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Schiele MA, Zwanzger P, Schwarte K, Arolt V, Baune BT, Domschke K. Serotonin Transporter Gene Promoter Hypomethylation as a Predictor of Antidepressant Treatment Response in Major Depression: A Replication Study. Int J Neuropsychopharmacol 2020; 24:191-199. [PMID: 33125470 PMCID: PMC7968622 DOI: 10.1093/ijnp/pyaa081] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The serotonin transporter gene (SLC6A4; 5-HTT; SERT) is considered a prime candidate in pharmacogenetic research in major depressive disorder (MDD). Besides genetic variation, recent advances have spotlighted the involvement of epigenetic mechanisms such as DNA methylation in predicting antidepressant treatment response in "pharmaco-epigenetic" approaches. In MDD, lower SLC6A4 promoter methylation has been suggested to predict impaired response to serotonergic antidepressants. The present study sought to replicate and extend this finding in a large, independent sample of MDD patients. METHODS The sample comprised n = 236 Caucasian patients with MDD receiving antidepressant medication in a naturalistic treatment setting. Functional DNA methylation of 9 CpG sites located in the SLC6A4 promoter region was analyzed via direct sequencing of sodium bisulfite- treated DNA extracted from blood cells. Patients were assessed over the course of a 6-week in-patient treatment using the Hamilton Depression Scale (HAM-D). RESULTS Results confirm relative SLC6A4 hypomethylation to predict impaired antidepressant response both dimensionally and categorically (HAM-D reductions < 50%) and to furthermore be indicative of nonremission (HAM-D > 7). This also held true in a homogenous subgroup of patients continuously treated with selective serotonin reuptake inhibitors or serotonin/noradrenaline reuptake inhibitors (n = 110). CONCLUSIONS Impaired response to serotonergic antidepressants via SLC6A4 hypomethylation may be conveyed by increased gene expression and consequently decreased serotonin availability, which may counteract the effects of serotonergic antidepressants. The present results could in the future inform clinical decision-making towards a more personalized treatment of MDD.
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Affiliation(s)
- M A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - P Zwanzger
- kbo-Inn-Salzach-Klinikum, Wasserburg am Inn, Germany,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - K Schwarte
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - V Arolt
- Institute of Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - B T Baune
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany,Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - K Domschke
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany,Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Germany,Correspondence: Katharina Domschke, MA, MD, PhD, Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstrasse 5, D-79104 Freiburg, Germany ()
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Abstract
Autoimmune encephalitis is a group of autoimmune inflammatory disorders affecting both grey and white matter of the central nervous system. Encephalitis with autoantibodies against the N‑methyl-D-aspartate receptor (NMDA-R) is the most frequent autoimmune encephalitis syndrome presenting with a characteristic sequence of psychiatric and neurological symptoms. Treatment necessitates a close interdisciplinary cooperation. This article provides an update on the current knowledge on diagnostic standards, pathogenesis, and treatment strategies for anti-NMDA-R encephalitis from psychiatric and neurological perspectives.
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Affiliation(s)
- S Kovac
- Klinik für Allgemeine Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - J Alferink
- Cluster of Excellence EXC 1003, Cells in Motion, Universität Münster, Münster, Deutschland
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - D Ahmetspahic
- Cluster of Excellence EXC 1003, Cells in Motion, Universität Münster, Münster, Deutschland
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - V Arolt
- Cluster of Excellence EXC 1003, Cells in Motion, Universität Münster, Münster, Deutschland
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - N Melzer
- Klinik für Allgemeine Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.
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3
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Hibar DP, Westlye LT, Doan NT, Jahanshad N, Cheung JW, Ching CRK, Versace A, Bilderbeck AC, Uhlmann A, Mwangi B, Krämer B, Overs B, Hartberg CB, Abé C, Dima D, Grotegerd D, Sprooten E, Bøen E, Jimenez E, Howells FM, Delvecchio G, Temmingh H, Starke J, Almeida JRC, Goikolea JM, Houenou J, Beard LM, Rauer L, Abramovic L, Bonnin M, Ponteduro MF, Keil M, Rive MM, Yao N, Yalin N, Najt P, Rosa PG, Redlich R, Trost S, Hagenaars S, Fears SC, Alonso-Lana S, van Erp TGM, Nickson T, Chaim-Avancini TM, Meier TB, Elvsåshagen T, Haukvik UK, Lee WH, Schene AH, Lloyd AJ, Young AH, Nugent A, Dale AM, Pfennig A, McIntosh AM, Lafer B, Baune BT, Ekman CJ, Zarate CA, Bearden CE, Henry C, Simhandl C, McDonald C, Bourne C, Stein DJ, Wolf DH, Cannon DM, Glahn DC, Veltman DJ, Pomarol-Clotet E, Vieta E, Canales-Rodriguez EJ, Nery FG, Duran FLS, Busatto GF, Roberts G, Pearlson GD, Goodwin GM, Kugel H, Whalley HC, Ruhe HG, Soares JC, Fullerton JM, Rybakowski JK, Savitz J, Chaim KT, Fatjó-Vilas M, Soeiro-de-Souza MG, Boks MP, Zanetti MV, Otaduy MCG, Schaufelberger MS, Alda M, Ingvar M, Phillips ML, Kempton MJ, Bauer M, Landén M, Lawrence NS, van Haren NEM, Horn NR, Freimer NB, Gruber O, Schofield PR, Mitchell PB, Kahn RS, Lenroot R, Machado-Vieira R, Ophoff RA, Sarró S, Frangou S, Satterthwaite TD, Hajek T, Dannlowski U, Malt UF, Arolt V, Gattaz WF, Drevets WC, Caseras X, Agartz I, Thompson PM, Andreassen OA. Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group. Mol Psychiatry 2018; 23:932-942. [PMID: 28461699 PMCID: PMC5668195 DOI: 10.1038/mp.2017.73] [Citation(s) in RCA: 422] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 02/04/2017] [Accepted: 02/10/2017] [Indexed: 12/13/2022]
Abstract
Despite decades of research, the pathophysiology of bipolar disorder (BD) is still not well understood. Structural brain differences have been associated with BD, but results from neuroimaging studies have been inconsistent. To address this, we performed the largest study to date of cortical gray matter thickness and surface area measures from brain magnetic resonance imaging scans of 6503 individuals including 1837 unrelated adults with BD and 2582 unrelated healthy controls for group differences while also examining the effects of commonly prescribed medications, age of illness onset, history of psychosis, mood state, age and sex differences on cortical regions. In BD, cortical gray matter was thinner in frontal, temporal and parietal regions of both brain hemispheres. BD had the strongest effects on left pars opercularis (Cohen's d=-0.293; P=1.71 × 10-21), left fusiform gyrus (d=-0.288; P=8.25 × 10-21) and left rostral middle frontal cortex (d=-0.276; P=2.99 × 10-19). Longer duration of illness (after accounting for age at the time of scanning) was associated with reduced cortical thickness in frontal, medial parietal and occipital regions. We found that several commonly prescribed medications, including lithium, antiepileptic and antipsychotic treatment showed significant associations with cortical thickness and surface area, even after accounting for patients who received multiple medications. We found evidence of reduced cortical surface area associated with a history of psychosis but no associations with mood state at the time of scanning. Our analysis revealed previously undetected associations and provides an extensive analysis of potential confounding variables in neuroimaging studies of BD.
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Affiliation(s)
- D P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA,Janssen Research & Development, San Diego, CA, USA
| | - L T Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,Department of Psychology, University of Oslo, Oslo, Norway
| | - N T Doan
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - N Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - J W Cheung
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - C R K Ching
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA,Neuroscience Interdepartmental Graduate Program, University of California, Los Angeles, Los Angeles, CA, USA
| | - A Versace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - A C Bilderbeck
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - A Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,MRC Unit on Anxiety and Stress Disorders, Groote Schuur Hospital (J-2), University of Cape Town, Cape Town, South Africa
| | - B Mwangi
- UT Center of Excellence on Mood Disorders, Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - B Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - B Overs
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - C B Hartberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - C Abé
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden
| | - D Dima
- Department of Psychology, City University London, London, UK,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - D Grotegerd
- Department of Psychiatry, University of Münster, Münster, Germany
| | - E Sprooten
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E Bøen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - E Jimenez
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - F M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - G Delvecchio
- IRCCS "E. Medea" Scientific Institute, San Vito al Tagliamento, Italy
| | - H Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - J Starke
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - J R C Almeida
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - J M Goikolea
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - J Houenou
- INSERM U955 Team 15 ‘Translational Psychiatry’, University Paris East, APHP, CHU Mondor, Fondation FondaMental, Créteil, France,NeuroSpin, UNIACT Lab, Psychiatry Team, CEA Saclay, Gif Sur Yvette, France
| | - L M Beard
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - L Rauer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - L Abramovic
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Bonnin
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - M F Ponteduro
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - M Keil
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - M M Rive
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - N Yao
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - N Yalin
- Centre for Affective Disorders, King’s College London, London, UK
| | - P Najt
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - P G Rosa
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - R Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - S Trost
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - S Hagenaars
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - S C Fears
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA,West Los Angeles Veterans Administration, Los Angeles, CA, USA
| | - S Alonso-Lana
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - T Nickson
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - T M Chaim-Avancini
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - T B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA,Laureate Institute for Brain Research, Tulsa, OK, USA
| | - T Elvsåshagen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - U K Haukvik
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Adult Psychiatry, University of Oslo, Oslo, Norway
| | - W H Lee
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A H Schene
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - A J Lloyd
- Academic Psychiatry and Northern Centre for Mood Disorders, Newcastle University/Northumberland Tyne & Wear NHS Foundation Trust, Newcastle, UK
| | - A H Young
- Centre for Affective Disorders, King’s College London, London, UK
| | - A Nugent
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - A M Dale
- MMIL, Department of Radiology, University of California San Diego, San Diego, CA, USA,Department of Cognitive Science, Neurosciences and Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - A Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - B Lafer
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - B T Baune
- Department of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - C J Ekman
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden
| | - C A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - C E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - C Henry
- INSERM U955 Team 15 ‘Translational Psychiatry’, University Paris East, APHP, CHU Mondor, Fondation FondaMental, Créteil, France,Institut Pasteur, Unité Perception et Mémoire, Paris, France
| | - C Simhandl
- Bipolar Center Wiener Neustadt, Wiener Neustadt, Austria
| | - C McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - C Bourne
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK,Department of Psychology & Counselling, Newman University, Birmingham, UK
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,MRC Unit on Anxiety and Stress Disorders, Groote Schuur Hospital (J-2), University of Cape Town, Cape Town, South Africa
| | - D H Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - D M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - D C Glahn
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - D J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - E Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - E Vieta
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - E J Canales-Rodriguez
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - F G Nery
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - F L S Duran
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - G F Busatto
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - G Roberts
- School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - G D Pearlson
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - G M Goodwin
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - H Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - H G Ruhe
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK,Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J C Soares
- UT Center of Excellence on Mood Disorders, Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J M Fullerton
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - J K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - J Savitz
- Laureate Institute for Brain Research, Tulsa, OK, USA,Faculty of Community Medicine, The University of Tulsa, Tulsa, OK, USA
| | - K T Chaim
- Department of Radiology, University of São Paulo, São Paulo, Brazil,LIM44-Laboratory of Magnetic Resonance in Neuroradiology, University of São Paulo, São Paulo, Brazil
| | - M Fatjó-Vilas
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - M G Soeiro-de-Souza
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - M P Boks
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M V Zanetti
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - M C G Otaduy
- Department of Radiology, University of São Paulo, São Paulo, Brazil,LIM44-Laboratory of Magnetic Resonance in Neuroradiology, University of São Paulo, São Paulo, Brazil
| | - M S Schaufelberger
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - M Ingvar
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - M L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - M J Kempton
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - M Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Landén
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden,Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the Gothenburg University, Goteborg, Sweden
| | - N S Lawrence
- Department of Psychology, University of Exeter, Exeter, UK
| | - N E M van Haren
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - N R Horn
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - N B Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - O Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - P R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - P B Mitchell
- School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - R S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Lenroot
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - R Machado-Vieira
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - R A Ophoff
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands,Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - S Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - S Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - T Hajek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,National Institute of Mental Health, Klecany, Czech Republic
| | - U Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - U F Malt
- Division of Clinical Neuroscience, Department of Research and Education, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - V Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - W F Gattaz
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - W C Drevets
- Janssen Research & Development, Titusville, NJ, USA
| | - X Caseras
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - I Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - P M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - O A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,NORMENT, KG Jebsen Centre for Psychosis Research—TOP Study, Oslo University Hospital, Ullevål, Building 49, Kirkeveien 166, PO Box 4956, Nydalen, 0424, Oslo, Norway. E-mail:
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4
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Affiliation(s)
- V Arolt
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster, Albert Schweitzer Campus 1/A9, 48149, Münster, Deutschland.
