The neural substrates of affective processing in depressed patients treated with venlafaxine
The neural substrates of affective processing in depressed patients treated with venlafaxine
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DOI：
10.1176/appi.ajp.160.1.64
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发表时间：
2003-01-01
影响因子：
17.7
通讯作者：
Kalin, NH
中科院分区：
文献类型：
--
作者：
Davidson, RJ;Irwin, W;Kalin, NH
目的：本研究的目的是使用功能性磁共振成像（fMRI），以探测与负性和正性情感刺激的反应性在治疗前和治疗2周和8周后的文拉法辛的抑郁症患者的神经回路。基线神经激活和响应treatment.Method之间的关系也进行了评估：患者与重性抑郁症（N=12）和健康的对照组（N=5）进行了扫描三次，在此期间，试验的情感和中性的图片视觉刺激的交替块。在每次测试时评估症状，两组都完成了情绪的自我报告措施。统计参数映射被用来检查功能磁共振成像数据，重点是组的时间interactions.Results：患者表现出显着减少抑郁症状的治疗。在左岛叶皮层和左前扣带皮层中发现了对负性刺激和中性刺激的时间交互。在基线时，两组都显示出视觉皮层、外侧前额叶皮层和杏仁核对负性刺激和中性刺激的双侧激活，患者的视觉皮层激活程度更高，左侧前额叶皮层激活程度更低。患者在基线时更大的相对前扣带回激活的负性与中性刺激表现出最强大的治疗respons.Conclusions：研究结果强调了抑郁症的负面影响激活的神经回路的重要性，并表明该电路的组成部分可以改变2周内的抗抑郁药，药物治疗。
Objective: The purpose of this study was to use functional magnetic resonance imaging (fMRI) to probe the neural circuitry associated with reactivity to negative and positive affective stimuli in patients with major depressive disorder before treatment and after 2 and 8 weeks of treatment with venlafaxine. Relations between baseline neural activation and response to treatment were also evaluated.Method: Patients with major depressive disorder (N=12) and healthy comparison subjects (N=5) were scanned on three occasions, during which trials of alternating blocks of affective and neutral pictorial visual stimuli were presented. Symptoms were evaluated at each testing occasion, and both groups completed self-report measures of mood. Statistical parametric mapping was used to examine the fMRI data with a focus on the group-by-time interactions.Results: Patients showed a significant reduction in depressive symptoms with treatment. Group-by-time interactions in response to the negative versus neutral stimuli were found in the left insular cortex and the left anterior cingulate. At baseline, both groups showed bilateral activation in the visual cortices, lateral prefrontal cortex, and amygdala in response to the negative versus neutral stimuli, with patients showing greater activation in the visual cortex and less activation in the left lateral prefrontal cortex. Patients with greater relative anterior cingulate activation at baseline in response to the negative versus neutral stimuli showed the most robust treatment response.Conclusions: The findings underscore the importance of the neural circuitry activated by negative affect in depression and indicate that components of this circuitry can be changed within 2 weeks of treatment with antidepressant, medication.