Brain Imaging Correlates of Depressive Symptom Severity and Predictors of Symptom Improvement After Antidepressant Treatment

Brain Mapping Unit, University of Cambridge, Department of Psychiatry, Addenbrooke's Hospital, Cambridge, UK.
Biological Psychiatry (Impact Factor: 10.25). 10/2007; 62(5):407-14. DOI: 10.1016/j.biopsych.2006.09.018
Source: PubMed

ABSTRACT It would be therapeutically useful to predict clinical response to antidepressant drugs. We evaluated structural magnetic resonance imaging (MRI) and functional MRI (fMRI) data as predictors of symptom change in people with depression.
Brain structure and function were measured with MRI in 17 patients with major depression immediately before 8 weeks treatment with fluoxetine 20 mg/day. For fMRI, patients were scanned during visual presentation of faces representing different intensities of sadness. Clinical response was measured by change in serial scores on the Hamilton Rating Scale for Depression. Symptom change scores (and baseline symptom severity) were regressed on structural and functional MRI data to map brain regions where grey matter volume, or activation by sad facial affect processing, was significantly associated with symptom change (or baseline severity).
Faster rates of symptom improvement were strongly associated with greater grey matter volume in anterior cingulate cortex, insula, and right temporo-parietal cortex. Patients with greater than median grey matter volume in this system had faster rates of improvement and significantly lower residual symptom scores after 8 weeks' treatment. Faster improvement was also predicted by greater functional activation of anterior cingulate cortex. Baseline symptom severity was negatively correlated with greater grey matter volume in dorsal prefrontal and anterior midcingulate regions anatomically distinct from the pregenual and subgenual cingulate regions predicting treatment response.
Structural MRI measurements of anterior cingulate cortex could provide a useful predictor of antidepressant treatment response.

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Available from: John Suckling, Aug 22, 2015
    • "This is also consistent with model proposed by Goldapple et al. (2004). Despite the increased interest sparked by neuroimaging studies that assessed brain modifications after psychotherapy (Fu et al. 2008; Schnell and Herpertz 2007; Schienle et al. 2009; Goldapple et al. 2004) and pharmacological treatment (Bremner et al. 2007; Brody et al. 1999; Chen et al. 2007; Davidson et al. 2003; Fu et al. 2004; Haldane et al. 2008; Jogia et al. 2008; Kalin et al. 1997; Kennedy et al. 2001; Mayberg et al. 2000; Pizzagalli et al. 2001; Saxena et al. 2003; Vlassenko et al. 2004; Goldapple et al. 2004), it is still unclear whether the same neural mechanisms underlie both PsyTh and DrugTh. Indeed, because of the great heterogeneity of these studies, especially regarding the type of psychiatric disorder and experimental paradigm, we are still far from reaching an unambiguous conclusion. "
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    • "However, reduced ACC volume is consistently reported in depressed patients (Bora et al, 2012; Koolschijn et al, 2009; Lai, 2013; van Tol et al, 2010). Moreover, greater ACC volume is associated with better clinical outcome (Chen et al, 2007; Frodl et al, 2008), suggesting that individual differences in the ACC structure may contribute to our ReHo and FC findings (Kuhn et al, 2012 "
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