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dc.contributor.authorSamson, Andrea C
dc.contributor.authorMeisenzahl, Eva
dc.contributor.authorScheuerecker, Johanna
dc.contributor.authorRose, Emma
dc.contributor.authorSchoepf, Veronika
dc.contributor.authorWiesmann, Martin
dc.contributor.authorFrodl, Thomas
dc.date.accessioned2012-02-01T10:50:37Z
dc.date.available2012-02-01T10:50:37Z
dc.date.issued2012-02-01T10:50:37Z
dc.identifier.citationJ Psychiatr Res. 2011 Sep;45(9):1214-22. Epub 2011 Apr 7.en_GB
dc.identifier.issn1879-1379 (Electronic)en_GB
dc.identifier.issn0022-3956 (Linking)en_GB
dc.identifier.pmid21477817en_GB
dc.identifier.doi10.1016/j.jpsychires.2011.03.009en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207937
dc.description.abstractMajor 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.
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnalysis of Varianceen_GB
dc.subject.meshAntidepressive Agents/pharmacology/therapeutic useen_GB
dc.subject.meshBrain/blood supply/drug effects/*physiopathologyen_GB
dc.subject.mesh*Brain Mappingen_GB
dc.subject.meshDepressive Disorder, Major/drug therapy/*pathologyen_GB
dc.subject.meshEmotions/drug effects/*physiologyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshImage Processing, Computer-Assisteden_GB
dc.subject.meshMagnetic Resonance Imaging/methodsen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshNeuropsychological Testsen_GB
dc.subject.meshOxygen/blooden_GB
dc.subject.meshPattern Recognition, Visual/drug effectsen_GB
dc.subject.meshPhotic Stimulation/methodsen_GB
dc.subject.meshPredictive Value of Testsen_GB
dc.subject.meshReaction Time/drug effects/physiologyen_GB
dc.titleBrain activation predicts treatment improvement in patients with major depressive disorder.en_GB
dc.contributor.departmentDepartment 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.eduen_GB
dc.identifier.journalJournal of psychiatric researchen_GB
dc.description.provinceLeinster
html.description.abstractMajor 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.


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