Brain effects of antidepressants in major depression: A meta-analysis of emotional processing studies
Brain effects of antidepressants in major depression: A meta-analysis of emotional processing studies
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DOI：
10.1016/j.jad.2010.09.032
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发表时间：
2011-04-01
影响因子：
6.6
通讯作者：
Fossati, Philippe
中科院分区：
文献类型：
--
作者：
Delaveau, Pauline;Jabourian, Maritza;Fossati, Philippe
背景资料：在许多静息态正电子发射断层扫描（PET）研究中，已经确定了重度抑郁症患者一致的大脑活动模式。这种功能失调的模式似乎可以通过抗抑郁药治疗正常化。这项荟萃分析的目的是更清楚地确定与抑郁症的临床改善后的抗抑郁药物治疗的模式，在情绪激活研究中使用功能磁共振成像（fMRI）。方法：对9项情绪激活fMRI和PET研究进行了定量激活似然估计（ALE）荟萃分析（126名患者）使用激活可能性估计技术。结果：抗抑郁药物治疗后，背外侧、背内侧和腹外侧前额叶皮质的激活增加，而杏仁核、海马、海马旁区、腹侧前扣带皮质、眶额皮质和颞叶皮质减少。此外，前扣带皮层（BA 32）和后扣带皮层以及楔前叶和顶下小叶的激活减少，这可能反映了默认模式网络的恢复失活。局限性：ALE分析中包含了少量使用异质任务的情绪激活研究。在抗抑郁药治疗后，参与重度抑郁症的几个脑区对情绪刺激的反应恢复正常。为了完善我们对抗抑郁药对重性抑郁症情绪处理神经基础影响的认识，神经影像学研究应该使用与抑郁症状相关的一致情绪任务，并涉及默认模式网络，如自我参照处理任务。(C)2010爱思唯尔有限公司版权所有。
Background: A consistent brain activity pattern has been identified in major depression across many resting positron emission tomography (PET) studies. This dysfunctional pattern seems to be normalized by antidepressant treatment. The aim of this meta-analysis was to identify more clearly the pattern associated with clinical improvement of depression following an antidepressant drug treatment, in emotional activation studies using functional magnetic resonance imaging (fMRI).Methods: A quantitative Activation Likelihood Estimation (ALE) meta-analysis was performed across 9 emotional activation fMRI and PET studies (126 patients) using the Activation Likelihood Estimation technique.Results: Following the antidepressant drug treatment, the activation of dorsolateral, dorsomedial and ventrolateral prefrontal cortices was increased whereas the activation of the amygdala, hippocampus, parahippocampal region, ventral anterior cingulate cortex, orbitofrontal cortex, and insula was decreased. Additionally, there was a decreased activation in the anterior (BA 32) and posterior cingulate cortices, as well as in the precuneus and inferior parietal lobule, which could reflect a restored deactivation of the default mode network.Limitations: The small number of emotional activation studies, using heterogeneous tasks, included in the ALE analysis.Conclusions: The activation of several brain regions involved in major depression, in response to emotional stimuli, was normalized after antidepressant treatment. To refine our knowledge of antidepressants' effect on the neural bases of emotional processing in major depression, neuroimaging studies should use consistent emotional tasks related to depressive symptoms and that involve the default mode network, such as self-referential processing tasks. (C) 2010 Elsevier B.V. All rights reserved.