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Lin K, Sunko D, Wang J, Yang J, Parsey RV, DeLorenzo C. Investigating the relationship between hippocampus/dentate gyrus volume and hypothalamus metabolism in participants with major depressive disorder. Sci Rep 2024; 14:10622. [PMID: 38724691 PMCID: PMC11082185 DOI: 10.1038/s41598-024-61519-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 05/07/2024] [Indexed: 05/12/2024] Open
Abstract
Reduced hippocampal volume occurs in major depressive disorder (MDD), potentially due to elevated glucocorticoids from an overactivated hypothalamus-pituitary-adrenal (HPA) axis. To examine this in humans, hippocampal volume and hypothalamus (HPA axis) metabolism was quantified in participants with MDD before and after antidepressant treatment. 65 participants (n = 24 males, n = 41 females) with MDD were treated in a double-blind, randomized clinical trial of escitalopram. Participants received simultaneous positron emission tomography (PET)/magnetic resonance imaging (MRI) before and after treatment. Linear mixed models examined the relationship between hippocampus/dentate gyrus volume and hypothalamus metabolism. Chi-squared tests and multivariable logistic regression examined the association between hippocampus/dentate gyrus volume change direction and hypothalamus activity change direction with treatment. Multiple linear regression compared these changes between remitter and non-remitter groups. Covariates included age, sex, and treatment type. No significant linear association was found between hippocampus/dentate gyrus volume and hypothalamus metabolism. 62% (38 of 61) of participants experienced a decrease in hypothalamus metabolism, 43% (27 of 63) of participants demonstrated an increase in hippocampus size (51% [32 of 63] for the dentate gyrus) following treatment. No significant association was found between change in hypothalamus activity and change in hippocampus/dentate gyrus volume, and this association did not vary by sex, medication, or remission status. As this multimodal study, in a cohort of participants on standardized treatment, did not find an association between hypothalamus metabolism and hippocampal volume, it supports a more complex pathway between hippocampus neurogenesis and hypothalamus metabolism changes in response to treatment.
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Affiliation(s)
| | | | - Junying Wang
- Department of Applied Mathematics and Statistics, Stony Brook University, New York, NY, USA
| | - Jie Yang
- Department of Family, Population & Preventive Medicine, Stony Brook University, New York, NY, USA
| | - Ramin V Parsey
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA.
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.
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Ananth MR, Gardus JD, Huang C, Palekar N, Slifstein M, Zaborszky L, Parsey RV, Talmage DA, DeLorenzo C, Role LW. Loss of cholinergic input to the entorhinal cortex is an early indicator of cognitive impairment in natural aging of humans and mice. Res Sq 2024:rs.3.rs-3851086. [PMID: 38260541 PMCID: PMC10802688 DOI: 10.21203/rs.3.rs-3851086/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
In a series of translational experiments using fully quantitative positron emission tomography (PET) imaging with a new tracer specific for the vesicular acetylcholine transporter ([18F]VAT) in vivo in humans, and genetically targeted cholinergic markers in mice, we evaluated whether changes to the cholinergic system were an early feature of age-related cognitive decline. We found that deficits in cholinergic innervation of the entorhinal cortex (EC) and decline in performance on behavioral tasks engaging the EC are, strikingly, early features of the aging process. In human studies, we recruited older adult volunteers that were physically healthy and without prior clinical diagnosis of cognitive impairment. Using [18F]VAT PET imaging, we demonstrate that there is measurable loss of cholinergic inputs to the EC that can serve as an early signature of decline in EC cognitive performance. These deficits are specific to the cholinergic circuit between the medial septum and vertical limb of the diagonal band (MS/vDB; CH1/2) to the EC. Using diffusion imaging, we further demonstrate impaired structural connectivity in the tracts between the MS/vDB and EC in older adults with mild cognitive impairment. Experiments in mouse, designed to parallel and extend upon the human studies, used high resolution imaging to evaluate cholinergic terminal density and immediate early gene (IEG) activity of EC neurons in healthy aging mice and in mice with genetic susceptibility to accelerated accumulation amyloid beta plaques and hyperphosphorylated mouse tau. Across species and aging conditions, we find that the integrity of cholinergic projections to the EC directly correlates with the extent of EC activation and with performance on EC-related object recognition memory tasks. Silencing EC-projecting cholinergic neurons in young, healthy mice during the object-location memory task impairs object recognition performance, mimicking aging. Taken together we identify a role for acetylcholine in normal EC function and establish loss of cholinergic input to the EC as an early, conserved feature of age-related cognitive decline in both humans and rodents.
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Donnelly BM, Hsu DT, Gardus J, Wang J, Yang J, Parsey RV, DeLorenzo C. Orbitofrontal and striatal metabolism, volume, thickness and structural connectivity in relation to social anhedonia in depression: A multimodal study. Neuroimage Clin 2023; 41:103553. [PMID: 38134743 PMCID: PMC10777107 DOI: 10.1016/j.nicl.2023.103553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/10/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Social anhedonia is common within major depressive disorder (MDD) and associated with worse treatment outcomes. The orbitofrontal cortex (OFC) is implicated in both reward (medial OFC) and punishment (lateral OFC) in social decision making. Therefore, to understand the biology of social anhedonia in MDD, medial/lateral OFC metabolism, volume, and thickness, as well as structural connectivity to the striatum, amygdala, and ventral tegmental area/nucleus accumbens were examined. A positive relationship between social anhedonia and these neurobiological outcomes in the lateral OFC was hypothesized, whereas an inverse relationship was hypothesized for the medial OFC. The association between treatment-induced changes in OFC neurobiology and depression improvement were also examined. METHODS 85 medication-free participants diagnosed with MDD were assessed with Wisconsin Schizotypy Scales to assess social anhedonia and received pretreatment simultaneous fluorodeoxyglucose positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI), including structural and diffusion. Participants were then treated in an 8-week randomized placebo-controlled double-blind course of escitalopram. PET/MRI were repeated following treatment. Metabolic rate of glucose uptake was quantified from dynamic FDG-PET frames using Patlak graphical analysis. Structure (volume and cortical thickness) was quantified from structural MRI using Freesurfer. To assess structural connectivity, probabilistic tractography was performed on diffusion MRI and average FA was calculated within the derived tracts. Linear mixed models with Bonferroni correction were used to examine the relationships between variables. RESULTS A significantly negative linear relationship between pretreatment social anhedonia score and structural connectivity between the medial OFC and the amygdala (estimated coefficient: -0.006, 95 % CI: -0.0108 - -0.0012, p-value = 0.0154) was observed. However, this finding would not survive multiple comparisons correction. No strong evidence existed to show a significant linear relationship between pretreatment social anhedonia score and metabolism, volume, thickness, or structural connectivity to any of the regions examined. There was also no strong evidence to suggest significant linear relationships between improvement in depression and percent change in these variables. CONCLUSIONS Based on these multimodal findings, the OFC likely does not underlie social anhedonia in isolation and therefore should not be the sole target of treatment for social anhedonia. This is consistent with previous reports that other areas of the brain such as the amygdala and the striatum are highly involved in this behavior. Relatedly, amygdala-medial OFC structural connectivity could be a future target. The results of this study are crucial as, to our knowledge, they are the first to relate structure/function of the OFC with social anhedonia severity in MDD. Future work may need to involve a whole brain approach in order to develop therapeutics for social anhedonia.
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Affiliation(s)
| | - David T Hsu
- Department of Psychiatry and Behavioral Health, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| | - John Gardus
- Department of Psychiatry and Behavioral Health, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Junying Wang
- Department of Applied Mathematics and Statistics, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Jie Yang
- Department of Family, Population & Preventive Medicine, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Ramin V Parsey
- Department of Psychiatry and Behavioral Health, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Christine DeLorenzo
- Department of Psychiatry and Behavioral Health, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA; Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA.
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Giles MA, Cooper CM, Jha MK, Chin Fatt CR, Pizzagalli DA, Mayes TL, Webb CA, Greer TL, Etkin A, Trombello JM, Chase HW, Phillips ML, McInnis MG, Carmody T, Adams P, Parsey RV, McGrath PJ, Weissman M, Kurian BT, Fava M, Trivedi MH. Reward Behavior Disengagement, a Neuroeconomic Model-Based Objective Measure of Reward Pathology in Depression: Findings from the EMBARC Trial. Behav Sci (Basel) 2023; 13:619. [PMID: 37622759 PMCID: PMC10451479 DOI: 10.3390/bs13080619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/28/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
The probabilistic reward task (PRT) has identified reward learning impairments in those with major depressive disorder (MDD), as well as anhedonia-specific reward learning impairments. However, attempts to validate the anhedonia-specific impairments have produced inconsistent findings. Thus, we seek to determine whether the Reward Behavior Disengagement (RBD), our proposed economic augmentation of PRT, differs between MDD participants and controls, and whether there is a level at which RBD is high enough for depressed participants to be considered objectively disengaged. Data were gathered as part of the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study, a double-blind, placebo-controlled clinical trial of antidepressant response. Participants included 195 individuals with moderate to severe MDD (Quick Inventory of Depressive Symptomatology (QIDS-SR) score ≥ 15), not in treatment for depression, and with complete PRT data. Healthy controls (n = 40) had no history of psychiatric illness, a QIDS-SR score < 8, and complete PRT data. Participants with MDD were treated with sertraline or placebo for 8 weeks (stage I of the EMBARC trial). RBD was applied to PRT data using discriminant analysis, and classified MDD participants as reward task engaged (n = 137) or reward task disengaged (n = 58), relative to controls. Reward task engaged/disengaged groups were compared on sociodemographic features, reward-behavior, and sertraline/placebo response (Hamilton Depression Rating Scale scores). Reward task disengaged MDD participants responded only to sertraline, whereas those who were reward task engaged responded to sertraline and placebo (F(1293) = 4.33, p = 0.038). Reward task engaged/disengaged groups did not differ otherwise. RBD was predictive of reward impairment in depressed patients and may have clinical utility in identifying patients who will benefit from antidepressants.
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Affiliation(s)
- Michael A. Giles
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Crystal M. Cooper
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
- Jane and John Justin Neurosciences Center, Cook Children’s Health Care System, Fort Worth, TX 76104, USA
| | - Manish K. Jha
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
| | - Cherise R. Chin Fatt
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
| | - Diego A. Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
- McLean Hospital, Belmont, MA 02478, USA
| | - Taryn L. Mayes
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
| | - Christian A. Webb
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
- McLean Hospital, Belmont, MA 02478, USA
| | - Tracy L. Greer
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
- Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Joseph M. Trombello
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
| | - Henry W. Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Mary L. Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Melvin G. McInnis
- Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Thomas Carmody
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Phillip Adams
- Department of Psychiatry, Columbia University, New York, NY 10032, USA
| | - Ramin V. Parsey
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794, USA
| | | | - Myrna Weissman
- Department of Psychiatry, Columbia University, New York, NY 10032, USA
| | - Benji T. Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Maurizio Fava
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
- Massachusetts General Hospital, Boston, MA 02114, USA
| | - Madhukar H. Trivedi
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
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Piccolo M, Belleau EL, Holsen LM, Trivedi MH, Parsey RV, McGrath PJ, Weissman MM, Pizzagalli DA, Javaras KN. Alterations in resting-state functional activity and connectivity for major depressive disorder appetite and weight disturbance phenotypes. Psychol Med 2023; 53:4517-4527. [PMID: 35670301 PMCID: PMC9949733 DOI: 10.1017/s0033291722001398] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is often accompanied by changes in appetite and weight. Prior task-based functional magnetic resonance imaging (fMRI) findings suggest these MDD phenotypes are associated with altered reward and interoceptive processing. METHODS Using resting-state fMRI data, we compared the fractional amplitude of low-frequency fluctuations (fALFF) and seed-based connectivity (SBC) among hyperphagic (n = 77), hypophagic (n = 66), and euphagic (n = 42) MDD groups and a healthy comparison group (n = 38). We examined fALFF and SBC in a mask restricted to reward [nucleus accumbens (NAcc), putamen, caudate, ventral pallidum, and orbitofrontal cortex (OFC)] and interoceptive (anterior insula and hypothalamus) regions and also performed exploratory whole-brain analyses. SBC analyses included as seeds the NAcc and also regions demonstrating group differences in fALFF (i.e. right lateral OFC and right anterior insula). All analyses used threshold-free cluster enhancement. RESULTS Mask-restricted analyses revealed stronger fALFF in the right lateral OFC, and weaker fALFF in the right anterior insula, for hyperphagic MDD v. healthy comparison. We also found weaker SBC between the right lateral OFC and left anterior insula for hyperphagic MDD v. healthy comparison. Whole-brain analyses revealed weaker fALFF in the right anterior insula, and stronger SBC between the right lateral OFC and left precentral gyrus, for hyperphagic MDD v. healthy comparison. Findings were no longer significant after controlling for body mass index, which was higher for hyperphagic MDD. CONCLUSIONS Our results suggest hyperphagic MDD may be associated with altered activity in and connectivity between interoceptive and reward regions.
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Affiliation(s)
- Mayron Piccolo
- McLean Hospital, Belmont MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Emily L. Belleau
- McLean Hospital, Belmont MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Laura M. Holsen
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital, Boston MA 02115, USA
- Department of Psychiatry, Brigham and Women’s Hospital, Boston MA 02115, USA
| | - Madhukar H. Trivedi
- Division of Mood Disorders, University of Texas, Southwestern Medical Center, Dallas TX 75390 USA
| | - Ramin V. Parsey
- Neuroscience Institute, Renaissance School of Medicine, Stony Brook University, Stony Brook NY 11733 USA
| | - Patrick J. McGrath
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York NY 10032 USA
| | - Myrna M. Weissman
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York NY 10032 USA
| | - Diego A. Pizzagalli
- McLean Hospital, Belmont MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Kristin N. Javaras
- McLean Hospital, Belmont MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
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Ali FZ, Parsey RV, Lin S, Schwartz J, DeLorenzo C. Circadian rhythm biomarker from wearable device data is related to concurrent antidepressant treatment response. NPJ Digit Med 2023; 6:81. [PMID: 37120493 PMCID: PMC10148831 DOI: 10.1038/s41746-023-00827-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/11/2023] [Indexed: 05/01/2023] Open
Abstract
Major depressive disorder (MDD) is associated with circadian rhythm disruption. Yet, no circadian rhythm biomarkers have been clinically validated for assessing antidepressant response. In this study, 40 participants with MDD provided actigraphy data using wearable devices for one week after initiating antidepressant treatment in a randomized, double-blind, placebo-controlled trial. Their depression severity was calculated pretreatment, after one week and eight weeks of treatment. This study assesses the relationship between parametric and nonparametric measures of circadian rhythm and change in depression. Results show significant association between a lower circadian quotient (reflecting less robust rhythmicity) and improvement in depression from baseline following first week of treatment (estimate = 0.11, F = 7.01, P = 0.01). There is insufficient evidence of an association between circadian rhythm measures acquired during the first week of treatment and outcomes after eight weeks of treatment. Despite this lack of association with future treatment outcome, this scalable, cost-effective biomarker may be useful for timely mental health care through remote monitoring of real-time changes in current depression.
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Affiliation(s)
- Farzana Z Ali
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA.
| | - Ramin V Parsey
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Radiology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Shan Lin
- Department of Electrical and Computer Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Joseph Schwartz
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Christine DeLorenzo
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
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Bartlett EA, Yttredahl AA, Boldrini M, Tyrer AE, Hill KR, Ananth MR, Milak MS, Oquendo MA, Mann JJ, DeLorenzo C, Parsey RV. In vivo serotonin 1A receptor hippocampal binding potential in depression and reported childhood adversity. Eur Psychiatry 2023; 66:e17. [PMID: 36691786 PMCID: PMC9970152 DOI: 10.1192/j.eurpsy.2023.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Reported childhood adversity (CA) is associated with development of depression in adulthood and predicts a more severe course of illness. Although elevated serotonin 1A receptor (5-HT1AR) binding potential, especially in the raphe nuclei, has been shown to be a trait associated with major depression, we did not replicate this finding in an independent sample using the partial agonist positron emission tomography tracer [11C]CUMI-101. Evidence suggests that CA can induce long-lasting changes in expression of 5-HT1AR, and thus, a history of CA may explain the disparate findings. METHODS Following up on our initial report, 28 unmedicated participants in a current depressive episode (bipolar n = 16, unipolar n = 12) and 19 non-depressed healthy volunteers (HVs) underwent [11C]CUMI-101 imaging to quantify 5-HT1AR binding potential. Participants in a depressive episode were stratified into mild/moderate and severe CA groups via the Childhood Trauma Questionnaire. We hypothesized higher hippocampal and raphe nuclei 5-HT1AR with severe CA compared with mild/moderate CA and HVs. RESULTS There was a group-by-region effect (p = 0.011) when considering HV, depressive episode mild/moderate CA, and depressive episode severe CA groups, driven by significantly higher hippocampal 5-HT1AR binding potential in participants in a depressive episode with severe CA relative to HVs (p = 0.019). Contrary to our hypothesis, no significant binding potential differences were detected in the raphe nuclei (p-values > 0.05). CONCLUSIONS With replication in larger samples, elevated hippocampal 5-HT1AR binding potential may serve as a promising biomarker through which to investigate the neurobiological link between CA and depression.
