DTI指标无法明确轴突变化的性质：我们的研究结果表明，麻省理工学院改变了与联想和执行控制功能相关回路的大脑结构连接。这些微观结构变化可能表示活动依赖性可塑性，可能代表了MIT效应的神经生物学机制：ClinicalTrials.govNCT02370316 (https://clinicaltrials.gov/study/NCT02370316)。
Effect of metacognitive interpersonal therapy on brain structural connectivity in borderline personality disorder: Results from the CLIMAMITHE randomized clinical trial.
Background: Recently, we showed that Metacognitive Interpersonal Therapy (MIT) is effective in improving clinical symptoms in borderline personality disorder (BPD). Here, we investigated whether the effect of MIT on clinical features is associated to microstructural changes in brain circuits supporting core BPD symptoms.
Methods: Forty-seven BPD were randomized to MIT or structured clinical management, and underwent a clinical assessment and diffusion-weighted imaging before and after the intervention. Fractional anisotropy (FA), mean, radial, and axial diffusivities maps were computed using FSL toolbox. Microstructural changes were assessed (i) voxel-wise, with tract based spatial statistics (TBSS) and (ii) ROI-wise, in the triple network system (default mode, salience, and executive control networks). The effect of MIT on brain microstructure was assessed with paired tests using FSL PALM (voxel-wise), Linear Mixed-Effect Models or Generalized Linear Mixed Models (ROI-wise). Associations between microstructural and clinical changes were explored with linear regression (voxel-wise) and correlations (ROI-wise).
Results: The voxel-wise analysis showed that MIT was associated with increased FA in the bilateral thalamic radiation and left associative tracts (p < .050, family-wise error rate corrected). At network system level, MIT increased FA and both interventions reduced AD in the executive control network (p = .05, uncorrected).
Limitations: The DTI metrics can't clarify the nature of axonal changes.
Conclusions: Our results indicate that MIT modulates brain structural connectivity in circuits related to associative and executive control functions. These microstructural changes may denote activity-dependent plasticity, possibly representing a neurobiological mechanism underlying MIT effects.
期刊介绍：
The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.
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