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Westlund Schreiner M, Roberts H, Dillahunt AK, Farstead B, Feldman D, Thomas L, Jacobs RH, Bessette KL, Welsh RC, Watkins ER, Langenecker SA, Crowell SE. Negative association between non-suicidal self-injury in adolescents and default mode network activation during the distraction blocks of a rumination task. Suicide Life Threat Behav 2023; 53:510-521. [PMID: 36942887 PMCID: PMC10441767 DOI: 10.1111/sltb.12960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/17/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Rumination, or repetitive and habitual negative thinking, is associated with psychopathology and related behaviors in adolescents, including non-suicidal self-injury (NSSI). Despite the link between self-reported rumination and NSSI, there is limited understanding of how rumination is represented at the neurobiological level among youth with NSSI. METHOD We collected neuroimaging and rumination data from 39 adolescents with current or past NSSI and remitted major depression. Participants completed a rumination induction fMRI task, consisting of both rumination and distraction blocks. We examined brain activation associated with total lifetime NSSI in the context of the rumination versus distraction contrast. RESULTS Lifetime NSSI was associated with a greater discrepancy in activation during rumination relative to distraction conditions in clusters including the precuneus, posterior cingulate, superior, and middle frontal gyrus, and cerebellum. CONCLUSION Difficulties associated with rumination in adolescents with NSSI may be related to requiring greater cognitive effort to distract from ruminative content in addition to increased attention in the context of ruminative content. Increasing knowledge of neurobiological circuits and nodes associated with rumination and their relationship with NSSI may enable us to better tailor interventions that can facilitate lasting well-being and neurobiological change.
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Affiliation(s)
- Mindy Westlund Schreiner
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | | | - Alina K Dillahunt
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Brian Farstead
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Daniel Feldman
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Leah Thomas
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Rachel H Jacobs
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Katie L Bessette
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California, USA
| | - Robert C Welsh
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California, USA
| | | | - Scott A Langenecker
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Sheila E Crowell
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
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2
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Sheu YH, Magdamo C, Miller M, Das S, Blacker D, Smoller JW. AI-assisted prediction of differential response to antidepressant classes using electronic health records. NPJ Digit Med 2023; 6:73. [PMID: 37100858 PMCID: PMC10133261 DOI: 10.1038/s41746-023-00817-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/04/2023] [Indexed: 04/28/2023] Open
Abstract
Antidepressant selection is largely a trial-and-error process. We used electronic health record (EHR) data and artificial intelligence (AI) to predict response to four antidepressants classes (SSRI, SNRI, bupropion, and mirtazapine) 4 to 12 weeks after antidepressant initiation. The final data set comprised 17,556 patients. Predictors were derived from both structured and unstructured EHR data and models accounted for features predictive of treatment selection to minimize confounding by indication. Outcome labels were derived through expert chart review and AI-automated imputation. Regularized generalized linear model (GLM), random forest, gradient boosting machine (GBM), and deep neural network (DNN) models were trained and their performance compared. Predictor importance scores were derived using SHapley Additive exPlanations (SHAP). All models demonstrated similarly good prediction performance (AUROCs ≥ 0.70, AUPRCs ≥ 0.68). The models can estimate differential treatment response probabilities both between patients and between antidepressant classes for the same patient. In addition, patient-specific factors driving response probabilities for each antidepressant class can be generated. We show that antidepressant response can be accurately predicted from real-world EHR data with AI modeling, and our approach could inform further development of clinical decision support systems for more effective treatment selection.