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Affiliation(s)
- Elizabeth A Bartlett
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York10032, USA.,Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York10032, USA
| | - Ashley A Yttredahl
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York10032, USA.,Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York10032, USA
| | - Maura Boldrini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York10032, USA
| | - Andrea E Tyrer
- Department of Psychiatry, Stony Brook Medicine, Stony Brook, NY11794, USA.,Clinical Genetics Research Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, OntarioM5S, Canada
| | - Kathryn R Hill
- Department of Psychiatry, Stony Brook Medicine, Stony Brook, NY11794, USA
| | - Mala R Ananth
- National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, Maryland20892, USA
| | - Matthew S Milak
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York10032, USA.,Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York10032, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania19104, USA
| | - J John Mann
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York10032, USA.,Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, New York10032, USA.,Department of Radiology, Columbia University, New York, New York10027, USA
| | - Christine DeLorenzo
- Department of Psychiatry, Stony Brook Medicine, Stony Brook, NY11794, USA.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York11794, USA
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook Medicine, Stony Brook, NY11794, USA.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York11794, USA.,Department of Radiology, Stony Brook University, Stony Brook, New York11794, USA
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8
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Hill KR, Hsu DT, Taylor SF, Ogden RT, Parsey RV, DeLorenzo C. Mu Opioid Receptor Dynamics in Healthy Volunteers with a History of Childhood Maltreatment. J Child Adolesc Trauma 2022; 15:1105-1112. [PMID: 36439668 PMCID: PMC9684394 DOI: 10.1007/s40653-022-00463-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 06/16/2023]
Abstract
Evidence suggests that adults with a history of childhood maltreatment, the experience of emotional or physical neglect and/or abuse within the family during childhood, have blunted reward and stress processing, and higher risk of depression. The mu opioid receptor rich nucleus accumbens and amygdala are critical to reward and stress processing respectively. We hypothesized that nucleus accumbens and amygdala mu opioid receptor densities and activity (change in receptor binding due to endogenous opioid release or receptor conformation change) were negatively associated with childhood maltreatment in healthy young adults. Maltreatment was assessed with the Childhood Trauma Questionnaire (CTQ). Healthy participants, n = 75 (52% female) completed [11C]carfentanil positron emission tomography imaging labeling mu opioid receptors. The relationship between CTQ score and binding potential (BPND, proportional to density of unoccupied receptors) was evaluated with a linear mixed effects model. No significant relationship was found between CTQ score and BPND (f = 3.28; df = 1, 73; p = 0.074) or change in BPND (activity) (t = 1.48; df = 198.3; p = 0.14). This is the first investigation of mu opioid receptors in those with childhood maltreatment. We did not identify a significant relationship between mu opioid receptor dynamics and severity of maltreatment in those without psychopathology. Because this cohort has a low CTQ score average, this may indicate that those with low severity of maltreatment may not have associated changes in mu opioid receptor dynamics. Future directions include evaluating a cohort with increased severity of childhood maltreatment.
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Affiliation(s)
- Kathryn R. Hill
- Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794 United States
| | - David T. Hsu
- Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794 United States
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109 USA
| | - Stephan F. Taylor
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109 USA
| | - R. Todd Ogden
- Department of Biostatistics, Columbia University Mailman School of Public Health, NY, NY 10032 USA
| | - Ramin V. Parsey
- Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794 United States
| | - Christine DeLorenzo
- Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794 United States
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Ali FZ, Wengler K, He X, Nguyen MH, Parsey RV, DeLorenzo C. Gradient boosting decision-tree-based algorithm with neuroimaging for personalized treatment in depression. Neurosci Inform 2022; 2:100110. [PMID: 36699194 PMCID: PMC9873411 DOI: 10.1016/j.neuri.2022.100110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction Pretreatment positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) and magnetic resonance spectroscopy (MRS) may identify biomarkers for predicting remission (absence of depression). Yet, no such image-based biomarkers have achieved clinical validity. The purpose of this study was to identify biomarkers of remission using machine learning (ML) with pretreatment FDG-PET/MRS neuroimaging, to reduce patient suffering and economic burden from ineffective trials. Methods This study used simultaneous PET/MRS neuroimaging from a double-blind, placebo-controlled, randomized antidepressant trial on 60 participants with major depressive disorder (MDD) before initiating treatment. After eight weeks of treatment, those with ≤ 7 on 17-item Hamilton Depression Rating Scale were designated a priori as remitters (free of depression, 37%). Metabolic rate of glucose uptake (metabolism) from 22 brain regions were acquired from PET. Concentrations (mM) of glutamine and glutamate and gamma-aminobutyric acid (GABA) in anterior cingulate cortex were quantified from MRS. The data were randomly split into 67% train and cross-validation (n = 40), and 33% test (n = 20) sets. The imaging features, along with age, sex, handedness, and treatment assignment (selective serotonin reuptake inhibitor or SSRI vs. placebo) were entered into the eXtreme Gradient Boosting (XGBoost) classifier for training. Results In test data, the model showed 62% sensitivity, 92% specificity, and 77% weighted accuracy. Pretreatment metabolism of left hippocampus from PET was the most predictive of remission. Conclusions The pretreatment neuroimaging takes around 60 minutes but has potential to prevent weeks of failed treatment trials. This study effectively addresses common issues for neuroimaging analysis, such as small sample size, high dimensionality, and class imbalance.
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Affiliation(s)
- Farzana Z. Ali
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Kenneth Wengler
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Xiang He
- Department of Radiology, Stony Brook Medicine, Stony Brook, NY, USA
- Department of Radiology, Northshore University Hospital, Manhasset, NY, USA
| | - Minh Hoai Nguyen
- Department of Computer Science, Stony Brook University, Stony Brook, NY, USA
| | - Ramin V. Parsey
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
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10
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Kaiser RH, Chase HW, Phillips ML, Deckersbach T, Parsey RV, Fava M, McGrath PJ, Weissman M, Oquendo MA, McInnis MG, Carmody T, Cooper CM, Trivedi MH, Pizzagalli DA. Dynamic Resting-State Network Biomarkers of Antidepressant Treatment Response. Biol Psychiatry 2022; 92:533-542. [PMID: 35680431 PMCID: PMC10640874 DOI: 10.1016/j.biopsych.2022.03.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/02/2022] [Accepted: 03/23/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Delivery of effective antidepressant treatment has been hampered by a lack of objective tools for predicting or monitoring treatment response. This study aimed to address this gap by testing novel dynamic resting-state functional network markers of antidepressant response. METHODS The Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study randomized adults with major depressive disorder to 8 weeks of either sertraline or placebo, and depression severity was evaluated longitudinally. Participants completed resting-state neuroimaging pretreatment and again after 1 week of treatment (n = 259 eligible for analyses). Coactivation pattern analyses identified recurrent whole-brain states of spatial coactivation, and computed time spent in each state for each participant was the main dynamic measure. Multilevel modeling estimated the associations between pretreatment network dynamics and sertraline response and between early (pretreatment to 1 week) changes in network dynamics and sertraline response. RESULTS Dynamic network markers of early sertraline response included increased time in network states consistent with canonical default and salience networks, together with decreased time in network states characterized by coactivation of cingulate and ventral limbic or temporal regions. The effect of sertraline on depression recovery was mediated by these dynamic network changes. In contrast, early changes in dynamic functioning of corticolimbic and frontoinsular-default networks were related to patterns of symptom recovery common across treatment groups. CONCLUSIONS Dynamic resting-state markers of early antidepressant response or general recovery may assist development of clinical tools for monitoring and predicting effective intervention.
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Affiliation(s)
- Roselinde H Kaiser
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado; Institute of Cognitive Science, University of Colorado Boulder, Boulder, Colorado; Renée Crown Wellness Institute, University of Colorado Boulder, Boulder, Colorado.
| | - Henry W Chase
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Thilo Deckersbach
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, New York
| | - Maurizio Fava
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts
| | - Patrick J McGrath
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Myrna Weissman
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Thomas Carmody
- Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Crystal M Cooper
- Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Boston, Massachusetts
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11
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Jones JS, Goldstein SJ, Wang J, Gardus J, Yang J, Parsey RV, DeLorenzo C. Evaluation of brain structure and metabolism in currently depressed adults with a history of childhood trauma. Transl Psychiatry 2022; 12:392. [PMID: 36115855 PMCID: PMC9482635 DOI: 10.1038/s41398-022-02153-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 08/26/2022] [Accepted: 09/05/2022] [Indexed: 11/22/2022] Open
Abstract
Structural differences in the dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), hippocampus, and amygdala were reported in adults who experienced childhood trauma; however, it is unknown whether metabolic differences accompany these structural differences. This multimodal imaging study examined structural and metabolic correlates of childhood trauma in adults with major depressive disorder (MDD). Participants with MDD completed the Childhood Trauma Questionnaire (CTQ, n = 83, n = 54 female (65.1%), age: 30.4 ± 14.1) and simultaneous positron emission tomography (PET)/magnetic resonance imaging (MRI). Structure (volume, n = 80, and cortical thickness, n = 81) was quantified from MRI using Freesurfer. Metabolism (metabolic rate of glucose uptake) was quantified from dynamic 18F-fluorodeoxyglucose (FDG)-PET images (n = 70) using Patlak graphical analysis. A linear mixed model was utilized to examine the association between structural/metabolic variables and continuous childhood trauma measures while controlling for confounding factors. Bonferroni correction was applied. Amygdala volumes were significantly inversely correlated with continuous CTQ scores. Specifically, volumes were lower by 7.44 mm3 (95% confidence interval [CI]: -12.19, -2.68) per point increase in CTQ. No significant relationship was found between thickness/metabolism and CTQ score. While longitudinal studies are required to establish causation, this study provides insight into potential consequences of, and therefore potential therapeutic targets for, childhood trauma in the prevention of MDD. This work aims to reduce heterogeneity in MDD studies by quantifying neurobiological correlates of trauma within MDD. It further provides biological targets for future interventions aimed at preventing MDD following trauma. To our knowledge, this is the first simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) study to assess both structure and metabolism associated with childhood trauma in adults with MDD.
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Affiliation(s)
- Joshua S. Jones
- grid.16416.340000 0004 1936 9174University of Rochester, Rochester, NY USA
| | - Samantha J. Goldstein
- grid.36425.360000 0001 2216 9681Department of Psychiatry and Behavioral Science, Stony Brook University, New York, NY USA
| | - Junying Wang
- grid.36425.360000 0001 2216 9681Department of Applied Mathematics and Statistics, Stony Brook University, New York, NY USA
| | - John Gardus
- grid.36425.360000 0001 2216 9681Department of Psychiatry and Behavioral Science, Stony Brook University, New York, NY USA
| | - Jie Yang
- grid.36425.360000 0001 2216 9681Department of Family, Population & Preventive Medicine, Stony Brook University, New York, NY USA
| | - Ramin V. Parsey
- grid.36425.360000 0001 2216 9681Department of Psychiatry and Behavioral Science, Stony Brook University, New York, NY USA
| | - Christine DeLorenzo
- grid.36425.360000 0001 2216 9681Department of Psychiatry and Behavioral Science, Stony Brook University, New York, NY USA ,grid.36425.360000 0001 2216 9681Department of Biomedical Engineering, Stony Brook University, New York, NY USA
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12
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Hill KR, Hsu DT, Taylor SF, Ogden RT, DeLorenzo C, Parsey RV. Rejection sensitivity and mu opioid receptor dynamics associated with mood alterations in response to social feedback. Psychiatry Res Neuroimaging 2022; 324:111505. [PMID: 35688046 PMCID: PMC9338686 DOI: 10.1016/j.pscychresns.2022.111505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/17/2022] [Accepted: 06/01/2022] [Indexed: 11/19/2022]
Abstract
Rejection sensitivity (RS) is the heightened expectation or perception of social rejection and is a feature of many psychiatric disorders. As endogenous opioid pathways have been implicated in response to social rejection and reward, we hypothesize that RS will be negatively associated with mu opioid receptor (MOR) baseline binding and activity during rejection and acceptance stimuli. In exploratory analyses, we assessed the relationships between MOR activity and changes in mood and self-esteem before and after stimuli. Healthy participants, N = 75 (52% female), completed rejection and acceptance tasks during [11C]carfentanil positron emission tomography (PET) scans. MOR activity in the amygdala, midline thalamus, anterior insula, and nucleus accumbens (NAc) was evaluated. RS was not related to MOR baseline binding potential or activity during acceptance or rejection tasks in any region. Increased MOR activity in the NAc was associated with increase in ratings of self-esteem and positive mood during the period between acceptance task administration and approximately 5 min after the task completion. Our results suggest that endogenous opioid response to social rejection is independent of RS in healthy individuals. MOR activity in the NAc was associated with increase self-esteem and positive mood after experiencing social feedback, warranting further investigation.
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Affiliation(s)
- Kathryn R Hill
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, 11794, United States.
| | - David T Hsu
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, 11794, United States; Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Stephan F Taylor
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI, 48109, United States
| | - R Todd Ogden
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, United States
| | - Christine DeLorenzo
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, 11794, United States
| | - Ramin V Parsey
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, 11794, United States
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13
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Trombello JM, Cooper CM, Fatt CC, Grannemann BD, Carmody TJ, Jha MK, Mayes TL, Greer TL, Yezhuvath U, Aslan S, Pizzagalli DA, Weissman MM, Webb CA, Dillon DG, McGrath PJ, Fava M, Parsey RV, McInnis MG, Etkin A, Trivedi MH. Neural substrates of emotional conflict with anxiety in major depressive disorder: Findings from the Establishing Moderators and biosignatures of Antidepressant Response in Clinical Care (EMBARC) randomized controlled trial. J Psychiatr Res 2022; 149:243-251. [PMID: 35290819 PMCID: PMC9746288 DOI: 10.1016/j.jpsychires.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/16/2022] [Accepted: 03/07/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND The brain circuitry of depression and anxiety/fear is well-established, involving regions such as the limbic system and prefrontal cortex. We expand prior literature by examining the extent to which four discrete factors of anxiety (immediate state anxiety, physiological/panic, neuroticism/worry, and agitation/restlessness) among depressed outpatients are associated with differential responses during reactivity to and regulation of emotional conflict. METHODS A total of 172 subjects diagnosed with major depressive disorder underwent functional magnetic resonance imaging while performing an Emotional Stroop Task. Two main contrasts were examined using whole brain voxel wise analyses: emotional reactivity and emotion regulation. We also evaluated the association of these contrasts with the four aforementioned anxiety factors. RESULTS During emotional reactivity, participants with higher immediate state anxiety showed potentiated activation in the rolandic operculum and insula, while individuals with higher levels of physiological/panic demonstrated decreased activation in the posterior cingulate. No significant results emerged for any of the four factors on emotion regulation. When re-analyzing these statistically-significant brain regions through analyses of a subsample with (n = 92) and without (n = 80) a current anxiety disorder, no significant associations occurred among those without an anxiety disorder. Among those with an anxiety disorder, results were similar to the full sample, except the posterior cingulate was associated with the neuroticism/worry factor. CONCLUSIONS Divergent patterns of task-related brain activation across four discrete anxiety factors could be used to inform treatment decisions and target specific aspects of anxiety that involve intrinsic processing to attenuate overactive responses to emotional stimuli.
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Affiliation(s)
- Joseph M. Trombello
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Crystal M. Cooper
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Neuroscience Research, Cook Children’s Medical Center, Fort Worth, TX, USA
| | - Cherise Chin Fatt
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bruce D. Grannemann
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas J. Carmody
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Manish K. Jha
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L. Mayes
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tracy L. Greer
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Department of Psychology, The University of Texas at Arlington, Arlington, TX, USA
| | | | - Sina Aslan
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Advance MRI LLC, Frisco, TX, USA
| | - Diego A. Pizzagalli
- Harvard Medical School, McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Myrna M. Weissman
- Columbia University, Department of Psychiatry, New York, NY, USA,New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Christian A. Webb
- Harvard Medical School, McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Daniel G. Dillon
- Harvard Medical School, McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Patrick J. McGrath
- Columbia University, Department of Psychiatry, New York, NY, USA,New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Maurizio Fava
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA
| | - Ramin V. Parsey
- Stony Brook University, Department of Psychiatry, Stony Brook, NY, USA
| | - Melvin G. McInnis
- University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA
| | - Amit Etkin
- Stanford University School of Medicine, Department of Psychiatry, Palo Alto, CA, USA
| | - Madhukar H. Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Corresponding author. Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, USA. (M.H. Trivedi)
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14
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Hill KR, Gardus JD, Bartlett EA, Perlman G, Parsey RV, DeLorenzo C. Measuring brain glucose metabolism in order to predict response to antidepressant or placebo: A randomized clinical trial. Neuroimage Clin 2022; 32:102858. [PMID: 34689056 PMCID: PMC8551925 DOI: 10.1016/j.nicl.2021.102858] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/18/2021] [Accepted: 10/12/2021] [Indexed: 01/09/2023] Open
Abstract
There is critical need for a clinically useful tool to predict antidepressant treatment outcome in major depressive disorder (MDD) to reduce suffering and mortality. This analysis sought to build upon previously reported antidepressant treatment efficacy prediction from 2-[18F]-fluorodeoxyglucose - Positron Emission Tomography (FDG-PET) using metabolic rate of glucose uptake (MRGlu) from dynamic FDG-PET imaging with the goal of translation to clinical utility. This investigation is a randomized, double-blind placebo-controlled trial. All participants were diagnosed with MDD and received an FDG-PET scan before randomization and after treatment. Hamilton Depression Rating Scale (HDRS-17) was completed in participants diagnosed with MDD before and after 8 weeks of escitalopram, or placebo. MRGlu (mg/(min*100 ml)) was estimated within the raphe nuclei, right insula, and left ventral Prefrontal Cortex in 63 individuals. Linear regression was used to examine the association between pretreatment MRGlu and percent decrease in HDRS-17. Additionally, the association between percent decrease in HDRS-17 and percent change in MRGlu between pretreatment scan and post-treatment scan was examined. Covariates were treatment type (SSRI/placebo), handedness, sex, and age. Depression severity decrease (n = 63) was not significantly associated with pretreatment MRGlu in the raphe nuclei (β = -2.61e-03 [-0.26, 0.25], p = 0.98), right insula (β = 0.05 [-0.23, 0.32], p = 0.72), or ventral prefrontal cortex (β = 0.06 [-0.23, 0.34], p = 0.68) where β is the standardized estimated coefficient, with a 95% confidence interval, or in whole brain voxelwise analysis (family-wise error correction, alpha = 0.05). MRGlu percent change was not significantly associated with depression severity decrease (n = 58) before multiple comparison correction in the RN (β = 0.20 [-0.07, 0.47], p = 0.15), right insula (β = 0.24 [-0.03, 0.51], p = 0.08), or vPFC (β = 0.22 [-0.06, 0.50], p = 0.12). We propose that FDG-PET imaging does not indicate a clinically relevant biomarker of escitalopram or placebo treatment response in heterogeneous major depressive disorder cohorts. Future directions include focusing on potential biologically-based subtypes of major depressive disorder by implementing biomarker stratified designs.
