Chronic and treatment-resistant depression: A study using arterial spin labeling perfusion MRI at 3Tesla

Duhameau, Bérengère; Ferré, Jean–Christophe; Jannin, Pierre; Gauvrit, Jean‐Yves; Vérin, Marc; Millet, Bruno; Drapier, Dominique

doi:10.1016/j.pscychresns.2010.01.009

Cited by 75 publications

(51 citation statements)

References 48 publications

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“…55 It appears that patterns of blood flow or metabolism may be critically linked to clinical aspects of the disorder, especially when studied cross-sectionally. Patients in our sample were acutely ill but have not yet been characterized treatment-refractory, for whom hyperperfusion 35 or hypermetabolism 56 in the subcallosal regions of the ACC have been reported. 57 Decreased rCBF in the PHC in the acute phase of the illness is consistent with reported lower mean medial temporal lobe blood flow in adolescent depression.…”

Section: Discussionmentioning

confidence: 99%

“…Third, in patients with MDD we explored the association between rCBF and clinical features, such as the severity of depressive symptoms and the duration of illness, including the number of depressive episodes. Based on cerebral perfusion data in adolescent, 33 adult [34][35][36] and late-life depression 37 and on PET findings reporting metabolic changes in patients with MDD, we predicted that patients would exhibit abnormal lateral prefrontal, anterior cingulate and medial temporal rCBF compared with controls. Given that regions exhibiting abnormal neural activity and aberrant brain volume in patients with MDD may spatially overlap, we expected that correction for brain atrophy would also affect rCBF data.…”

Section: Introductionmentioning

confidence: 99%

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Baseline brain perfusion and brain structure in patients with major depression: a multimodal magnetic resonance imaging study

Vasić

Wolf

Grön

et al. 2015

J Psychiatry Neurosci

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IntroductionIn the past 2 decades, functional and structural neuroimaging techniques have been developing rapidly, yielding a large body of research addressing neural correlates of major depressive disorder (MDD). Neuroimaging has substantially shaped our understanding of depressive etiopathology, indicating its potential to become an objective tool of diagnostic, therapeutic and prognostic value.1 In MDD, first neuroimaging studies examined cerebral metabolism by means of positron emission tomography (PET). Predominantly left-sided decreased regional cerebral blood flow (rCBF) in the dorsolateral prefrontal cortex (DLPFC), medial prefrontal cortex (MPFC) and anterior cingulate cortex (ACC) were found.2,3 Comparing periods of acute illness with periods of recovery, remission of depressive symptoms was associated with a significant increase in rCBF in the left DLPFC cortical midline regions, such as the MPFC and ACC, suggesting state-relatedness of metabolic alterations. 4 Pretreatment metabolism in the rostral (pregenual) part of the ACC was reported to predict positive treatment response, 5-7 whereas hypermetabolism in the subcallosal part of the ACC was related to treatment resistance.8-11 Different treatment modalities have been shown to target distinct regions of the brain in patients with MDD. For instance, cognitive behavioural therapy was found to be associated with increased metabolism in the hippocampus and dorsal ACC together with metabolic decreases in prefrontal areas. In contrast, pharmacotherapy with paroxetine was related to prefrontal metabolism increases and subcortical decreases.12 Based on a rapidly growing body of neuroimaging evidence, specific neurobiological Background: Abnormal regional cerebral blood flow (rCBF) and grey matter volume have been frequently reported in patients with major depressive disorder (MDD). However, it is unclear to what extent structural and functional change co-occurs in patients with MDD and whether markers of neural activity, such as rCBF, can be predicted by structural change. Methods: Using MRI, we investigated resting-state rCBF and brain structure in patients with MDD and healthy controls between July 2008 and January 2013. We acquired perfusion images obtained with continuous arterial spin labelling, used voxel-based morphometry to assess grey matter volume and integrated biological parametric mapping analyses to investigate the impact of brain atrophy on rCBF. Results: We included 43 patients and 29 controls in our study. Frontotemporal grey matter volume was reduced in patients compared with controls. In patients, rCBF was reduced in the anterior cingulate and bilateral parahippocampal areas and increased in frontoparietal and striatal regions. These abnormalities were confirmed by analyses with brain volume as a covariate. In patients with MDD there were significant negative correlations between the extent of depressive symptoms and bilateral parahippocampal rCBF. We found a positive correlation between depressive symptoms and rCBF for right middle fron...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Baseline brain perfusion and brain structure in patients with major depression: a multimodal magnetic resonance imaging study

Vasić

Wolf

Grön

et al. 2015

J Psychiatry Neurosci

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“…ASL is increasingly used in investigations of neurological and neuropsychiatric disorders as well as in neuroscience research (2)(3)(4)(5)(6)(7). However, ASL is a low signal-to-noise ratio (SNR) measurement technique and the perfusion signal is weak.…”

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confidence: 99%

Improving quality of arterial spin labeling MR imaging at 3 tesla with a 32‐channel coil and parallel imaging

