Atypical Neural Activity Facilitates Positivity After Experiencing Negative Events

Post by Rebecca Hill

The takeaway

Individuals who interpret negative circumstances in a more positive light are more easily able to weather hardships, but it is still unclear how this happens in the brain. Atypical neural activity in a brain network called the default network facilitates this positive interpretation after witnessing a negative event. 

What's the science?

The ability to be optimistic during adverse life experiences, such as a poor medical diagnosis or difficulties with interpersonal relationships, can improve physical and mental health outcomes after these events. However, the brain mechanisms that allow for these positive outlooks after negative experiences are still unknown. Previous work has suggested that the default network, which is implicated in subjective interpretation, could be involved with this positive thinking. This week in PNAS, Iyer and colleagues studied which cognitive mechanisms are used to facilitate positive interpretations of negative events.

How did they do it?

The authors had participants watch videos about cystic fibrosis while measuring their brain activity in regions throughout the default network using a functional MRI (fMRI). Subjects watched one video of patients discussing their experience with cystic fibrosis and one video of an explanation of the biological mechanisms of cystic fibrosis. This was to test whether an experience that was more open to interpretation – the video of the patient – led to more atypical neural processing than an experience that was not open to interpretation – the explanation of cystic fibrosis. After each video was played, subjects were scanned for 6 minutes during a rest period. The authors used this method to pinpoint the time that atypical thinking might be occurring to encourage positive interpretation. To measure neural activity associated with this atypical thinking, the authors calculated the activity connecting regions within the default network, and then compared this activity between participants. They used this to sort subjects into similar or dissimilar activity, as those with dissimilar activity to all other subjects experience atypical neural activity. After subjects completed their fMRI, they were asked to write descriptions of what they remembered about each video and the descriptions were then analyzed for how much positive or negative wording was used.

What did they find?

The authors found that atypical neural activity within the default network after watching the patient video was significantly related to positive descriptions from the subjects. Subjects who gave negative descriptions of the patient video instead had similar neural activity. This suggests that atypical thought processes and neural activity are necessary for interpreting negative events positively. When analyzing these responses both while subjects were watching the video and afterward, during the rest period, the authors found the most activity during the earlier half of the rest period. This suggests that positive thinking is facilitated by atypical neural activity occurring relatively quickly after experiencing a negative event. When testing for which region in the default network is most important for atypical neural activity, the authors found that the ventromedial prefrontal cortex, part of the reward system in the brain, was the only region required to facilitate a positive interpretation of negative experiences.

What's the impact?

This study is the first to describe that atypical neural activity is required to view negative experiences in a positive light. Understanding the neural mechanisms that allow for optimism during adversity is important for being able to encourage resiliency in response to negative events. Everyone goes through difficult experiences during life, so being able to identify and use effective coping strategies is essential for protecting mental and physical health.

Access the original scientific publication here

Pinpointing Target Regions for Brain Stimulation in Treatment-Resistant Depression

Post by Natalia Ladyka-Wojcik

The takeaway

This is the first large-scale randomized controlled trial to demonstrate the importance of pinpointing target regions involved in depression with magnetic resonance imaging (MRI) for treatment with transcranial magnetic stimulation (TMS). Treatment benefits can last longer than we previously understood - up to six months after TMS. 

What's the science?

Although antidepressants and psychotherapies are effective treatment methods for many people with severe major depressive disorder, some individuals have treatment-resistant depression and may benefit from therapeutic neuromodulation, such as repetitive transcranial magnetic stimulation (rTMS). rTMS for depression has been popular for the past several decades, but – critically – no data is available to support its long-term effectiveness (beyond 1-3 months). Moreover, rTMS is traditionally applied to the same site on the scalp such that individual differences in the brain circuits involved in depression may not be accounted for. A more recent approach called connectivity-guided intermittent theta burst stimulation (cgiTBS), may provide longer-lasting treatment effects than standard rTMS by personalizing the targets to each individual’s brain circuitry using MRI data. This month in Nature Medicine, Morriss and colleagues directly compared the efficacy of both therapeutic neuromodulation approaches in a multi-center, randomized controlled trial for treatment-resistant depression over 26 weeks.

How did they do it?

Participants in this study were randomly assigned to receive 20 sessions of either rTMS or cgiTBS over four to six weeks. For both groups, sessions involved placing an electromagnetic coil against the scalp to deliver magnetic pulses that can alter activity in brain circuits thought to be involved in depression. The authors pinpointed the precise location of a brain region involved in depression (the left dorsolateral prefrontal cortex) for each participant by collecting structural or functional MRI (think brain anatomy vs. brain activity) for those undergoing rTMS or cgiTBS, respectively. cgiTBS coordinates were based on the correlation between brain activity of the left dorsolateral prefrontal cortex and the right anterior insula. Crucially, a computerized tracking system, called Neuronavigation, allowed them to deliver the treatment consistently across all 20 sessions, reducing the variability in stimulation at each session. To determine if participants showed a long-lasting reduction in depression symptoms following rTMS or cgiTBS, they administered a widely used depression assessment scale at the start of the study, and later at 8, 16, and 26 weeks.