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Affiliation(s)
- Kathryn R Hill
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 101 Nicolls Rd, Stony Brook, NY, 11794, USA.
| | - John D Gardus
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 101 Nicolls Rd, Stony Brook, NY, 11794, USA.
| | - Elizabeth A Bartlett
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA; Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Dr, New York, NY 10032, USA.
| | - Greg Perlman
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 101 Nicolls Rd, Stony Brook, NY, 11794, USA.
| | - Ramin V Parsey
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 101 Nicolls Rd, Stony Brook, NY, 11794, USA.
| | - Christine DeLorenzo
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 101 Nicolls Rd, Stony Brook, NY, 11794, USA; Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Dr, New York, NY 10032, USA.
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15
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Deri Y, Clouston SAP, DeLorenzo C, Gardus JD, Bartlett EA, Santiago-Michels S, Bangiyev L, Kreisl WC, Kotov R, Huang C, Slifstein M, Parsey RV, Luft BJ. Neuroinflammation in World Trade Center responders at midlife: A pilot study using [ 18F]-FEPPA PET imaging. Brain Behav Immun Health 2021; 16:100287. [PMID: 34589784 PMCID: PMC8474562 DOI: 10.1016/j.bbih.2021.100287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 02/08/2023] Open
Abstract
Background Neuroinflammation has long been theorized to arise from exposures to fine particulate matter and to be modulated when individuals experience chronic stress, both of which are also though to cause cognitive decline in part as a result of neuroinflammation. Objectives Hypothesizing that neuroinflammation might be linked to experiences at the World Trade Center (WTC) events, this study explored associations between glial activation and neuropsychological measures including post-traumatic stress disorder (PTSD) symptom severity and WTC exposure duration. Methods Translocator protein 18-kDa (TSPO) is overexpressed by activated glial cells, predominantly microglia and astrocytes, making TSPO distribution a putative biomarker for neuroinflammation. Twenty WTC responders completed neuropsychological assessments and in vivo PET brain scan with [18F]-FEPPA. Generalized linear modeling was used to test associations between PTSD, and WTC exposure duratiioni as the predictor and both global and regional [18F]-FEPPA total distribution volumes as the outcomes. Result Responders were 56.0 ± 4.7 years-old, and 75% were police officers on 9/11/2001, and all had at least a high school education. Higher PTSD symptom severity was associated with global and regional elevations in [18F]-FEPPA binding predominantly in the hippocampus (d = 0.72, P = 0.001) and frontal cortex (d = 0.64, P = 0.004). Longer exposure duration to WTC sites was associated with higher [18F]-FEPPA binding in the parietal cortex. Conclusion Findings from this study of WTC responders at midlife suggest that glial activation is associated with PTSD symptoms, and WTC exposure duration. Future investigation is needed to understand the important role of neuroinflammation in highly exposed WTC responders. We examined the theory that glial activation is associated with 9/11 exposures. TSPO-Vt was examined using PET in 20 responders adjusting for TSPO genotype. Responders with PTSD had increased TSPO distribution volume in the hippocampus. Heavily exposed responders had increased TSPO distribution in the parietal cortex.
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Affiliation(s)
- Yael Deri
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Sean A P Clouston
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - John D Gardus
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Elizabeth A Bartlett
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA.,Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Stephanie Santiago-Michels
- Stony Brook World Trade Center Wellness Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Lev Bangiyev
- Department of Radiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - William C Kreisl
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Roman Kotov
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Chuan Huang
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.,Department of Radiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Mark Slifstein
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Ramin V Parsey
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Benjamin J Luft
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Stony Brook World Trade Center Wellness Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
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16
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Kim DJ, Bartlett EA, DeLorenzo C, Parsey RV, Kilts C, Cáceda R. Examination of structural brain changes in recent suicidal behavior. Psychiatry Res Neuroimaging 2021; 307:111216. [PMID: 33129637 PMCID: PMC9227957 DOI: 10.1016/j.pscychresns.2020.111216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 11/17/2022]
Abstract
We aimed to identify brain structural changes in cortical and subcortical regions linked to recent suicidal behavior. We performed secondary analyses of structural MRI data of two independent studies, namely the Establishing Moderators/Biosignatures of Antidepressant Response - Clinical Care (EMBARC) study and a Little Rock study on acute suicidal behavior. Study 1 (EMBARC, N = 187), compared individuals with remote suicide attempts (Remote-SA), individuals with lifetime suicide ideation but no attempts (Lifetime-SI only), and depressed individuals without lifetime suicide ideation or attempts (non-suicidal depressed). Study 2 (Little Rock data, N = 34) included patients recently hospitalized for suicide ideation or attempt constituted by: patients who recently attempted suicide (Recent-SA), individuals with remote suicide attempts (Remote-SA), and Lifetime-SI only. Study 3 combined the EMBARC and Little Rock datasets including Recent-SA, Remote-SA, Lifetime-SI only and non-suicidal depressed individuals. In Study 1 and Study 2, no significant differences were observed between groups. In Study 3, significantly lower middle temporal gyrus thickness, insular surface area, and thalamic volume and higher volume in the nucleus accumbens were observed in Recent-SA. This pattern of structural abnormalities may underlie pain and emotion dysregulation, which have been linked to the transition from suicidal thoughts to action.
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Affiliation(s)
- Diane J Kim
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States.
| | - Elizabeth A Bartlett
- Columbia University College of Physicians and Surgeons, Department of Psychiatry, New York, NY, United States; New York State Psychiatric Institute, Division of Molecular Imaging and Neuropathology, New York, New York, United States
| | - Christine DeLorenzo
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States; Stony Brook University, Department of Biomedical Engineering, Stony Brook, New York, United States
| | - Ramin V Parsey
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States
| | - Clinton Kilts
- University of Arkansas for Medical Sciences, Psychiatric Research Institute, Little Rock, Arkansas, United States
| | - Ricardo Cáceda
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States
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17
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Cooper CM, Chin Fatt CR, Liu P, Grannemann BD, Carmody T, Almeida JRC, Deckersbach T, Fava M, Kurian BT, Malchow AL, McGrath PJ, McInnis M, Oquendo MA, Parsey RV, Bartlett E, Weissman M, Phillips ML, Lu H, Trivedi MH. Discovery and replication of cerebral blood flow differences in major depressive disorder. Mol Psychiatry 2020; 25:1500-1510. [PMID: 31388104 DOI: 10.1038/s41380-019-0464-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 03/06/2019] [Accepted: 03/26/2019] [Indexed: 01/08/2023]
Abstract
Major depressive disorder (MDD) is a serious, heterogeneous disorder accompanied by brain-related changes, many of which are still to be discovered or refined. Arterial spin labeling (ASL) is a neuroimaging technique used to measure cerebral blood flow (CBF; perfusion) to understand brain function and detect differences among groups. CBF differences have been detected in MDD, and may reveal biosignatures of disease-state. The current work aimed to discover and replicate differences in CBF between MDD participants and healthy controls (HC) as part of the EMBARC study. Participants underwent neuroimaging at baseline, prior to starting study medication, to investigate biosignatures in MDD. Relative CBF (rCBF) was calculated and compared between 106 MDD and 36 HC EMBARC participants (whole-brain Discovery); and 58 MDD EMBARC participants and 58 HC from the DLBS study (region-of-interest Replication). Both analyses revealed reduced rCBF in the right parahippocampus, thalamus, fusiform and middle temporal gyri, as well as the left and right insula, for those with MDD relative to HC. Both samples also revealed increased rCBF in MDD relative to HC in both the left and right inferior parietal lobule, including the supramarginal and angular gyri. Cingulate and prefrontal regions did not fully replicate. Lastly, significant associations were detected between rCBF in replicated regions and clinical measures of MDD chronicity. These results (1) provide reliable evidence for ASL in detecting differences in perfusion for multiple brain regions thought to be important in MDD, and (2) highlight the potential role of using perfusion as a biosignature of MDD.
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Affiliation(s)
- Crystal M Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Cherise R Chin Fatt
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peiying Liu
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Bruce D Grannemann
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jorge R C Almeida
- Department of Psychiatry, Dell Medical School, University of Texas Austin, Austin, TX, USA
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Benji T Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ashley L Malchow
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Patrick J McGrath
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA
| | - Melvin McInnis
- Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Elizabeth Bartlett
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA
| | - Myrna Weissman
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Hanzhang Lu
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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18
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Pillai RLI, Bartlett EA, Ananth MR, Zhu C, Yang J, Hajcak G, Parsey RV, DeLorenzo C. Examining the underpinnings of loudness dependence of auditory evoked potentials with positron emission tomography. Neuroimage 2020; 213:116733. [PMID: 32169543 DOI: 10.1016/j.neuroimage.2020.116733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 03/07/2020] [Accepted: 03/09/2020] [Indexed: 11/30/2022] Open
Abstract
Loudness dependence of auditory evoked potentials (LDAEP) has long been considered to reflect central basal serotonin transmission. However, the relationship between LDAEP and individual serotonin receptors and transporters has not been fully explored in humans and may involve other neurotransmitter systems. To examine LDAEP's relationship with the serotonin system, we performed PET using serotonin-1A (5-HT1A) imaging via [11C]CUMI-101 and serotonin transporter (5-HTT) imaging via [11C]DASB on a mixed sample of healthy controls (n = 4: 4 females, 0 males), patients with unipolar (MDD, n = 11: 4 females, 7 males) and bipolar depression (BD, n = 8: 4 females, 4 males). On these same participants, we also performed electroencephalography (EEG) within a week of PET scanning, using 1000 Hz tones of varying intensity to evoke LDAEP. We then evaluated the relationship between LDAEP and 5-HT1A or 5-HTT binding in both the raphe (5-HT1A)/midbrain (5-HTT) areas and in the temporal cortex. We found that LDAEP was significantly correlated with 5-HT1A positively and with 5-HTT negatively in the temporal cortex (p < 0.05), but not correlated with either in midbrain or raphe. In males only, exploratory analysis showed multiple regions in which LDAEP significantly correlated with 5-HT1A throughout the brain; we did not find this with 5-HTT. This multimodal study partially validates preclinical models of a serotonergic influence on LDAEP. Replication in larger samples is necessary to further clarify our understanding of the role of serotonin in perception of auditory tones.
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Affiliation(s)
| | - Elizabeth A Bartlett
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, United States
| | - Mala R Ananth
- Department of Psychiatry, Stony Brook University, United States
| | - Chencan Zhu
- Department of Applied Mathematics and Statistics, Stony Brook University, United States
| | - Jie Yang
- Department of Family, Population, and Preventive Medicine, Stony Brook University, United States
| | - Greg Hajcak
- Department of Biomedical Sciences and Psychology, Florida State University, United States
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, United States
| | - Christine DeLorenzo
- Department of Psychiatry, Stony Brook University, United States; Department of Biomedical Engineering, Stony Brook University, United States
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19
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Ananth M, Bartlett EA, DeLorenzo C, Lin X, Kunkel L, Vadhan NP, Perlman G, Godstrey M, Holzmacher D, Ogden RT, Parsey RV, Huang C. Prediction of lithium treatment response in bipolar depression using 5-HTT and 5-HT 1A PET. Eur J Nucl Med Mol Imaging 2020; 47:2417-2428. [PMID: 32055965 DOI: 10.1007/s00259-020-04681-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/02/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Lithium, one of the few effective treatments for bipolar depression (BPD), has been hypothesized to work by enhancing serotonergic transmission. Despite preclinical evidence, it is unknown whether lithium acts via the serotonergic system. Here we examined the potential of serotonin transporter (5-HTT) or serotonin 1A receptor (5-HT1A) pre-treatment binding to predict lithium treatment response and remission. We hypothesized that lower pre-treatment 5-HTT and higher pre-treatment 5-HT1A binding would predict better clinical response. Additional analyses investigated group differences between BPD and healthy controls and the relationship between change in binding pre- to post-treatment and clinical response. Twenty-seven medication-free patients with BPD currently in a depressive episode received positron emission tomography (PET) scans using 5-HTT tracer [11C]DASB, a subset also received a PET scan using 5-HT1A tracer [11C]-CUMI-101 before and after 8 weeks of lithium monotherapy. Metabolite-corrected arterial input functions were used to estimate binding potential, proportional to receptor availability. Fourteen patients with BPD with both [11C]DASB and [11C]-CUMI-101 pre-treatment scans and 8 weeks of post-treatment clinical scores were included in the prediction analysis examining the potential of either pre-treatment 5-HTT or 5-HT1A or the combination of both to predict post-treatment clinical scores. RESULTS We found lower pre-treatment 5-HTT binding (p = 0.003) and lower 5-HT1A binding (p = 0.035) were both significantly associated with improved clinical response. Pre-treatment 5-HTT predicted remission with 71% accuracy (77% specificity, 60% sensitivity), while 5-HT1A binding was able to predict remission with 85% accuracy (87% sensitivity, 80% specificity). The combined prediction analysis using both 5-HTT and 5-HT1A was able to predict remission with 84.6% accuracy (87.5% specificity, 60% sensitivity). Additional analyses BPD and controls pre- or post-treatment, and the change in binding were not significant and unrelated to treatment response (p > 0.05). CONCLUSIONS Our findings suggest that while lithium may not act directly via 5-HTT or 5-HT1A to ameliorate depressive symptoms, pre-treatment binding may be a potential biomarker for successful treatment of BPD with lithium. CLINICAL TRIAL REGISTRATION PET and MRI Brain Imaging of Bipolar Disorder Identifier: NCT01880957; URL: https://clinicaltrials.gov/ct2/show/NCT01880957.
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Affiliation(s)
- Mala Ananth
- Neurobiology & Behavior, Stony Brook University, Stony Brook, NY, 11794, USA.
| | | | - Christine DeLorenzo
- Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.,Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Xuejing Lin
- Biostatistics, Columbia University, New York, NY, USA
| | - Laura Kunkel
- Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Nehal P Vadhan
- Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Great Neck, NY, USA
| | - Greg Perlman
- Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | | | | | - R Todd Ogden
- Biostatistics, Columbia University, New York, NY, USA
| | - Ramin V Parsey
- Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.,Psychiatry, Stony Brook University, Stony Brook, NY, USA.,Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Chuan Huang
- Psychiatry, Stony Brook University, Stony Brook, NY, USA.,Radiology, Stony Brook University, Stony Brook, NY, USA
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20
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Chin Fatt CR, Jha MK, Cooper CM, Fonzo G, South C, Grannemann B, Carmody T, Greer TL, Kurian B, Fava M, McGrath PJ, Adams P, McInnis M, Parsey RV, Weissman M, Phillips ML, Etkin A, Trivedi MH. Effect of Intrinsic Patterns of Functional Brain Connectivity in Moderating Antidepressant Treatment Response in Major Depression. Am J Psychiatry 2020; 177:143-154. [PMID: 31537090 DOI: 10.1176/appi.ajp.2019.18070870] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Major depressive disorder is associated with aberrant resting-state functional connectivity across multiple brain networks supporting emotion processing, executive function, and reward processing. The purpose of this study was to determine whether patterns of resting-state connectivity between brain regions predict differential outcome to antidepressant medication (sertraline) compared with placebo. METHODS Participants in the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study underwent structural and resting-state functional MRI at baseline. Participants were then randomly assigned to receive either sertraline or placebo treatment for 8 weeks (N=279). A region of interest-based approach was utilized to compute functional connectivity between brain regions. Linear mixed-model intent-to-treat analyses were used to identify brain regions that moderated (i.e., differentially predicted) outcomes between the sertraline and placebo arms. RESULTS Prediction of response to sertraline involved several within- and between-network connectivity patterns. In general, higher connectivity within the default mode network predicted better outcomes specifically for sertraline, as did greater between-network connectivity of the default mode and executive control networks. In contrast, both placebo and sertraline outcomes were predicted (in opposite directions) by between-network hippocampal connectivity. CONCLUSIONS This study identified specific functional network-based moderators of treatment outcome involving brain networks known to be affected by major depression. Specifically, functional connectivity patterns of brain regions between and within networks appear to play an important role in identifying a favorable response for a drug treatment for major depressive disorder.
