Anterior cingulate activity as a predictor of degree of treatment response in major depression: Evidence from brain electrical tomography analysis
Anterior cingulate activity as a predictor of degree of treatment response in major depression: Evidence from brain electrical tomography analysis
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DOI：
10.1176/appi.ajp.158.3.405
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发表时间：
2001-03-01
影响因子：
17.7
通讯作者：
Davidson, RJ
中科院分区：
文献类型：
--
作者：
Pizzagalli, D;Pascual-Marqui, RD;Davidson, RJ
目的：前扣带皮层与抑郁症有密切关系。结果最好解释考虑解剖和细胞结构的细分。有证据表明，抑郁症的特征是背侧前扣带回的活动减退，而头侧前扣带回的活动过度与对治疗的良好反应有关。作者检验了这一假设，即在抑郁状态下，前扣带回喙侧的活动对治疗的最终反应程度具有预后价值。而以前的研究使用血流动力学成像，本次调查使用EEC.Method：作者记录了28通道的EEC数据为18名未服药的抑郁症患者和18名匹配的对照组。去甲替林治疗后评估临床结局。在18名抑郁症患者中，16名在初步评估后4-6个月被认为是应答者。使用中位数分割对反应进行分类，并使用低分辨率电磁断层扫描分析显示反应较好（N=9）和较差（N=9）的患者的预处理EEG数据，这是一种根据Talairach脑图谱计算给定EEG频带的三维皮层电流密度的新方法。反应较好的患者在头端前扣带回（Brodmann区24/32）表现出活动过度（θ活动较高）。随访分析表明，这一发现的特异性，这是不混淆的年龄或预处理抑郁症severity.Conclusions：这些结果，基于电生理成像，不仅支持血流动力学结果牵连激活前扣带回作为抑郁症的反应的预测，但他们也表明，在喙前扣带回的差分活动与反应的分级。
Objective: The anterior cingulate cortex has been implicated in depression. Results are best interpreted by considering anatomic and cytoarchitectonic subdivisions. Evidence suggests depression is characterized by hypoactivity in the dorsal anterior cingulate, whereas hyperactivity in the rostral anterior cingulate is associated with good response to treatment. The authors tested the hypothesis that activity in the rostral anterior cingulate during the depressed state has prognostic value for the degree of eventual response to treatment. Whereas prior studies used hemodynamic imaging, this investigation used EEC.Method: The authors recorded 28-channel EEC data for 18 unmedicated patients with major depression and 18 matched comparison subjects. Clinical outcome was assessed after nortriptyline treatment. Of the 18 depressed patients, 16 were considered responders 4-6 months after initial assessment. A median split was used to classify response, and the pretreatment EEG data of patients showing better (N=9) and worse (N=9) responses were analyzed with low-resolution electromagnetic tomography, a new method to compute three-dimensional cortical current density for given EEG frequency bands according to a Talairach brain atlas.Results: The patients with better responses showed hyperactivity (higher theta activity) in the rostral anterior cingulate (Brodmann's area 24/32). Follow-up analyses demonstrated the specificity of this finding, which was not confounded by age or pretreatment depression severity.Conclusions: These results, based on electrophysiological imaging, not only support hemodynamic findings implicating activation of the anterior cingulate as a predictor of response in depression, but they also suggest that differential activity in the rostral anterior cingulate is associated with gradations of response.