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Brain activation predicts treatment improvement in patients with major depressive disorder.
MedLine Citation:
PMID:  21477817     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Major depressive disorder (MDD) is associated with alterations in brain function that might be useful for therapy evaluation. The current study aimed to identify predictors for therapy improvement and to track functional brain changes during therapy. Twenty-one drug-free patients with MDD underwent functional MRI twice during performance of an emotional perception task: once before and once after 4 weeks of antidepressant treatment (mirtazapine or venlafaxine). Twelve healthy controls were investigated once with the same methods. A significant difference between groups was a relative greater activation of the right dorsolateral prefrontal cortex (dlPFC) in the patients vs. controls. Before treatment, patients responding better to pharmacological treatment showed greater activation in the dorsomedial PFC (dmPFC), posterior cingulate cortex (pCC) and superior frontal gyrus (SFG) when viewing of negative emotional pictures was compared with the resting condition. Activations in the caudate nucleus and insula contrasted for emotional compared to neutral stimuli were also associated with successful treatment. Responders had also significantly higher levels of activation, compared to non-responders, in a range of other brain regions. Brain activation related to treatment success might be related to altered self-referential processes and a differential response to external emotional stimuli, suggesting differences in the processing of emotionally salient stimuli between those who are likely to respond to pharmacological treatment and those who will not. The present investigation suggests the pCC, dmPFC, SFG, caudate nucleus and insula may have a key role as a biological marker for treatment response and predictor for therapeutic success.
Authors:
Andrea C Samson; Eva Meisenzahl; Johanna Scheuerecker; Emma Rose; Veronika Schoepf; Martin Wiesmann; Thomas Frodl
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-6
Journal Detail:
Title:  Journal of psychiatric research     Volume:  -     ISSN:  1879-1379     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376331     Medline TA:  J Psychiatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Psychiatry, School of Medicine & Trinity College Institute of Neuroscience, Integrated Neuroimaging, The Adelaide and Meath Hospital incorporating the National Children's Hospital (AMNCH), & St. James's Hospital, Trinity College, Dublin, Ireland; Department of Psychology, Stanford University, 450 Serra Mall, Bldg 420, Stanford, CA 94305-2130, USA.
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