Brain Imaging Study on the Pathogenesis of Depression & Therapeutic Effect of Selective Serotonin Reuptake Inhibitors

Abstract

Objective Predefining the most effective treatment for patients with depressive disorders remains a problem. We will examine the differential brain regions of gray matter (GM) in major depressive disorder (MDD) patients and the relationship between changes in their volume and the efficacy of early antidepressant treatment using magnetic resonance imaging (MRI).Methods 159 never-medicated patients with first-episode MDD and 53 normal control subjects (NCs) were enrolled. The brains were scanned by MRI and measured with the 17-item Hamilton Depression Rating Scale (HAMD-17) at baseline and after 2 weeks of treatment with selective serotonin reuptake inhibitor (SSRI)s, and the non-responder group and responder group were obtained. The patients were analyzed by voxel-based morphological (VBM) and SPSS software. Receiver operator characteristics (ROC) analysis was performed for the difference between the responder group and the non-responder group in the differential brain regions, and Pearson correlations were computed between volume size and HAMD score reduction rate.Results Smaller GM volume of the right superior temporal gyrus (STG), and the orbital parts of the right medial frontal gyrus and right inferior frontal gyrus were observed in MDD versus the NCs. The non-responder group demonstrated a significant volume reduction at the right STG compared with the responders, but no corresponding change in orbital part of right medial frontal gyrus and right inferior frontal gyrus. ROC analysis showed that Accuracy=71.2%. There was a positive correlation between the STG gray matter volume and the HAMD-17 score reduction rate (r=0.347, p=0.002).Conclusion The study results confirmed the local changes in brain structure in MDD and may initially predict the early treatment response produced by SSRIs as antidepressants.

Gray matter volume reduction in orbitofrontal cortex correlated with plasma glial cell line-derived neurotrophic factor (GDNF) levels within major depressive disorder

“…Numerous studies have found that patients with MDD have abnormally reduced GMV in the frontal brain regions ( Kim et al, 2019 , Schmaal et al, 2017 , Meng et al, 2020 , Fossati et al, 2004 , Duman and Monteggia, 2006 , Du et al, 2012 , Stratmann et al, 2014 , Lloyd et al, 2004 , Bora et al, 2012 ), especially in the OFC, where the GMV is significantly smaller than that of HCs ( Lai et al, 2000 , Zhao et al, 2017 , Ballmaier et al, 2004 ), which further confirms our findings. The OFC is located in the corticomotor and ventral premotor areas of the PFC and is primarily involved in cognitive functions, where individuals make choices or avoid risks.…”

“…There is evidence that major depressive disorder (MDD) is linked to abnormally low gray matter volume (GMV) in various brain regions, such as the hippocampus, cingulate gyrus, frontal lobe, occipital lobe, temporal lobe, insula, and striatum ( Kim et al, 2019 , Schmaal et al, 2017 , Meng et al, 2020 , Fossati et al, 2004 , Duman and Monteggia, 2006 , Du et al, 2012 , Stratmann et al, 2014 , Lloyd et al, 2004 ). Moreover, researchers have found that MDD patients had less GMV in the frontal lobes ( Bora et al, 2012 ), especially in the prefrontal cortex (PFC) ( Czeh and Nagy, 2018 ), which was smaller than in healthy controls (HCs) ( Grieve et al, 2013 , Ansell et al, 2012 , Nakano et al, 2014 ).…”

Hippocampal and parahippocampal volume and function predict antidepressant response in patients with major depression: A multimodal neuroimaging study

“…However, a recent metaanalysis stressed the need to investigate the relation between right temporal areas and response in depression, provided that only these two studies reported significant associations, that the direction of the effect is opposite to what is usually found and expected, and that no analogous result has been identified for studies investigating structural correlates or treatment response to ECT or cognitive behavioral therapy (CBD) (Enneking et al, 2020). Following the publication of the meta-analysis, a new VBM study identified lower volumes of the right superior temporal gyrus in non-responders MDD patients (Meng et al, 2020); therefore, our result appears to be in line with this latter study, associating volumetric reductions in right temporal areas to worse treatment response.…”

Efficacy of acupuncture at ghost points combined with fluoxetine in treating depression: A randomized study

“…The HAMD reduction rate ([before treatment - after treatment]/before treatment × 100%) was used to evaluate the treatment efficacy[ 9 ]. Reduction rates of ≥ 90, 70%–89%, and ≤ 69% indicated that the treatments were markedly effective, effective, and ineffective, respectively.…”