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Jindal M, Chhetri A, Ludhiadch A, Singh P, Peer S, Singh J, Brar RS, Munshi A. Neuroimaging Genomics a Predictor of Major Depressive Disorder (MDD). Mol Neurobiol 2024; 61:3427-3440. [PMID: 37989980 DOI: 10.1007/s12035-023-03775-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
Depression is a complex psychiatric disorder influenced by various genetic and environmental factors. Strong evidence has established the contribution of genetic factors in depression through twin studies and the heritability rate for depression has been reported to be 37%. Genetic studies have identified genetic variations associated with an increased risk of developing depression. Imaging genetics is an integrated approach where imaging measures are combined with genetic information to explore how specific genetic variants contribute to brain abnormalities. Neuroimaging studies allow us to examine both structural and functional abnormalities in individuals with depression. This review has been designed to study the correlation of the significant genetic variants with different regions of neural activity, connectivity, and structural alteration in the brain as detected by imaging techniques to understand the scope of biomarkers in depression. This might help in developing novel therapeutic interventions targeting specific genetic pathways or brain circuits and the underlying pathophysiology of depression based on this integrated approach can be established at length.
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Affiliation(s)
- Manav Jindal
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Aakash Chhetri
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151401, India
| | - Abhilash Ludhiadch
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151401, India
| | - Paramdeep Singh
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Sameer Peer
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Jawahar Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bathinda, India
| | - Rahatdeep Singh Brar
- Department of Diagnostic and Interventional Radiology, Homi Bhabha Cancer Hospital & Research Center, Mohali, India
| | - Anjana Munshi
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151401, India.
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2
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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] [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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3
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Zahrai A, Vahid-Ansari F, Daigle M, Albert PR. Fluoxetine-induced recovery of serotonin and norepinephrine projections in a mouse model of post-stroke depression. Transl Psychiatry 2020; 10:334. [PMID: 32999279 PMCID: PMC7527452 DOI: 10.1038/s41398-020-01008-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 08/21/2020] [Accepted: 09/03/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic treatment with fluoxetine (FLX) is required for its antidepressant effects, but the role of serotonin (5-HT) axonal plasticity in FLX action is unknown. To address this, we examined mice with a stroke in the left medial prefrontal cortex (mPFC) resulting in persistent anxiety-like and depression-like behaviors and memory deficits as a model of post-stroke depression. Chronic treatment with FLX (but not exercise) completely reversed the behavioral phenotype and partially reversed changes in FosB-labeled cells in the mPFC, nucleus accumbens, septum, hippocampus, basolateral amygdala (BLA), and dorsal raphe. In these regions, 5-HT or norepinephrine (NE) innervation was quantified by staining for 5-HT or NE transporters, respectively. 5-HT synapses and synaptic triads were identified as synaptophysin-stained sites on 5-HT axons located proximal to gephyrin-stained or PSD95-stained spines. A week after stroke, 5-HT innervation was greatly reduced at the stroke site (left cingulate gyrus (CG) of the mPFC) and the left BLA. Chronically, 5-HT and NE innervation was reduced at the left CG, nucleus accumbens, and BLA, with no changes in other regions. In these areas, pre-synaptic and post-synaptic 5-HT synapses and triads to inhibitory (gephyrin+) sites were reduced, while 5-HT contacts at excitatory (PSD95+) sites were reduced in the CG and prelimbic mPFC. Chronic FLX, but not exercise, reversed these reductions in 5-HT innervation but incompletely restored NE projections. Changes in 5-HT innervation were verified using YFP staining in mice expressing YFP-tagged channelrhodopsin in 5-HT neurons. Thus, FLX-induced 5-HT axonal neuroplasticity of forebrain projections may help mediate recovery from brain injury.