Ferré

Petr

Bannier

et al. 2012

Magnetic Resonance Imaging

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Purpose: To compare 12-channel and 32-channel phased-array coils and to determine the optimal parallel imaging (PI) technique and factor for brain perfusion imaging using Pulsed Arterial Spin labeling (PASL) at 3 Tesla (T).Materials and Methods: Twenty-seven healthy volunteers underwent 10 different PASL perfusion PICORE Q2TIPS scans at 3T using 12-channel and 32-channel coils without PI and with GRAPPA or mSENSE using factor 2. PI with factor 3 and 4 were used only with the 32-channel coil. Visual quality was assessed using four parameters. Quantitative analyses were performed using temporal noise, contrastto-noise and signal-to-noise ratios (CNR, SNR).Results: Compared with 12-channel acquisition, the scores for 32-channel acquisition were significantly higher for overall visual quality, lower for noise and higher for SNR and CNR. With the 32-channel coil, artifact compromise achieved the best score with PI factor 2. Noise increased, SNR and CNR decreased with PI factor. However mSENSE 2 scores were not always significantly different from acquisition without PI. Conclusion:For PASL at 3T, the 32-channel coil at 3T provided better quality than the 12-channel coil. With the 32-channel coil, mSENSE 2 seemed to offer the best compromise for decreasing artifacts without significantly reducing SNR, CNR.

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“…Neuroimaging techniques have been used to identify dysfunctional circuits in patients with TRD. In particular, the use of a perfusion magnetic resonance imaging (MRI) technique known as arterial spin labelling (ASL) has found hyperfusion regions in the bilateral subgenual anterior cingulate cortex (sACC), left dorsomedial prefrontal cortex and left subcortical areas (putamen, pallidum and amygdala) in TRD patients compared to healthy controls (Duhameau, et al, 2010). Hyperactivation of the sACC has provided evidence for dysfunctional cortico circuits in depression (Duhameau, et al, 2010).…”

Section: Neuroendocrine and Immune Systemsmentioning

confidence: 99%

“…In particular, the use of a perfusion magnetic resonance imaging (MRI) technique known as arterial spin labelling (ASL) has found hyperfusion regions in the bilateral subgenual anterior cingulate cortex (sACC), left dorsomedial prefrontal cortex and left subcortical areas (putamen, pallidum and amygdala) in TRD patients compared to healthy controls (Duhameau, et al, 2010). Hyperactivation of the sACC has provided evidence for dysfunctional cortico circuits in depression (Duhameau, et al, 2010). The subgenual cingulate region has been previously implicated in modulating negative mood states and also in antidepressant treatment response (Seminowicz, et al, 2004).…”

Section: Neuroendocrine and Immune Systemsmentioning

confidence: 99%

Chronic and treatment-resistant depression

Murphy¹

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Major Depression does not always remit even with appropriate treatment, and unremitting or difficult-to-treat depression is thought to contribute to the large disease burden caused by depression. Difficult-to-treat depression is an overarching term that can be used to describe depression which is chronic, unremitting or treatment-resistant. The concept of difficult-to-treat depression and the terms used to describe it have not been well validated or universally adopted for use in research and clinical practice. Accordingly, the overarching aim of this thesis was to investigate difficult-to-treat depression, including its conceptualisation and its correlates, with a particular focus on chronic and treatment-resistant depression (TRD). Three methodological approaches were employed to examine this complex phenomenon: 1) a systematic review of the literature; 2) analysis of epidemiological data; and 3) analysis of clinical data. found to have a lifetime prevalence of 4.6% (95% CI: 3.9 -5.3%) and was found to be present in 29.4% (95% CI: 25.6 -33.3%) of community-residing individuals with a lifetime depressive disorder. Higher rates of psychiatric co-morbidity (OR = 1.42; 95% CI = 1.26-1.61), older current age (OR = 1.04; 95% CI = 1.02-1.05), a younger age of onset (OR = .97; 95% CI = .95-.98) and more frequent episodes of depression (OR = 1.75; 95% CI = 1.07-2.86) were significant correlates of chronic depression. Differences in health service utilisation associated with chronic depression were assessed to determine whether chronic depression treated in the tertiary care sector was likely to represent TRD. Survey respondents with chronic depression who were treated in tertiary care settings had more complex presentations and many of the clinical features previously associated with TRD, including higher levels of medical and psychiatric co-morbidity, greater traumatic load, higher levels of disability, greater symptom severity and greater risk of attempting suicide. iv The findings from the NSMHWB suggested that those whose chronic depression is treated in tertiary care settings may be less responsive to treatment, thus indicating likely TRD. In order to assess the degree of TRD in patients seen in tertiary care settings a sample of depressed inpatients (N = 70) was recruited. The majority of these depressed inpatients had a chronic illness trajectory (N = 64; 91.4%) and had a moderate to high level of TRD as determined by the five existing staging models of TRD. Each of the five staging models of TRD was highly correlated with the other four models, suggesting a substantial degree of agreement between models on their ratings of TRD. An omnibus measure of TRD (M = 0; SD = 4.5) was created by combining the five TRD models into one composite index. Using this composite index as the outcome variable, the following covariates were found to be associated with higher levels of TRD: higher prevalence of suicide attempts (β = 1.71, t(11) = 3.62, p < .001), older current age (β = 14, t(11) = 2.92, p < .005), earlier a...

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Chronic and treatment-resistant depression: A study using arterial spin labeling perfusion MRI at 3Tesla

Cited by 75 publications

References 48 publications

Baseline brain perfusion and brain structure in patients with major depression: a multimodal magnetic resonance imaging study

Baseline brain perfusion and brain structure in patients with major depression: a multimodal magnetic resonance imaging study

Improving quality of arterial spin labeling MR imaging at 3 tesla with a 32‐channel coil and parallel imaging

Chronic and treatment-resistant depression

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