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Affiliation(s)
- Yi-Han Sheu
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| | - Colin Magdamo
- Department of Neurology, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
| | - Matthew Miller
- Harvard Injury Control Research Center, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sudeshna Das
- Department of Neurology, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
| | - Deborah Blacker
- Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jordan W Smoller
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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3
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Fisher PM, Ozenne B, Ganz M, Frokjaer VG, Dam VN, Penninx BW, Sankar A, Miskowiak K, Jensen PS, Knudsen GM, Jorgensen MB. Emotional faces processing in major depressive disorder and prediction of antidepressant treatment response: A NeuroPharm study. J Psychopharmacol 2022; 36:626-636. [PMID: 35549538 DOI: 10.1177/02698811221089035] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a prevalent neuropsychiatric illness for which it is important to resolve underlying brain mechanisms. Current treatments are often unsuccessful, precipitating a need to identify predictive markers. AIM We evaluated (1) alterations in brain responses to an emotional faces functional magnetic resonance imaging (fMRI) paradigm in individuals with MDD, compared to controls, (2) whether pretreatment brain responses predicted antidepressant treatment response, and (3) pre-post change in brain responses following treatment. METHODS Eighty-nine medication-free, depressed individuals and 115 healthy controls completed the fMRI paradigm. Depressed individuals completed a nonrandomized, open-label, 8-week treatment with escitalopram, including the option to switch to duloxetine after 4 weeks. We examined patient-control group differences in regional fMRI responses at baseline, whether baseline fMRI responses predicted treatment response at 8 weeks, including early life stress moderating effects, and change in fMRI responses in 36 depressed individuals rescanned following 8 weeks of treatment. RESULTS Task reaction time was 5% slower in patients. Multiple brain regions showed significant task-related responses, but we observed no statistically significant patient-control group differences (Cohen's d < 0.35). Patient pretreatment brain responses did not predict antidepressant treatment response (area under the curve of the receiver operator characteristic (AUC-ROC) < 0.6) and brain responses were not statistically significantly changed after treatment (Cohen's d < 0.33). CONCLUSION This represents the largest prediction study to date examining emotional faces fMRI features as predictors of antidepressant treatment response. Brain response to this fMRI emotional faces paradigm did not distinguish depressed individuals from healthy controls, nor was it predictive of antidepressant treatment response.Clinical Trial Registration: Site: https://clinicaltrials.gov, Trial Number: NCT02869035, Trial Title: Treatment Outcome in Major Depressive Disorder.
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Affiliation(s)
- Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Melanie Ganz
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Vibeke Nh Dam
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Brenda Wjh Penninx
- BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Anajli Sankar
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kamilla Miskowiak
- BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Peter S Jensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin B Jorgensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,NeuroPharm, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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4
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Lai CH. Fronto-limbic neuroimaging biomarkers for diagnosis and prediction of treatment responses in major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2021; 107:110234. [PMID: 33370569 DOI: 10.1016/j.pnpbp.2020.110234] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/02/2020] [Accepted: 12/21/2020] [Indexed: 12/23/2022]
Abstract
The neuroimaging is an important tool for understanding the biomarkers and predicting treatment responses in major depressive disorder (MDD). The potential biomarkers and prediction of treatment response in MDD will be addressed in the review article. The brain regions of cognitive control and emotion regulation, such as the frontal and limbic regions, might represent the potential targets for MDD biomarkers. The potential targets of frontal lobes might include anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC). For the limbic system, hippocampus and amygdala might be the potentially promising targets for MDD. The potential targets of fronto-limbic regions have been found in the studies of several major neuroimaging modalities, such as the magnetic resonance imaging, near-infrared spectroscopy, electroencephalography, positron emission tomography, and single-photon emission computed tomography. Additional regions, such as brainstem and midbrain, might also play a part in the MDD biomarkers. For the prediction of treatment response, the gray matter volumes, white matter tracts, functional representations and receptor bindings of ACC, DLPFC, OFC, amygdala, and hippocampus might play a role in the prediction of antidepressant responses in MDD. For the response prediction of psychotherapies, the fronto-limbic, reward regions, and insula will be the potential targets. For the repetitive transcranial magnetic stimulation, the DLPFC, ACC, limbic, and visuospatial regions might represent the predictive targets for treatment. The neuroimaging targets of MDD might be focused in the fronto-limbic regions. However, the neuroimaging targets for the prediction of treatment responses might be inconclusive and beyond the fronto-limbic regions.
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Affiliation(s)
- Chien-Han Lai
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan; PhD Psychiatry & Neuroscience Clinic, Taoyuan, Taiwan.