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5
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Notzon S, Vennewald N, Gajewska A, Klahn AL, Diemer J, Winter B, Fohrbeck I, Arolt V, Pauli P, Domschke K, Zwanzger P. Is prepulse modification altered by continuous theta burst stimulation? DAT1 genotype and motor threshold interact on prepulse modification following brain stimulation. Eur Arch Psychiatry Clin Neurosci 2017; 267:767-779. [PMID: 28337537 DOI: 10.1007/s00406-017-0786-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 03/13/2017] [Indexed: 12/14/2022]
Abstract
Previous studies suggest an inhibitory top-down control of the amygdala by the prefrontal cortex (PFC). Both brain regions play a role in the modulation of prepulse modification (PPM) of the acoustic startle response by a pre-stimulus. Repetitive transcranial magnetic stimulation (rTMS) can modulate the activity of the PFC and might thus affect PPM. This study tested the effect of inhibitory rTMS on PPM accounting for a genetic variant of the dopamine transporter gene (DAT1). Healthy participants (N = 102) were stimulated with continuous theta burst stimulation (cTBS, an intense form of inhibitory rTMS) or sham treatment over the right PFC. Afterwards, during continuous presentation of a background white noise a louder noise burst was presented either alone (control startle) or preceded by a prepulse. Participants were genotyped for a DAT1 variable number tandem repeat (VNTR) polymorphism. Two succeeding sessions of cTBS over the right PFC (2 × 600 stimuli with a time lag of 15 min) attenuated averaged prepulse inhibition (PPI) in participants with a high resting motor threshold. An attenuation of PPI induced by prepulses with great distances to the pulse (480, 2000 ms) was observed following active cTBS in participants that were homozygous carriers of the 10-repeat-allele of the DAT1 genotype and had a high resting motor threshold. Our results confirm the importance of the prefrontal cortex for the modulation of PPM. The effects were observed in participants with a high resting motor threshold only, probably because they received a higher dose of cTBS. The effects in homozygous carriers of the DAT1 10-repeat allele confirm the relevance of dopamine for PPM. Conducting an exploratory study we decided against the use of a correction for multiple testing.
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Affiliation(s)
- S Notzon
- Department of Psychiatry and Psychotherapy, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Germany.
| | - N Vennewald
- School of Health, Münster University of Applied Sciences, Leonardo Campus 8, 48149, Münster, Germany
| | - A Gajewska
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - A L Klahn
- Department of Psychiatry and Psychotherapy, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Germany
| | - J Diemer
- kbo-Inn-Salzach-Hospital, Gabersee 7, 83512, Wasserburg am Inn, Germany
| | - B Winter
- Catholic University of Applied Sciences North Rhine-Westphalia, Münster, Piusallee 89, 48147, Münster, Germany
| | - I Fohrbeck
- Department of Psychiatry and Psychotherapy, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Germany
| | - V Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Germany
| | - P Pauli
- Department of Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Marcusstraße 9-11, 97070, Würzburg, Germany
| | - K Domschke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
- Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstrasse 5, 79104, Freiburg, Germany
| | - P Zwanzger
- Department of Psychiatry and Psychotherapy, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Germany
- kbo-Inn-Salzach-Hospital, Gabersee 7, 83512, Wasserburg am Inn, Germany
- Department of Psychiatry und Psychotherapy, Ludwig Maximilians University, Munich, Germany
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6
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Lueken U, Kuhn M, Yang Y, Straube B, Kircher T, Wittchen HU, Pfleiderer B, Arolt V, Wittmann A, Ströhle A, Weber H, Reif A, Domschke K, Deckert J, Lonsdorf TB. Modulation of defensive reactivity by GLRB allelic variation: converging evidence from an intermediate phenotype approach. Transl Psychiatry 2017; 7:e1227. [PMID: 28872638 PMCID: PMC5639239 DOI: 10.1038/tp.2017.186] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/07/2017] [Accepted: 07/04/2017] [Indexed: 01/20/2023] Open
Abstract
Representing a phylogenetically old and very basic mechanism of inhibitory neurotransmission, glycine receptors have been implicated in the modulation of behavioral components underlying defensive responding toward threat. As one of the first findings being confirmed by genome-wide association studies for the phenotype of panic disorder and agoraphobia, allelic variation in a gene coding for the glycine receptor beta subunit (GLRB) has recently been associated with increased neural fear network activation and enhanced acoustic startle reflexes. On the basis of two independent healthy control samples, we here aimed to further explore the functional significance of the GLRB genotype (rs7688285) by employing an intermediate phenotype approach. We focused on the phenotype of defensive system reactivity across the levels of brain function, structure, and physiology. Converging evidence across both samples was found for increased neurofunctional activation in the (anterior) insular cortex in GLRB risk allele carriers and altered fear conditioning as a function of genotype. The robustness of GLRB effects is demonstrated by consistent findings across different experimental fear conditioning paradigms and recording sites. Altogether, findings provide translational evidence for glycine neurotransmission as a modulator of the brain's evolutionary old dynamic defensive system and provide further support for a strong, biologically plausible candidate intermediate phenotype of defensive reactivity. As such, glycine-dependent neurotransmission may open up new avenues for mechanistic research on the etiopathogenesis of fear and anxiety disorders.
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Affiliation(s)
- U Lueken
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - M Kuhn
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Y Yang
- Department of Psychiatry and Psychotherapy, Phillips-University Marburg, Marburg, Germany
| | - B Straube
- Department of Psychiatry and Psychotherapy, Phillips-University Marburg, Marburg, Germany
| | - T Kircher
- Department of Psychiatry and Psychotherapy, Phillips-University Marburg, Marburg, Germany
| | - H-U Wittchen
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - B Pfleiderer
- Department of Clinical Radiology, University Hospital Münster, Münster, Germany
| | - V Arolt
- Department of Psychiatry, University Hospital Münster, Münster, Germany
| | - A Wittmann
- Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Berlin, Germany
| | - A Ströhle
- Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Berlin, Germany
| | - H Weber
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - K Domschke
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Deckert
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - T B Lonsdorf
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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7
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Redlich R, Bürger C, Dohm K, Grotegerd D, Opel N, Zaremba D, Meinert S, Förster K, Repple J, Schnelle R, Wagenknecht C, Zavorotnyy M, Heindel W, Kugel H, Gerbaulet M, Alferink J, Arolt V, Zwanzger P, Dannlowski U. Effects of electroconvulsive therapy on amygdala function in major depression - a longitudinal functional magnetic resonance imaging study. Psychol Med 2017; 47:2166-2176. [PMID: 28397635 DOI: 10.1017/s0033291717000605] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is one of the most effective treatments for severe depression. However, little is known regarding brain functional processes mediating ECT effects. METHOD In a non-randomized prospective study, functional magnetic resonance imaging data during the automatic processing of subliminally presented emotional faces were obtained twice, about 6 weeks apart, in patients with major depressive disorder (MDD) before and after treatment with ECT (ECT, n = 24). Additionally, a control sample of MDD patients treated solely with pharmacotherapy (MED, n = 23) and a healthy control sample (HC, n = 22) were obtained. RESULTS Before therapy, both patient groups equally showed elevated amygdala reactivity to sad faces compared with HC. After treatment, a decrease in amygdala activity to negative stimuli was discerned in both patient samples indicating a normalization of amygdala function, suggesting mechanisms potentially unspecific for ECT. Moreover, a decrease in amygdala activity to sad faces was associated with symptomatic improvements in the ECT sample (r spearman = -0.48, p = 0.044), and by tendency also for the MED sample (r spearman = -0.38, p = 0.098). However, we did not find any significant association between pre-treatment amygdala function to emotional stimuli and individual symptom improvement, neither for the ECT sample, nor for the MED sample. CONCLUSIONS In sum, the present study provides first results regarding functional changes in emotion processing due to ECT treatment using a longitudinal design, thus validating and extending our knowledge gained from previous treatment studies. A limitation was that ECT patients received concurrent medication treatment.
