PET IMAGING--COMORBID COCAINE DEPENDENCE AND DEPRESSION

描述：（申请人摘要） 可卡因依赖与重度抑郁障碍的共病 一个重要的临床挑战。 这种相对较高的发病率 科摩罗和以前的各种调查提出了有趣的 这些疾病之间的神经生物学联系的问题。 我们 将使用正电子发射断层扫描（PET）的人脑代谢， 在共病疾病治疗之前和之后，作为了解这些疾病的窗口， 神经生物学关系 我们的团队将专业知识与先进的 脑功能成像，具有诊断和治疗 共病MDD和可卡因依赖。 本研究的受试者将是 在四个样本中仔细筛选志愿者：仅可卡因依赖（CD）， 单纯MDD、CD合并MDD和正常对照。 相等数量的 将招募男性和女性，以评估性别差异。 的MDD 和CD+MDD组将用文拉法辛治疗12周， 抗抑郁药，我们的试点数据表明，是有效的共病 人口 关于脑代谢谱的具体假设 这些组将进行如下检查：1）在所有组的基线，2） 治疗后，将比较基线和治疗后扫描 识别可能涉及治疗效果的大脑部位，以及3） 治疗后，当基线扫描应答者和非应答者时 将与治疗结果相关， 识别预测反应性的治疗前代谢特征。 我们 将采用先进的定量程序， 和“网络”大脑代谢，并将这些措施与 治疗成功的标准化措施。 这种方法论的严谨性将 有助于了解患者的病理生理学和治疗 患有抑郁症和可卡因依赖症

DESCRIPTION: (Applicant's Abstract) Comorbidity of cocaine dependence and major depressive disorder (MDD) poses an important clinical challenge. The relatively high incidence of such comorbidity and a variety of previous investigations raise intriguing questions about neurobiological connections between these disorders. We will use positron emission tomography (PET) of human brain metabolism, before and after treatment of the comorbid disorders, as a window into such neurobiological relationships. Our team combines expertise in advanced functional brain imaging with experience in the diagnosis and treatment of comorbid MDD and cocaine dependence. Subjects for this study will be carefully screened volunteers in four samples: cocaine-dependent (CD) only, MDD alone, CD comorbid with MDD, and normal controls. Equal numbers of males and females will be recruited to assess gender differences. The MDD and CD+MDD groups will be treated for 12 weeks with venlafaxine, an antidepressant which our pilot data indicates is effective in the comorbid population. Specific hypotheses about the profile of cerebral metabolism in these groups will be examined as follows: 1) at baseline in all groups, 2) following treatment, when baseline and post-treatment scans will be compared to identify brain sites potentially involved in treatment effects, and 3) following treatment, when baseline scans for responders and non-responders in each treatment group will be correlated with treatment outcome to identify pre-treatment metabolic features which predict responsiveness. We will apply advanced quantitative procedures for examining global, regional, and "network" brain metabolism, and will correlate these measures with standardized measures of treatment success. This methodologic rigor will contribute to understanding the pathophysiology and treatment of patients with comorbid depression and cocaine dependence.