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5
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Nielson DM, Keren H, O'Callaghan G, Jackson SM, Douka I, Vidal-Ribas P, Pornpattananangkul N, Camp CC, Gorham LS, Wei C, Kirwan S, Zheng CY, Stringaris A. Great Expectations: A Critical Review of and Suggestions for the Study of Reward Processing as a Cause and Predictor of Depression. Biol Psychiatry 2021; 89:134-143. [PMID: 32797941 PMCID: PMC10726343 DOI: 10.1016/j.biopsych.2020.06.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/20/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
Both human and animal studies support the relationship between depression and reward processing abnormalities, giving rise to the expectation that neural signals of these processes may serve as biomarkers or mechanistic treatment targets. Given the great promise of this research line, we scrutinized those findings and the theoretical claims that underlie them. To achieve this, we applied the framework provided by classical work on causality as well as contemporary approaches to prediction. We identified a number of conceptual, practical, and analytical challenges to this line of research and used a preregistered meta-analysis to quantify the longitudinal associations between reward processing abnormalities and depression. We also investigated the impact of measurement error on reported data. We found that reward processing abnormalities do not reach levels that would be useful for clinical prediction, yet the available evidence does not preclude a possible causal role in depression.
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Affiliation(s)
- Dylan M Nielson
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Hanna Keren
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Georgia O'Callaghan
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Sarah M Jackson
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ioanna Douka
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Pablo Vidal-Ribas
- Social and Behavioral Science Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | | | - Christopher C Camp
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Lisa S Gorham
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Christine Wei
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Stuart Kirwan
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Charles Y Zheng
- Machine Learning Team, Functional Magnetic Resonance Imaging Facility, National Institutes of Health, Bethesda, Maryland
| | - Argyris Stringaris
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
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6
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Taylor JJ, Kurt HG, Anand A. Resting State Functional Connectivity Biomarkers of Treatment Response in Mood Disorders: A Review. Front Psychiatry 2021; 12:565136. [PMID: 33841196 PMCID: PMC8032870 DOI: 10.3389/fpsyt.2021.565136] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 02/26/2021] [Indexed: 12/24/2022] Open
Abstract
There are currently no validated treatment biomarkers in psychiatry. Resting State Functional Connectivity (RSFC) is a popular method for investigating the neural correlates of mood disorders, but the breadth of the field makes it difficult to assess progress toward treatment response biomarkers. In this review, we followed general PRISMA guidelines to evaluate the evidence base for mood disorder treatment biomarkers across diagnoses, brain network models, and treatment modalities. We hypothesized that no treatment biomarker would be validated across these domains or with independent datasets. Results are organized, interpreted, and discussed in the context of four popular analytic techniques: (1) reference region (seed-based) analysis, (2) independent component analysis, (3) graph theory analysis, and (4) other methods. Cortico-limbic connectivity is implicated across studies, but there is no single biomarker that spans analyses or that has been replicated in multiple independent datasets. We discuss RSFC limitations and future directions in biomarker development.
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Affiliation(s)
- Joseph J Taylor
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Hatice Guncu Kurt
- Center for Behavioral Health, Cleveland Clinic, Cleveland, OH, United States
| | - Amit Anand
- Center for Behavioral Health, Cleveland Clinic, Cleveland, OH, United States
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7
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Preuss A, Bolliger B, Schicho W, Hättenschwiler J, Seifritz E, Brühl AB, Herwig U. SSRI Treatment Response Prediction in Depression Based on Brain Activation by Emotional Stimuli. Front Psychiatry 2020; 11:538393. [PMID: 33281635 PMCID: PMC7691246 DOI: 10.3389/fpsyt.2020.538393] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 09/17/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction: The prediction of antidepressant treatment response may improve outcome. Functional magnetic resonance imaging (fMRI) of emotion processing in major depressive disorder (MDD) may reveal regional brain function serving as predictors of response to treatment with selective serotonin reuptake inhibitor (SSRI). Methods: We examined the association between pre-treatment neural activity by means of fMRI during the perception of emotional stimuli in 22 patients with MDD and the treatment outcome after 6 weeks' medication with an SSRI. A whole brain correlation analysis with Beck Depression Inventory (BDI) change between pre- to post-treatment was conducted to identify neural regions associated with treatment response. Results: During the perception of positive stimuli, responders were characterized by more activation in posterior cingulate cortex (PCC), medial prefrontal cortex, and thalamus as well as middle temporal gyrus. During perception of negative stimuli, PCC, and pregenual anterior cingulate cortex showed the highest correlation with treatment response. Furthermore, responders exhibited higher activation to emotional stimuli than to neutral stimuli in all the above-mentioned regions, while non-responders demonstrated an attenuated neural response to emotional compared to neutral stimuli. Conclusion: Our data suggest that the activity of distinct brain regions is correlated with SSRI treatment outcome and may serve as treatment response predictor. While some regions, in which activity was correlated with treatment response, can be assigned to networks that have been implied in the pathophysiology of depression, most of our regions of interest could also be matched to the default mode network (DMN). Higher DMN activity has been associated with increased rumination as well as negative self-referential processing in previous studies. This may suggest our responders to SSRI to be characterized by such dysregulations and that SSRIs might modify the function associated with this network.