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Affiliation(s)
- R Redlich
- Department of Psychiatry,University of Münster,Münster,Germany
| | - C Bürger
- Department of Psychiatry,University of Münster,Münster,Germany
| | - K Dohm
- Department of Psychiatry,University of Münster,Münster,Germany
| | - D Grotegerd
- Department of Psychiatry,University of Münster,Münster,Germany
| | - N Opel
- Department of Psychiatry,University of Münster,Münster,Germany
| | - D Zaremba
- Department of Psychiatry,University of Münster,Münster,Germany
| | - S Meinert
- Department of Psychiatry,University of Münster,Münster,Germany
| | - K Förster
- Department of Psychiatry,University of Münster,Münster,Germany
| | - J Repple
- Department of Psychiatry,University of Münster,Münster,Germany
| | - R Schnelle
- Department of Psychiatry,University of Münster,Münster,Germany
| | - C Wagenknecht
- Department of Psychiatry,University of Münster,Münster,Germany
| | - M Zavorotnyy
- Department of Psychiatry,University of Marburg,Marburg,Germany
| | - W Heindel
- Department of Clinical Radiology,University of Münster,Münster,Germany
| | - H Kugel
- Department of Clinical Radiology,University of Münster,Münster,Germany
| | - M Gerbaulet
- Department of Psychiatry,University of Münster,Münster,Germany
| | - J Alferink
- Department of Psychiatry,University of Münster,Münster,Germany
| | - V Arolt
- Department of Psychiatry,University of Münster,Münster,Germany
| | - P Zwanzger
- Department of Psychiatry,University of Münster,Münster,Germany
| | - U Dannlowski
- Department of Psychiatry,University of Münster,Münster,Germany
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8
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Wong ML, Arcos-Burgos M, Liu S, Vélez JI, Yu C, Baune BT, Jawahar MC, Arolt V, Dannlowski U, Chuah A, Huttley GA, Fogarty R, Lewis MD, Bornstein SR, Licinio J. The PHF21B gene is associated with major depression and modulates the stress response. Mol Psychiatry 2017; 22:1015-1025. [PMID: 27777418 PMCID: PMC5461220 DOI: 10.1038/mp.2016.174] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/14/2016] [Accepted: 08/16/2016] [Indexed: 12/04/2022]
Abstract
Major depressive disorder (MDD) affects around 350 million people worldwide; however, the underlying genetic basis remains largely unknown. In this study, we took into account that MDD is a gene-environment disorder, in which stress is a critical component, and used whole-genome screening of functional variants to investigate the 'missing heritability' in MDD. Genome-wide association studies (GWAS) using single- and multi-locus linear mixed-effect models were performed in a Los Angeles Mexican-American cohort (196 controls, 203 MDD) and in a replication European-ancestry cohort (499 controls, 473 MDD). Our analyses took into consideration the stress levels in the control populations. The Mexican-American controls, comprised primarily of recent immigrants, had high levels of stress due to acculturation issues and the European-ancestry controls with high stress levels were given higher weights in our analysis. We identified 44 common and rare functional variants associated with mild to moderate MDD in the Mexican-American cohort (genome-wide false discovery rate, FDR, <0.05), and their pathway analysis revealed that the three top overrepresented Gene Ontology (GO) processes were innate immune response, glutamate receptor signaling and detection of chemical stimulus in smell sensory perception. Rare variant analysis replicated the association of the PHF21B gene in the ethnically unrelated European-ancestry cohort. The TRPM2 gene, previously implicated in mood disorders, may also be considered replicated by our analyses. Whole-genome sequencing analyses of a subset of the cohorts revealed that European-ancestry individuals have a significantly reduced (50%) number of single nucleotide variants compared with Mexican-American individuals, and for this reason the role of rare variants may vary across populations. PHF21b variants contribute significantly to differences in the levels of expression of this gene in several brain areas, including the hippocampus. Furthermore, using an animal model of stress, we found that Phf21b hippocampal gene expression is significantly decreased in animals resilient to chronic restraint stress when compared with non-chronically stressed animals. Together, our results reveal that including stress level data enables the identification of novel rare functional variants associated with MDD.
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Affiliation(s)
- M-L Wong
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia,Department of Psychiatry, Flinders
University School of Medicine, Bedford Park, SA,
Australia,Mind & Brain Theme, South Australian Health and Medical
Research Institute (SAHMRI), North Terrace, PO Box 11060,
Adelaide, SA
5001, Australia. E-mail: or
| | - M Arcos-Burgos
- Department of Genome Sciences, John
Curtin School of Medical Research, Australian National University,
Canberra, ACT, Australia,University of Rosario International
Institute of Translational Medicine, Bogotá,
Colombia
| | - S Liu
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia,Department of Psychiatry, Flinders
University School of Medicine, Bedford Park, SA,
Australia
| | - J I Vélez
- Department of Genome Sciences, John
Curtin School of Medical Research, Australian National University,
Canberra, ACT, Australia,Universidad del Norte,
Barranquilla, Colombia
| | - C Yu
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia,Department of Psychiatry, Flinders
University School of Medicine, Bedford Park, SA,
Australia
| | - B T Baune
- Discipline of Psychiatry, University of
Adelaide, Adelaide, SA, Australia
| | - M C Jawahar
- Discipline of Psychiatry, University of
Adelaide, Adelaide, SA, Australia
| | - V Arolt
- Department of Psychiatry and
Psychotherapy, University of Münster, Münster,
Germany
| | - U Dannlowski
- Department of Psychiatry and
Psychotherapy, University of Münster, Münster,
Germany,Department of Psychiatry and
Psychotherapy, University of Marburg, Marburg,
Germany
| | - A Chuah
- Department of Genome Sciences, John
Curtin School of Medical Research, Australian National University,
Canberra, ACT, Australia
| | - G A Huttley
- Department of Genome Sciences, John
Curtin School of Medical Research, Australian National University,
Canberra, ACT, Australia
| | - R Fogarty
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia
| | - M D Lewis
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia,Department of Psychiatry, Flinders
University School of Medicine, Bedford Park, SA,
Australia
| | - S R Bornstein
- Department of Psychiatry and
Psychotherapy, University of Münster, Münster,
Germany,Medical Clinic III, Carl Gustav Carus
University Hospital, Dresden University of Technology, Dresden,
Germany
| | - J Licinio
- Mind & Brain Theme, South Australian
Health and Medical Research Institute (SAHMRI), Adelaide,
SA, Australia,Department of Psychiatry, Flinders
University School of Medicine, Bedford Park, SA,
Australia,Mind & Brain Theme, South Australian Health and Medical
Research Institute (SAHMRI), North Terrace, PO Box 11060,
Adelaide, SA
5001, Australia. E-mail: or
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9
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Diemer J, Zwanzger P, Fohrbeck I, Zavorotnyy M, Notzon S, Silling K, Arolt V, Domschke K, Pfleiderer B. Influence of single-dose quetiapine on fear network activity - A pharmaco-imaging study. Prog Neuropsychopharmacol Biol Psychiatry 2017; 76:80-87. [PMID: 28259723 DOI: 10.1016/j.pnpbp.2017.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/23/2017] [Accepted: 02/28/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Anxiety disorders are among the most frequent psychiatric disorders. Current treatment guidelines recommend antidepressants, the calcium modulator gabapentin, and benzodiazepines as pharmacological treatments. However, delayed onset of action precludes the use of antidepressants as an acute treatment, while benzodiazepines can be recommended only as an emergency treatment due to their inherent risk of dependence. Therefore, an alternative pharmacological agent with acute efficacy is needed. Preliminary evidence points towards possible anxiolytic properties of the atypical antipsychotic quetiapine. The goals of this study were to test the acute anxiolytic properties of quetiapine in patients suffering from arachnophobia in a challenge paradigm, and to assess the effects of quetiapine on the central nervous fear network. METHODS In a randomized, double-blind, placebo-controlled proof-of-concept study, n=58 arachnophobic patients underwent an fMRI scan while looking at phobia-related and neutral stimuli. Subjective anxiety was evaluated retrospectively in questionnaires. RESULTS The functional imaging data revealed that patients showed stronger amygdala activation to phobia-related than to neutral stimuli. However, no effect of quetiapine on fear network activity was detected. Further, on questionnaire measures, quetiapine significantly reduced somatic anxiety symptoms, but had no effect on general psychological anxiety. CONCLUSION Viewing phobic pictures resulted in a robust amygdala activation in arachnophobic patients. Quetiapine seems to have no influence on activation in anxiety-related brain areas but appears to reduce acute somatic anxiety symptoms in patients with specific phobia. The central nervous correlates of the anxiolytic effects of quetiapine remain to be clarified in future studies.
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Affiliation(s)
- J Diemer
- Department of Psychiatry, University of Muenster, Albert-Schweitzer-Campus 1, Building A9, 48149 Muenster, Germany.
| | - P Zwanzger
- Department of Psychiatry, University of Muenster, Albert-Schweitzer-Campus 1, Building A9, 48149 Muenster, Germany.
| | - I Fohrbeck
- Department of Psychiatry, University of Muenster, Albert-Schweitzer-Campus 1, Building A9, 48149 Muenster, Germany
| | - M Zavorotnyy
- Department of Psychiatry, University of Muenster, Albert-Schweitzer-Campus 1, Building A9, 48149 Muenster, Germany.
| | - S Notzon
- Department of Psychiatry, University of Muenster, Albert-Schweitzer-Campus 1, Building A9, 48149 Muenster, Germany.
| | - K Silling
- Department of Psychiatry, University of Muenster, Albert-Schweitzer-Campus 1, Building A9, 48149 Muenster, Germany.
| | - V Arolt
- Department of Psychiatry, University of Muenster, Albert-Schweitzer-Campus 1, Building A9, 48149 Muenster, Germany.
| | - K Domschke
- Department of Psychiatry, University of Muenster, Albert-Schweitzer-Campus 1, Building A9, 48149 Muenster, Germany; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, 97080 Wuerzburg, Germany.
| | - B Pfleiderer
- Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Campus 1, Building A16, 48129 Muenster, Germany.
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10
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Schmaal L, Hibar DP, Sämann PG, Hall GB, Baune BT, Jahanshad N, Cheung JW, van Erp TGM, Bos D, Ikram MA, Vernooij MW, Niessen WJ, Tiemeier H, Hofman A, Wittfeld K, Grabe HJ, Janowitz D, Bülow R, Selonke M, Völzke H, Grotegerd D, Dannlowski U, Arolt V, Opel N, Heindel W, Kugel H, Hoehn D, Czisch M, Couvy-Duchesne B, Rentería ME, Strike LT, Wright MJ, Mills NT, de Zubicaray GI, McMahon KL, Medland SE, Martin NG, Gillespie NA, Goya-Maldonado R, Gruber O, Krämer B, Hatton SN, Lagopoulos J, Hickie IB, Frodl T, Carballedo A, Frey EM, van Velzen LS, Penninx BWJH, van Tol MJ, van der Wee NJ, Davey CG, Harrison BJ, Mwangi B, Cao B, Soares JC, Veer IM, Walter H, Schoepf D, Zurowski B, Konrad C, Schramm E, Normann C, Schnell K, Sacchet MD, Gotlib IH, MacQueen GM, Godlewska BR, Nickson T, McIntosh AM, Papmeyer M, Whalley HC, Hall J, Sussmann JE, Li M, Walter M, Aftanas L, Brack I, Bokhan NA, Thompson PM, Veltman DJ. Cortical abnormalities in adults and adolescents with major depression based on brain scans from 20 cohorts worldwide in the ENIGMA Major Depressive Disorder Working Group. Mol Psychiatry 2017; 22:900-909. [PMID: 27137745 PMCID: PMC5444023 DOI: 10.1038/mp.2016.60] [Citation(s) in RCA: 687] [Impact Index Per Article: 98.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/25/2016] [Accepted: 03/17/2016] [Indexed: 12/20/2022]
Abstract
The neuro-anatomical substrates of major depressive disorder (MDD) are still not well understood, despite many neuroimaging studies over the past few decades. Here we present the largest ever worldwide study by the ENIGMA (Enhancing Neuro Imaging Genetics through Meta-Analysis) Major Depressive Disorder Working Group on cortical structural alterations in MDD. Structural T1-weighted brain magnetic resonance imaging (MRI) scans from 2148 MDD patients and 7957 healthy controls were analysed with harmonized protocols at 20 sites around the world. To detect consistent effects of MDD and its modulators on cortical thickness and surface area estimates derived from MRI, statistical effects from sites were meta-analysed separately for adults and adolescents. Adults with MDD had thinner cortical gray matter than controls in the orbitofrontal cortex (OFC), anterior and posterior cingulate, insula and temporal lobes (Cohen's d effect sizes: -0.10 to -0.14). These effects were most pronounced in first episode and adult-onset patients (>21 years). Compared to matched controls, adolescents with MDD had lower total surface area (but no differences in cortical thickness) and regional reductions in frontal regions (medial OFC and superior frontal gyrus) and primary and higher-order visual, somatosensory and motor areas (d: -0.26 to -0.57). The strongest effects were found in recurrent adolescent patients. This highly powered global effort to identify consistent brain abnormalities showed widespread cortical alterations in MDD patients as compared to controls and suggests that MDD may impact brain structure in a highly dynamic way, with different patterns of alterations at different stages of life.