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Affiliation(s)
- Amin Zahrai
- grid.412687.e0000 0000 9606 5108Ottawa Hospital Research Institute (Neuroscience), UOttawa Brain and Mind Research Institute, 451 Smyth Road, Ottawa, ON K1H-8M5 Canada
| | - Faranak Vahid-Ansari
- grid.412687.e0000 0000 9606 5108Ottawa Hospital Research Institute (Neuroscience), UOttawa Brain and Mind Research Institute, 451 Smyth Road, Ottawa, ON K1H-8M5 Canada
| | - Mireille Daigle
- grid.412687.e0000 0000 9606 5108Ottawa Hospital Research Institute (Neuroscience), UOttawa Brain and Mind Research Institute, 451 Smyth Road, Ottawa, ON K1H-8M5 Canada
| | - Paul R. Albert
- grid.412687.e0000 0000 9606 5108Ottawa Hospital Research Institute (Neuroscience), UOttawa Brain and Mind Research Institute, 451 Smyth Road, Ottawa, ON K1H-8M5 Canada
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4
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Saricicek Aydogan A, Oztekin E, Esen ME, Dusmez S, Gelal F, Besiroğlu L, Zorlu N. Cortical thickening in remitters compared to non-remitters with major depressive disorder following 8-week antidepressant treatment. Acta Psychiatr Scand 2019; 140:217-226. [PMID: 31250445 DOI: 10.1111/acps.13065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/24/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Little is known about the relationship between antidepressant treatment outcomes and underlying neurobiological mechanisms in patients with major depressive disorder (MDD). In this prospective study, we aimed to investigate how cortical thickness and subcortical volumes differed between remitter and non-remitter patients with MDD. METHODS Fifty-eight patients with MDD with a score of at least 17 on the 17-item Hamilton Depression Rating Scale and free of medication for at least 2 months and 41 healthy controls underwent structural magnetic resonance imaging. At the baseline, patients with MDD started on either selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, or vortioxetine. After 8-week antidepressant treatment, patients with MDD were scanned using the same MRI protocol. Structural images were analyzed using the FreeSurfer software package (version 6.0). RESULTS Longitudinal analyses showed remitter patients with MDD had significantly greater right cerebral cortex thickening in six significant clusters, including superior temporal cortex, precuneus, rostral middle frontal cortex, pars opercularis (although the cluster extends into the insula), inferior parietal cortex, and supramarginal cortex than in non-remitter patients with MDD. CONCLUSION Our results suggest that distinct antidepressant treatment-related structural alterations in brain regions implicated in cognition, emotion regulation, and rumination might be associated with treatment outcome.
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Affiliation(s)
- A Saricicek Aydogan
- Department of Psychiatry, Faculty of Medicine, Ataturk Training and Research Hospital, Izmir Katip Celebi University, İzmir, Turkey
| | - E Oztekin
- Department of Psychiatry, Faculty of Medicine, Ataturk Training and Research Hospital, Izmir Katip Celebi University, İzmir, Turkey
| | - M E Esen
- Clinic of Psychiatry, Idil State Hospital, Sirnak, Turkey
| | - S Dusmez
- Department of Psychiatry, Faculty of Medicine, Ataturk Training and Research Hospital, Izmir Katip Celebi University, İzmir, Turkey
| | - F Gelal
- Department of Radiodiagnostics, Faculty of Medicine, Ataturk Training and Research Hospital, Izmir Katip Celebi University, İzmir, Turkey
| | - L Besiroğlu
- Department of Psychiatry, Faculty of Medicine, Ataturk Training and Research Hospital, Izmir Katip Celebi University, İzmir, Turkey
| | - N Zorlu
- Department of Psychiatry, Faculty of Medicine, Ataturk Training and Research Hospital, Izmir Katip Celebi University, İzmir, Turkey
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5
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Pillai RL, Zhang M, Yang J, Mann JJ, Oquendo MA, Parsey RV, DeLorenzo C. Molecular connectivity disruptions in males with major depressive disorder. J Cereb Blood Flow Metab 2019; 39. [PMID: 29519187 PMCID: PMC6681531 DOI: 10.1177/0271678x18764053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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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6
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Albert PR, Le François B, Vahid-Ansari F. Genetic, epigenetic and posttranscriptional mechanisms for treatment of major depression: the 5-HT1A receptor gene as a paradigm. J Psychiatry Neurosci 2019; 44:164-176. [PMID: 30807072 PMCID: PMC6488484 DOI: 10.1503/jpn.180209] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Major depression and anxiety are highly prevalent and involve chronic dysregulation of serotonin, but they remain poorly understood. Here, we review novel transcriptional (genetic, epigenetic) and posttranscriptional (microRNA, alternative splicing) mechanisms implicated in mental illness, focusing on a key serotonin-related regulator, the serotonin 1A (5-HT1A) receptor. Functional single-nucleotide polymorphisms and stress-induced DNA methylation of the 5-HT1A promoter converge to differentially alter pre- and postsynaptic 5-HT1A receptor expression associated with major depression and reduced therapeutic response to serotonergic antidepressants. Major depression is also associated with altered levels of splice factors and microRNA, posttranscriptional mechanisms that regulate RNA stability. The human 5-HT1A 3′-untranslated region is alternatively spliced, removing microRNA sites and increasing 5-HT1A expression, which is reduced in major depression and may be genotype-dependent. Thus, the 5-HT1A receptor gene illustrates the convergence of genetic, epigenetic and posttranscriptional mechanisms in gene expression, neurodevelopment and neuroplasticity, and major depression. Understanding gene regulatory mechanisms could enhance the detection, categorization and personalized treatment of major depression.
