Brain activation predicts treatment improvement in patients with major depressive disorder.
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Authors
Samson, Andrea CMeisenzahl, Eva
Scheuerecker, Johanna
Rose, Emma
Schoepf, Veronika
Wiesmann, Martin
Frodl, Thomas
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. andrea.samson@stanford.eduIssue Date
2012-02-01T10:50:37ZMeSH
AdultAnalysis of Variance
Antidepressive Agents/pharmacology/therapeutic use
Brain/blood supply/drug effects/*physiopathology
*Brain Mapping
Depressive Disorder, Major/drug therapy/*pathology
Emotions/drug effects/*physiology
Female
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging/methods
Male
Middle Aged
Neuropsychological Tests
Oxygen/blood
Pattern Recognition, Visual/drug effects
Photic Stimulation/methods
Predictive Value of Tests
Reaction Time/drug effects/physiology
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J Psychiatr Res. 2011 Sep;45(9):1214-22. Epub 2011 Apr 7.Journal
Journal of psychiatric researchDOI
10.1016/j.jpsychires.2011.03.009PubMed ID
21477817Abstract
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.Language
engISSN
1879-1379 (Electronic)0022-3956 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1016/j.jpsychires.2011.03.009
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