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Affiliation(s)
- L Schmaal
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - D P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - P G Sämann
- Neuroimaging Core Unit, Max Planck Institute of Psychiatry, Munich, Germany
| | - G B Hall
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - B T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - N Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - J W Cheung
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - D Bos
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M A Ikram
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M W Vernooij
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - W J Niessen
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Medical Informatics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - H Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - K Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - H J Grabe
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - D Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - R Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - M Selonke
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), partner site Griefswald, Greifswald, Germany
- German Center for Diabetes Research (DZD), partner site Griefswald, Greifswald, Germany
| | - D Grotegerd
- Department of Psychiatry, University of Muenster, Muenster, Germany
| | - U Dannlowski
- Department of Psychiatry, University of Muenster, Muenster, Germany
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - V Arolt
- Department of Psychiatry, University of Muenster, Muenster, Germany
| | - N Opel
- Department of Psychiatry, University of Muenster, Muenster, Germany
| | - W Heindel
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
| | - H Kugel
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
| | - D Hoehn
- Neuroimaging Core Unit, Max Planck Institute of Psychiatry, Munich, Germany
| | - M Czisch
- Neuroimaging Core Unit, Max Planck Institute of Psychiatry, Munich, Germany
| | - B Couvy-Duchesne
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - M E Rentería
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - L T Strike
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - M J Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - N T Mills
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - G I de Zubicaray
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - K L McMahon
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - S E Medland
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - N G Martin
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - N A Gillespie
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - R Goya-Maldonado
- Centre for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August-University, Göttingen, Germany
| | - O Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - B Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - S N Hatton
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - J Lagopoulos
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - I B Hickie
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - T Frodl
- Department of Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
- Department of Psychiatry and Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - A Carballedo
- Department of Psychiatry and Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - E M Frey
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - L S van Velzen
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - M-J van Tol
- Neuroimaging Center, Section of Cognitive Neuropsychiatry, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - N J van der Wee
- Department of Psychiatry and Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
| | - C G Davey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - B J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - B Mwangi
- UT Center of Excellence on Mood Disoders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - B Cao
- UT Center of Excellence on Mood Disoders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J C Soares
- UT Center of Excellence on Mood Disoders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - I M Veer
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - H Walter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - D Schoepf
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - B Zurowski
- Center for Integrative Psychiatry, University of Lübeck, Lübeck, Germany
| | - C Konrad
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum Rotenburg, Rotenburg, Germany
| | - E Schramm
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
| | - C Normann
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
| | - K Schnell
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - M D Sacchet
- Neurosciences Program and Department of Psychology, Stanford University, Stanford, CA, USA
| | - I H Gotlib
- Neurosciences Program and Department of Psychology, Stanford University, Stanford, CA, USA
| | - G M MacQueen
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - B R Godlewska
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - T Nickson
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Centre for Cogntive Ageing and Cogntive Epidemiology, University of Edinburgh, Edinburg, UK
| | - M Papmeyer
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Division of Systems Neuroscience of Psychopathology, Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - J Hall
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - J E Sussmann
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Department of Psychiatry, NHS Borders, Melrose, UK
| | - M Li
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - M Walter
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Psychiatry, University Tübingen, Tübingen, Germany
| | - L Aftanas
- Department of Experimental and Clinical Neuroscience, Scientific Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
| | - I Brack
- Department of Experimental and Clinical Neuroscience, Scientific Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
| | - N A Bokhan
- Mental Health Research Institute, Tomsk, Russia
- Faculty of Psychology, National Research Tomsk State University, Tomsk, Russia
- Department of General Medicine, Siberian State Medical University, Tomsk, Russia
| | - P M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - D J Veltman
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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11
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Opel N, Redlich R, Kaehler C, Grotegerd D, Dohm K, Heindel W, Kugel H, Thalamuthu A, Koutsouleris N, Arolt V, Teuber A, Wersching H, Baune BT, Berger K, Dannlowski U. Prefrontal gray matter volume mediates genetic risks for obesity. Mol Psychiatry 2017; 22:703-710. [PMID: 28348383 DOI: 10.1038/mp.2017.51] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/25/2017] [Accepted: 01/26/2017] [Indexed: 12/18/2022]
Abstract
Genetic and neuroimaging research has identified neurobiological correlates of obesity. However, evidence for an integrated model of genetic risk and brain structural alterations in the pathophysiology of obesity is still absent. Here we investigated the relationship between polygenic risk for obesity, gray matter structure and body mass index (BMI) by the use of univariate and multivariate analyses in two large, independent cohorts (n=330 and n=347). Higher BMI and higher polygenic risk for obesity were significantly associated with medial prefrontal gray matter decrease, and prefrontal gray matter was further shown to significantly mediate the effect of polygenic risk for obesity on BMI in both samples. Building on this, the successful individualized prediction of BMI by means of multivariate pattern classification algorithms trained on whole-brain imaging data and external validations in the second cohort points to potential clinical applications of this imaging trait marker.
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Affiliation(s)
- N Opel
- Department of Psychiatry, University of Münster, Münster, Germany
| | - R Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - C Kaehler
- Department of Psychiatry, University of Münster, Münster, Germany.,Department of Mathematics and Computer Science, University of Münster, Münster, Germany
| | - D Grotegerd
- Department of Psychiatry, University of Münster, Münster, Germany
| | - K Dohm
- Department of Psychiatry, University of Münster, Münster, Germany
| | - W Heindel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - H Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - A Thalamuthu
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - N Koutsouleris
- Department of Psychiatry, University of Munich, Munich, Germany
| | - V Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - A Teuber
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - H Wersching
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - B T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - K Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - U Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
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12
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Notzon S, Domschke K, Holitschke K, Ziegler C, Arolt V, Pauli P, Reif A, Deckert J, Zwanzger P. Attachment style and oxytocin receptor gene variation interact in influencing social anxiety. World J Biol Psychiatry 2016; 17:76-83. [PMID: 26488131 DOI: 10.3109/15622975.2015.1091502] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Social anxiety has been suggested to be promoted by an insecure attachment style. Oxytocin is discussed as a mediator of trust and social bonding as well as a modulator of social anxiety. Applying a gene-environment (G × E) interaction approach, in the present pilot study the main and interactive effects of attachment styles and oxytocin receptor (OXTR) gene variation were probed in a combined risk factor model of social anxiety in healthy probands. METHODS Participants (N = 388; 219 females, 169 males; age 24.7 ± 4.7 years) were assessed for anxiety in social situations (Social Phobia and Anxiety Inventory) depending on attachment style (Adult Attachment Scale, AAS) and OXTR rs53576 A/G genotype. RESULTS A less secure attachment style was significantly associated with higher social anxiety. This association was partly modulated by OXTR genotype, with a stronger negative influence of a less secure attachment style on social anxiety in A allele carriers as compared to GG homozygotes. CONCLUSIONS The present pilot data point to a strong association of less secure attachment and social anxiety as well as to a gene-environment interaction effect of OXTR rs53576 genotype and attachment style on social anxiety possibly constituting a targetable combined risk marker of social anxiety disorder.
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Affiliation(s)
- S Notzon
- a Department of Psychiatry and Psychotherapy , University of Muenster , Muenster , Germany
| | - K Domschke
- b Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Wuerzburg , Germany
| | - K Holitschke
- a Department of Psychiatry and Psychotherapy , University of Muenster , Muenster , Germany
| | - C Ziegler
- b Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Wuerzburg , Germany
| | - V Arolt
- a Department of Psychiatry and Psychotherapy , University of Muenster , Muenster , Germany
| | - P Pauli
- c Department of Biological Psychology, Clinical Psychology and Psychotherapy , University of Wuerzburg , Wuerzburg , Germany
| | - A Reif
- d Department of Psychiatry, Psychosomatics and Psychotherapy , University of Frankfurt , Frankfurt am Main , Germany
| | - J Deckert
- b Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Wuerzburg , Germany
| | - P Zwanzger
- a Department of Psychiatry and Psychotherapy , University of Muenster , Muenster , Germany .,e kbo-Inn-Salzach-Hospital , Wasserburg am Inn , Germany , and.,f Department of Psychiatry and Psychotherapy , Ludwig-Maximilians-University , Munich , Germany
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13
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Stacey D, Redlich R, Büschel A, Opel N, Grotegerd D, Zaremba D, Dohm K, Bürger C, Meinert SL, Förster K, Repple J, Kaufmann C, Kugel H, Heindel W, Arolt V, Dannlowski U, Baune BT. TNF receptors 1 and 2 exert distinct region-specific effects on striatal and hippocampal grey matter volumes (VBM) in healthy adults. Genes Brain Behav 2016; 16:352-360. [PMID: 27528091 DOI: 10.1111/gbb.12318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/20/2016] [Accepted: 08/10/2016] [Indexed: 12/23/2022]
Abstract
Tumour necrosis factor alpha (TNFα) has been implicated in the pathophysiology of neurodegenerative and neuropsychiatric disease, with research highlighting a role for TNFα in hippocampal and striatal regulation. TNFα signals are primarily transduced by TNF receptors 1 and 2 (TNFR1 and TNFR2), encoded by TNFRSF1A and TNFRSF1B, which exert opposing effects on cell survival (TNFR1, neurodegenerative; TNFR2, neuroprotective). We therefore sought to explore the respective roles of TNFR1 and TNFR2 in the regulation of hippocampal and striatal morphology in an imaging genetics study. Voxel-based morphometry was used to analyse the associations between TNFRSF1A (rs4149576 and rs4149577) and TNFRSF1B (rs1061624) genotypes and grey matter structure. The final samples comprised a total of 505 subjects (mean age = 33.29, SD = 11.55 years; 285 females and 220 males) for morphometric analyses of rs1061624 and rs4149576, and 493 subjects for rs4149577 (mean age = 33.20, SD = 11.56 years; 281 females and 212 males). Analyses of TNFRSF1A single nucleotide polymorphisms (SNPs) rs4149576 and rs4149577 showed highly significant genotypic associations with striatal volume but not the hippocampus. Specifically, for rs4149576, G homozygotes were associated with reduced caudate nucleus volumes relative to A homozygotes and heterozygotes, whereas for rs4149577, reduced caudate volumes were observed in C homozygotes relative to T homozygotes and heterozygotes. Analysis of the TNFRSF1B SNP rs1061624 yielded a significant association with hippocampal but not with striatal volume, whereby G homozygotes were associated with increased volumes relative to A homozygotes and heterozygotes. Our findings indicate a role for TNFR1 in regulating striatal but not hippocampal morphology, as well as a complementary role for TNFR2 in hippocampal but not in striatal morphology.
