Brain metabolic changes in major depressive disorder from pre- to post-treatment with paroxetine

Brody, Arthur L.; Saxena, Sanjaya; Silverman, Daniel; Fairbanks, Lynn A.; Phelps, Michael E.; Huang, Shou-Hsuan Stephen; Wu, Hsiao-Ming; Maidment, Karron M.; Baxter, Lewis R.; Alborzian, Shervin

doi:10.1016/s0925-4927(99)00034-7

Cited by 276 publications

(156 citation statements)

References 38 publications

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“…16,17,[32][33][34][35] This finding is not specific for mood disorders, as it has been reported in various anxiety disorders as well as in experimentally induced sadness and anxiety. 36 Although CBF/ metabolism seems to consistently be decreased in the remitted phase as compared with the depressed phase of MDD, 17,[37][38][39] an inverse relationship between depression severity and CBF/metabolism during the depressed phase of the illness has been reported. 16,17 Studies of relatively mild, treatment-responsive depression in subjects with MDD or BD have shown increased orbital activity relative to healthy controls, whereas more severely depressed, treatment-resistant individuals with MDD or BD, as well as individuals with depression secondary to neurological disorders, showed no difference or had decreased activity of this region relative to controls.…”

Section: Functional Anatomy Of Mood Disordersmentioning

confidence: 99%

“…39,114 Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), two forms of psychotherapy studied for efficacy in the treatment of depression, have effects on affective circuitry that are distinct from those of antidepressant medication. 37,115,116 A "top-down" mechanism has been postulated in which these therapies may enhance function of the orbital cortex/anterior insula and other cortical regions to more effectively attenuate dysregulated limbic activity. 12,116 These findings support the hypothesis that it is an imbalance within these circuits, rather than any specific directional disturbance in a sin- gle region, that provides a neural substrate for mood dysregulation.…”

Section: Presumptive Mood Disorder Circuitsmentioning

confidence: 99%

See 1 more Smart Citation

Neural circuitry and neuroplasticity in mood disorders: Insights for novel therapeutic targets

Carlson¹,

Singh²,

Zarate³

et al. 2006

NeuroRX

136

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Summary:Major depressive disorder and bipolar disorder are severe mood disorders that affect the lives and functioning of millions each year. The majority of previous neurobiological research and standard pharmacotherapy regimens have approached these illnesses as purely neurochemical disorders, with particular focus on the monoaminergic neurotransmitter systems. Not altogether surprisingly, these treatments are inadequate for many individuals afflicted with these devastating illnesses. Recent advances in functional brain imaging have identified critical neural circuits involving the amygdala and other limbic structures, prefrontal cortical regions, thalamus, and basal ganglia that modulate emotional behavior and are disturbed in primary and secondary mood disorders. Growing evidence suggests that mechanisms of neural plasticity and cellular resilience, including impairments of neurotrophic signaling cascades as well as altered glutamatergic and glucocorticoid signaling, underlie the dysregulation in these circuits. The increasing ability to monitor and modulate activity in these circuits is beginning to yield greater insight into the neurobiological basis of mood disorders. Modulation of dysregulated activity in these affective circuits via pharmacological agents that enhance neuronal resilience and plasticity, and possibly via emerging nonpharmacologic, circuitry-based modalities (for example, deep brain stimulation, magnetic stimulation, or vagus nerve stimulation) offers promising targets for novel experimental therapeutics in the treatment of mood disorders.

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Section: Functional Anatomy Of Mood Disordersmentioning

confidence: 99%

Section: Presumptive Mood Disorder Circuitsmentioning

confidence: 99%

Neural circuitry and neuroplasticity in mood disorders: Insights for novel therapeutic targets

Carlson¹,

Singh²,

Zarate³

et al. 2006

NeuroRX

136

View full text Add to dashboard Cite

show abstract

“…Alternatively, the effects of depression in this area may overpower those of impulsivity in BPD as some functional imaging studies have also suggested a role for the orbital prefrontal cortex in the pathophysiology of depression. For example, studies that examined abnormalities during a Major Depressive Episode and after various forms of treatment report normalization of orbitofrontal and anterior cingulate abnormalities with treatment (Baxter Jr et al, 1989;Bench et al, 1995;Brody et al, 1999;Buchsbaum et al, 1997;Mayberg et al, 2000Mayberg et al, , 2002. Indeed, Bremner et al (1997) found that depressed patients who were 6 weeks into a course of antidepressant treatment exhibited decreases in glucose metabolic rates in the orbitofrontal cortex and thalamus after a tryptophan-depletion-induced acute relapse compared to patients without depressive symptoms.…”