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Affiliation(s)
- Paul R. Albert
- From the Department of Neuroscience, Ottawa Hospital Research Institute, UOttawa Brain and Mind Research Institute, Ottawa, Ont., Canada
| | - Brice Le François
- From the Department of Neuroscience, Ottawa Hospital Research Institute, UOttawa Brain and Mind Research Institute, Ottawa, Ont., Canada
| | - Faranak Vahid-Ansari
- From the Department of Neuroscience, Ottawa Hospital Research Institute, UOttawa Brain and Mind Research Institute, Ottawa, Ont., Canada
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7
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Affiliation(s)
- Paul R. Albert
- From the Department of Neuroscience, Ottawa Hospital Research Institute, UOttawa Brain and Mind Research Institute, Ottawa, Ont., Canada
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8
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Langenecker SA, Mickey BJ, Eichhammer P, Sen S, Elverman KH, Kennedy SE, Heitzeg MM, Ribeiro SM, Love TM, Hsu DT, Koeppe RA, Watson SJ, Akil H, Goldman D, Burmeister M, Zubieta JK. Cognitive Control as a 5-HT 1A-Based Domain That Is Disrupted in Major Depressive Disorder. Front Psychol 2019; 10:691. [PMID: 30984083 PMCID: PMC6450211 DOI: 10.3389/fpsyg.2019.00691] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/12/2019] [Indexed: 12/21/2022] Open
Abstract
Heterogeneity within Major Depressive Disorder (MDD) has hampered identification of biological markers (e.g., intermediate phenotypes, IPs) that might increase risk for the disorder or reflect closer links to the genes underlying the disease process. The newer characterizations of dimensions of MDD within Research Domain Criteria (RDoC) domains may align well with the goal of defining IPs. We compare a sample of 25 individuals with MDD compared to 29 age and education matched controls in multimodal assessment. The multimodal RDoC assessment included the primary IP biomarker, positron emission tomography (PET) with a selective radiotracer for 5-HT1A [(11C)WAY-100635], as well as event-related functional MRI with a Go/No-go task targeting the Cognitive Control network, neuropsychological assessment of affective perception, negative memory bias and Cognitive Control domains. There was also an exploratory genetic analysis with the serotonin transporter (5-HTTLPR) and monamine oxidase A (MAO-A) genes. In regression analyses, lower 5-HT1A binding potential (BP) in the MDD group was related to diminished engagement of the Cognitive Control network, slowed resolution of interfering cognitive stimuli, one element of Cognitive Control. In contrast, higher/normative levels of 5-HT1A BP in MDD (only) was related to a substantial memory bias toward negative information, but intact resolution of interfering cognitive stimuli and greater engagement of Cognitive Control circuitry. The serotonin transporter risk allele was associated with lower 1a BP and the corresponding imaging and cognitive IPs in MDD. Lowered 5HT 1a BP was present in half of the MDD group relative to the control group. Lowered 5HT 1a BP may represent a subtype including decreased engagement of Cognitive Control network and impaired resolution of interfering cognitive stimuli. Future investigations might link lowered 1a BP to neurobiological pathways and markers, as well as probing subtype-specific treatment targets.
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Affiliation(s)
- Scott A Langenecker
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Brian J Mickey
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Peter Eichhammer
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Srijan Sen
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Kathleen H Elverman
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Susan E Kennedy
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
| | - Mary M Heitzeg
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Saulo M Ribeiro
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
| | - Tiffany M Love
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
| | - David T Hsu
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
| | - Robert A Koeppe
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Stanley J Watson
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Huda Akil
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - David Goldman
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States
| | - Margit Burmeister
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Jon-Kar Zubieta
- The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
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9
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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] [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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10
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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] [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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