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Affiliation(s)
- D Stacey
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - R Redlich
- Department of Psychiatry, University of Münster, Münster
| | - A Büschel
- Department of Psychiatry, University of Münster, Münster
| | - N Opel
- Department of Psychiatry, University of Münster, Münster
| | - D Grotegerd
- Department of Psychiatry, University of Münster, Münster
| | - D Zaremba
- Department of Psychiatry, University of Münster, Münster
| | - K Dohm
- Department of Psychiatry, University of Münster, Münster
| | - C Bürger
- Department of Psychiatry, University of Münster, Münster
| | - S L Meinert
- Department of Psychiatry, University of Münster, Münster
| | - K Förster
- Department of Psychiatry, University of Münster, Münster
| | - J Repple
- Department of Psychiatry, University of Münster, Münster
| | - C Kaufmann
- Department of Psychiatry, University of Münster, Münster
| | - H Kugel
- Department of Clinical Radiology, University of Münster, Münster
| | - W Heindel
- Department of Clinical Radiology, University of Münster, Münster
| | - V Arolt
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - U Dannlowski
- Department of Psychiatry, University of Münster, Münster.,Department of Psychiatry, University of Marburg, Marburg, Germany
| | - B T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
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14
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Abstract
Late-onset depression (LOD) is defined as depression manifesting for the first time in later life. Up to now, there has been no exact definition of the lower age limit for LOD. Psychopathological symptoms of LOD do not fundamentally differ from depression in other phases of life; however, cognitive deficits are typically more pronounced. The LOD is associated with an increased risk of developing dementia. Imaging studies show reduction in gray matter volume and white matter lesions caused by vascular diseases. The occurrence of depression with vascular lesions of the brain is also referred to as "vascular depression". The diagnostic procedure includes a detailed medical history and the observation of psychopathological changes, physical examination, laboratory tests, electroencephalograph (EEG), electrocardiograph (ECG) and magnetic resonance imaging (MRI) of the head and neuropsychological tests to measure cognitive deficits. Psychotherapy is an effective treatment option. Selective serotonin reuptake inhibitors are the first-line pharmacological therapy.
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Affiliation(s)
- S Notzon
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Deutschland.
| | - J Alferink
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Deutschland
| | - V Arolt
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Deutschland
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15
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Opel N, Zwanzger P, Redlich R, Grotegerd D, Dohm K, Arolt V, Heindel W, Kugel H, Dannlowski U. Differing brain structural correlates of familial and environmental risk for major depressive disorder revealed by a combined VBM/pattern recognition approach. Psychol Med 2016; 46:277-290. [PMID: 26355299 DOI: 10.1017/s0033291715001683] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Neuroimaging traits of either familial or environmental risk for major depressive disorder (MDD) have been interpreted as possibly useful vulnerability markers. However, the simultaneous occurrence of familial and environmental risk might prove to be a major obstacle in the attempt of recent studies to confine the precise impact of each of these conditions on brain structure. Moreover, the exclusive use of group-level analyses does not permit prediction of individual illness risk which would be the basic requirement for the clinical application of imaging vulnerability markers. Hence, we aimed to distinguish between brain structural characteristics of familial predisposition and environmental stress by using both group- and individual-level analyses. METHOD We investigated grey matter alterations between 20 healthy control subjects (HC) and 20 MDD patients; 16 healthy first-degree relatives of MDD patients (FH+) and 20 healthy subjects exposed to former childhood maltreatment (CM+) by using a combined VBM/pattern recognition approach. RESULTS We found similar grey matter reductions in the insula and the orbitofrontal cortex in patients and FH+ subjects and in the hippocampus in patients and CM+ subjects. No direct overlap in grey matter alterations was found between FH+ and CM+ subjects. Pattern classification successfully detected subjects at risk for the disease even by strictly focusing on morphological traits of MDD. CONCLUSIONS Familial and environmental risk factors for MDD are associated with differing morphometric anomalies. Pattern recognition might be a promising instrument in the search for and future application of vulnerability markers for MDD.
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Affiliation(s)
- N Opel
- Department of Psychiatry,University of Münster,Münster,Germany
| | - P Zwanzger
- Department of Psychiatry,University of Münster,Münster,Germany
| | - R Redlich
- Department of Psychiatry,University of Münster,Münster,Germany
| | - D Grotegerd
- Department of Psychiatry,University of Münster,Münster,Germany
| | - K Dohm
- Department of Psychiatry,University of Münster,Münster,Germany
| | - V Arolt
- Department of Psychiatry,University of Münster,Münster,Germany
| | - W Heindel
- Department of Clinical Radiology,University of Münster,Münster,Germany
| | - H Kugel
- Department of Clinical Radiology,University of Münster,Münster,Germany
| | - U Dannlowski
- Department of Psychiatry,University of Münster,Münster,Germany
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16
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Ruland T, Domschke K, Schütte V, Zavorotnyy M, Kugel H, Notzon S, Vennewald N, Ohrmann P, Arolt V, Pfleiderer B, Zwanzger P. Neuropeptide S receptor gene variation modulates glutamatergic anterior cingulate cortex activity during CCK-4 induced panic. Pharmacopsychiatry 2015. [DOI: 10.1055/s-0035-1558026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Ambree O, Ruland C, Zwanzger P, Arolt V, Alferink J. Altered myeloid and lymphoid immune cell responses following repeated social defeat stress. Pharmacopsychiatry 2015. [DOI: 10.1055/s-0035-1557941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Drenckhan I, Glöckner-Rist A, Rist F, Richter J, Gloster AT, Fehm L, Lang T, Alpers GW, Hamm AO, Fydrich T, Kircher T, Arolt V, Deckert J, Ströhle A, Wittchen HU, Gerlach AL. Dimensional structure of bodily panic attack symptoms and their specific connections to panic cognitions, anxiety sensitivity and claustrophobic fears. Psychol Med 2015; 45:1675-1685. [PMID: 25482960 DOI: 10.1017/s0033291714002803] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Previous studies of the dimensional structure of panic attack symptoms have mostly identified a respiratory and a vestibular/mixed somatic dimension. Evidence for additional dimensions such as a cardiac dimension and the allocation of several of the panic attack symptom criteria is less consistent. Clarifying the dimensional structure of the panic attack symptoms should help to specify the relationship of potential risk factors like anxiety sensitivity and fear of suffocation to the experience of panic attacks and the development of panic disorder. METHOD In an outpatient multicentre study 350 panic patients with agoraphobia rated the intensity of each of the ten DSM-IV bodily symptoms during a typical panic attack. The factor structure of these data was investigated with nonlinear confirmatory factor analysis (CFA). The identified bodily symptom dimensions were related to panic cognitions, anxiety sensitivity and fear of suffocation by means of nonlinear structural equation modelling (SEM). RESULTS CFA indicated a respiratory, a vestibular/mixed somatic and a cardiac dimension of the bodily symptom criteria. These three factors were differentially associated with specific panic cognitions, different anxiety sensitivity facets and suffocation fear. CONCLUSIONS Taking into account the dimensional structure of panic attack symptoms may help to increase the specificity of the associations between the experience of panic attack symptoms and various panic related constructs.
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Affiliation(s)
- I Drenckhan
- Clinical Psychology and Psychotherapy,Institute of Psychology,University of Münster,Fliednerstraße 21,Münster,Germany
| | - A Glöckner-Rist
- Department Survey Design and Methodology,GESIS Leibniz Institute for Social Science,Mannheim,Germany
| | - F Rist
- Clinical Psychology and Psychotherapy,Institute of Psychology,University of Münster,Fliednerstraße 21,Münster,Germany
| | - J Richter
- Department of Biological and Clinical Psychology,University of Greifswald,Greifswald,Germany
| | - A T Gloster
- Institute of Clinical Psychology and Psychotherapy,Technische Universität Dresden,Dresden,Germany
| | - L Fehm
- Department of Psychology,Humboldt University of Berlin,Berlin,Germany
| | - T Lang
- Christoph-Dornier Foundation for Clinical Psychology,Bremen,Germany
| | - G W Alpers
- Department of Clinical and Biological Psychology,University of Mannheim,Mannheim,Germany
| | - A O Hamm
- Department of Biological and Clinical Psychology,University of Greifswald,Greifswald,Germany
| | - T Fydrich
- Department of Psychology,Humboldt University of Berlin,Berlin,Germany
| | - T Kircher
- Department of Psychiatry and Psychotherapy,Philipps-University Marburg,Marburg,Germany
| | - V Arolt
- Department of Psychiatry,University of Münster,Germany
| | - J Deckert
- Department of Psychiatry,Psychosomatics and Psychotherapy,University of Würzburg,Würzburg,Germany
| | - A Ströhle
- Department of Psychiatry and Psychotherapy,Charité-UniversitätsmedizinBerlin,Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy,Technische Universität Dresden,Dresden,Germany
| | - A L Gerlach
- Clinical Psychology and Psychotherapy,Institute of Psychology,University of Münster,Fliednerstraße 21,Münster,Germany
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19
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Biernacka JM, Sangkuhl K, Jenkins G, Whaley RM, Barman P, Batzler A, Altman RB, Arolt V, Brockmöller J, Chen CH, Domschke K, Hall-Flavin DK, Hong CJ, Illi A, Ji Y, Kampman O, Kinoshita T, Leinonen E, Liou YJ, Mushiroda T, Nonen S, Skime MK, Wang L, Baune BT, Kato M, Liu YL, Praphanphoj V, Stingl JC, Tsai SJ, Kubo M, Klein TE, Weinshilboum R. The International SSRI Pharmacogenomics Consortium (ISPC): a genome-wide association study of antidepressant treatment response. Transl Psychiatry 2015; 5:e553. [PMID: 25897834 PMCID: PMC4462610 DOI: 10.1038/tp.2015.47] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 03/01/2015] [Indexed: 12/21/2022] Open
Abstract
Response to treatment with selective serotonin reuptake inhibitors (SSRIs) varies considerably between patients. The International SSRI Pharmacogenomics Consortium (ISPC) was formed with the primary goal of identifying genetic variation that may contribute to response to SSRI treatment of major depressive disorder. A genome-wide association study of 4-week treatment outcomes, measured using the 17-item Hamilton Rating Scale for Depression (HRSD-17), was performed using data from 865 subjects from seven sites. The primary outcomes were percent change in HRSD-17 score and response, defined as at least 50% reduction in HRSD-17. Data from two prior studies, the Pharmacogenomics Research Network Antidepressant Medication Pharmacogenomics Study (PGRN-AMPS) and the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, were used for replication, and a meta-analysis of the three studies was performed (N=2394). Although many top association signals in the ISPC analysis map to interesting candidate genes, none were significant at the genome-wide level and the associations were not replicated using PGRN-AMPS and STAR*D data. The top association result in the meta-analysis of response represents SNPs 5′ upstream of the neuregulin-1 gene, NRG1 (P = 1.20E - 06). NRG1 is involved in many aspects of brain development, including neuronal maturation and variations in this gene have been shown to be associated with increased risk for mental disorders, particularly schizophrenia. Replication and functional studies of these findings are warranted.