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Affiliation(s)
- Cherise R Chin Fatt
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Manish K Jha
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Crystal M Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Gregory Fonzo
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Charles South
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Bruce Grannemann
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Thomas Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Tracy L Greer
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Benji Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Maurizio Fava
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Patrick J McGrath
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Phillip Adams
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Melvin McInnis
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Ramin V Parsey
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Myrna Weissman
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Mary L Phillips
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Amit Etkin
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
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21
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Pillai RL, Chuan H, LaBella A, Mengru Z, Jie Y, Trivedi M, Weissman M, McGrath P, Fava M, Kurian B, Cooper C, McInnis M, Oquendo MA, Pizzagalli DA, Parsey RV, DeLorenzo C. Examining raphe-amygdala structural connectivity as a biological predictor of SSRI response. J Affect Disord 2019; 256:8-16. [PMID: 31158720 PMCID: PMC6750958 DOI: 10.1016/j.jad.2019.05.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 04/18/2019] [Accepted: 05/27/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Our lab has previously found that structural integrity in tracts from the raphe nucleus (RN) to the amygdala, measured by fractional anisotropy (FA), predicts remission to selective serotonin reuptake inhibitors (SSRIs) in major depressive disorder (MDD). This could potentially serve as a biomarker for remission that can guide clinical decision-making. To enhance repeatability and reproducibility, we replicated our study in a larger, more representative multi-site sample. METHODS 64 direction DTI was collected in 144 medication-free patients with MDD from the Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC) study. We performed probabilistic tractography between the RN and bilateral amygdala and hippocampus and calculated weighted FA in these tracts. Patients were treated with either sertraline or placebo, and their change in Hamilton Depression Rating Scale (HDRS) score reported. Pretreatment weighted FA was compared between remitters and nonremitters, and correlation between FA and percent change in HDRS score was assessed. Exploratory moderator and voxel analyses were also performed. RESULTS Contrary to our hypotheses, FA was greater in nonremitters than in remitters in RN-left and right amygdala tracts (p = 0.02 and 0.01, respectively). Pretreatment FA between the raphe and left amygdala correlated with greater, not reduced, HDRS (r = 0.18, p = 0.04). This finding was found to be greater in the placebo group. Moderator and voxel analyses yielded no significant findings. CONCLUSIONS We found greater FA in nonremitters between the RN and amygdala than in remitters, and a correlation between FA and symptom worsening, particularly with placebo. These findings may help reveal more about the nature of MDD, as well as guide research methods involving placebo response.
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Affiliation(s)
| | - Huang Chuan
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States,Department of Radiology, Stony Brook University, Stony Brook, NY, United States,Corresponding author at: Department of Psychiatry, Stony Brook Medicine, HSC-T10-020, Stony Brook, NY 11794, United States., (C. Huang)
| | - Andrew LaBella
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Zhang Mengru
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, United States
| | - Yang Jie
- Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Madhukar Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States
| | - Myrna Weissman
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University and the New York Psychiatric Institute, United States
| | - Patrick McGrath
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University and the New York Psychiatric Institute, United States
| | - Maurizio Fava
- Department of Psychiatry, Harvard Medical School, United States
| | - Benji Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States
| | - Crystal Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States
| | - Melvin McInnis
- Department of Psychiatry, University of Michigan, United States
| | - Maria A. Oquendo
- Department of Psychiatry, University of Pennsylvania, United States
| | | | - Ramin V. Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States
| | - Christine DeLorenzo
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States,Department of Psychiatry, Molecular Imaging and Neuropathology Division, Columbia University, New York, NY, United States
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22
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Abstract
In most positron emission tomography (PET) molecular brain imaging studies, regions of interest have been defined anatomically and examined in isolation. However, by defining regions based on physiology and examining relationships between them, we may derive more sensitive measures of receptor abnormalities in conditions such as major depressive disorder (MDD). Using an average of 52 normalized binding potential maps, acquired using radiotracer [11C]-WAY100635 and full arterial input analysis, we identified two molecular volumes of interest (VOIs) with contiguously high serotonin 1A receptor (5-HT1A) binding sites: the olfactory sulcus (OLFS) and a band of tissue including piriform, olfactory, and entorhinal cortex (PRF). We applied these VOIs to a separate cohort of 25 healthy control males and 16 males with MDD who received [11C]-WAY100635 imaging. Patients with MDD had significantly higher binding than controls in both VOIs, (p < 0.01). To identify potential homeostatic disruptions in MDD, we examined molecular connectivity, i.e. the correlation between binding of raphe nucleus (RN) 5-HT1A autoreceptors and post-synaptic receptors in molecular VOIs. Molecular connectivity was significant in healthy controls (p < 0.01), but not in patients with MDD. This disruption in molecular connectivity allowed identification of MDD cases with high sensitivity (81%) and specificity (88%).
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Affiliation(s)
| | - Mengru Zhang
- 2 Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Jie Yang
- 3 Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - J John Mann
- 4 Department of Psychiatry, Molecular Imaging and Neuropathology Division, Columbia University, New York, NY, USA
| | - Maria A Oquendo
- 5 Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Ramin V Parsey
- 1 Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- 1 Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA.,4 Department of Psychiatry, Molecular Imaging and Neuropathology Division, Columbia University, New York, NY, USA
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23
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Cooper CM, Chin Fatt CR, Jha M, Fonzo GA, Grannemann BD, Carmody T, Ali A, Aslan S, Almeida JR, Deckersbach T, Fava M, Kurian BT, McGrath PJ, McInnis M, Parsey RV, Weissman M, Phillips ML, Lu H, Etkin A, Trivedi MH. Cerebral Blood Perfusion Predicts Response to Sertraline versus Placebo for Major Depressive Disorder in the EMBARC Trial. EClinicalMedicine 2019; 10:32-41. [PMID: 31193824 PMCID: PMC6543260 DOI: 10.1016/j.eclinm.2019.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Major Depressive Disorder (MDD) has been associated with brain-related changes. However, biomarkers have yet to be defined that could "accurately" identify antidepressant-responsive patterns and reduce the trial-and-error process in treatment selection. Cerebral blood perfusion, as measured by Arterial Spin Labelling (ASL), has been used to understand resting-state brain function, detect abnormalities in MDD, and could serve as a marker for treatment selection. As part of a larger trial to identify predictors of treatment outcome, the current investigation aimed to identify perfusion predictors of treatment response in MDD. METHODS For this secondary analysis, participants include 231 individuals with MDD from the EMBARC study, a randomised, placebo-controlled trial investigating clinical, behavioural, and biological predictors of antidepressant response. Participants received sertraline (n = 114) or placebo (n = 117) and response was monitored for 8 weeks. Pre-treatment neuroimaging was completed, including ASL. A whole-brain, voxel-wise linear mixed-effects model was conducted to identify brain regions in which perfusion levels differentially predict (moderate) treatment response. Clinical effectiveness of perfusion moderators was investigated by composite moderator analysis and remission rates. Composite moderator analysis combined the effect of individual perfusion moderators and identified which contribute to sertraline or placebo as the "preferred" treatment. Remission rates were calculated for participants "accurately" treated based on the composite moderator (lucky) versus "inaccurately" treated (unlucky). FINDINGS Perfusion levels in multiple brain regions differentially predicted improvement with sertraline over placebo. Of these regions, perfusion in the putamen and anterior insula, inferior temporal gyrus, fusiform, parahippocampus, inferior parietal lobule, and orbital frontal gyrus contributed to sertraline response. Remission rates increased from 37% for all those who received sertraline to 53% for those who were lucky to have received it and sertraline was their perfusion-preferred treatment. INTERPRETATION This large study showed that perfusion patterns in brain regions involved with reward, salience, affective, and default mode processing moderate treatment response favouring sertraline over placebo. Accurately matching patients with defined perfusion patterns could significantly increase remission rates. FUNDING National Institute of Mental Health, the Hersh Foundation, and the Center for Depression Research and Clinical Care, Peter O'Donnell Brain Institute at UT Southwestern Medical Center.Trial Registration.Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care for Depression (EMARC) Registration Number: NCT01407094 (https://clinicaltrials.gov/ct2/show/NCT01407094).
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Affiliation(s)
- Crystal M. Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Cherise R. Chin Fatt
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Manish Jha
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Gregory A. Fonzo
- Department of Psychiatry and behavioural Sciences, Stanford University School of Medicine, United States of America
- Stanford Neurosciences Institute, Stanford University, United States of America
- Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, United States of America
| | - Bruce D. Grannemann
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Thomas Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Aasia Ali
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Sina Aslan
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
- Advance MRI, LLC, United States of America
| | - Jorge R.C. Almeida
- Department of Psychiatry, University of Texas Austin, United States of America
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, United States of America
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, United States of America
| | - Benji T. Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Patrick J. McGrath
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, United States of America
| | - Melvin McInnis
- Department of Psychiatry, University of Michigan School of Medicine, United States of America
| | - Ramin V. Parsey
- Departments of Psychiatry, Stony Brook University, United States of America
| | - Myrna Weissman
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, United States of America
| | - Mary L. Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America
| | - Hanzhang Lu
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
- Department of Radiology, Johns Hopkins University, United States of America
| | - Amit Etkin
- Department of Psychiatry and behavioural Sciences, Stanford University School of Medicine, United States of America
- Stanford Neurosciences Institute, Stanford University, United States of America
- Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, United States of America
| | - Madhukar H. Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
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24
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Liao A, Walker R, Carmody TJ, Cooper C, Shaw MA, Grannemann BD, Adams P, Bruder GE, McInnis MG, Webb CA, Dillon DG, Pizzagalli DA, Phillips ML, Kurian BT, Fava M, Parsey RV, McGrath PJ, Weissman MM, Trivedi MH. Anxiety and anhedonia in depression: Associations with neuroticism and cognitive control. J Affect Disord 2019; 245:1070-1078. [PMID: 30699849 PMCID: PMC9667857 DOI: 10.1016/j.jad.2018.11.072] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/10/2018] [Accepted: 11/10/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Despite the fact that higher levels of anxiety and anhedonia in Major Depressive Disorder (MDD) are linked to poorer treatment outcomes, mechanisms contributing to these clinical presentations remain unclear. Neuroticism, impaired cognitive control, and blunted reward learning may be critical processes involved in MDD and may help to explain symptoms of anxiety and anhedonia. METHODS Using baseline data from patients with early-onset MDD (N = 296) in the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) trial, we conducted a path analysis to model relationships between neuroticism, cognitive control, and reward learning to levels of anxiety and anhedonia. RESULTS Neuroticism was positively associated with both anhedonia (standardized coefficient = 0.26, p < .001) and anxiety (standardized coefficient = 0.40, p < .001). Cognitive control was negatively associated with anxiety (standardized coefficient = -0.18, p < .05). Reward learning was not significantly associated with either anxiety or anhedonia. LIMITATIONS Extraneous variables not included in the model may have even more influence in explaining symptoms of anxiety and anhedonia. Restricted range in these variables may have attenuated some of the hypothesized relationships. Most important, because this was a cross-sectional analysis in a currently depressed sample, we cannot draw any causal conclusions without experimental and longitudinal data. CONCLUSIONS These cross-sectional findings suggest that neuroticism may contribute to anxiety and anhedonia in patients with early onset and either chronic or recurrent MDD, while enhanced cognitive control may protect against anxiety.
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Affiliation(s)
- Allen Liao
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Robrina Walker
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Thomas J. Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Crystal Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | | | | | - Phil Adams
- Department of Psychiatry, Columbia University
| | | | | | | | | | | | | | - Benji T. Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | | | - Ramin V. Parsey
- Department of Psychiatry, Stonybrook University School of Medicine
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25
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Nørgaard M, Ganz M, Svarer C, Feng L, Ichise M, Lanzenberger R, Lubberink M, Parsey RV, Politis M, Rabiner EA, Slifstein M, Sossi V, Suhara T, Talbot PS, Turkheimer F, Strother SC, Knudsen GM. Cerebral serotonin transporter measurements with [ 11C]DASB: A review on acquisition and preprocessing across 21 PET centres. J Cereb Blood Flow Metab 2019; 39:210-222. [PMID: 29651896 PMCID: PMC6365604 DOI: 10.1177/0271678x18770107] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Positron Emission Tomography (PET) imaging has become a prominent tool to capture the spatiotemporal distribution of neurotransmitters and receptors in the brain. The outcome of a PET study can, however, potentially be obscured by suboptimal and/or inconsistent choices made in complex processing pipelines required to reach a quantitative estimate of radioligand binding. Variations in subject selection, experimental design, data acquisition, preprocessing, and statistical analysis may lead to different outcomes and neurobiological interpretations. We here review the approaches used in 105 original research articles published by 21 different PET centres, using the tracer [11C]DASB for quantification of cerebral serotonin transporter binding, as an exemplary case. We highlight and quantify the impact of the remarkable variety of ways in which researchers are currently conducting their studies, while implicitly expecting generalizable results across research groups. Our review provides evidence that the foundation for a given choice of a preprocessing pipeline seems to be an overlooked aspect in modern PET neuroscience. Furthermore, we believe that a thorough testing of pipeline performance is necessary to produce reproducible research outcomes, avoiding biased results and allowing for better understanding of human brain function.
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Affiliation(s)
- Martin Nørgaard
- 1 Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,2 Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Melanie Ganz
- 1 Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,3 Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Claus Svarer
- 1 Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ling Feng
- 1 Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Masanori Ichise
- 4 Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Rupert Lanzenberger
- 5 Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Mark Lubberink
- 6 Department of Nuclear Medicine and Positron Emission Tomography, Uppsala University, Uppsala, Sweden
| | - Ramin V Parsey
- 7 Department of Psychiatry, School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Marios Politis
- 8 Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Eugenii A Rabiner
- 9 Imanova Limited, London, UK.,10 Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mark Slifstein
- 7 Department of Psychiatry, School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Vesna Sossi
- 11 Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Tetsuya Suhara
- 4 Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Peter S Talbot
- 12 Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Stephen C Strother
- 14 Rotman Research Institute at Baycrest, University of Toronto, Toronto, Canada
| | - Gitte M Knudsen
- 1 Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,2 Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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26
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Trombello JM, Killian MO, Grannemann BD, Rush AJ, Mayes TL, Parsey RV, McInnis M, Jha MK, Ali A, McGrath PJ, Adams P, Oquendo MA, Weissman MM, Carmody TJ, Trivedi MH. The Concise Health Risk Tracking-Self Report: Psychometrics within a placebo-controlled antidepressant trial among depressed outpatients. J Psychopharmacol 2019; 33:185-193. [PMID: 30652941 PMCID: PMC6379122 DOI: 10.1177/0269881118817156] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND/AIMS While substantial prior research has evaluated the psychometric properties of the 12-item Concise Health Risk Tracking-Self Report (CHRT-SR12), a measure of suicide propensity and suicidal thoughts, no prior research has investigated its factor structure, sensitivity to change over time, and other psychometric properties in a placebo-controlled trial of antidepressant medication, nor determined whether symptoms change throughout treatment. METHODS Participants in the multi-site Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study ( n=278) provided data to evaluate the factor structure and sensitivity to change over time of the CHRT-SR12 through eight weeks of a clinical trial in which participants received either placebo or antidepressant medication (sertraline). RESULTS/OUTCOMES Factor analysis confirmed two factors: propensity (comprised of first-order factors including pessimism, helplessness, social support, and despair) and suicidal thoughts. Internal consistency (α's ranged from 0.69-0.92) and external validity were both acceptable, with the total score and propensity factor scores significantly correlated with total scores and single-item suicidal-thoughts scores on the self-report Quick Inventory of Depressive Symptoms and the clinician-rated 17-item Hamilton Rating Scale for Depression. Through analyzing CHRT-SR12 changes over eight treatment weeks, the total score and both the factors decreased regardless of baseline suicidal thoughts. Change in clinician-rated suicidal thoughts was reflected by change in both the total score and propensity factor score. CONCLUSIONS/INTERPRETATION These results confirm the reliability, validity, and applicability of the CHRT-SR12 to a placebo-controlled clinical trial of depressed outpatients receiving antidepressant medication.