What did they find?

This study provides large-scale evidence for both rTMS and cgiTBS as effective interventions for treatment-resistant depression. Both groups showed a similar and large average decrease in symptom scores on the depression assessment scale at the 8-week follow-up compared to the start of the study and both groups maintained lower symptom scores on average at the 26-week follow-up. Participants experienced improvements in quality of life despite previously not responding to other treatment approaches for depression, with over two-thirds having reported feeling better by session 20 of stimulation. Importantly, a third of participants across both rTMS and cgiTBS groups showed a 50% drop in depression symptoms, with a fifth of participants maintaining this drop even after 26 weeks. The authors also found that participants who completed fewer than 20 stimulation sessions of either rTMS or cgiTBS showed less improvement in their depressive symptoms at the 26-week follow-up. Together, these findings demonstrate that personalizing the targeted brain sites (via either functional or structural means) for TMS using MRI in patients with treatment-resistant depression can result in long-lasting reductions of depression symptoms, even beyond what has previously been assessed in the literature. 

What's the impact?

This study is the first large-scale trial to find evidence that MRI-guided TMS (both rTMS and cgiTBS) is an effective, long-lasting approach for treatment-resistant depression. Given that around a third of all people with major depressive disorder experience treatment-resistant depression which does not respond to antidepressants and psychotherapies, the results of this study highlight the need to establish MRI-guided TMS as a standard treatment approach in these cases.  

Access the original scientific publication here.

Firing in Rhythm: Simultaneous Ripples Across Distant Brain Regions Facilitate the Integration of Brain Signals

Post by Rachel Sharp

The takeaway

When high-frequency brain waves, known as “ripples”, occur simultaneously across different brain regions, they help integrate signals between these regions through coordinated neural activity. These findings support the hypothesis that ripples play an important role in helping our brains combine complex information across distant brain regions.

What's the science?

How do individual elements of a neural event occurring at different locations across the brain unify into a cohesive mental experience? The “binding-by-synchrony” hypothesis suggests that high-frequency ripples synchronize across brain regions, forming integrated networks of neural activity. Ripples have been shown to synchronize, and have even been shown to organize cell firing in rodents, but the impact of synchronized rippling across distant brain regions in humans is still unknown. This week in PNAS, Verzhbinsky and colleagues test the impact of simultaneous rippling on the integration of neural signals across different brain areas in humans. To do this, the authors used implanted microelectrodes spanning distances of up to 16mm (a US dime is 17.9 mm in diameter) in regions of the cortex used to execute movements and process language.

How did they do it?

The authors implanted four Utah Arrays (a group of 96 microelectrodes with the ability to record spatially accurate neural activity) into the cortex of three participants. They then recorded activity from these electrodes for each patient, over several hours, during both wake and sleep, and analyzed how selected neurons changed their firing rates in response to ripple activity detected by neighboring electrodes. After collecting the full recordings from each participant, the authors analyzed the rate at which ripples co-occurred, whether or not co-firing increased across brain regions when those regions were co-rippling, and whether co-rippling neurons across different regions were better able to predict the firing patterns of other neurons, compared to non-co-rippling neurons. To examine this, they categorized individual neurons as either “predicting drivers (B)” or “predicted targets (A)”. They measured the extent to which firing patterns in B neurons predicted observed firing patterns in A neurons when the surrounding neurons were co-rippling.

What did they find?

The authors found that brain regions that experienced co-rippling also experienced greater integration of neural firing across patients, brain regions, and brain states (wake vs. sleep). They also found that neurons were more likely to fire in synchrony with co-occurring ripples, which was correlated with the ability of neurons to predict another neuron’s firing patterns. This finding supports the idea that networks of neurons distributed across different brain regions synchronize through simultaneous high-frequency ripples. Neurons in co-rippling regions are more likely to fire together, and to exhibit predictive firing patterns. Ultimately, their findings supported the “binding-by-synchrony” hypothesis, showing evidence for networks of co-firing neurons across brain regions, enhanced by simultaneous ripple activity. 

What's the impact?

This study found that simultaneous ripples improve connections between both nearby and distant neurons in the human brain. These ripples were able to organize firing across large groups of neurons, showing the importance co-occurring ripples may have on integrating complex neural events, even when they occur in different brain regions. This integration of neural events helps us achieve complex cognition, organize our thoughts, and make appropriate decisions. Understanding the biological mechanism that drives neural integration gives us another clue to deciphering the puzzle of complex human perception and cognition.