The value of HMPAO SPECT in predicting treatment response to citalopram in patients with major depression

Brockmann, Holger; Zobel, Astrid; Joe, Alexius; Biermann, Kim; Scheef, Lukas; Schuhmacher, Anna; Widdern, Olrik von; Metten, Martin; Biersack, H. J.; Maier, Wolfgang; Boecker, Henning

doi:10.1016/j.pscychresns.2008.10.006

Cited by 53 publications

(38 citation statements)

References 33 publications

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“…Although there is no previously published study on brain functional predictors of positive clinical outcome associated with duloxetine, our findings are highly coincident with imaging literature showing the important role for the subgenualpregenual ACC and extended medial prefrontal areas and, albeit to a lesser extent, dorsolateral prefrontal regions, in predicting clinical responses to various treatment modalities in MDD (Brockmann et al, 2009;Chen et al, 2007;Davidson et al, 2003;Dougherty et al, 2003;Keedwell et al, 2010;Little et al, 2005;Mayberg et al, 1997;Mottaghy et al, 2002;Saxena et al, 2003;Siegle et al, 2006;Wu et al, 1999).…”

Section: Discussionsupporting

confidence: 87%

Effects of Duloxetine Treatment on Brain Response to Painful Stimulation in Major Depressive Disorder

López‐Solà

Pujol

Hernández‐Ribas

et al. 2010

Neuropsychopharmacol

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Major depressive disorder (MDD) is characterized by a constellation of affective, cognitive, and somatic symptoms associated with functional abnormalities in relevant brain systems. Painful stimuli are primarily stressful and can trigger consistent responses in brain regions highly overlapping with the regions altered in MDD patients. Duloxetine has proven to be effective in treating both core emotional symptoms and somatic complaints in depression. This study aimed to assess the effects of duloxetine treatment on brain response to painful stimulation in MDD patients. A total of 13 patients and a reference group of 20 healthy subjects were assessed on three occasions (baseline, treatment week 1, and week 8) with functional magnetic resonance imaging (fMRI) during local application of painful heat stimulation. Treatment with duloxetine was associated with a significant reduction in brain responses to painful stimulation in MDD patients in regions generally showing abnormally enhanced activation at baseline. Clinical improvement was associated with pain-related activation reductions in the pregenual anterior cingulate cortex, right prefrontal cortex, and pons. Pontine changes were specifically related to clinical remission. Increased baseline activations in the right prefrontal cortex and reduced deactivations in the subgenual anterior cingulate cortex predicted treatment responders at week 8. This is the first fMRI study addressed to assess the effect of duloxetine in MDD. As a novel approach, the application of painful stimulation as a basic neural stressor proved to be effective in mapping brain response changes associated with antidepressant treatment and brain correlates of symptom improvement in regions of special relevance to MDD pathophysiology.

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Section: Discussionsupporting

confidence: 87%

Effects of Duloxetine Treatment on Brain Response to Painful Stimulation in Major Depressive Disorder

López‐Solà

Pujol

Hernández‐Ribas

et al. 2010

Neuropsychopharmacol

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“…Hyperperfusion in the frontoparietal regions is in accordance with some previous CBF findings in patients with MDD, particularly derived from single-photon emission computed tomography (SPECT) investigations. 54,64 This may be explained by the fact that most patients were on antidepressants. Nonmedi cated patients may present prefrontal hypoperfusion when measured with ASL.…”

Section: Discussionmentioning

confidence: 99%

Baseline brain perfusion and brain structure in patients with major depression: a multimodal magnetic resonance imaging study

Vasić

Wolf

Grön

et al. 2015

J Psychiatry Neurosci

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IntroductionIn the past 2 decades, functional and structural neuroimaging techniques have been developing rapidly, yielding a large body of research addressing neural correlates of major depressive disorder (MDD). Neuroimaging has substantially shaped our understanding of depressive etiopathology, indicating its potential to become an objective tool of diagnostic, therapeutic and prognostic value.1 In MDD, first neuroimaging studies examined cerebral metabolism by means of positron emission tomography (PET). Predominantly left-sided decreased regional cerebral blood flow (rCBF) in the dorsolateral prefrontal cortex (DLPFC), medial prefrontal cortex (MPFC) and anterior cingulate cortex (ACC) were found.2,3 Comparing periods of acute illness with periods of recovery, remission of depressive symptoms was associated with a significant increase in rCBF in the left DLPFC cortical midline regions, such as the MPFC and ACC, suggesting state-relatedness of metabolic alterations. 4 Pretreatment metabolism in the rostral (pregenual) part of the ACC was reported to predict positive treatment response, 5-7 whereas hypermetabolism in the subcallosal part of the ACC was related to treatment resistance.8-11 Different treatment modalities have been shown to target distinct regions of the brain in patients with MDD. For instance, cognitive behavioural therapy was found to be associated with increased metabolism in the hippocampus and dorsal ACC together with metabolic decreases in prefrontal areas. In contrast, pharmacotherapy with paroxetine was related to prefrontal metabolism increases and subcortical decreases.12 Based on a rapidly growing body of neuroimaging evidence, specific neurobiological Background: Abnormal regional cerebral blood flow (rCBF) and grey matter volume have been frequently reported in patients with major depressive disorder (MDD). However, it is unclear to what extent structural and functional change co-occurs in patients with MDD and whether markers of neural activity, such as rCBF, can be predicted by structural change. Methods: Using MRI, we investigated resting-state rCBF and brain structure in patients with MDD and healthy controls between July 2008 and January 2013. We acquired perfusion images obtained with continuous arterial spin labelling, used voxel-based morphometry to assess grey matter volume and integrated biological parametric mapping analyses to investigate the impact of brain atrophy on rCBF. Results: We included 43 patients and 29 controls in our study. Frontotemporal grey matter volume was reduced in patients compared with controls. In patients, rCBF was reduced in the anterior cingulate and bilateral parahippocampal areas and increased in frontoparietal and striatal regions. These abnormalities were confirmed by analyses with brain volume as a covariate. In patients with MDD there were significant negative correlations between the extent of depressive symptoms and bilateral parahippocampal rCBF. We found a positive correlation between depressive symptoms and rCBF for right middle fron...

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“…Subsequent SPECT studies have conversely linked increased fronto-temporal blood flow to treatment response, either with HMPAO or 99mTc-ethyl cysteinate dimer (Brockmann et al, 2009;Hanada et al, 2013).…”

Section: Pet and Spect Biomarkersmentioning

confidence: 99%

Imaging predictors of remission to anti-depressant medications in major depressive disorder

Korgaonkar

Grieve

2015

Journal of Affective Disorders

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The value of HMPAO SPECT in predicting treatment response to citalopram in patients with major depression

Cited by 53 publications

References 33 publications

Effects of Duloxetine Treatment on Brain Response to Painful Stimulation in Major Depressive Disorder

Effects of Duloxetine Treatment on Brain Response to Painful Stimulation in Major Depressive Disorder

Baseline brain perfusion and brain structure in patients with major depression: a multimodal magnetic resonance imaging study

Imaging predictors of remission to anti-depressant medications in major depressive disorder

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