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Affiliation(s)
- Joseph M Trombello
- 1 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Michael O Killian
- 2 College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Bruce D Grannemann
- 1 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Augustus John Rush
- 3 Department of Psychiatry, Duke Medical School, Durham, NC, USA.,5 Duke-National University of Singapore, Singapore
| | - Taryn L Mayes
- 1 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ramin V Parsey
- 6 Department of Psychiatry, Stony Brook University, Stony Brook, NY USA
| | - Melvin McInnis
- 7 Department of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Manish K Jha
- 1 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Aasia Ali
- 1 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Patrick J McGrath
- 8 Department of Psychiatry, Columbia University, New York, NY USA.,9 New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY USA
| | - Phil Adams
- 9 New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY USA
| | - Maria A Oquendo
- 10 Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Myrna M Weissman
- 8 Department of Psychiatry, Columbia University, New York, NY USA.,9 New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY USA
| | - Thomas J Carmody
- 1 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Madhukar H Trivedi
- 1 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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27
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Milak MS, Potter WA, Pantazatos SP, Keilp JG, Zanderigo F, Schain M, Sublette ME, Oquendo MA, Malone KM, Brandenburg H, Parsey RV, Mann JJ. Resting regional brain activity correlates of verbal learning deficit in major depressive disorder. Psychiatry Res Neuroimaging 2019; 283:96-103. [PMID: 30580237 DOI: 10.1016/j.pscychresns.2018.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/31/2018] [Accepted: 12/06/2018] [Indexed: 02/06/2023]
Abstract
Memory deficits are reported in major depressive disorder (MDD). Prefrontal cortical and mesiotemporal cortical (MTC)/subcortical regions are involved in the Buschke Selective Reminding Task (SRT), a verbal list-learning task. To determine whether depression-related changes in resting brain metabolism explain (in part) the deficits in SRT performance found in MDD, statistical correlation maps were calculated between SRT total recall score (TR) and relative regional cerebral metabolic rate for glucose (rCMRglu), measured by [18F]-flourodeoxyglucose (FDG) positron emission tomography (PET), in unmedicated, depressed MDD patients (N = 29). Subsequently, to explore hypothesized loss of top-down control in MDD, we compared the correlations between rCMRglu of SRT-relevant regions of the dorsolateral prefrontal cortex (dlPFC) and amygdala in a larger cohort of MDD (N = 60; 29 inclusive) versus healthy controls (HC) (N = 43). SRT performance of patients is on average 0.5 standard deviation below published normative mean. TR and rCMRglu positively correlate in bilateral dorsomedial PFC, dlPFC, dorsal anterior cingulate; negatively correlate in bilateral MTC/subcortical regions, and cerebellum. rCMRglu in dlPFC correlates negatively with that in amygdala in HC but not in MDD. Depression-related changes present in FDG-PET measured resting brain activity may be in part responsible for memory deficit found in MDD.
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Affiliation(s)
- Matthew S Milak
- Departments of Psychiatry and Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
| | - W Antonio Potter
- Departments of Psychiatry and Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Spiro P Pantazatos
- Departments of Psychiatry and Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - John G Keilp
- Departments of Psychiatry and Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Francesca Zanderigo
- Departments of Psychiatry and Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Martin Schain
- Departments of Psychiatry and Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - M Elizabeth Sublette
- Departments of Psychiatry and Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kevin M Malone
- Departments of Psychiatry and Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Holly Brandenburg
- Departments of Psychiatry and Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Ramin V Parsey
- Stony Brook Medicine, Stony Brook University, Stony Brook, NY, USA
| | - J John Mann
- Departments of Psychiatry and Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
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Prabhakaran J, DeLorenzo C, Zanderigo F, Knudsen GM, Gilling N, Pratap M, Jorgensen MJ, Daunais J, Kaplan JR, Parsey RV, Mann JJ, Kumar D. In vivo PET Imaging of [11C]CIMBI-5, a 5-HT2AR Agonist Radiotracer in Nonhuman Primates. J Pharm Pharm Sci 2019; 22:352-364. [PMID: 31356761 PMCID: PMC7453972 DOI: 10.18433/jpps30329] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE 5-HT2AR exists in high and low affinity states. Agonist PET tracers measure binding to the active high affinity site and thus provide a functionally relevant measure of the receptor. Limited in vivo data have been reported so far for a comparison of agonist versus antagonist tracers for 5-HT2AR used as a proof of principle for measurement of high and low affinity states of this receptor. We compared the in vivo binding of [11C]CIMBI-5, a 5-HT2AR agonist, and of the antagonist [11C]M100907, in monkeys and baboons. METHODS [11C]CIMBI-5 and [11C]M100907 baseline PET scans were performed in anesthetized male baboons (n=2) and male vervet monkeys (n=2) with an ECAT EXACT HR+ and GE 64-slice PET/CT Discovery VCT scanners. Blocking studies were performed in vervet monkeys by pretreatment with MDL100907 (0.5 mg/kg, i.v.) 60 minutes prior to the scan. Regional distribution volumes and binding potentials were calculated for each ROI using the likelihood estimation in graphical analysis and Logan plot, with either plasma input function or reference region as input, and simplified reference tissue model approaches. RESULTS PET imaging of [11C]CIMBI-5 in baboons and monkeys showed the highest binding in 5-HT2AR-rich cortical regions, while the lowest binding was observed in cerebellum, consistent with the expected distribution of 5-HT2AR. Very low free fractions and rapid metabolism were observed for [11C]CIMBI-5 in baboon plasma. Binding potential values for [11C]CIMBI-5 were 25-33% lower than those for [11C]MDL100907 in the considered brain regions. CONCLUSION The lower binding potential of [11C]CIMBI-5 in comparison to [11C]MDL100907 is likely due to the preferential binding of the former to the high affinity site in vivo in contrast to the antagonist, [11C]MDL100907, which binds to both high and low affinity sites.
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Affiliation(s)
- Jaya Prabhakaran
- Department of Psychiatry, Columbia University Medical Center, New York, USA. Area of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, USA
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Kumar JSD, Zanderigo F, Prabhakaran J, Rubin-Falcone H, Parsey RV, Mann JJ. In vivo evaluation of [ 11C]TMI, a COX-2 selective PET tracer, in baboons. Bioorg Med Chem Lett 2018; 28:3592-3595. [PMID: 30396759 DOI: 10.1016/j.bmcl.2018.10.049] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/27/2018] [Accepted: 10/30/2018] [Indexed: 02/02/2023]
Abstract
Overexpression of Cyclooxygenase-2 (COX-2) enzyme is associated with the pathogenesis of inflammation, cancers, stroke, arthritis, and neurological disorders. Because of the involvement of COX-2 in these diseases, quantification of COX-2 expression using Positron Emission Tomography (PET) may be a biological marker for early diagnosis, monitoring of disease progression, and an indicator of effective treatment. At present there is no target-specific or validated PET tracer available for in vivo quantification of COX-2. The objective of this study is to evaluate [11C]TMI, a selective COX-2 inhibitor (Ki ≤ 1 nM) in nonhuman primates using PET imaging. PET imaging in baboons showed that [11C]TMI penetrates the blood brain barrier (BBB) and accumulates in brain in a somewhat heterogeneous pattern. Metabolite analyses indicated that [11C]TMI undergoes no significant metabolism of parent tracer in the plasma for baseline scans, however a relative faster metabolism was found for blocking scan. All the tested quantification approaches provide comparable tracer total distribution volume (VT) estimates in the range of 3.2-7 (mL/cm3). We observed about 25% lower VT values in blocking studies with meloxicam, a nonselective COX-2 inhibitor, compared to baseline [11C]TMI binding. Our findings indicate that [11C]TMI may be a suitable PET tracer for the quantification of COX-2 in vivo. Further experiments are needed to confirm the potential of this tracer in COX-2 overexpressing models for brain diseases.
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Affiliation(s)
- J S Dileep Kumar
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA.
| | - Francesca Zanderigo
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA; Department of Psychiatry, Columbia University Medical Center, New York, USA
| | - Jaya Prabhakaran
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA; Department of Psychiatry, Columbia University Medical Center, New York, USA
| | | | - Ramin V Parsey
- Department of Psychiatry, Stony Brook Medical Center, Stony Brook, New York, USA
| | - J John Mann
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA; Department of Psychiatry, Columbia University Medical Center, New York, USA
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30
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Bartlett EA, DeLorenzo C, Sharma P, Yang J, Zhang M, Petkova E, Weissman M, McGrath PJ, Fava M, Ogden RT, Kurian BT, Malchow A, Cooper CM, Trombello JM, McInnis M, Adams P, Oquendo MA, Pizzagalli DA, Trivedi M, Parsey RV. Pretreatment and early-treatment cortical thickness is associated with SSRI treatment response in major depressive disorder. Neuropsychopharmacology 2018; 43:2221-2230. [PMID: 29955151 PMCID: PMC6135779 DOI: 10.1038/s41386-018-0122-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/30/2018] [Accepted: 06/11/2018] [Indexed: 12/19/2022]
Abstract
To date, there are no biomarkers for major depressive disorder (MDD) treatment response in clinical use. Such biomarkers could allow for individualized treatment selection, reducing time spent on ineffective treatments and the burden of MDD. In search of such a biomarker, multisite pretreatment and early-treatment (1 week into treatment) structural magnetic resonance (MR) images were acquired from 184 patients with MDD randomized to an 8-week trial of the selective serotonin reuptake inhibitor (SSRI) sertraline or placebo. This study represents a large, multisite, placebo-controlled effort to examine the association between pretreatment differences or early-treatment changes in cortical thickness and treatment-specific outcomes. For standardization, a novel, robust site harmonization procedure was applied to structural measures in a priori regions (rostral and caudal anterior cingulate, lateral orbitofrontal, rostral middle frontal, and hippocampus), chosen based on previously published reports. Pretreatment cortical thickness or volume did not significantly associate with SSRI response. Thickening of the rostral anterior cingulate cortex in the first week of treatment was associated with better 8-week responses to SSRI (p = 0.010). These findings indicate that frontal lobe structural alterations in the first week of treatment may be associated with long-term treatment efficacy. While these associational findings may help to elucidate the specific neural targets of SSRIs, the predictive accuracy of pretreatment or early-treatment structural alterations in classifying treatment remitters from nonremitters was limited to 63.9%. Therefore, in this large sample of adults with MDD, structural MR imaging measures were not found to be clinically translatable biomarkers of treatment response to SSRI or placebo.
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Affiliation(s)
- Elizabeth A. Bartlett
- 0000 0001 2216 9681grid.36425.36Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY USA
| | - Christine DeLorenzo
- 0000 0001 2216 9681grid.36425.36Department of Psychiatry, Stony Brook University, Stony Brook, NY USA
| | - Priya Sharma
- 0000 0001 2216 9681grid.36425.36Department of Psychiatry, Stony Brook University, Stony Brook, NY USA
| | - Jie Yang
- 0000 0001 2216 9681grid.36425.36Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, NY USA
| | - Mengru Zhang
- 0000 0001 2216 9681grid.36425.36Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY USA
| | - Eva Petkova
- 0000 0001 2109 4251grid.240324.3Department of Child & Adolescent Psychiatry, Department of Population Health, New York University Langone Medical Center, NY, NY USA
| | - Myrna Weissman
- 0000000419368729grid.21729.3fDepartment of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, NY, NY USA
| | - Patrick J. McGrath
- 0000000419368729grid.21729.3fDepartment of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, NY, NY USA
| | - Maurizio Fava
- 0000 0004 0386 9924grid.32224.35Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA
| | - R. Todd Ogden
- 0000000419368729grid.21729.3fDepartment of Biostatistics, Columbia University, NY, NY USA
| | - Benji T. Kurian
- 0000 0000 9482 7121grid.267313.2Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Ashley Malchow
- 0000 0000 9482 7121grid.267313.2Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Crystal M. Cooper
- 0000 0000 9482 7121grid.267313.2Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Joseph M. Trombello
- 0000 0000 9482 7121grid.267313.2Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Melvin McInnis
- 0000000086837370grid.214458.eDepartment of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Phillip Adams
- 0000000419368729grid.21729.3fDepartment of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, NY, NY USA
| | - Maria A. Oquendo
- 0000 0004 1936 8972grid.25879.31Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Diego A. Pizzagalli
- 000000041936754Xgrid.38142.3cDepartment of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Madhukar Trivedi
- 0000 0000 9482 7121grid.267313.2Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Ramin V. Parsey
- 0000 0001 2216 9681grid.36425.36Department of Psychiatry, Stony Brook University, Stony Brook, NY USA
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Miller JM, Zanderigo F, Purushothaman PD, DeLorenzo C, Rubin-Falcone H, Ogden RT, Keilp J, Oquendo MA, Nabulsi N, Huang YH, Parsey RV, Carson RE, Mann JJ. Kappa opioid receptor binding in major depression: A pilot study. Synapse 2018; 72:e22042. [PMID: 29935119 PMCID: PMC7599086 DOI: 10.1002/syn.22042] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/31/2018] [Accepted: 06/10/2018] [Indexed: 12/19/2022]
Abstract
Endogenous kappa opioids mediate pathological responses to stress in animal models. However, the relationship of the kappa opioid receptor (KOR) to life stress and to psychopathology in humans is not well described. This pilot study sought, for the first time, to quantify KOR in major depressive disorder (MDD) in vivo in humans using positron emission tomography (PET). KOR binding was quantified in vivo by PET imaging with the [11 C]GR103545 radiotracer in 13 healthy volunteers and 10 participants with current MDD. We examined the relationship between regional [11 C]GR103545 total volume of distribution (VT ) and diagnosis, childhood trauma, recent life stress, and, in a subsample, salivary cortisol levels during a modified Trier Social Stress Test (mTSST), amygdala, hippocampus, ventral striatum and raphe nuclei. Whole-brain voxel-wise analyses were also performed. [11 C]GR103545 VT did not differ significantly between MDD participants and healthy volunteers in the four a priori ROIs (p = 0.50). [11 C]GR103545 VT was unrelated to reported childhood adversity (p = 0.17) or recent life stress (p = 0.56). A trend-level inverse correlation was observed between [11 C]GR103545 VT and cortisol area-under-the curve with respect to ground during the mTSST (p = 0.081). No whole-brain voxel-wise contrasts were significant. Regional [11 C]GR103545 VT , a measure of in vivo KOR binding, does not differentiate MDD from healthy volunteers in this pilot sample. Future studies may examine KOR binding in subgroups of depressed individuals at increased risk for KOR abnormalities, including co-occurring mood and substance use disorders, as well as depression with psychotic features.
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Affiliation(s)
- Jeffrey M. Miller
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Columbia University, New York, NY
| | - Francesca Zanderigo
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Columbia University, New York, NY
| | | | - Christine DeLorenzo
- Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine
| | - Harry Rubin-Falcone
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Columbia University, New York, NY
| | - R. Todd Ogden
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - John Keilp
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Columbia University, New York, NY
| | - Maria A. Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Nabeel Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine
| | - Yiyun H. Huang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine
| | - Ramin V. Parsey
- Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine
| | - Richard E. Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine
| | - J. John Mann
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Columbia University, New York, NY
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32
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Yang J, Zhang M, Ahn H, Zhang Q, Jin TB, Li I, Nemesure M, Joshi N, Jiang H, Miller JM, Ogden RT, Petkova E, Milak MS, Sublette ME, Sullivan GM, Trivedi MH, Weissman M, McGrath PJ, Fava M, Kurian BT, Pizzagalli DA, Cooper CM, McInnis M, Oquendo MA, Mann JJ, Parsey RV, DeLorenzo C. Development and evaluation of a multimodal marker of major depressive disorder. Hum Brain Mapp 2018; 39:4420-4439. [PMID: 30113112 DOI: 10.1002/hbm.24282] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/16/2018] [Accepted: 06/04/2018] [Indexed: 12/30/2022] Open
Abstract
This study aimed to identify biomarkers of major depressive disorder (MDD), by relating neuroimage-derived measures to binary (MDD/control), ordinal (severe MDD/mild MDD/control), or continuous (depression severity) outcomes. To address MDD heterogeneity, factors (severity of psychic depression, motivation, anxiety, psychosis, and sleep disturbance) were also used as outcomes. A multisite, multimodal imaging (diffusion MRI [dMRI] and structural MRI [sMRI]) cohort (52 controls and 147 MDD patients) and several modeling techniques-penalized logistic regression, random forest, and support vector machine (SVM)-were used. An additional cohort (25 controls and 83 MDD patients) was used for validation. The optimally performing classifier (SVM) had a 26.0% misclassification rate (binary), 52.2 ± 1.69% accuracy (ordinal) and r = .36 correlation coefficient (p < .001, continuous). Using SVM, R2 values for prediction of any MDD factors were <10%. Binary classification in the external data set resulted in 87.95% sensitivity and 32.00% specificity. Though observed classification rates are too low for clinical utility, four image-based features contributed to accuracy across all models and analyses-two dMRI-based measures (average fractional anisotropy in the right cuneus and left insula) and two sMRI-based measures (asymmetry in the volume of the pars triangularis and the cerebellum) and may serve as a priori regions for future analyses. The poor accuracy of classification and predictive results found here reflects current equivocal findings and sheds light on challenges of using these modalities for MDD biomarker identification. Further, this study suggests a paradigm (e.g., multiple classifier evaluation with external validation) for future studies to avoid nongeneralizable results.