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Affiliation(s)
- Antonia Preuss
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich, Switzerland.,Clinic for Psychiatry and Psychotherapy Clienia, Oetwil am See, Switzerland
| | - Bianca Bolliger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich, Switzerland
| | - Wenzel Schicho
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich, Switzerland
| | - Josef Hättenschwiler
- Center for Treatment of Anxiety and Affection Disorder Zentrum für Angst- und Depressionsbehandlung Zürich (ZADZ), Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich, Switzerland
| | - Annette Beatrix Brühl
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich, Switzerland
| | - Uwe Herwig
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich, Switzerland.,Center for Psychiatry Reichenau, Academic Hospital University of Konstanz, Konstanz, Germany
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8
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Langenecker SA, Mickey BJ, Eichhammer P, Sen S, Elverman KH, Kennedy SE, Heitzeg MM, Ribeiro SM, Love TM, Hsu DT, Koeppe RA, Watson SJ, Akil H, Goldman D, Burmeister M, Zubieta JK. Cognitive Control as a 5-HT 1A-Based Domain That Is Disrupted in Major Depressive Disorder. Front Psychol 2019; 10:691. [PMID: 30984083 PMCID: PMC6450211 DOI: 10.3389/fpsyg.2019.00691] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/12/2019] [Indexed: 12/21/2022] Open
Abstract
Heterogeneity within Major Depressive Disorder (MDD) has hampered identification of biological markers (e.g., intermediate phenotypes, IPs) that might increase risk for the disorder or reflect closer links to the genes underlying the disease process. The newer characterizations of dimensions of MDD within Research Domain Criteria (RDoC) domains may align well with the goal of defining IPs. We compare a sample of 25 individuals with MDD compared to 29 age and education matched controls in multimodal assessment. The multimodal RDoC assessment included the primary IP biomarker, positron emission tomography (PET) with a selective radiotracer for 5-HT1A [(11C)WAY-100635], as well as event-related functional MRI with a Go/No-go task targeting the Cognitive Control network, neuropsychological assessment of affective perception, negative memory bias and Cognitive Control domains. There was also an exploratory genetic analysis with the serotonin transporter (5-HTTLPR) and monamine oxidase A (MAO-A) genes. In regression analyses, lower 5-HT1A binding potential (BP) in the MDD group was related to diminished engagement of the Cognitive Control network, slowed resolution of interfering cognitive stimuli, one element of Cognitive Control. In contrast, higher/normative levels of 5-HT1A BP in MDD (only) was related to a substantial memory bias toward negative information, but intact resolution of interfering cognitive stimuli and greater engagement of Cognitive Control circuitry. The serotonin transporter risk allele was associated with lower 1a BP and the corresponding imaging and cognitive IPs in MDD. Lowered 5HT 1a BP was present in half of the MDD group relative to the control group. Lowered 5HT 1a BP may represent a subtype including decreased engagement of Cognitive Control network and impaired resolution of interfering cognitive stimuli. Future investigations might link lowered 1a BP to neurobiological pathways and markers, as well as probing subtype-specific treatment targets.
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Affiliation(s)
- Scott A. Langenecker
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Brian J. Mickey
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Peter Eichhammer
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Srijan Sen
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | | | - Susan E. Kennedy
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
| | - Mary M. Heitzeg
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Saulo M. Ribeiro
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
| | - Tiffany M. Love
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
| | - David T. Hsu
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
| | - Robert A. Koeppe
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Stanley J. Watson
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Huda Akil
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - David Goldman
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States
| | - Margit Burmeister
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Jon-Kar Zubieta
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
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