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Affiliation(s)
- J M Biernacka
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA,Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA,Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. E-mail:
| | - K Sangkuhl
- Department of Genetics, Stanford University, Stanford, CA, USA
| | - G Jenkins
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - R M Whaley
- Department of Genetics, Stanford University, Stanford, CA, USA
| | - P Barman
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - A Batzler
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - R B Altman
- Department of Genetics, Stanford University, Stanford, CA, USA,Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - V Arolt
- Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
| | - J Brockmöller
- Department of Clinical Pharmacology, University Göttingen, Göttingen, Germany
| | - C H Chen
- Department of Psychiatry, Taipei Medical University-Shuangho Hospital, New Taipei City, Taiwan
| | - K Domschke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - D K Hall-Flavin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - C J Hong
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - A Illi
- Department of Psychiatry, School of Medicine, University of Tampere, Tampere, Finland
| | - Y Ji
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - O Kampman
- Department of Psychiatry, School of Medicine, University of Tampere, Tampere, Finland,Department of Psychiatry, Seinäjoki Hospital District, Seinäjoki, Finland
| | - T Kinoshita
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - E Leinonen
- Department of Psychiatry, School of Medicine, University of Tampere, Tampere, Finland,Department of Psychiatry, Tampere University Hospital, Tampere, Finland
| | - Y J Liou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - T Mushiroda
- RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - S Nonen
- Department of Pharmacy, Hyogo University of Health Sciences, Hyogo, Japan
| | - M K Skime
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - L Wang
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - B T Baune
- Department of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - M Kato
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Y L Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
| | - V Praphanphoj
- Center for Medical Genetics Research, Rajanukul Institute, Department of Mental Health, Ministry of Public Health Bangkok, Bangkok, Thailand
| | - J C Stingl
- Research Division Federal Institute for Drugs and Medical Devices, Bonn, Germany
| | - S J Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - M Kubo
- RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - T E Klein
- Department of Genetics, Stanford University, Stanford, CA, USA
| | - R Weinshilboum
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
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20
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Dannlowski U, Grabe HJ, Wittfeld K, Klaus J, Konrad C, Grotegerd D, Redlich R, Suslow T, Opel N, Ohrmann P, Bauer J, Zwanzger P, Laeger I, Hohoff C, Arolt V, Heindel W, Deppe M, Domschke K, Hegenscheid K, Völzke H, Stacey D, Meyer Zu Schwabedissen H, Kugel H, Baune BT. Multimodal imaging of a tescalcin (TESC)-regulating polymorphism (rs7294919)-specific effects on hippocampal gray matter structure. Mol Psychiatry 2015; 20:398-404. [PMID: 24776739 DOI: 10.1038/mp.2014.39] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 02/09/2014] [Accepted: 03/17/2014] [Indexed: 02/07/2023]
Abstract
In two large genome-wide association studies, an intergenic single-nucleotide polymorphism (SNP; rs7294919) involved in TESC gene regulation has been associated with hippocampus volume. Further characterization of neurobiological effects of the TESC gene is warranted using multimodal brain-wide structural and functional imaging. Voxel-based morphometry (VBM8) was used in two large, well-characterized samples of healthy individuals of West-European ancestry (Münster sample, N=503; SHIP-TREND, N=721) to analyze associations between rs7294919 and local gray matter volume. In subsamples, white matter fiber structure was investigated using diffusion tensor imaging (DTI) and limbic responsiveness was measured by means of functional magnetic resonance imaging (fMRI) during facial emotion processing (N=220 and N=264, respectively). Furthermore, gene x environment (G × E) interaction and gene x gene interaction with SNPs from genes previously found to be associated with hippocampal size (FKBP5, Reelin, IL-6, TNF-α, BDNF and 5-HTTLPR/rs25531) were explored. We demonstrated highly significant effects of rs7294919 on hippocampal gray matter volumes in both samples. In whole-brain analyses, no other brain areas except the hippocampal formation and adjacent temporal structures were associated with rs7294919. There were no genotype effects on DTI and fMRI results, including functional connectivity measures. No G × E interaction with childhood maltreatment was found in both samples. However, an interaction between rs7294919 and rs2299403 in the Reelin gene was found that withstood correction for multiple comparisons. We conclude that rs7294919 exerts highly robust and regionally specific effects on hippocampal gray matter structures, but not on other neuropsychiatrically relevant imaging markers. The biological interaction between TESC and RELN pointing to a neurodevelopmental origin of the observed findings warrants further mechanistic investigations.
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Affiliation(s)
- U Dannlowski
- 1] Department of Psychiatry, University of Münster, Münster, Germany [2] Department of Psychiatry, University of Marburg, Marburg, Germany
| | - H J Grabe
- 1] Department of Psychiatry, University Medicine Greifswald, HELIOS-Hospital Stralsund, Stralsund, Germany [2] German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - K Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - J Klaus
- Department of Psychiatry, University of Münster, Münster, Germany
| | - C Konrad
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - D Grotegerd
- Department of Psychiatry, University of Münster, Münster, Germany
| | - R Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - T Suslow
- 1] Department of Psychiatry, University of Münster, Münster, Germany [2] Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - N Opel
- Department of Psychiatry, University of Münster, Münster, Germany
| | - P Ohrmann
- Department of Psychiatry, University of Münster, Münster, Germany
| | - J Bauer
- Department of Psychiatry, University of Münster, Münster, Germany
| | - P Zwanzger
- Department of Psychiatry, University of Münster, Münster, Germany
| | - I Laeger
- Department of Psychiatry, University of Münster, Münster, Germany
| | - C Hohoff
- Department of Psychiatry, University of Münster, Münster, Germany
| | - V Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - W Heindel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - M Deppe
- Department of Neurology, University of Münster, Münster, Germany
| | - K Domschke
- Department of Psychiatry, University of Würzburg, Würzburg, Germany
| | - K Hegenscheid
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - D Stacey
- Discipline of Psychiatry, School of Medicine, University of Adelaide: North Terrace, Adelaide, SA, Australia
| | | | - H Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - B T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide: North Terrace, Adelaide, SA, Australia
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21
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Windgassen K, Arolt V. [Obituary for prof. Dr. Rainer Tölle]. Nervenarzt 2015; 86:373-374. [PMID: 25787861 DOI: 10.1007/s00115-015-4264-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- K Windgassen
- Fachkrankenhaus für Psychiatrie, Psychotherapie, Psychosomatik und Neurologie, Evangelische Stiftung Tannenhof, Remscheid, Deutschland
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22
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Straube B, Reif A, Richter J, Lueken U, Weber H, Arolt V, Jansen A, Zwanzger P, Domschke K, Pauli P, Konrad C, Gerlach AL, Lang T, Fydrich T, Alpers GW, Ströhle A, Wittmann A, Pfleiderer B, Wittchen HU, Hamm A, Deckert J, Kircher T. The functional -1019C/G HTR1A polymorphism and mechanisms of fear. Transl Psychiatry 2014; 4:e490. [PMID: 25514753 PMCID: PMC4270311 DOI: 10.1038/tp.2014.130] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 10/23/2014] [Accepted: 10/26/2014] [Indexed: 01/01/2023] Open
Abstract
Serotonin receptor 1A gene (HTR1A) knockout mice show pronounced defensive behaviour and increased fear conditioning to ambiguous conditioned stimuli. Such behaviour is a hallmark of pathological human anxiety, as observed in panic disorder with agoraphobia (PD/AG). Thus, variations in HTR1A might contribute to neurophysiological differences within subgroups of PD/AG patients. Here, we tested this hypothesis by combining genetic with behavioural techniques and neuroimaging. In a clinical multicentre trial, patients with PD/AG received 12 sessions of manualized cognitive-behavioural therapy (CBT) and were genotyped for HTR1A rs6295. In four subsamples of this multicentre trial, exposure behaviour (n=185), defensive reactivity measured using a behavioural avoidance test (BAT; before CBT: n=245; after CBT: n=171) and functional magnetic resonance imaging (fMRI) data during fear conditioning were acquired before and after CBT (n=39). HTR1A risk genotype (GG) carriers more often escaped during the BAT before treatment. Exploratory fMRI results suggest increased activation of the amygdala in response to threat as well as safety cues before and after treatment in GG carriers. Furthermore, GG carriers demonstrated reduced effects of CBT on differential conditioning in regions including the bilateral insulae and the anterior cingulate cortex. Finally, risk genotype carriers demonstrated reduced self-initiated exposure behaviour to aversive situations. This study demonstrates the effect of HTR1A variation on defensive behaviour, amygdala activity, CBT-induced neural plasticity and normalization of defence behaviour in PD/AG. Our results, therefore, translate evidence from animal studies to humans and suggest a central role for HTR1A in differentiating subgroups of patients with anxiety disorders.
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Affiliation(s)
- B Straube
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany,Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany. E-mail:
| | - A Reif
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - J Richter
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - U Lueken
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - H Weber
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - V Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - A Jansen
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - P Zwanzger
- Department of Psychiatry, University of Münster, Münster, Germany
| | - K Domschke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - P Pauli
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - C Konrad
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany,Department of Psychiatry, University of Münster, Münster, Germany
| | - A L Gerlach
- Department of Psychology, University of Cologne, Cologne, Germany
| | - T Lang
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany,University of Bremen and Christoph-Dornier Foundation for Clinical Psychology, Bremen, Germany
| | - T Fydrich
- Department of Psychology, Humboldt University, Berlin, Germany
| | - G W Alpers
- Department of Psychology, Clinical and Biological Psychology, School of Social Sciences, Mannheim, Germany
| | - A Ströhle
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - A Wittmann
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - B Pfleiderer
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - A Hamm
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - J Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - T Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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23
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Wittmann A, Schlagenhauf F, Guhn A, Lueken U, Gaehlsdorf C, Stoy M, Bermpohl F, Fydrich T, Pfleiderer B, Bruhn H, Gerlach AL, Kircher T, Straube B, Wittchen HU, Arolt V, Heinz A, Ströhle A. Anticipating agoraphobic situations: the neural correlates of panic disorder with agoraphobia. Psychol Med 2014; 44:2385-2396. [PMID: 24398049 DOI: 10.1017/s0033291713003085] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Panic disorder with agoraphobia is characterized by panic attacks and anxiety in situations where escape might be difficult. However, neuroimaging studies specifically focusing on agoraphobia are rare. Here we used functional magnetic resonance imaging (fMRI) with disorder-specific stimuli to investigate the neural substrates of agoraphobia. METHOD We compared the neural activations of 72 patients suffering from panic disorder with agoraphobia with 72 matched healthy control subjects in a 3-T fMRI study. To isolate agoraphobia-specific alterations we tested the effects of the anticipation and perception of an agoraphobia-specific stimulus set. During fMRI, 48 agoraphobia-specific and 48 neutral pictures were randomly presented with and without anticipatory stimulus indicating the content of the subsequent pictures (Westphal paradigm). RESULTS During the anticipation of agoraphobia-specific pictures, stronger activations were found in the bilateral ventral striatum and left insula in patients compared with controls. There were no group differences during the perception phase of agoraphobia-specific pictures. CONCLUSIONS This study revealed stronger region-specific activations in patients suffering from panic disorder with agoraphobia in anticipation of agoraphobia-specific stimuli. Patients seem to process these stimuli more intensively based on individual salience. Hyperactivation of the ventral striatum and insula when anticipating agoraphobia-specific situations might be a central neurofunctional correlate of agoraphobia. Knowledge about the neural correlates of anticipatory and perceptual processes regarding agoraphobic situations will help to optimize and evaluate treatments, such as exposure therapy, in patients with panic disorder and agoraphobia.
