The pulvinar nucleus and antidepressant treatment: dynamic modeling of antidepressant response and remission with ultra-high field functional MRI

Functional magnetic resonance imaging (fMRI) successfully disentangled neuronal pathophysiology of major depression (MD), but only a few fMRI studies have investigated correlates and predictors of remission. Moreover, most studies have used clinical outcome parameters from two time points, which do...

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Bibliographic Details
Published in:Molecular psychiatry 2019-05, Vol.24 (5), p.746-756
Main Authors: Kraus, Christoph, Klöbl, Manfred, Tik, Martin, Auer, Bastian, Vanicek, Thomas, Geissberger, Nicole, Pfabigan, Daniela M., Hahn, Andreas, Woletz, Michael, Paul, Katharina, Komorowski, Arkadiusz, Kasper, Siegfried, Windischberger, Christian, Lamm, Claus, Lanzenberger, Rupert
Format: Article
Language:English
Subjects:
59/36
59/57
631/378
692/53/2423
692/699/476/1414
Adult
Antidepressants
Antidepressive Agents - therapeutic use
Behavioral Sciences
Biological Psychology
Brain - physiopathology
Brain Mapping - methods
Clinical trials
Depression - diagnostic imaging
Depression - drug therapy
Depression - physiopathology
Depressive Disorder, Major - diagnostic imaging
Depressive Disorder, Major - drug therapy
Female
Functional magnetic resonance imaging
Humans
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Mediodorsal Thalamic Nucleus - physiopathology
Mental depression
Neurosciences
NMR
Nuclear magnetic resonance
Pain - physiopathology
Patients
Pharmacotherapy
Psychiatry
Pulvinar
Pulvinar - diagnostic imaging
Pulvinar - physiopathology
Remission
Thalamic nuclei
Thalamus
Thalamus - physiopathology
Young Adult
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Summary:Functional magnetic resonance imaging (fMRI) successfully disentangled neuronal pathophysiology of major depression (MD), but only a few fMRI studies have investigated correlates and predictors of remission. Moreover, most studies have used clinical outcome parameters from two time points, which do not optimally depict differential response times. Therefore, we aimed to detect neuronal correlates of response and remission in an antidepressant treatment study with 7 T fMRI, potentially harnessing advances in detection power and spatial specificity. Moreover, we modeled outcome parameters from multiple study visits during a 12-week antidepressant fMRI study in 26 acute (aMD) patients compared to 36 stable remitted (rMD) patients and 33 healthy control subjects (HC). During an electrical painful stimulation task, significantly higher baseline activity in aMD compared to HC and rMD in the medial thalamic nuclei of the pulvinar was detected ( p  = 0.004, FWE-corrected), which was reduced by treatment. Moreover, clinical response followed a sigmoid function with a plateau phase in the beginning, a rapid decline and a further plateau at treatment end. By modeling the dynamic speed of response with fMRI-data, perigenual anterior cingulate activity after treatment was significantly associated with antidepressant response ( p  
ISSN:1359-4184
1476-5578
DOI:10.1038/s41380-017-0009-x