Brain metabolic changes in major depressive disorder from pre- to post-treatment with paroxetine
- PMID: 10641577
- DOI: 10.1016/s0925-4927(99)00034-7
Brain metabolic changes in major depressive disorder from pre- to post-treatment with paroxetine
Abstract
Functional brain imaging studies of subjects with Major Depressive Disorder (MDD) have suggested that decreased dorsolateral (DLPFC) and increased ventrolateral (VLPFC) prefrontal cortical activity mediate the depressed state. Pre- to post-treatment studies indicate that these abnormalities normalize with successful treatment. We performed [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) scans on 16 outpatients with MDD before and after treatment with paroxetine (target dose = 40 mg/day). Regions of interest (ROIs) for this analysis were drawn by a rater blind to subject identity on the magnetic resonance image of each subject and transferred onto their coregistered PET scans. We hypothesized that DLPFC metabolism would increase, while ventral frontal metabolism [in the VLPFC, the orbitofrontal cortex (OFC), and the inferior frontal gyrus (IFG)] would decrease with successful treatment. Treatment response was defined as a decrease in the Hamilton Depression Rating Scale of > 50% and a Clinical Global Improvement Scale rating of 'much' or 'very much' improved. By these criteria, nine of the subjects were classified as treatment responders. These responders had significantly greater decreases in normalized VLPFC and OFC metabolism than did non-responders. There were no significant effects of treatment response on change in the DLPFC or IFG in this sample. However, there was a positive correlation between change in HAM-D scores and change in normalized IFG and VLPFC metabolism. There were no significant interactions with laterality. On pre-treatment scans, lower metabolism in the left ventral anterior cingulate gyrus was associated with better treatment response. These findings implicate ventral prefrontal-subcortical brain circuitry in the mediation of response to serotonin reuptake inhibitors in MDD.
Similar articles
-
Differential cerebral metabolic changes with paroxetine treatment of obsessive-compulsive disorder vs major depression.Arch Gen Psychiatry. 2002 Mar;59(3):250-61. doi: 10.1001/archpsyc.59.3.250. Arch Gen Psychiatry. 2002. PMID: 11879163
-
Modulation of cortical-limbic pathways in major depression: treatment-specific effects of cognitive behavior therapy.Arch Gen Psychiatry. 2004 Jan;61(1):34-41. doi: 10.1001/archpsyc.61.1.34. Arch Gen Psychiatry. 2004. PMID: 14706942
-
Changes in regional brain glucose metabolism measured with positron emission tomography after paroxetine treatment of major depression.Am J Psychiatry. 2001 Jun;158(6):899-905. doi: 10.1176/appi.ajp.158.6.899. Am J Psychiatry. 2001. PMID: 11384897
-
Prefrontal-subcortical and limbic circuit mediation of major depressive disorder.Semin Clin Neuropsychiatry. 2001 Apr;6(2):102-12. doi: 10.1053/scnp.2001.21837. Semin Clin Neuropsychiatry. 2001. PMID: 11296310 Review.
-
[Repetitive transcranial magnetic stimulation in major depression: response factor].Encephale. 2012 Sep;38(4):360-8. doi: 10.1016/j.encep.2011.08.004. Epub 2011 Oct 11. Encephale. 2012. PMID: 22980479 Review. French.
Cited by
-
The utility of PET imaging in depression.Front Psychiatry. 2024 Apr 22;15:1322118. doi: 10.3389/fpsyt.2024.1322118. eCollection 2024. Front Psychiatry. 2024. PMID: 38711875 Free PMC article. Review.
-
Roles of the medial and lateral orbitofrontal cortex in major depression and its treatment.Mol Psychiatry. 2024 Apr;29(4):914-928. doi: 10.1038/s41380-023-02380-w. Epub 2024 Jan 12. Mol Psychiatry. 2024. PMID: 38212376 Review.
-
rTMS in mental health disorders.Front Netw Physiol. 2023 Jul 28;3:943223. doi: 10.3389/fnetp.2023.943223. eCollection 2023. Front Netw Physiol. 2023. PMID: 37577037 Free PMC article. Review.
-
Depressive Pseudodementia with Reversible AD-like Brain Hypometabolism: A Case Report and a Review of the Literature.J Pers Med. 2022 Oct 6;12(10):1665. doi: 10.3390/jpm12101665. J Pers Med. 2022. PMID: 36294804 Free PMC article.
-
The Role of Mitochondria in Mood Disorders: From Physiology to Pathophysiology and to Treatment.Front Psychiatry. 2021 Jul 6;12:546801. doi: 10.3389/fpsyt.2021.546801. eCollection 2021. Front Psychiatry. 2021. PMID: 34295268 Free PMC article. Review.
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Other Literature Sources
Medical