Antidepressant short-term and long-term brain effects during self-referential processing in major depression

• Published in: Psychiatry research. Neuroimaging 2016-01, Vol.247, p.17-24
• Main Authors: Delaveau, Pauline, Jabourian, Maritza, Lemogne, Cédric, Allaïli, Najib, Choucha, Walid, Girault, Nathalie, Lehericy, Stéphane, Laredo, Judith, Fossati, Philippe
• Format: Article
• Language: English
• Subjects: Acetamides - administration & dosage; Acetamides - pharmacology; Adult; Antidepressant; Antidepressive Agents - administration & dosage; Antidepressive Agents - pharmacology; Brain - drug effects; Brain - physiopathology; Brain Mapping - methods; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - psychology; Double-Blind Method; Emotions - drug effects; Emotions - physiology; Female; Functional magnetic resonance imaging (fMRI); Gyrus Cinguli - physiopathology; Humans; Long-term; Magnetic Resonance Imaging - methods; Major depressive disorder; Middle Aged; Prefrontal Cortex - drug effects; Prefrontal Cortex - physiopathology; Psychiatric Status Rating Scales - statistics & numerical data; Psychiatry; Radiology; Self-referential processing; Severity of Illness Index; Short-term; Treatment Outcome
• ISSN: 0925-4927; 1872-7506
• DOI: 10.1016/j.pscychresns.2015.11.007

Abstract Acute depression is associated with impaired self-referential processing. Antidepressant effects on the neural bases of self-referential processing in depression are unknown. This study aimed to assess short- and long-term effects of agomelatine on these neural bases in depressed patients and the association between pre-treatment brain activation and remission of depression 6 months later. We conducted a randomized double-blind, placebo-controlled, functional magnetic resonance imaging (fMRI) study during an emotional self-referential task, including three scanning sessions (baseline, after 1 week, and after 7 weeks). Twenty-five depressed outpatients were included, all treated with agomelatine or placebo for 1 week. Then, all patients received agomelatine for 24 weeks. Fourteen matched healthy volunteers (HV) who received placebo for 1 week were also included. After 7 days, only depressed patients receiving agomelatine significantly deactivated the ventrolateral prefrontal cortex during self-referential processing, as observed in HV at baseline. After 7 weeks, depressed patients significantly increased the activation of the ventral anterior cingulate cortex. Finally dorsomedial prefrontal cortex and precuneus activations at baseline significantly separated remitters from non-remitters at 24 weeks. In depressed patients, agomelatine had short- and long-term effects on brain structures involved in anhedonia and emotional regulation during self-referential processing. Activation of the dorsomedial prefrontal cortex and precuneus could be informative in the development of biomarker-based treatment of major depression.