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Affiliation(s)
- A Wittmann
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - F Schlagenhauf
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - A Guhn
- Department of Psychiatry, Psychosomatics and Psychotherapy,University of Wuerzburg,Wuerzburg,Germany
| | - U Lueken
- Institute of Clinical Psychology and Psychotherapy,Technische Universität Dresden,Dresden,Germany
| | - C Gaehlsdorf
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - M Stoy
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - F Bermpohl
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - T Fydrich
- Institute of Psychology,Psychotherapy and Somatopsychology - Humboldt Universität zu Berlin,Germany
| | - B Pfleiderer
- Department of Clinical Radiology,University of Münster,Münster,Germany
| | - H Bruhn
- Department of Radiology,University of Jena,Jena,Germany
| | - A L Gerlach
- Department of Psychology,University of Cologne,Cologne,Germany
| | - T Kircher
- Department of Psychiatry and Psychotherapy,Philipps-University Marburg,Marburg,Germany
| | - B Straube
- Department of Psychiatry and Psychotherapy,Philipps-University Marburg,Marburg,Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy,Technische Universität Dresden,Dresden,Germany
| | - V Arolt
- Department of Psychiatry,University of Münster,Münster,Germany
| | - A Heinz
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
| | - A Ströhle
- Department of Psychiatry and Psychotherapy,Charité University Medicine Berlin,Germany
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24
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Lueken U, Straube B, Reinhardt I, Maslowski NI, Wittchen HU, Ströhle A, Wittmann A, Pfleiderer B, Konrad C, Ewert A, Uhlmann C, Arolt V, Jansen A, Kircher T. Altered top-down and bottom-up processing of fear conditioning in panic disorder with agoraphobia. Psychol Med 2014; 44:381-394. [PMID: 23611156 DOI: 10.1017/s0033291713000792] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Although several neurophysiological models have been proposed for panic disorder with agoraphobia (PD/AG), there is limited evidence from functional magnetic resonance imaging (fMRI) studies on key neural networks in PD/AG. Fear conditioning has been proposed to represent a central pathway for the development and maintenance of this disorder; however, its neural substrates remain elusive. The present study aimed to investigate the neural correlates of fear conditioning in PD/AG patients. METHOD The blood oxygen level-dependent (BOLD) response was measured using fMRI during a fear conditioning task. Indicators of differential conditioning, simple conditioning and safety signal processing were investigated in 60 PD/AG patients and 60 matched healthy controls. RESULTS Differential conditioning was associated with enhanced activation of the bilateral dorsal inferior frontal gyrus (IFG) whereas simple conditioning and safety signal processing were related to increased midbrain activation in PD/AG patients versus controls. Anxiety sensitivity was associated positively with the magnitude of midbrain activation. CONCLUSIONS The results suggest changes in top-down and bottom-up processes during fear conditioning in PD/AG that can be interpreted within a neural framework of defensive reactions mediating threat through distal (forebrain) versus proximal (midbrain) brain structures. Evidence is accumulating that this network plays a key role in the aetiopathogenesis of panic disorder.
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Affiliation(s)
- U Lueken
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - B Straube
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Germany
| | - I Reinhardt
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Germany
| | - N I Maslowski
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - A Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - A Wittmann
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - B Pfleiderer
- Department of Clinical Radiology, University of Münster, Germany
| | - C Konrad
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Germany
| | - A Ewert
- Department of Clinical Radiology, University of Münster, Germany
| | - C Uhlmann
- Department of Psychiatry and Psychotherapy, University of Münster, Germany
| | - V Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Germany
| | - A Jansen
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Germany
| | - T Kircher
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Germany
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25
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Arolt V, Behnken A, Zwanzger P. EPA-1254 – Clinical profile of neurocognitive dysfunction in major depression. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78491-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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26
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Sumaski L, Birkenhäger TK, Carvalho LA, Bergink V, Drexhage HA, Arolt V. Depression symptoms in relation to inflammatory monocyte gene expression in patients with major depressive disorder. Pharmacopsychiatry 2013. [DOI: 10.1055/s-0033-1353351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Grotegerd D, Stuhrmann A, Kugel H, Schmidt S, Redlich R, Zwanzger P, Rauch AV, Heindel W, Zwitserlood P, Arolt V, Suslow T, Dannlowski U. Prediction of unipolar and bipolar depression on the basis of pattern classification techniques using amygdala excitability to subliminally presented emotional faces. Pharmacopsychiatry 2013. [DOI: 10.1055/s-0033-1353272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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28
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Kirchner H, Siegmund A, Arolt V. NMDAR-Enzephalitis nach ovarieller Zystektomie mit den Symptomen einer akut polymorph psychotischen Störung. Akt Neurol 2013. [DOI: 10.1055/s-0033-1343469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- H. Kirchner
- Euregioklinik Nordhorn, Psychiatrie, Nordhorn
| | - A. Siegmund
- Euregioklinik Nordhorn, Psychiatrie, Nordhorn
| | - V. Arolt
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster
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30
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Domschke K, Tidow N, Schrempf M, Schwarte K, Klauke B, Reif A, Arolt V, Zwanzger P, Deckert J. 613 – Glutamate decarboxylase 1 dna hypomethylation - an epigenetic signature of panic disorder? Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)75878-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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31
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Stein M, Dietrich DE, Agelink MW, Becker W, Chrysanthou C, Driessen M, Kruse G, Machleidt W, Reker T, Schneider U, Schulze Mönking H, Emrich HM, Arolt V, Rothermundt M. Naturalistic pharmacotherapy of acute episodes of schizophrenic disorders in comparison to treatment guidelines. Pharmacopsychiatry 2012; 45:189-95. [PMID: 22456956 DOI: 10.1055/s-0031-1301286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION This study was designed to investigate to what extent guidelines regarding the pharmacological treatment of patients suffering from schizophrenia-like psychosis are adopted in a naturalistic treatment setting. METHODS Medical records of n=819 patients undergoing inpatient treatment for schizophrenia-like psychosis in 11 psychiatric hospitals in northwestern Germany were retrospectively analyzed and findings were compared to current schizophrenia guideline recommendations. RESULTS The prescription rate of second generation antipsychotics increased from 47.1% on admission to 62.5% at discharge. Only half the patients (52.3%) received antipsychotic monotherapy while 47.7% took between 2 and 4 antipsychotic substances at a time. Dosage increases occurred most frequently (in 60%) within the first week of inpatient treatment, 16.6% experienced an elevation between days 15 and 29. A change within the atypical medication was found in 19.3%. Clozapine prescriptions increased throughout the treatment but were combined with other antipsychotic substances in the majority of cases. CONCLUSION Under naturalistic conditions guideline recommendations for treatment of schizophrenia-like psychosis are adhered to only partially. Combination therapy with 2 or more antipsychotic drugs is quite common despite a clear recommendation for monotherapy.
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Affiliation(s)
- M Stein
- Department of Psychiatry, University Hospital Münster, Münster, Germany
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Baune BT, Stuart M, Gilmour A, Wersching H, Heindel W, Arolt V, Berger K. The relationship between subtypes of depression and cardiovascular disease: a systematic review of biological models. Transl Psychiatry 2012; 2:e92. [PMID: 22832857 PMCID: PMC3309537 DOI: 10.1038/tp.2012.18] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 02/04/2012] [Indexed: 12/13/2022] Open
Abstract
A compelling association has been observed between cardiovascular disease (CVD) and depression, suggesting individuals with depression to be at significantly higher risk for CVD and CVD-related mortality. Systemic immune activation, hypothalamic-pituitary-adrenal (HPA) axis hyperactivity, arterial stiffness and endothelial dysfunction have been frequently implicated in this relationship. Although a differential epidemiological association between CVD and depression subtypes is evident, it has not been determined if this indicates subtype specific biological mechanisms. A comprehensive systematic literature search was conducted using PubMed and PsycINFO databases yielding 147 articles for this review. A complex pattern of systemic immune activation, endothelial dysfunction and HPA axis hyperactivity is suggestive of the biological relationship between CVD and depression subtypes. The findings of this review suggest that diagnostic subtypes rather than a unifying model of depression should be considered when investigating the bidirectional biological relationship between CVD and depression. The suggested model of a subtype-specific biological relationship between depression and CVDs has implications for future research and possibly for diagnostic and therapeutic processes.
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Affiliation(s)
- B T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia.
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Domschke K, Tidow N, Kuithan H, Schwarte K, Klauke B, Ambrée O, Reif A, Kersting A, Arolt V, Zwanzger P, Deckert J. P-125 - Epigenetics of panic disorder - evidence for MAO-A Gene Hypomethylation. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)74292-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Musil R, Schwarz MJ, Riedel M, Dehning S, Cerovecki A, Spellmann I, Arolt V, Müller N. Elevated macrophage migration inhibitory factor and decreased transforming growth factor-beta levels in major depression--no influence of celecoxib treatment. J Affect Disord 2011; 134:217-25. [PMID: 21684012 DOI: 10.1016/j.jad.2011.05.047] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 05/26/2011] [Accepted: 05/26/2011] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The involvement of an immune process in the pathophysiology of major depression disorder (MDD) was substantiated by studies demonstrating elevated levels of proinflammatory cytokines and prostaglandin E(2) (PGE(2)). Cyclooxygenase-2 (COX-2) inhibitors lead to a reduced production of PGE(2) and have been shown to improve depressive symptoms. We investigated the three immune parameters macrophage migration inhibitory factor (MIF), transforming growth factor-β (TGF-β) and soluble CD14 (sCD14) in a randomized, placebo-controlled trial of the COX-2 inhibitor celecoxib as add-on therapy in patients with MDD treated with reboxetine. METHODS Thirty-two patients with depression and 20 healthy controls participated in the study. The patients were treated with reboxetine and celecoxib or placebo. Immune parameters were measured from serum at baseline, after three and five weeks using ELISA. RESULTS Celecoxib as add-on strategy resulted in a significant reduction of Hamilton Depression Scale scores compared to placebo. Depressed patients showed significantly elevated MIF (p < 0.001) and reduced TGF-β (p = 0.006) concentrations at baseline. There was no difference in sCD14-concentrations. There was no difference between the placebo and the celecoxib group and no change over time. LIMITATIONS Limitations of the study are the relatively small sample size and lack of functional assessment of HPA axis in parallel. CONCLUSIONS MIF is a promising new candidate in the neuro-immune interplay that may link depressive symptoms, altered immune state and HPA-axis dysregulation. Reduced levels of TGF-β replicate previous findings and support the importance of this regulatory cytokine in major depressive disorder.
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Affiliation(s)
- R Musil
- Psychiatric Clinic of University Munich, Nussbaumstrasse 7, 80336 Munich, Germany.
