Cingulate function in depression

Abstract

The relationship between pretreatment regional cerebral glucose metabolism and eventual antidepressant drug response was measured using positron emission tomography (PET) in hospitalized patients with unipolar depression. Rostral anterior cingulate metabolism uniquely differentiated eventual treatment responders from non-responders. Hypometabolism characterized non-responders when compared with controls, in contrast to responders who were hypermetabolic. Metabolism in no other region discriminated the two groups, nor did associated demographic, clinical or behavioral measures, including motor speed, cognitive performance, depression severity or illness chronicity. Cingulate hypermetabolism may represent an important adaptive response to depression and failure of this response may underlie poor outcome. A critical role for rostral cingulate area 24a/b in the limbic-cortical network involved in abnormal mood states is proposed.

Subgenual Cingulate Theta Activity Predicts Treatment Response of Repetitive Transcranial Magnetic Stimulation in Participants With Vascular Depression

“…10 Although the rostral ACC is anatomically connected to the subgenual ACC, these regions are cytoarchitecturally distinct. 9, 30–32 The subgenual ACC is considered a more archaic region than the rostral ACC; has extensive connections with other parts of the brain such as the amygdala, raphe nuclei, and brain stem autonomic nuclei; and is involved in emotional processing, monoaminergic neurotransmitter release, and autonomic regulation. 33 While abnormal function has been found in both the rostral and the subgenual ACC in major depression, only the subgenual ACC has been associated with a reduction in volume, 31,34 and this may represent the core abnormality of treatment resistant depression.…”

“…33 While abnormal function has been found in both the rostral and the subgenual ACC in major depression, only the subgenual ACC has been associated with a reduction in volume, 31,34 and this may represent the core abnormality of treatment resistant depression. 35 Although elevated activity in the rostral ACC has been shown to predict response to pharmacological treatment, 9,10 response to antidepressant treatment has been shown to be primarily mediated by the subgenual ACC. A recent study by Kitou and Koga.…”

“…Higher than normal activity in the rostral anterior cingulate cortex (ACC) has been shown to predict response to antidepressant medication in patients with major depression. 6–9 High theta power in the rostral ACC has also been found to predict response in a similar population. 10 This same group found that metabolism and theta activity are linked in this region.…”

The mental wealth of nations

“…Similarly, differences in the subgenual anterior cingulate identified by structural and functional neuroimaging can predict the likely responsiveness to treatment 11,12 .…”

Experiencing, Psychopathology, and the Tripartite Mind

“…Alternately, resting state levels of activity in the BA 24b have recently found to be negatively correlated with anhedonia scores [95]. Increased resting state levels of activity in the same region have also repeatedly been found to predict improved outcome response in the treatment of depression [96,97]. Hyperactivity in the dmPFC has also recently been associated with anxiety arising from a sense of social threat [98].…”