Neural and genetic correlates of antidepressant response to sleep deprivation - A functional magnetic resonance imaging study of moral valence decision, in bipolar depression
Neural and genetic correlates of antidepressant response to sleep deprivation - A functional magnetic resonance imaging study of moral valence decision, in bipolar depression
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DOI：
10.1001/archpsyc.64.2.179
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发表时间：
2007-02-01
影响因子：
--
通讯作者：
Smeraldi, Enrico
中科院分区：
文献类型：
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作者：
Benedetti, Francesco;Bernasconi, Alessandro;Smeraldi, Enrico
研究背景：完全睡眠剥夺结合光疗法可迅速改善双相抑郁症。5-羟色胺转运体基因启动子区的多态性影响抗抑郁反应和特定脑区的结构和功能目的：探讨抗抑郁治疗或5-羟色胺转运体基因型是否影响以信息加工中抑郁偏向为靶点的神经反应模式设计：研究治疗反应的生物学相关性的前后试验。地点：大学医院。患者：20名双相抑郁症住院患者。干预：主要观察指标：治疗前后采用3.0 T扫描仪进行脑血氧水平依赖性功能磁共振成像。情绪的自我评定和观察者评定结果：在前扣带皮层、背外侧前额叶皮层、颞叶皮层和顶叶皮层中，治疗前后（视觉模拟量表3次/d）、对治疗的反应（汉密尔顿抑郁量表评分< 8分）和刺激的道德效价（正或负）之间存在显著的交互作用。在这些区域，反应者改变了他们的血氧水平依赖于情绪刺激的反应，在nonrespenders相反的模式。5-羟色胺转运体的启动子的基因型预测的治疗反应和影响的基线神经反应在前扣带皮层和背外侧前额叶cortex.Conclusion：多个因素，影响或在个人层面上的影响，在双相情感障碍的过程中的严重抑郁发作显着相互作用，影响大脑皮层的活动在特定的领域。
Context: Total sleep deprivation combined with light therapy causes rapid amelioration of bipolar depression. A polymorphism in the promoter for the serotonin transporter influences both antidepressant response and the structure and function of specific brain areas.Objective: To determine whether antidepressant therapy or the genotype of the serotonin transporter influence the pattern of neural response to a task targeting the depressive biases in information processing (moral valence decision).Design: Before-and-after trial studying the biologic correlates of response to treatment.Setting: University hospital.Patients: Twenty inpatients with bipolar depression.Intervention: Repeated total sleep deprivation combined with light therapy for I week.Main Outcome Measures: Brain blood oxygen level-dependent functional magnetic resonance imaging using a 3.0-T scanner before and after treatment. Self-ratings and observer ratings of mood (visual analog scale 3 times daily and Hamilton Depression Rating Scale) before and after treatment.Results: We found significant interactions of treatment (before and after), response to treatment (Hamilton Depression Rating Scale score < 8), and moral valence of the stimuli (positive or negative) in the anterior cingulate cortex, dorsolateral prefrontal cortex, insula, and parietal cortex. In these areas, responders changed their blood oxygen level-dependent responses to emotional stimuli in a pattern opposite of that in nonrespenders. Genotype of the promoter for the serotonin transporter predicted response to treatment and influenced baseline neural responses in the anterior cingulate cortex and the dorsolateral prefrontal cortex.Conclusion: Multiple factors that affect or are affected at the individual level by major depressive episodes in the course of bipolar disorder significantly interact in influencing brain cortical activity in specific areas.