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Affiliation(s)
- Jie Yang
- Department of Family, Population and Preventive Medicine, Stony Brook University, New York, New York
| | - Mengru Zhang
- Department of Applied Mathematics and Statistics, Stony Brook University, New York, New York
| | - Hongshik Ahn
- Department of Applied Mathematics and Statistics, Stony Brook University, New York, New York
| | - Qing Zhang
- Department of Applied Mathematics and Statistics, Stony Brook University, New York, New York
| | - Tony B Jin
- Department of Psychiatry, Stony Brook University, New York, New York
| | - Ien Li
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey
| | - Matthew Nemesure
- Integrative Neuroscience Program, Binghamton University, Binghamton, New York
| | - Nandita Joshi
- Department of Electrical and Computer Engineering, Stony Brook University, New York, New York
| | - Haoran Jiang
- Department of Applied Mathematics and Statistics, Stony Brook University, New York, New York
| | - Jeffrey M Miller
- Department of Psychiatry, Columbia University, New York, New York
| | | | - Eva Petkova
- Department of Child & Adolescent Psychiatry, Department of Population Health, New York University, New York, New York
| | - Matthew S Milak
- Department of Psychiatry, Columbia University, New York, New York
| | | | - Gregory M Sullivan
- Chief Medical Officer, Clinical Research and Development program, Tonix Pharmaceuticals, Inc., New York, New York
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Myrna Weissman
- Department of Psychiatry, Columbia University, New York, New York
| | | | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Benji T Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Crystal M Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Melvin McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Maria A Oquendo
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph John Mann
- Department of Psychiatry, Columbia University, New York, New York
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, New York, New York
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33
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Trombello JM, Pizzagalli DA, Weissman MM, Grannemann BD, Cooper CM, Greer TL, Malchow AL, Jha M, Carmody TJ, Kurian BT, Webb CA, Dillon DG, McGrath PJ, Bruder G, Fava M, Parsey RV, McInnis MG, Adams P, Trivedi MH. Characterizing anxiety subtypes and the relationship to behavioral phenotyping in major depression: Results from the EMBARC study. J Psychiatr Res 2018; 102:207-215. [PMID: 29689518 PMCID: PMC6097520 DOI: 10.1016/j.jpsychires.2018.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 03/29/2018] [Accepted: 04/05/2018] [Indexed: 01/05/2023]
Abstract
The current study aimed to characterize the multifaceted nature of anxiety in patients with major depression by evaluating distinct anxiety factors. We then related these derived anxiety factors to performance on a Flanker Task of cognitive control, in order to further validate these factors. Data were collected from 195 patients with nonpsychotic chronic or recurrent major depression or dysthymic disorder. At baseline, participants completed self-report measures of anxiety, depression, and other related symptoms (mania, suicidality) and clinicians administered a structured diagnostic interview and the Hamilton Rating Scale for Depression, including anxiety/somatization items. Four discrete factors (State Anxiety, Panic, Neuroticism/Worry, and Restlessness/Agitation) emerged, with high degrees of internal consistency. Discriminant and convergent validity analyses also yielded findings in the expected direction. Furthermore, the neuroticism/worry factor was associated with Flanker Task interference, such that individuals higher on neuroticism/worry responded more incorrectly (yet faster) to incongruent vs. congruent trials whereas individuals higher on the fear/panic factor responded more slowly, with no accuracy effect, to the Flanker Task stimuli. These results parse anxiety into four distinct factors that encompass physiological, psychological, and cognitive components of anxiety. While state anxiety, panic and neuroticism/worry are related to existing measures of anxiety, the Restlessness/Agitation factor appears to be a unique measure of general anxious arousal. Furthermore, two factors were independently validated through the Flanker Task. These results suggest that these anxiety domains have distinct behavioral profiles and could have differential responses to distinct treatments.
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Affiliation(s)
- Joseph M. Trombello
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Diego A. Pizzagalli
- Harvard Medical School – McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Myrna M. Weissman
- Columbia University, Department of Psychiatry, New York, NY, USA, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Bruce D. Grannemann
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Crystal M. Cooper
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Tracy L. Greer
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Ashley L. Malchow
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Manish Jha
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Thomas J. Carmody
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Benji T. Kurian
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Christian A. Webb
- Harvard Medical School – McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Daniel G. Dillon
- Harvard Medical School – McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Patrick J. McGrath
- Columbia University, Department of Psychiatry, New York, NY, USA, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Gerard Bruder
- Columbia University, Department of Psychiatry, New York, NY, USA, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Maurizio Fava
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA
| | - Ramin V. Parsey
- Stony Brook University, Department of Psychiatry, Stony Brook, NY, USA
| | - Melvin G. McInnis
- University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA
| | - Phil Adams
- New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Madhukar H. Trivedi
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
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Milak MS, Pantazatos S, Rashid R, Zanderigo F, DeLorenzo C, Hesselgrave N, Ogden RT, Oquendo MA, Mulhern ST, Miller JM, Burke AK, Parsey RV, Mann JJ. Higher 5-HT 1A autoreceptor binding as an endophenotype for major depressive disorder identified in high risk offspring - A pilot study. Psychiatry Res Neuroimaging 2018; 276:15-23. [PMID: 29702461 PMCID: PMC5959803 DOI: 10.1016/j.pscychresns.2018.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/10/2018] [Accepted: 04/12/2018] [Indexed: 01/10/2023]
Abstract
Higher serotonin-1A (5-HT1A) receptor binding potential (BPF) has been found in major depressive disorder (MDD) during and between major depressive episodes. We investigated whether higher 5-HT1A binding is a biologic trait transmitted to healthy high risk (HR) offspring of MDD probands. Data were collected contemporaneously from: nine HR, 30 depressed not-recently medicated (NRM) MDD, 18 remitted NRM MDD, 51 healthy volunteer (HV) subjects. Subjects underwent positron emission tomography (PET) using [11C]WAY100635 to quantify 5-HT1A BPF, estimated using metabolite, free fraction-corrected arterial input function and cerebellar white matter as reference region. Multivoxel pattern analyses (MVPA) of PET data evaluated group status classification of individuals. When tested across 13 regions of interest, an effect of diagnosis is found on BPF which remains significant after correction for sex, age, injected mass and dose: HR have higher BPF than HV (84.3% higher in midbrain raphe, 40.8% higher in hippocampus, mean BPF across all 13 brain regions is 49.9% ± 11.8% higher). Voxel-level BPF maps distinguish HR vs. HV. Elevated 5-HT1A BPF appears to be a familially transmitted trait abnormality. Future studies are needed to replicate this finding in a larger cohort and demonstrate the link to the familial transmission of mood disorders.
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Affiliation(s)
- Matthew S Milak
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States.
| | - Spiro Pantazatos
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - Rain Rashid
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - Francesca Zanderigo
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | | | - Natalie Hesselgrave
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - R Todd Ogden
- Department of Biostatistics, Columbia University, Mailman School of Public Health, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, United States
| | - Stephanie T Mulhern
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - Jeffrey M Miller
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - Ainsley K Burke
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook Medicine, Stony Brook, New York, United States
| | - J John Mann
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY, United States; Department of Radiology, Columbia University, College of Physicians and Surgeons, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
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35
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Prabhakaran J, Underwood M, Zanderigo F, Simpson NR, Cooper AR, Matthew J, Rubin-Falcone H, Parsey RV, Mann JJ, Dileep Kumar JS. Radiosynthesis and in vivo evaluation of [ 11C]MOV as a PET imaging agent for COX-2. Bioorg Med Chem Lett 2018; 28:2432-2435. [PMID: 29929881 DOI: 10.1016/j.bmcl.2018.06.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/08/2018] [Accepted: 06/09/2018] [Indexed: 12/15/2022]
Abstract
Radiosynthesis and in vivo evaluation of [11C]4-[5-(4-methylphenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl]benzenesulfonamide (methoxy analogue of valdecoxib, [11C]MOV), a COX-2 inhibitor, was conducted in rat and baboon. Synthesis of the reference standard MOV (3), and its desmethyl precursor 2 for radiolabeling were performed using 1,2-diphenylethan-1-one as the starting material in five steps with 15% overall yield. Radiosynthesis of [11C]MOV was accomplished in 40 ± 10% yield and >99% radiochemical purity by reacting the precursor 2 in dimethyl formamide (DMF) with [11C]CH3I followed by removal of the dimethoxytrityl (DMT) protective group using trifluroacetic acid. PET studies in anesthetized baboon showed very low uptake and homogeneous distribution of [11C]MOV in brain. The radioligand underwent rapid metabolism in baboon plasma. MicroPET studies in male Sprague Dawley rats revealed [11C]MOV binding in lower thorax. The tracer binding in rats was partially blocked in heart and duodenum by the administration of 1 mg/kg oral dose of COX-2 inhibitor valdecoxib.
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Affiliation(s)
- Jaya Prabhakaran
- Department of Psychiatry, Columbia University Medical Center, New York, USA; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA
| | - Mark Underwood
- Department of Psychiatry, Columbia University Medical Center, New York, USA; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA
| | - Francesca Zanderigo
- Department of Psychiatry, Columbia University Medical Center, New York, USA; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA
| | - Norman R Simpson
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA
| | - Anna R Cooper
- Department of Psychiatry, Columbia University Medical Center, New York, USA
| | - Jeffrey Matthew
- Department of Psychiatry, Columbia University Medical Center, New York, USA
| | - Harry Rubin-Falcone
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook Medical Center, Stony Brook, New York, USA
| | - J John Mann
- Department of Psychiatry, Columbia University Medical Center, New York, USA; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA
| | - J S Dileep Kumar
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, USA.
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36
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Pillai RLI, Zhang M, Yang J, Boldrini M, Mann JJ, Oquendo MA, Parsey RV, DeLorenzo C. Will imaging individual raphe nuclei in males with major depressive disorder enhance diagnostic sensitivity and specificity? Depress Anxiety 2018; 35:411-420. [PMID: 29365217 PMCID: PMC5934332 DOI: 10.1002/da.22721] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/01/2017] [Accepted: 01/05/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Positron emission tomography (PET) studies in major depressive disorder (MDD) have reported higher serotonin 1A (5-HT1A ) autoreceptor binding in the raphe. In males, the difference is so large that it can potentially be used as the first biological marker for MDD. However, the raphe includes several nuclei, which project to different regions of the brain and spinal cord and may be differentially involved in disease. We aimed to identify 5-HT1A differences in individual raphe nuclei using PET in order to determine whether use of subnuclei would provide greater sensitivity and specificity of diagnosing MDD. METHODS We identified individual nuclei using a hybrid set-level technique on an average [11 C]-WAY100635 PET image derived from 52 healthy volunteers (HV). We delineated three nuclei: dorsal raphe nucleus (DRN), median raphe nucleus (MRN), and raphe magnus (RMg). An atlas image of these nuclei was created and nonlinearly warped to each subject (through an associated MRI) in a separate sample of 41 males (25 HV, 16 MDD) who underwent [11 C]-WAY100635 PET. RESULTS 5-HT1A binding was elevated in DRN in MDD (P < .01), and was not different in the RMg and MRN between groups. Receiver operating characteristic (ROC) curves showed that combining DRN and MRN produces highest sensitivity (94%) and specificity (84%) to identify MDD. CONCLUSION In agreement with postmortem studies, we found higher 5-HT1A autoreceptor binding in MDD selectively in the DRN. 5-HT1A autoreceptor binding in the combined DRN and MRN is a better biomarker for MDD than in the raphe as a whole.
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Affiliation(s)
| | - Mengru Zhang
- Department of Applied Mathematics and Statistics, Columbia University, 630 W 168 St, New York, NY 10032
| | - Jie Yang
- Department of Family, Population, & Preventive Medicine, Columbia University, 630 W 168 St, New York, NY 10032
| | - Maura Boldrini
- Department of Psychiatry, Molecular Imaging and Neuropathology Division, University of Pennsylvania, 3525 Market Street, Philadelphia, PA 19104
| | - J. John Mann
- Department of Psychiatry, Molecular Imaging and Neuropathology Division, University of Pennsylvania, 3525 Market Street, Philadelphia, PA 19104
| | - Maria A. Oquendo
- Department of Psychiatry, University of Pennsylvania, 3525 Market Street, Philadelphia, PA 19104
| | - Ramin V. Parsey
- Department of Psychiatry, Stony Brook University, 101 Nicolls Rd, Stony Brook NY 11794
| | - Christine DeLorenzo
- Department of Psychiatry, Stony Brook University, 101 Nicolls Rd, Stony Brook NY 11794,Department of Psychiatry, Molecular Imaging and Neuropathology Division, University of Pennsylvania, 3525 Market Street, Philadelphia, PA 19104
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37
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Esterlis I, DellaGioia N, Pietrzak RH, Matuskey D, Nabulsi N, Abdallah CG, Yang J, Pittenger C, Sanacora G, Krystal JH, Parsey RV, Carson RE, DeLorenzo C. Ketamine-induced reduction in mGluR5 availability is associated with an antidepressant response: an [ 11C]ABP688 and PET imaging study in depression. Mol Psychiatry 2018; 23:824-832. [PMID: 28397841 PMCID: PMC5636649 DOI: 10.1038/mp.2017.58] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/28/2016] [Accepted: 01/24/2017] [Indexed: 12/13/2022]
Abstract
The mechanisms of action of the rapid antidepressant effects of ketamine, an N-methyl-D-aspartate glutamate receptor antagonist, have not been fully elucidated. This study examined the effects of ketamine on ligand binding to a metabotropic glutamatergic receptor (mGluR5) in individuals with major depressive disorder (MDD) and healthy controls. Thirteen healthy and 13 MDD nonsmokers participated in two [11C]ABP688 positron emission tomography (PET) scans on the same day-before and during intravenous ketamine administration-and a third scan 1 day later. At baseline, significantly lower [11C]ABP688 binding was detected in the MDD as compared with the control group. We observed a significant ketamine-induced reduction in mGluR5 availability (that is, [11C]ABP688 binding) in both MDD and control subjects (average of 14±9% and 19±22%, respectively; P<0.01 for both), which persisted 24 h later. There were no differences in ketamine-induced changes between MDD and control groups at either time point (P=0.8). A significant reduction in depressive symptoms was observed following ketamine administration in the MDD group (P<0.001), which was associated with the change in binding (P<0.04) immediately after ketamine. We hypothesize that glutamate released after ketamine administration moderates mGluR5 availability; this change appears to be related to antidepressant efficacy. The sustained decrease in binding may reflect prolonged mGluR5 internalization in response to the glutamate surge.
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Affiliation(s)
- Irina Esterlis
- Yale University Department of Psychiatry
- Yale University Department of Radiology and Biomedical Imaging
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System
| | | | - Robert H. Pietrzak
- Yale University Department of Psychiatry
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System
| | - David Matuskey
- Yale University Department of Psychiatry
- Yale University Department of Radiology and Biomedical Imaging
| | - Nabeel Nabulsi
- Yale University Department of Radiology and Biomedical Imaging
| | - Chadi G. Abdallah
- Yale University Department of Psychiatry
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System
| | - Jie Yang
- Stony Brook University Department of Preventive Medicine
| | | | | | - John H. Krystal
- Yale University Department of Psychiatry
- Yale University Department of Neuroscience
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System
| | - Ramin V. Parsey
- Stony Brook University Department of Psychiatry
- Stony Brook University Department of Biomedical Engineering
- Stony Brook University Department of Radiology
| | - Richard E. Carson
- Yale University Department of Radiology and Biomedical Imaging
- Yale University Department of Biomedical Engineering
| | - Christine DeLorenzo
- Stony Brook University Department of Psychiatry
- Stony Brook University Department of Biomedical Engineering
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38
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Zanderigo F, D’Agostino AE, Joshi N, Schain M, Kumar D, Parsey RV, DeLorenzo C, Mann JJ. [11C]Harmine Binding to Brain Monoamine Oxidase A: Test-Retest Properties and Noninvasive Quantification. Mol Imaging Biol 2018; 20:667-681. [DOI: 10.1007/s11307-018-1165-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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39
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Pillai RLI, Malhotra A, Rupert DD, Weschler B, Williams JC, Zhang M, Yang J, Mann JJ, Oquendo MA, Parsey RV, DeLorenzo C. Relations between cortical thickness, serotonin 1A receptor binding, and structural connectivity: A multimodal imaging study. Hum Brain Mapp 2017; 39:1043-1055. [PMID: 29323797 DOI: 10.1002/hbm.23903] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 11/19/2017] [Accepted: 11/22/2017] [Indexed: 01/03/2023] Open
Abstract
Serotonin 1A (5-HT1A ) receptors play a direct role in neuronal development, cell proliferation, and dendritic branching. We hypothesized that variability in 5-HT1A binding can affect cortical thickness, and may account for a subtype of major depressive disorder (MDD) in which both are altered. To evaluate this, we measured cortical thickness from structural magnetic resonance imaging (MRI) and 5-HT1A binding by positron emission tomography (PET) in an exploratory study. To examine a range of 5-HT1A binding and cortical thickness values, we recruited 25 healthy controls and 19 patients with MDD. We hypothesized increased 5-HT1A binding in the raphe nucleus (RN) would be negatively associated with cortical thickness due to reduced serotonergic transmission. Contrary to our hypothesis, raphe 5-HT1A binding was positively correlated with cortical thickness in right posterior cingulate cortex (PCC), a region implicated in the default mode network. Cortical thickness was also positively correlated with 5-HT1A in each cortical region. We further hypothesized that the strength of 5-HT1A -cortical thickness correlation depends on the number of axons between the raphe nucleus and each region. To explore this we related 5-HT1A -cortical thickness correlation coefficients to the number of tracts connecting that region and the raphe, as measured by diffusion tensor imaging (DTI) in an independent sample. The 5-HT1A -cortical thickness association correlated significantly with the number of tracts to each region, supporting our hypothesis. We posit a defect in the raphe may affect the PCC within the default mode network in MDD through serotonergic fibers, resulting in increased ruminative processing.
