Prediction of selective serotonin reuptake inhibitor response using diffusion-weighted MRI.
Prediction of selective serotonin reuptake inhibitor response using diffusion-weighted MRI.
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DOI：
10.3389/fpsyt.2013.00005
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发表时间：
2013
影响因子：
4.7
通讯作者：
Parsey RV
中科院分区：
文献类型：
--
作者：
Delorenzo C;Delaparte L;Thapa-Chhetry B;Miller JM;Mann JJ;Parsey RV
使用正电子发射断层扫描（PET）发现缓解至抗抑郁治疗的患者与未缓解至抗抑郁治疗的患者之间的多巴胺能结合的治疗前差异。为了研究这些差异，使用第二种成像方式，弥散加权MRI（DW-MRI）进行了探索性研究。18名无抗抑郁药的重度抑郁症受试者在接受8周选择性5-羟色胺再摄取抑制剂治疗前接受了25个方向的DW-MRI扫描。在中脑/中缝和涉及抑郁症病理生理学的两个目标区域（杏仁核和海马）之间进行概率神经纤维束成像。在SSRI缓解者和非缓解者之间比较了导出的神经束内的平均各向异性分数（FA），并评估了治疗前FA值与SSRI治疗结果之间的相关性。结果表明，在DW-MRI衍生的到右侧杏仁核的束中，非缓解者的平均FA（0.55 ± 0.04）显著低于缓解者（0.61 ± 0.04，p < 0.01）。此外，右杏仁核束的平均FA与SSRI治疗反应之间存在显著相关性。当使用左杏仁核作为纤维束成像目标时，发现这些关系处于趋势水平。当使用海马作为目标时，没有观察到显著差异。这些区域差异与之前的PET结果一致，表明终止于右侧杏仁核的白色纤维的完整性和/或数量可能在SSRI非缓解者中受到损害。此外，这项研究指出了多模式成像的好处，并表明DW-MRI可以提供SSRI抑郁症缓解8周的治疗前签名。
Pre-treatment differences in serotonergic binding between those who remit to antidepressant treatment and those who do not have been found using Positron Emission Tomography (PET). To investigate these differences, an exploratory study was performed using a second imaging modality, diffusion-weighted MRI (DW-MRI). Eighteen antidepressant-free subjects with Major Depressive Disorder received a 25-direction DW-MRI scan prior to 8 weeks of selective serotonin reuptake inhibitor treatment. Probabilistic tractography was performed between the midbrain/raphe and two target regions implicated in depression pathophysiology (amygdala and hippocampus). Average fractional anisotropy (FA) within the derived tracts was compared between SSRI remitters and non-remitters, and correlation between pre-treatment FA values and SSRI treatment outcome was assessed. Results indicate that average FA in DW-MRI-derived tracts to the right amygdala was significantly lower in non-remitters (0.55 ± 0.04) than remitters (0.61 ± 0.04, p < 0.01). In addition, there was a significant correlation between average FA in tracts to the right amygdala and SSRI treatment response. These relationships were found at a trend level when using the left amygdala as a tractography target. No significant differences were observed when using the hippocampus as target. These regional differences, consistent with previous PET findings, suggest that the integrity and/or number of white matter fibers terminating in the right amygdala may be compromised in SSRI non-remitters. Further, this study points to the benefits of multimodal imaging and suggests that DW-MRI may provide a pre-treatment signature of SSRI depression remission at 8 weeks.