fMRI response to negative words and SSRI treatment outcome in major depressive disorder: a preliminary study.
fMRI response to negative words and SSRI treatment outcome in major depressive disorder: a preliminary study.
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重度抑郁症对负面词语的功能磁共振成像反应和 SSRI 治疗结果：一项初步研究。
DOI：
10.1016/j.pscychresns.2013.08.001
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发表时间：
2013-12-30
影响因子：
11.3
通讯作者：
Parsey RV
中科院分区：
文献类型：
--
作者：
Miller JM;Schneck N;Siegle GJ;Chen Y;Ogden RT;Kikuchi T;Oquendo MA;Mann JJ;Parsey RV
临床上有用的预测治疗结果的重性抑郁症（MDD）仍然难以捉摸。我们研究了功能磁共振成像（fMRI）血氧水平依赖（BOLD）信号在积极消极的文字处理和随后的选择性5-羟色胺再摄取抑制剂（SSRI）治疗结果之间的关联。未用药的MDD受试者（n=17）进行了情绪文字处理功能磁共振成像任务，然后接受了8周的艾司西酞普兰标准化抗抑郁治疗。较低的治疗前BOLD反应，在中脑，背外侧前额叶皮层，副扣带回，前扣带回，丘脑和尾状核的负性词与艾司西酞普兰治疗后的改善显着相关。这些区域的激活反应消极的话与反应时间显着相关的评价词的相关性。使用交叉验证方法确定的体素的最大预测聚类预测了48%的治疗响应方差。这项研究提供了初步证据，表明SSRIs可能对那些在处理负面刺激时参与认知控制网络能力较低的患者最有益。这些发现和以前SSRI治疗结果的fMRI研究之间的差异可能与任务设计的差异有关。在这项研究中，对SSRI结果预测的阴性词的区域BOLD反应与先前研究中使用相同任务的认知行为治疗（CBT）结果预测重叠且不同。未来的研究可能会在随机对照试验的背景下检查不同治疗的差异结果的预测。
Clinically useful predictors of treatment outcome in major depressive disorder (MDD) remain elusive. We examined associations between functional magnetic resonance imaging (fMRI) blood oxygen level dependent (BOLD) signal during active negative word processing and subsequent selective serotonin reuptake inhibitor (SSRI) treatment outcome in MDD. Unmedicated MDD subjects (n=17) performed an emotional word processing fMRI task, and then received eight weeks of standardized antidepressant treatment with escitalopram. Lower pre-treatment BOLD responses to negative words in midbrain, dorsolateral prefrontal cortex, paracingulate, anterior cingulate, thalamus and caudate nuclei correlated significantly with greater improvement following escitalopram treatment. Activation of these regions in response to negative words correlated significantly with reaction time for rating word relevance. Maximally predictive clusters of voxels identified using a cross-validation approach predicted 48% of the variance in response to treatment. This study provides preliminary evidence that SSRIs may be most beneficial in patients who are less able to engage cognitive control networks while processing negative stimuli. Differences between these findings and previous fMRI studies of SSRI treatment outcome may relate to differences in task design. Regional BOLD responses to negative words predictive of SSRI outcome in this study were both overlapping and distinct from those predictive of outcome with cognitive behavioral therapy (CBT) in previous studies using the same task. Future studies may examine prediction of differential outcome across treatments in the context of a randomized controlled trial.
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