Major depressive disorder (MDD) is a serious mental illness characterized by dysfunctional connectivity among distributed brain regions. Previous connectome studies based on functional magnetic resonance imaging (fMRI) have focused primarily on undirected functional connectivity and existing directed effective connectivity (EC) studies concerned mostly task‐based fMRI and incorporated only a few brain regions. To overcome these limitations and understand whether MDD is mediated by within‐network or between‐network connectivities, we applied spectral dynamic causal modeling to estimate EC of a large‐scale network with 27 regions of interests from four distributed functional brain networks (default mode, executive control, salience, and limbic networks), based on large sample‐size resting‐state fMRI consisting of 100 healthy subjects and 100 individuals with first‐episode drug‐naive MDD. We applied a newly developed parametric empirical Bayes (PEB) framework to test specific hypotheses. We showed that MDD altered EC both within and between high‐order functional networks. Specifically, MDD is associated with reduced excitatory connectivity mainly within the default mode network (DMN), and between the default mode and salience networks. In addition, the network‐averaged inhibitory EC within the DMN was found to be significantly elevated in the MDD. The coexistence of the reduced excitatory but increased inhibitory causal connections within the DMNs may underlie disrupted self‐recognition and emotional control in MDD. Overall, this study emphasizes that MDD could be associated with altered causal interactions among high‐order brain functional networks.

Background: Major depressive disorder (MDD) is one of the most common and costly psychiatric disorders. In addition to significant changes in mood, MDD patients face an increased risk of developing cognitive dysfunction. It is important to gain an improved understanding of cognitive impairments and find a biomarker for cognitive impairment diagnosis in MDD. Methods: One hundred MDD patients and 100 normal controls (NCs) completed resting-state fMRI (rs-fMRI) scan, in which 34 MDD patients and 34 NCs had scores in multiple cognitive domains (executive function, verbal fluency, and processing speed). Twenty-seven regions of interest from the default mode network (DMN), central executive network (CEN), salience network (SN), and limbic system (LS) were selected as seeds for functional connectivity (FC) analyses with the voxels in the whole brain. Finally, partial correlations were conducted for cognitive domain scores and FCs with significant differences between the MDD and NC groups. Results: Significant FC differences between groups were identified among the seeds and clusters in the DMN, CEN, LS, visual network, somatomotor network, ventral attention network, and dorsal attention network. In the MDD patients, the magnitude of the Stroop interference effect was positively correlated with the illness duration, and the illness duration was negatively correlated with the FC between the right ventral hippocampal gyrus and the left inferior frontal gyrus. However, the correlation between the Stroop interference effect and the FC of the right anterior prefrontal cortex with the left cerebellum_4_5 was disrupted in these patients. Conclusions: The MDD patients have altered FCs among multiple brain networks and a disrupted correlation between the FC of prefrontal cortex and executive function. The disrupted correlation could present before the symptoms develop and may be the core process in the development of executive function impairment.

Purpose: To detect radiation‐induced changes of temporal lobe normal‐appearing white mater (NAWM) following radiation therapy (RT) for nasopharyngeal carcinoma (NPC).Materials and Methods: Seventy‐five H¹‐MR spectroscopy and diffusion‐tensor imaging (DTI) examinations were performed in 55 patients before and after receiving fractionated radiation therapy (total dose; 66–75GY). We divided the dataset into six groups, a pre‐RT control group and five other groups based on time after completion of RT. N‐acetylaspartic acid (NAA)/choline (Cho), NAA/creatine (Cr), Cho/Cr, mean diffusibility (MD), functional anisotropy (FA), radial diffusibility (λ_⟂), and axial diffusibility (λ_||) were calculated.Results: NAA/Cho and NAA/Cr decreased and λ_⟂ increased significantly within 1 year after RT compared with pre‐RT. After 1 year, NAA/Cho, NAA/Cr, and λ_⟂ were not significantly different from pre‐RT. In all post‐RT groups, FA decreased significantly. λ_|| decreased within 9 months after RT compared with pre‐RT, but was not significantly different from pre‐RT more than 9 months after RT.Conclusion: DTI and H¹‐MR spectroscopy can be used to detect early radiation‐induced changes of temporal lobe NAWM following radiation therapy for NPC. Metabolic alterations and water diffusion characteristics of temporal lobe NAWM in patients with NPC after RT were dynamic and transient. J. Magn. Reson. Imaging 2013;37:101–108.

The therapeutic planning varies for different grades of choroid plexus tumours (CPTs). The aim of this study was to define the similarities and distinctions among MRIs for different grades of CPTs, providing more guidance for clinical decisions. We reviewed the MRI findings in 35 patients with CPT verified by surgical pathology, including 18 choroid plexus papillomas (CPPs, grade I), 11 atypical choroid plexus papillomas (aCPPs, grade II), and 6 choroid plexus carcinomas (CPCs, grade III). Nonparametric testing based on ranks was performed to evaluate the association of pathological grade with MRI findings. Among the 35 CPTs, 29 were located in the ventricular system. The tumours were generally slightly hypo- or isointense on T1WI, slightly hyper- or isointense on T2WI, and moderately or strongly enhanced in post-contrast imaging. Twenty cases were accompanied by hydrocephalus. The median tumour longest diameters of CPPs, aCPPs, and CPCs were 28.6, 44.6, and 60.6 mm, respectively. Four cases were purely cystic, 6 were papillary, 10 were lobulated, and 2 were irregular. Three cases had necrosis. The median oedema diameters of CPPs, aCPPs, and CPCs were 0, 0, and 24.1 mm, respectively. The grades of CPTs were statistically associated with tumour longest diameter (rs = 0.68, P < 0.001), internal morphology (χ2 = 10.32, P = 0.016), necrosis (Z = 2.27, P = 0.023), and oedema diameter (rs = 0.72, P < 0.001). CPTs typically appeared as intraventricular papillary or lobulated lesions, often accompanied by hydrocephalus. Larger tumour, irregular or fuzzy internal morphology, presentation of necrosis and wide-ranging peritumoural oedema might increase the likelihood of malignancy.