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Affiliation(s)
- Rajapillai L I Pillai
- Stony Brook University SOM, Stony Brook, New York.,Department of Psychiatry, Stony Brook University, Stony Brook, New York.,Center for Understanding Biology using Imaging Technology, Stony Brook University, Stony Brook, New York
| | - Ashwin Malhotra
- Department of Neurology, New York-Presbyterian Weill Cornell Medical Center, New York, New York
| | | | | | | | - Mengru Zhang
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, New York
| | - Jie Yang
- Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, New York
| | - J John Mann
- Department of Biomedical Engineering, Columbia University, New York, New York
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philidelphia, Pennsylvania
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, New York.,Center for Understanding Biology using Imaging Technology, Stony Brook University, Stony Brook, New York
| | - Christine DeLorenzo
- Department of Psychiatry, Stony Brook University, Stony Brook, New York.,Center for Understanding Biology using Imaging Technology, Stony Brook University, Stony Brook, New York.,Department of Biomedical Engineering, Columbia University, New York, New York
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40
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Iscan Z, Rakesh G, Rossano S, Yang J, Zhang M, Miller J, Sullivan GM, Sharma P, McClure M, Oquendo MA, Mann JJ, Parsey RV, DeLorenzo C. A positron emission tomography study of the serotonergic system in relation to anxiety in depression. Eur Neuropsychopharmacol 2017; 27:1011-1021. [PMID: 28811068 PMCID: PMC5623123 DOI: 10.1016/j.euroneuro.2017.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 06/02/2017] [Accepted: 07/29/2017] [Indexed: 12/17/2022]
Abstract
Symptoms of anxiety are highly comorbid with major depressive disorder (MDD) and are known to alter the course of the disease. To help elucidate the biological underpinnings of these prevalent disorders, we previously examined the relationship between components of anxiety (somatic, psychic and motoric) and serotonin 1A receptor (5-HT1A) binding in MDD and found that higher psychic and lower somatic anxiety was associated with greater 5-HT1A binding. In this work, we sought to examine the correlation between these anxiety symptom dimensions and 5-HTT binding. Positron emission tomography with [11C]-3-amino-4-(3-dimethylamino-methylphenylsulfanyl)-benzonitrile ([11C]DASB) and a metabolite-corrected arterial input function were used to estimate regional 5-HTT binding in 55 subjects with MDD and anxiety symptoms. Somatic anxiety was negatively correlated with 5-HTT binding in the thalamus (β=-.33, p=.025), amygdala (β=-.31, p=.007) and midbrain (β=-.72, p<.001). Psychic anxiety was positively correlated with 5-HTT binding in midbrain only (β=.46, p=.0025). To relate to our previous study, correlation between 5-HT1A and 5-HTT binding was examined, and none was found. We also examined how much of the variance in anxiety symptom dimensions could be explained by both 5-HTT and 5-HT1A binding. The developed model was able to explain 68% (p<.001), 38% (p=.012) and 32% (p=.038) of the total variance in somatic, psychic, and motoric anxiety, respectively. Results indicate the tight coupling between the serotonergic system and anxiety components, which may be confounded when using aggregate anxiety measures. Uncovering serotonin's role in anxiety and depression in this way may give way to a new generation of therapeutics and treatment strategies.
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Affiliation(s)
- Zafer Iscan
- Centre for Cognition and Decision Making, National Research University, Higher School of Economics, Russian Federation; Cognitive Neuroimaging Unit, CEA DRF/Joliot Institute, INSERM, Université Paris-Sud, Université Paris-Saclay, NeuroSpin Center, 91191 Gif-sur-Yvette, France.
| | | | - Samantha Rossano
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Jie Yang
- Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Mengru Zhang
- Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Jeffrey Miller
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Gregory M Sullivan
- Tonix Pharmaceuticals, Inc., 509 Madison Avenue Suite 306, New York, NY, USA
| | - Priya Sharma
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Matthew McClure
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Maria A Oquendo
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - J John Mann
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA; Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA; New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
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41
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Ananth MR, DeLorenzo C, Yang J, Mann JJ, Parsey RV. Decreased Pretreatment Amygdalae Serotonin Transporter Binding in Unipolar Depression Remitters: A Prospective PET Study. J Nucl Med 2017; 59:665-670. [PMID: 28935838 DOI: 10.2967/jnumed.117.189654] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 07/25/2017] [Indexed: 01/11/2023] Open
Abstract
Major depressive disorder (MDD) is a debilitating condition that affects over 14 million Americans. Remission occurs only in a minority of individuals after first-line antidepressant treatment (∼35%); predictors of treatment outcome are therefore needed. Using PET imaging with a radiotracer specific for the serotonin transporter (5-HTT), 11C-McN5652, we found that patients with MDD who did not achieve remission after 12 mo of naturalistic treatment had lower pretreatment midbrain and amygdala binding than healthy volunteers. Here, using a superior 5-HTT tracer, 11C-DASB, we repeated this study with a prospective design with 8 wk of standardized treatment with escitalopram. As this same cohort also underwent 11C-WAY100635 scans (serotonin-1A receptor [5-HT1A]), we examined whether using both pretreatment 5-HTT and 5-HT1A binding could improve prediction of posttreatment remission status. Methods: Thirty-one healthy controls (Hamilton Depression Rating Scale-24 item [HDRS-24] = 1.7) and 26 medication-free patients with MDD (HDRS-24 = 24.8) underwent PET scanning using 11C-DASB. MDD subjects then received 8 wk of standardized pharmacotherapy with escitalopram. The relationship between pretreatment binding and posttreatment clinical status was examined. Arterial blood samples were collected to calculate the metabolite-corrected arterial input function. The outcome measure was VT/fP (VT is volume of distribution in region of interest, fP is free fraction in plasma). Remission was defined as a posttreatment depression score of less than 10 as well as 50% or more reduction in the score from baseline, resulting in 14 nonremitters (HDRS-24 = 17.6) and 12 remitters (HDRS-24 = 5.3). Results: A linear mixed-effects model comparing group differences in the a priori regions of interest (amygdala and midbrain) revealed a significant difference in amygdala binding between controls and remitters (P = 0.03, unadjusted), where remitters had an 11% lower amygdala binding than controls. Differences in amygdala binding between remitters and nonremitters approached significance (P = 0.06). No additional differences were found between any groups (all P > 0.05). Additionally, we found no relationship between pretreatment amygdala binding and posttreatment depression score, and were unable to predict posttreatment depression severity using both pretreatment 5-HTT (in the amygdala) and 5-HT1A binding (in the raphe). Conclusion: These results suggest 5-HTT amygdala binding should be examined further, in conjunction with other measures, as a potential biomarker for remission after standardized escitalopram treatment.
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Affiliation(s)
- Mala R Ananth
- Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, New York
| | - Christine DeLorenzo
- Psychiatry, Stony Brook University, Stony Brook, New York.,Biomedical Engineering, Stony Brook University, Stony Brook, New York.,Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, New York; and
| | - Jie Yang
- Family, Population and Preventative Medicine, Stony Brook University, Stony Brook, New York
| | - J John Mann
- Family, Population and Preventative Medicine, Stony Brook University, Stony Brook, New York
| | - Ramin V Parsey
- Psychiatry, Stony Brook University, Stony Brook, New York.,Biomedical Engineering, Stony Brook University, Stony Brook, New York
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42
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DeLorenzo C, Gallezot JD, Gardus J, Yang J, Planeta B, Nabulsi N, Ogden RT, Labaree DC, Huang YH, Mann JJ, Gasparini F, Lin X, Javitch JA, Parsey RV, Carson RE, Esterlis I. In vivo variation in same-day estimates of metabotropic glutamate receptor subtype 5 binding using [ 11C]ABP688 and [ 18F]FPEB. J Cereb Blood Flow Metab 2017; 37:2716-2727. [PMID: 27742888 PMCID: PMC5536783 DOI: 10.1177/0271678x16673646] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 08/02/2016] [Accepted: 09/12/2016] [Indexed: 01/11/2023]
Abstract
Positron emission tomography tracers [11C]ABP688 and [18F]FPEB target the metabotropic glutamate receptor subtype 5 providing quantification of the brain glutamatergic system in vivo. Previous [11C]ABP688 positron emission tomography human test-retest studies indicate that, when performed on the same day, significant binding increases are observed; however, little deviation is reported when scans are >7 days apart. Due to the small cohorts examined previously (eight and five males, respectively), we aimed to replicate the same-day test-retest studies in a larger cohort including both males and females. Results confirmed large within-subject binding differences (ranging from -23% to 108%), suggesting that measurements are greatly affected by study design. We further investigated whether this phenomenon was specific to [11C]ABP688. Using [18F]FPEB and methodology that accounts for residual radioactivity from the test scan, four subjects were scanned twice on the same day. In these subjects, binding estimates increased between 5% and 39% between scans. Consistent with [11C]ABP688, mean absolute test-retest variability was previously reported as <12% when scans were >21 days apart. This replication study and pilot extension to [18F]FPEB suggest that observed within-day binding variation may be due to characteristics of mGluR5; for example, diurnal variation in mGluR5 may affect measurement of this receptor.
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Affiliation(s)
- Christine DeLorenzo
- Department of Psychiatry, Stony Brook University, Stony Brook, USA
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, USA
- Department of Psychiatry, Columbia University, New York, USA
| | | | - John Gardus
- Department of Psychiatry, Stony Brook University, Stony Brook, USA
| | - Jie Yang
- Department of Preventive Medicine, Stony Brook University, Stony Brook, USA
| | - Beata Planeta
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, USA
| | - Nabeel Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, USA
| | - R Todd Ogden
- Department of Psychiatry, Columbia University, New York, USA
| | - David C Labaree
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, USA
| | - Yiyun H Huang
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, USA
| | - J John Mann
- Department of Psychiatry, Columbia University, New York, USA
| | | | - Xin Lin
- Department of Psychiatry, Columbia University, New York, USA
- Division of Molecular Therapeutics, New York State Psychiatric Institute, New York, USA
| | - Jonathan A Javitch
- Department of Psychiatry, Columbia University, New York, USA
- Division of Molecular Therapeutics, New York State Psychiatric Institute, New York, USA
- Department of Pharmacology, Columbia University, New York, USA
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, USA
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, USA
- Department of Radiology, Stony Brook University, Stony Brook, USA
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, USA
- Department of Biomedical Engineering, Yale University, New Haven, USA
| | - Irina Esterlis
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, USA
- Department of Psychiatry, Yale University, New Haven, USA
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Gheorghiade M, Larson CJ, Shah SJ, Greene SJ, Cleland JGF, Colucci WS, Dunnmon P, Epstein SE, Kim RJ, Parsey RV, Stockbridge N, Carr J, Dinh W, Krahn T, Kramer F, Wahlander K, Deckelbaum LI, Crandall D, Okada S, Senni M, Sikora S, Sabbah HN, Butler J. Developing New Treatments for Heart Failure: Focus on the Heart. Circ Heart Fail 2017; 9:CIRCHEARTFAILURE.115.002727. [PMID: 27166246 DOI: 10.1161/circheartfailure.115.002727] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 03/15/2016] [Indexed: 11/16/2022]
Abstract
Compared with heart failure (HF) care 20 to 30 years ago, there has been tremendous advancement in therapy for ambulatory HF with reduced ejection fraction with the use of agents that block maladaptive neurohormonal pathways. However, during the past decade, with few notable exceptions, the frequency of successful drug development programs has fallen as most novel therapies have failed to offer incremental benefit or raised safety concerns (ie, hypotension). Moreover, no therapy has been approved specifically for HF with preserved ejection fraction or for worsening chronic HF (including acutely decompensated HF). Across the spectrum of HF, preliminary results from many phase II trials have been promising but are frequently followed by unsuccessful phase III studies, highlighting a disconnect in the translational process between basic science discovery, early drug development, and definitive clinical testing in pivotal trials. A major unmet need in HF drug development is the ability to identify homogeneous subsets of patients whose underlying disease is driven by a specific mechanism that can be targeted using a new therapeutic agent. Drug development strategies should increasingly consider therapies that facilitate reverse remodeling by directly targeting the heart itself rather than strictly focusing on agents that unload the heart or target systemic neurohormones. Advancements in cardiac imaging may allow for more focused and direct assessment of drug effects on the heart early in the drug development process. To better understand and address the array of challenges facing current HF drug development, so that future efforts may have a better chance for success, the Food and Drug Administration facilitated a meeting on February 17, 2015, which was attended by clinicians, researchers, regulators, and industry representatives. The following discussion summarizes the key takeaway dialogue from this meeting.
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Affiliation(s)
- Mihai Gheorghiade
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.).
| | - Christopher J Larson
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Sanjiv J Shah
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Stephen J Greene
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - John G F Cleland
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Wilson S Colucci
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Preston Dunnmon
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Stephen E Epstein
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Raymond J Kim
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Ramin V Parsey
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Norman Stockbridge
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - James Carr
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Wilfried Dinh
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Thomas Krahn
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Frank Kramer
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Karin Wahlander
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Lawrence I Deckelbaum
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - David Crandall
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Shunichiro Okada
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Michele Senni
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Sergey Sikora
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Hani N Sabbah
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
| | - Javed Butler
- From the Center for Cardiovascular Innovation (M.G.) and Division of Cardiology (S.J.S.), Northwestern Feinberg School of Medicine, Northwestern University, Chicago, IL; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, Chicago, IL (C.J.L., S.O.); Division of Cardiology, Duke University Medical Center, Durham, NC (S.J.G., R.J.K.); National Heart & Lung Institute, Imperial College, London, United Kingdom (J.G.F.C.); Cardiovascular Medicine Section, Boston University School of Medicine and Boston Medical Center, MA (W.S.C.); Division of Cardiovascular and Renal Products, the United States Food and Drug Administration, Silver Spring, MD (P.D., N.S.); MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC (S.E.E.); Psychiatry Department (R.V.P.) and Cardiology Division (J.B.), Stony Brook University, NY; Stealth Bio Therapeutics, Philadelphia, PA (J.C.); Global Drug Discovery, Bayer HealthCare AG, Wuppertal, Germany (W.D., T.K., F.K.); Department of Cardiology, Witten University, Witten, Germany (W.D.); Astra Zeneca Research and Development, Gothenburg, Sweden (K.W.); CSL Behring, Philadelphia, PA (L.I.D.); Sunovion Pharmaceuticals Inc, Marlborough, MA (D.C.); Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy (M.S.); Cardiocell Inc, San Diego, CA (S.S.); and Cardiology Division, Henry Ford Hospital, Detroit, MI (H.N.S.)
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Delaparte L, Yeh FC, Adams P, Malchow A, Trivedi MH, Oquendo MA, Deckersbach T, Ogden T, Pizzagalli DA, Fava M, Cooper C, McInnis M, Kurian BT, Weissman MM, McGrath PJ, Klein DN, Parsey RV, DeLorenzo C. A comparison of structural connectivity in anxious depression versus non-anxious depression. J Psychiatr Res 2017; 89:38-47. [PMID: 28157545 PMCID: PMC5374003 DOI: 10.1016/j.jpsychires.2017.01.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/16/2016] [Accepted: 01/19/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) and anxiety disorders are highly co-morbid. Research has shown conflicting evidence for white matter alteration and amygdala volume reduction in mood and anxiety disorders. To date, no studies have examined differences in structural connectivity between anxious depressed and non-anxious depressed individuals. This study compared fractional anisotropy (FA) and density of selected white matter tracts and amygdala volume between anxious depressed and non-anxious depressed individuals. METHODS 64- direction DTI and T1 scans were collected from 110 unmedicated subjects with MDD, 39 of whom had a co-morbid anxiety disorder diagnosis. Region of interest (ROI) and tractography methods were performed to calculate amygdala volume and FA in the uncinate fasciculus, respectively. Diffusion connectometry was performed to identify whole brain group differences in white matter health. Correlations were computed between biological and clinical measures. RESULTS Tractography and ROI analyses showed no significant differences between bilateral FA values or bilateral amygdala volumes when comparing the anxious depressed and non-anxious depressed groups. The diffusion connectometry analysis showed no significant differences in anisotropy between the groups. Furthermore, there were no significant relationships between MRI-based and clinical measures. CONCLUSION The lack of group differences could indicate that structural connectivity and amygdalae volumes of those with anxious-depression are not significantly altered by a co-morbid anxiety disorder. Improving understanding of anxiety co-morbid with MDD would facilitate development of treatments that more accurately target the underlying networks.
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Affiliation(s)
- Lauren Delaparte
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA; Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA.
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pittsburgh
| | - Phil Adams
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, New York
| | - Ashley Malchow
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Madhukar H. Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Maria A. Oquendo
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, New York
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Todd Ogden
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, New York
| | | | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Crystal Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Melvin McInnis
- Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Benji T. Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Myrna M. Weissman
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, New York
| | - Patrick J. McGrath
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, New York
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | - Ramin V. Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, New York,Department of Radiology, Stony Brook University, Stony Brook, New York
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Lan MJ, Ogden RT, Kumar D, Stern Y, Parsey RV, Pelton GH, Rubin-Falcone H, Pradhaban G, Zanderigo F, Miller JM, Mann JJ, Devanand DP. Utility of Molecular and Structural Brain Imaging to Predict Progression from Mild Cognitive Impairment to Dementia. J Alzheimers Dis 2017; 60:939-947. [PMID: 28984586 PMCID: PMC5679746 DOI: 10.3233/jad-161284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This project compares three neuroimaging biomarkers to predict progression to dementia in subjects with mild cognitive impairment (MCI). Eighty-eight subjects with MCI and 40 healthy controls (HCs) were recruited. Subjects had a 3T magnetic resonance imaging (MRI) scan, and two positron emission tomography (PET) scans, one with Pittsburgh compound B ([11C]PIB) and one with fluorodeoxyglucose ([18F]FDG). MCI subjects were followed for up to 4 y and progression to dementia was assessed on an annual basis. MCI subjects had higher [11C]PIB binding potential (BPND) than HCs in multiple brain regions, and lower hippocampus volumes. [11C]PIB BPND, [18F]FDG standard uptake value ratio (SUVR), and hippocampus volume were associated with time to progression to dementia using a Cox proportional hazards model. [18F]FDG SUVR demonstrated the most statistically significant association with progression, followed by [11C]PIB BPND and then hippocampus volume. [11C]PIB BPND and [18F]FDG SUVR were independently predictive, suggesting that combining these measures is useful to increase accuracy in the prediction of progression to dementia. Hippocampus volume also had independent predictive properties to [11C]PIB BPND, but did not add predictive power when combined with the [18F]FDG SUVR data. This work suggests that PET imaging with both [11C]PIB and [18F]FDG may help to determine which MCI subjects are likely to progress to AD, possibly directing future treatment options.
