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Resting-state brain alteration after a single dose of SSRI administration predicts 8-week remission of patients with major depressive disorder

Published online by Cambridge University Press:  04 October 2016

Y. Cheng ,
J. Xu ,
D. Arnone ,
B. Nie ,
H. Yu ,
H. Jiang ,
Y. Bai ,
C. Luo ,
R. A. A. Campbell  and
B. Shan
...Show all authors
Y. Cheng
Affiliation:
Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
J. Xu
Affiliation:
Department of Internal Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China
D. Arnone
Affiliation:
Department of Psychological Medicine, Centre for Affective Disorders, King's College London, London, UK
B. Nie
Affiliation:
Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
H. Yu
Affiliation:
Magnetic Resonance Imaging Center, the First Hospital of Kunming City, Kunming, China
H. Jiang
Affiliation:
Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
Y. Bai
Affiliation:
Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
C. Luo
Affiliation:
Magnetic Resonance Imaging Center, the First Hospital of Kunming City, Kunming, China
R. A. A. Campbell
Affiliation:
Department of Neuroscience, Cold Spring Harbor Laboratory, New York, USA
B. Shan
Affiliation:
Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
L. Xu
Affiliation:
Key Laboratory of Animal Models and Human Disease Mechanisms, Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, China
X. Xu*
Affiliation:
Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
*
*Address for correspondence: X. Xu, MD, Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming 650032, People's Republic of China. (Email: xfxu2004@sina.com, xuxf2012@163.com)
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Abstract

Background

The present study investigated alteration of brain resting-state activity induced by antidepressant treatment and attempted to investigate whether treatment efficacy can be predicted at an early stage of pharmacological treatment.

Method

Forty-eight first-episode medication-free patients diagnosed with major depression received treatment with escitalopram. Resting-state functional magnetic resonance imaging was administered prior to treatment, 5 h after the first dose, during the course of pharmacological treatment (week 4) and at endpoint (week 8). Resting-state activity was evaluated in the course of the 8-week treatment and in relation to clinical improvement.

Results

Escitalopram dynamically modified resting-state activity in depression during the treatment. After 5 h the antidepressant induced a significant decrease in the signal in the occipital cortex and an increase in the dorsolateral and dorsomedial prefrontal cortices and middle cingulate cortex. Furthermore, while remitters demonstrated more obvious changes following treatment, these were more modest in non-responders suggesting possible tonic and dynamic differences in the serotonergic system. Changes after 5 h in the caudate, occipital and temporal cortices were the best predictor of clinical remission at endpoint.

Conclusions

This study revealed the possibility of using the measurement of resting-state neural changes a few hours after acute administration of antidepressant to identify individuals likely to remit after a few weeks of treatment.

Keywords

Escitalopramfirst-episodefractional amplitude of low-frequency fluctuation (fALFF)major depressive disorderneuroimagingremissionresting-state fMRI
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 3 , February 2017 , pp. 438 - 450
Copyright
Copyright © Cambridge University Press 2016 

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