Section: Orbitofrontal Cortex In Mdd With Bpd Compared To Mddmentioning

confidence: 99%

Positron Emission Tomography of Regional Brain Metabolic Responses to a Serotonergic Challenge in Major Depressive Disorder with and without Borderline Personality Disorder

Oquendo

Krunic

Parsey

et al. 2005

Neuropsychopharmacol

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Previous neuroimaging studies of major depression have not controlled for the presence of personality disorders characterized by impulsive aggressive behavior, such as borderline personality disorder (BPD). Using positron emission tomography (PET), we studied regional glucose uptake in response to fenfluramine (FEN) in depressed subjects with BPD (n ¼ 11) and depressed patients without Cluster B Axis II disorders (n ¼ 8). Subjects were scanned while medication-free after a single blind placebo administration and after FEN on a second day. Brain responses were measured by PET imaging of [ 18 F]fluorodeoxyglucose (FDG) and serial prolactin levels. Scans were compared at a voxel level using statistical parametric mapping. Correlations of changes in relative regional cerebral uptake (rCMRglu) with clinical measures were assessed. Depressed borderline patients had greater relative activity in parietotemporal cortical regions (BA 40, BA 22, and BA 42) before and after FEN activation compared to those without BPD. They also had less relative uptake in the anterior cingulate cortex (BA 32) at baseline compared to depressed patients without BPD and FEN abolished this difference. Impulsivity was positively correlated with rCMRglu in superior and middle frontal cortex (BA 6 and 44). Hostility was positively correlated with rCMRglu in temporal cortical regions (BA 21 and 22). In conclusions, borderline pathology in the context of a Major Depressive Disorder is associated with altered activity in parietotemporal and anterior cingulate cortical regions. Controlling for the presence of BPD in future imaging studies of mood disorders may elucidate similarities and differences in regional serotonergic function in these two often comorbid disorders.

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“…There is, however, growing evidence that individual differences among depressed patients on genetic (Zanardi et al, 2001), biochemical (Figueras et al, 1999), neuroimaging (Buchsbaum et al, 1997;Mayberg et al, 1997;Brody et al, 1999;Saxena et al, 2003;Davidson et al, 2003), electrophysiologic (Bruder et al, 2001;Cook and Leuchter, 2001;Pizzagalli et al 2001;Kalayam and Alexopoulos, 2003;Mulert et al, 2002), and neurocognitive (Dunkin et al, 2000) measures are associated with therapeutic response to an SSRI or other antidepressants.…”

Section: Introductionmentioning

confidence: 99%

Dichotic Listening Tests of Functional Brain Asymmetry Predict Response to Fluoxetine in Depressed Women and Men

Bruder

Stewart

McGrath

et al. 2004

Neuropsychopharmacol

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Patients having a depressive disorder vary widely in their therapeutic responsiveness to a selective serotonin reuptake inhibitor (SSRI), but there are no clinical predictors of treatment outcome. Studies using dichotic listening, electrophysiologic and neuroimaging measures suggest that pretreatment differences among depressed patients in functional brain asymmetry are related to responsiveness to antidepressants. Two new studies replicate differences in dichotic listening asymmetry between fluoxetine responders and nonresponders, and demonstrate the importance of gender in this context. Right-handed outpatients who met DSM-IV criteria for major depression, dysthymia, or depression not otherwise specified were tested on dichotic fused-words and complex tones tests before completing 12 weeks of fluoxetine treatment. Perceptual asymmetry (PA) scores were compared for 75 patients (38 women) who responded to treatment and 39 patients (14 women) who were nonresponders. Normative data were also obtained for 101 healthy adults (61 women). Patients who responded to fluoxetine differed from nonresponders and healthy adults in favoring left-over righthemisphere processing of dichotic stimuli, and this difference was dependent on gender and test. Heightened left-hemisphere advantage for dichotic words in responders was present among women but not men, whereas reduced right-hemisphere advantage for dichotic tones in responders was present among men but not women. Pretreatment PA was also predictive of change in depression severity following treatment. Responder vs nonresponder differences for verbal dichotic listening in women and nonverbal dichotic listening in men are discussed in terms of differences in cognitive function, hemispheric organization, and neurotransmitter function.

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Brain metabolic changes in major depressive disorder from pre- to post-treatment with paroxetine

Cited by 276 publications

References 38 publications

Neural circuitry and neuroplasticity in mood disorders: Insights for novel therapeutic targets

Neural circuitry and neuroplasticity in mood disorders: Insights for novel therapeutic targets

Positron Emission Tomography of Regional Brain Metabolic Responses to a Serotonergic Challenge in Major Depressive Disorder with and without Borderline Personality Disorder

Dichotic Listening Tests of Functional Brain Asymmetry Predict Response to Fluoxetine in Depressed Women and Men

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