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Affiliation(s)
- Martin J Lan
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - R Todd Ogden
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Dileep Kumar
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Yaakov Stern
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Taub Institute for Research on Alzheimer's Disease and Aging Brain, New York, NY, USA
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Gregory H Pelton
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, USA
- Taub Institute for Research on Alzheimer's Disease and Aging Brain, New York, NY, USA
| | - Harry Rubin-Falcone
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Gnanavalli Pradhaban
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Francesca Zanderigo
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Jeffrey M Miller
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - J John Mann
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - D P Devanand
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, USA
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Oquendo MA, Galfalvy H, Sullivan GM, Miller JM, Milak MM, Sublette ME, Cisneros-Trujillo S, Burke AK, Parsey RV, Mann JJ. Positron Emission Tomographic Imaging of the Serotonergic System and Prediction of Risk and Lethality of Future Suicidal Behavior. JAMA Psychiatry 2016; 73:1048-1055. [PMID: 27463606 PMCID: PMC6552665 DOI: 10.1001/jamapsychiatry.2016.1478] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Biomarkers that predict suicidal behavior, especially highly lethal behavior, are urgently needed. In cross-sectional studies, individuals with depression who attempt suicide have lower midbrain serotonin transporter binding potential compared with those who do not attempt suicide, and higher serotonin1A binding potential in the raphe nuclei (RN) is associated with greater lethality of past suicide attempts and suicidal intent and ideation. OBJECTIVES To determine whether serotonin transporter binding potential in the lower midbrain predicts future suicide attempts and whether higher RN serotonin1A binding potential predicts future suicidal ideation and intent and lethality of future suicide attempts. DESIGN, SETTING, AND PARTICIPANTS In this prospective 2-year observational study, a well-characterized cohort of 100 patients presenting for treatment of a major depressive episode of at least moderate severity underwent positron emission tomography using carbon 11-labeled N-(2-(1-(4-(2-methoxyphenyl)-1-piperazinyl)ethyl))-N-(2-pyridyl)-cyclohexanecarboxamide ([11C]WAY-100635), a serotonin1A antagonist; a subset of 50 patients also underwent imaging with carbon 11-labeled 3-amino-4-(2-dimethylaminomethyl-phenylsulfanyl)- benzonitrile ([11C]DASB), a serotonin transporter radioligand. Imaging was performed at Columbia University Medical Center from May 3, 1999, to March 11, 2008. Follow-up was completed on May 28, 2010, and data were analyzed from August 1, 2013, to March 1, 2016. EXPOSURES Patients were treated naturalistically in the community and followed up for 2 years with documentation of suicidal behavior, its lethality, and suicidal ideation and intent. MAIN OUTCOMES AND MEASURES Suicide attempt or suicide. RESULTS Of the 100 patients undergoing follow-up for more than 2 years (39 men; 61 women; mean [SD] age, 40.2 [11.2] years), 15 made suicide attempts, including 2 who died by suicide. Higher RN serotonin1A binding potential predicted more suicidal ideation at 3 (b = 0.02; t = 3.45; P = .001) and 12 (b = 0.02; t = 3.63; P = .001) months and greater lethality of subsequent suicidal behavior (b = 0.08; t = 2.89; P = .01). Exploratory analyses suggest that the serotonin1A binding potential of the insula (t = 2.41; P = .04), anterior cingulate (t = 2.27; P = .04), and dorsolateral prefrontal cortex (t = 2.44; P = .03) were also predictive of lethality. Contrary to our hypotheses, suicidal intent was not predicted by serotonin1A binding potential in any brain region (F1,10 = 0.83; P = .38), and midbrain serotonin transporter binding potential did not predict future attempts (log-rank χ21 = 0.4; P = .54), possibly owing to low power. CONCLUSIONS AND RELEVANCE Greater RN serotonin1A binding potential predicted higher suicidal ideation and more lethal suicidal behavior during a 2-year period. This effect may be mediated through less serotonin neuron firing and release, which affects mood and suicidal ideation and thereby decision making.
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Affiliation(s)
- Maria A. Oquendo
- New York State Psychiatric Institute, New York,Department of Psychiatry, Columbia University, New York, New York
| | - Hanga Galfalvy
- New York State Psychiatric Institute, New York,Department of Psychiatry, Columbia University, New York, New York
| | | | - Jeffrey M. Miller
- New York State Psychiatric Institute, New York,Department of Psychiatry, Columbia University, New York, New York
| | - Matthew M. Milak
- New York State Psychiatric Institute, New York,Department of Psychiatry, Columbia University, New York, New York
| | - M. Elizabeth Sublette
- New York State Psychiatric Institute, New York,Department of Psychiatry, Columbia University, New York, New York
| | - Sebastian Cisneros-Trujillo
- New York State Psychiatric Institute, New York,Department of Psychiatry, Columbia University, New York, New York
| | - Ainsley K. Burke
- New York State Psychiatric Institute, New York,Department of Psychiatry, Columbia University, New York, New York
| | - Ramin V. Parsey
- Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine, Stony Brook, New York
| | - J. John Mann
- New York State Psychiatric Institute, New York,Department of Radiology, Columbia University, New York, New York
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Strupp-Levitsky M, Miller JM, Rubin-Falcone H, Zanderigo F, Milak MS, Sullivan G, Ogden RT, Oquendo MA, DeLorenzo C, Simpson N, Parsey RV, Mann JJ. Lack of association between the serotonin transporter and serotonin 1A receptor: an in vivo PET imaging study in healthy adults. Psychiatry Res 2016; 255:81-86. [PMID: 27567324 PMCID: PMC5175477 DOI: 10.1016/j.pscychresns.2016.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/11/2016] [Accepted: 08/06/2016] [Indexed: 01/12/2023]
Abstract
The serotonin neurotransmitter system is modulated in part by the uptake of synaptically released serotonin (5-HT) by the serotonin transporter (5-HTT), and by specific serotonin autoreceptors such as the somatodendritic 5-HT1A receptor, which can limit serotonin neuron depolarization. However, little is known about how 5-HTT and 5-HT1A are related in vivo. To study this question, we reanalyzed positron emission tomography (PET) data obtained earlier in 40 healthy participants (21 females) using [(11)C]WAY-100635 for quantification of 5-HT1A binding and [(11)C](+)-McN-5652 for quantification of 5-HTT binding. We hypothesized negative correlations between 5-HT1A binding in the raphe nuclei (RN) and 5-HTT binding in RN terminal field regions. Controlling for sex, no significant correlations were found (all p>0.05). Similarly, an exploratory analysis correlating whole-brain voxel-wise 5-HTT binding with 5-HT1A binding in RN identified no significant clusters meeting our a priori statistical threshold. The lack of correlation between 5-HT1A and 5-HTT binding observed in the current study may be due to the different temporal responsiveness of regulatory processes controlling the somatodendritic 5-HT1A receptor and 5-HTT in response to changing availability of intrasynaptic serotonin.
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Affiliation(s)
- Michael Strupp-Levitsky
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive #42, New York, NY 10032, USA
| | - Jeffrey M Miller
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive #42, New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Drive #42, New York, NY 10032, USA.
| | - Harry Rubin-Falcone
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive #42, New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Drive #42, New York, NY 10032, USA
| | - Francesca Zanderigo
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive #42, New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Drive #42, New York, NY 10032, USA
| | - Matthew S Milak
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive #42, New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Drive #42, New York, NY 10032, USA
| | - Gregory Sullivan
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive #42, New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Drive #42, New York, NY 10032, USA
| | - R Todd Ogden
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive #42, New York, NY 10032, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Maria A Oquendo
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive #42, New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Drive #42, New York, NY 10032, USA
| | - Christine DeLorenzo
- Now at Department of Psychiatry, Department of Radiology, Stony Brook Medicine, Stony Brook, NY, USA
| | - Norman Simpson
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive #42, New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Drive #42, New York, NY 10032, USA
| | - Ramin V Parsey
- Now at Department of Psychiatry, Department of Radiology, Stony Brook Medicine, Stony Brook, NY, USA
| | - J John Mann
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive #42, New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Drive #42, New York, NY 10032, USA
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Trivedi MH, McGrath PJ, Fava M, Parsey RV, Kurian BT, Phillips ML, Oquendo MA, Bruder G, Pizzagalli D, Toups M, Cooper C, Adams P, Weyandt S, Morris DW, Grannemann BD, Ogden RT, Buckner R, McInnis M, Kraemer HC, Petkova E, Carmody TJ, Weissman MM. Establishing moderators and biosignatures of antidepressant response in clinical care (EMBARC): Rationale and design. J Psychiatr Res 2016; 78:11-23. [PMID: 27038550 PMCID: PMC6100771 DOI: 10.1016/j.jpsychires.2016.03.001] [Citation(s) in RCA: 180] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 03/02/2016] [Accepted: 03/03/2016] [Indexed: 12/28/2022]
Abstract
UNLABELLED Remission rates for Major Depressive Disorder (MDD) are low and unpredictable for any given antidepressant. No biological or clinical marker has demonstrated sufficient ability to match individuals to efficacious treatment. Biosignatures developed from the systematic exploration of multiple biological markers, which optimize treatment selection for individuals (moderators) and provide early indication of ultimate treatment response (mediators) are needed. The rationale and design of a multi-site, placebo-controlled randomized clinical trial of sertraline examining moderators and mediators of treatment response is described. The target sample is 300 participants with early onset (≤30 years) recurrent MDD. Non-responders to an 8-week trial are switched double blind to either bupropion (for sertraline non-responders) or sertraline (for placebo non-responders) for an additional 8 weeks. Clinical moderators include anxious depression, early trauma, gender, melancholic and atypical depression, anger attacks, Axis II disorder, hypersomnia/fatigue, and chronicity of depression. Biological moderator and mediators include cerebral cortical thickness, task-based fMRI (reward and emotion conflict), resting connectivity, diffusion tensor imaging (DTI), arterial spin labeling (ASL), electroencephalograpy (EEG), cortical evoked potentials, and behavioral/cognitive tasks evaluated at baseline and week 1, except DTI, assessed only at baseline. The study is designed to standardize assessment of biomarkers across multiple sites as well as institute replicable quality control methods, and to use advanced data analytic methods to integrate these markers. A Differential Depression Treatment Response Index (DTRI) will be developed. The data, including biological samples (DNA, RNA, and plasma collected before and during treatment), will become available in a public scientific repository. CLINICAL TRIAL REGISTRATION Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care for Depression (EMBARC). Identifier: NCT01407094. URL: http://clinicaltrials.gov/show/NCT01407094.
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Affiliation(s)
| | - Patrick J McGrath
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | | | | | - Benji T Kurian
- University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | | | - Maria A Oquendo
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Gerard Bruder
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | | | - Marisa Toups
- University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | - Crystal Cooper
- University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | - Phil Adams
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Sarah Weyandt
- University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | - David W Morris
- University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | | | | | | | | | | | | | - Thomas J Carmody
- University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | - Myrna M Weissman
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
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Kumar JSD, Walker M, Packiarajan M, Jubian V, Prabhakaran J, Chandrasena G, Pratap M, Parsey RV, Mann JJ. Radiosynthesis and in Vivo Evaluation of Neuropeptide Y5 Receptor (NPY5R) PET Tracers. ACS Chem Neurosci 2016; 7:540-5. [PMID: 26886507 DOI: 10.1021/acschemneuro.5b00315] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Neuropeptide Y receptor type 5 (NPY5R) is a G-protein coupled receptor (GPCR) that belongs to the subfamily of neuropeptide receptors (NPYR) that mediate the action of endogenous neuropeptide Y (NPY). Animal models and preclinical studies indicate a role for NPY5R in the pathophysiology of depression, anxiety, and obesity and as a target of potential therapeutic drugs. To better understand the pathophysiological involvement of NPY5R, and to measure target occupancy by potential therapeutic drugs, it would be advantageous to measure NPY5R binding in vivo by positron emission tomography (PET). Four potent and selective NPY5R antagonists were radiolabeled via nucleophilic aromatic substitution reactions with [(18)F]fluoride. Of the four radioligands investigated, PET studies in anesthetized baboons showed that [(18)F]LuAE00654 ([(18)F]N-[trans-4-({[4-(2-fluoropyridin-3-yl)thiazol-2-yl]amino}methyl)cyclohexyl]propane-2-sulfonamide) penetrates blood brain barrier (BBB) and a small amount is retained in the brain. Slow metabolism of [(18)F]LuAE00654 was observed in baboon plasma. Blocking studies with a specific NPY5R antagonist demonstrated up to 60% displacement of radioactivity in striatum, the brain region with highest NPY5R binding. Our studies suggest that [(18)F]LuAE00654 can be a potential PET radiotracer for the quantification and occupancy studies of NPY5R drug candidates.
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Affiliation(s)
- J. S. Dileep Kumar
- Division
of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York 10032, United States
- Department
of Psychiatry and Behavioral Medicine, Stony Brook University, New York, New York 11794, United States
| | - Mary Walker
- Chemical & Pharmacokinetic Sciences and Synaptic Transmission, Disease Biological Unit, Lundbeck Research USA, Paramus, New Jersey 07652, United States
| | - Mathivanan Packiarajan
- Chemical & Pharmacokinetic Sciences and Synaptic Transmission, Disease Biological Unit, Lundbeck Research USA, Paramus, New Jersey 07652, United States
| | - Vrej Jubian
- Chemical & Pharmacokinetic Sciences and Synaptic Transmission, Disease Biological Unit, Lundbeck Research USA, Paramus, New Jersey 07652, United States
| | - Jaya Prabhakaran
- Department
of Psychiatry, Columbia University Medical Center, New York, New York 10032, United States
| | - Gamini Chandrasena
- Chemical & Pharmacokinetic Sciences and Synaptic Transmission, Disease Biological Unit, Lundbeck Research USA, Paramus, New Jersey 07652, United States
| | - Mali Pratap
- Division
of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York 10032, United States
| | - Ramin V. Parsey
- Department
of Psychiatry and Behavioral Medicine, Stony Brook University, New York, New York 11794, United States
| | - J. John Mann
- Division
of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York 10032, United States
- Department
of Psychiatry, Columbia University Medical Center, New York, New York 10032, United States
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50
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Kumar JSD, Underwood MD, Simpson NR, Kassir SA, Prabhakaran J, Majo VJ, Bakalian MJ, Parsey RV, Mann JJ, Arango V. Autoradiographic Evaluation of [(18)F]FECUMI-101, a High Affinity 5-HT1AR Ligand in Human Brain. ACS Med Chem Lett 2016; 7:482-6. [PMID: 27190597 DOI: 10.1021/acsmedchemlett.5b00499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 03/13/2016] [Indexed: 12/29/2022] Open
Abstract
[(18)F]FECUMI-101 ([(18)F]1) is a 5HT1AR ligand demonstrating specific binding in brain regions corresponding to the distribution of 5-HT1AR in baboons. However, we detected moderate uptake of [(18)F]1 in baboon thalamus, a brain region lacking 5-HT1AR. We sought to investigate the relative binding of [(18)F]1 to 5-HT1AR, α1R, and 5-HT7R in vitro. Using autoradiography in human brain sections, specific binding of [(18)F]1 to 5-HT1AR was confirmed. However, [(18)F]1 also showed 26% binding to α1R in PFC. The hippocampal formation exhibited 51% and 92% binding of [(18)F]1 to α1R and 5-HT1AR, respectively. Thalamus and cerebellum showed very little binding. There is no measurable specific binding of [(18)F]1 to 5-HT7R and no effect of temperature on [(18)F]1 specific binding to 5-HT1AR or α1R. These results indicate that, while [(18)F]FECUMI-101 is not a completely selective 5-HT1AR ligand for receptor quantification, it may be useful for occupancy measurements of drugs acting at 5-HT1AR in vivo.
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Affiliation(s)
- J. S. Dileep Kumar
- Division
of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York 10032, United States
- Department
of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York 11794, United States
| | - Mark D. Underwood
- Division
of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York 10032, United States
- Department
of Psychiatry, Columbia University Medical Center, New York, New York 10032, United States
| | - Norman R. Simpson
- Division
of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York 10032, United States
| | - Suham A. Kassir
- Division
of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York 10032, United States
| | - Jaya Prabhakaran
- Department
of Psychiatry, Columbia University Medical Center, New York, New York 10032, United States
| | - Vattoly J. Majo
- Department
of Psychiatry, Columbia University Medical Center, New York, New York 10032, United States
| | - Mihran J. Bakalian
- Division
of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York 10032, United States
| | - Ramin V. Parsey
- Department
of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York 11794, United States
| | - J. John Mann
- Division
of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York 10032, United States
- Department
of Psychiatry, Columbia University Medical Center, New York, New York 10032, United States
| | - Victoria Arango
- Division
of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York 10032, United States
- Department
of Psychiatry, Columbia University Medical Center, New York, New York 10032, United States
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