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Buschert J, Steinbrink J, Steinbeck J, Rothermundt M, Zhang W, Arolt V, Ambree O. Effects of psychosocial stress on the behavior of S100B transgenic mice. Pharmacopsychiatry 2011. [DOI: 10.1055/s-0031-1292454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Konrad C, Kugel H, Zwitserlood P, Dannlowski U, Pyka M, Domschke K, Arolt V, Kircher T, Schöning S. Serotonin-transporter polymorphism modulates anterior cingulate cortex activation during working memory tasks – an fMRI study. Pharmacopsychiatry 2011. [DOI: 10.1055/s-0031-1292508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hennings JM, Kohli MA, Czamara D, Wolf C, Domschke K, Arolt V, Baune T, Horstmann S, Brückl T, Klengel T, Menke A, Müller-Myhsok B, Ising M, Uhr M, Lucae S. BDNF and NTRK2 polymorphisms and antidepressant treatment outcome. Pharmacopsychiatry 2011. [DOI: 10.1055/s-0031-1292496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ambree O, Zlomuzica A, Buschert J, Rothermundt M, Zhang W, Arolt V, Dere E. Impaired water-maze performance and altered adult hippocampal neurogenesis in histamine H1-receptor knockout mice. Pharmacopsychiatry 2011. [DOI: 10.1055/s-0031-1292444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Konrad C, Geburek AJ, Rist F, Blumenroth H, Fischer B, Husstedt I, Arolt V, Schiffbauer H, Lohmann H. Long-term cognitive and emotional consequences of mild traumatic brain injury. Psychol Med 2011; 41:1197-1211. [PMID: 20860865 DOI: 10.1017/s0033291710001728] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The objective of this study was to investigate long-term cognitive and emotional sequelae of mild traumatic brain injury (mTBI), as previous research has remained inconclusive with respect to their prevalence and extent. METHOD Thirty-three individuals who had sustained mTBI on average 6 years prior to the study and 33 healthy control subjects were matched according to age, gender and education. Structural brain damage at time of testing was excluded by magnetic resonance imaging (MRI). A comprehensive neuropsychological test battery was conducted to assess learning, recall, working memory, attention and executive function. Psychiatric symptoms were assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Beck Depression Inventory (BDI). Possible negative response bias was ruled out by implementing the Word Memory Test (WMT). RESULTS The mTBI individuals had significant impairments in all cognitive domains compared to the healthy control subjects. Effect sizes of cognitive deficits were medium to large, and could not be accounted for by self-perceived deficits, depression, compensation claims or negative response bias. BDI scores were significantly higher in the patient group, and three patients fulfilled DSM-IV criteria for a mild episode of major depression. CONCLUSIONS Primarily, well-recovered individuals who had sustained a minor trauma more than half a decade ago continue to have long-term cognitive and emotional sequelae relevant for everyday social and professional life. mTBI may lead to a lasting disruption of neurofunctional circuits not detectable by standard structural MRI and needs to be taken seriously in clinical and forensic evaluations.
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Affiliation(s)
- C Konrad
- Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Germany.
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Sehlmeyer C, Dannlowski U, Schöning S, Kugel H, Pyka M, Pfleiderer B, Zwitserlood P, Schiffbauer H, Heindel W, Arolt V, Konrad C. Neural correlates of trait anxiety in fear extinction. Psychol Med 2011; 41:789-798. [PMID: 20550755 DOI: 10.1017/s0033291710001248] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Fear conditioning involves the amygdala as the main neural structure for learning fear responses whereas fear extinction mainly activates the inhibitory prefrontal cortex (PFC). In this study we investigated whether individual differences in trait anxiety affect amygdala and dorsal anterior cingulate cortex (dACC) activation during fear conditioning and extinction. METHOD Thirty-two healthy subjects were investigated by functional magnetic resonance imaging (fMRI) at 3 T while performing a cued fear-conditioning task. All participants completed the trait version of the State-Trait Anxiety Inventory (STAI-T). Activations of the amygdala and the dACC were examined with respect to the effects of trait anxiety. RESULTS Analysis of the fMRI data demonstrated enhanced activation in fear-related brain areas, such as the insula and the ACC, during both fear conditioning and extinction. Activation of the amygdala appeared only during the late acquisition phase whereas deactivation was observed during extinction. Regression analyses revealed that highly trait-anxious subjects exhibited sustained amygdala activation and reduced dACC involvement during the extinction of conditioned responses. CONCLUSIONS This study reveals that high levels of trait anxiety are associated with both increased amygdala activation and reduced dACC recruitment during the extinction of conditioned fear. This hyper-responsivity of the amygdala and the deficient cognitive control during the extinction of conditioned fear in anxious subjects reflect an increased resistance to extinct fear responses and may thereby enhance the vulnerability to developing anxiety disorders.
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Affiliation(s)
- C Sehlmeyer
- Department of Psychiatry, University Hospital of Muenster, Germany
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Abstract
Organische Ursachen akuter psychiatrischer Syndrome stellen die wichtigste Differenzialdiagnose bei psychiatrischen Akutaufnahmen, im Konsiliardienst und ambulanten Notdienst dar. Gerade mit der wachsenden Gruppe älterer Patienten treten Delirien, oft multifaktoriell ausgelöst, sehr häufig auf. Trotz ihrer ungünstigen Prognose bleiben sie allerdings zu oft unerkannt und unbehandelt. Medikamentöse, akutneurologische, infektiöse, metabolische und andere somatische Ursachen müssen differenzialdiagnostisch fundiert durch Anamnese, körperlichen Befund, Labor und Bildgebung ausgeschlossen werden. Erstmanifestationen wie auch psychiatrische Begleitsymptome stellen oft eine differenzialdiagnostische Herausforderung dar, auch in der teilweise allerdings nicht sicher möglichen Abgrenzung von reaktiven psychischen Störungen. Bestätigt sich eine organische Ursache, ist die Therapie primär ursachenorientiert und erst in einem zweiten Schritt symptomatisch mit antipsychotischer, antidepressiver oder sedierender Medikation. Einer iatrogenen Verursachung von Delirien sowie deren Prävention gilt ein besonderes Augenmerk, um die medizinische Qualität gerade für Ältere zu verbessern.
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Affiliation(s)
- C Thomas
- Abteilung Gerontopsychiatrie, Klinik für Psychiatrie und Psychotherapie Bethel, Evangelisches Krankenhaus Bielefeld, Gilead III, Bethesdaweg 12, 33617, Bielefeld, Deutschland.
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Dannlowski U, Konrad C, Arolt V, Suslow T. [Neurogenetics of emotional processes. Neuroimaging findings as endophenotypes for depression]. Nervenarzt 2010; 81:24-31. [PMID: 20013254 DOI: 10.1007/s00115-009-2828-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Major depression is one of the most frequent and serious psychiatric diseases. Although the disease is highly heritable, the search for candidate genes has been of limited success hitherto. The complex, polygenetic hereditary transmissions coding for heterogeneous, clinically defined phenotypes such as major depression may be better identified using the endophenotype approach. A recent study, reporting an association of the risk allele in a serotonin transporter polymorphism (5-HTTLPR) with increased amygdala responsiveness to aversive stimuli, stimulated the new research field of imaging genetics, which is characterized by the choice of neurobiological activity patterns as endophenotypes. This review discusses recent studies from this rapidly growing research field, focussing on genetic effects on cortico-limbic circuitries during emotion processing. Evidence is reviewed suggesting that potential risk-alleles for depression are associated with functional cortico-limbic abnormalities, which frequently occur in patients with major depression.
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Affiliation(s)
- U Dannlowski
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum, Albert-Schweitzer-Strasse 11, 48149 Münster.
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Suslow T, Kugel H, Reber H, Bauer J, Dannlowski U, Kersting A, Arolt V, Heindel W, Ohrmann P, Egloff B. Automatic brain response to facial emotion as a function of implicitly and explicitly measured extraversion. Neuroscience 2010; 167:111-23. [PMID: 20144695 DOI: 10.1016/j.neuroscience.2010.01.038] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Revised: 01/19/2010] [Accepted: 01/20/2010] [Indexed: 01/23/2023]
Affiliation(s)
- T Suslow
- Department of Psychiatry, University of Münster, Münster, Germany.
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Affiliation(s)
- K. Domschke
- Department of Psychiatry, University of Münster, Münster, Germany
| | - J. Deckert
- Department of Psychiatry, University of Würzburg, Würzburg, Germany
| | - V. Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - BT Baune
- Department of Psychiatry, James Cook University, Queensland, Australia
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Rauch AV, Paul V, ter Horst L, Bauer J, Ohrmann P, Konrad C, Dannlowski U, Egloff B, Heindel W, Arolt V, Suslow T. Repressive coping style modulates neural responses during encoding of emotional faces. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zwanzger P, Arolt V. [Persistent depressive mood and residual symptoms after depression. Often inconspicuous but still need to be treated]. MMW Fortschr Med 2010; 152:30. [PMID: 20333962 DOI: 10.1007/bf03365930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Pohle K, Domschke K, Roehrs T, Arolt V, Baune BT. Medical comorbidity affects antidepressant treatment response in patients with melancholic depression. Psychother Psychosom 2010; 78:359-63. [PMID: 19738401 DOI: 10.1159/000235975] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2008] [Accepted: 12/06/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study aimed at the impact of medical comorbidity (MC) on response to antidepressant treatment over 6 weeks in diagnostic subtypes of patients with major depressive episode (MDE). METHODS In a clinical sample of 241 admitted patients with MDE, MC was assessed by medical specialists and weekly response to antidepressant treatment was assessed with the Hamilton Depression Scale (HAM-D 21). RESULTS Over 6 weeks of treatment, patients with melancholic depression and MC had poorer treatment response on the HAM-D scale and a worse functional outcome (GAF) as opposed to their counterparts without MC, which was first detected after 4 weeks of treatment (p = 0.02). More specifically, subjects with melancholic depression and cardiovascular or endocrinological MC showed significantly poorer treatment response over 6 weeks. Interestingly, these effects were not related to various antidepressant treatment regimens. CONCLUSIONS MC has a negative impact on treatment response in patients with melancholic depression.
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Affiliation(s)
- K Pohle
- Department of Psychiatry, University of Muenster, Muenster, Germany
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Gloster AT, Wittchen HU, Einsle F, Höfler M, Lang T, Helbig-Lang S, Fydrich T, Fehm L, Hamm AO, Richter J, Alpers GW, Gerlach AL, Ströhle A, Kircher T, Deckert J, Zwanzger P, Arolt V. Mechanism of action in CBT (MAC): methods of a multi-center randomized controlled trial in 369 patients with panic disorder and agoraphobia. Eur Arch Psychiatry Clin Neurosci 2009; 259 Suppl 2:S155-66. [PMID: 19876674 DOI: 10.1007/s00406-009-0065-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated.
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Affiliation(s)
- A T Gloster
- Dresden University of Technology, Dresden, Germany
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Ising M, Lucae S, Binder EB, Bettecken T, Uhr M, Ripke S, Kohli MA, Hennings JM, Horstmann S, Kloiber S, Menke A, Bondy B, Rupprecht R, Domschke K, Baune BT, Arolt V, Rush AJ, Holsboer F, Müller-Myhsok B. A genome-wide association study points to multiple loci predicting antidepressant treatment outcome in depression. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zavorotnyy M, Zwanzger P, Diemer J, Christ M, Michael N, Arolt V, Pfleiderer B. Altered Auditive Processing as a Possible Trait-Marker of Major Depressive Disorder. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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