Modulation of amygdala reactivity following rapidly acting interventions for major depression.
Adult
Amygdala
/ diagnostic imaging
Antidepressive Agents
/ administration & dosage
Brain Mapping
Depressive Disorder, Major
/ diagnostic imaging
Electroconvulsive Therapy
Emotions
Female
Humans
Injections, Intravenous
Ketamine
/ administration & dosage
Magnetic Resonance Imaging
Male
Middle Aged
Oxygen
/ blood
ECT
MDD
amygdala
emotion processing
ketamine
tfMRI
Journal
Human brain mapping
ISSN: 1097-0193
Titre abrégé: Hum Brain Mapp
Pays: United States
ID NLM: 9419065
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
11
10
2019
revised:
26
11
2019
accepted:
30
11
2019
pubmed:
3
3
2020
medline:
23
9
2021
entrez:
3
3
2020
Statut:
ppublish
Résumé
Electroconvulsive therapy (ECT) and ketamine treatment both induce rapidly acting antidepressant effects in patients with major depressive disorder unresponsive to standard treatments, yet their specific impact on emotion processing is unknown. Here, we examined the neural underpinnings of emotion processing within and across patients (N = 44) receiving either ECT (N = 17, mean age: 36.8, 11.0 SD) or repeated subanesthetic (0.5 mg/kg) intravenous ketamine therapy (N = 27, mean age: 37.3, 10.8 SD) using a naturalistic study design. MRI and clinical data were collected before (TP1) and after treatment (TP2); healthy controls (N = 31, mean age: 34.5, 13.5 SD) completed one MRI session (TP1). An fMRI face-matching task probed negative- and positive-valence systems. Whole-brain analysis, comparing neurofunctional changes within and across treatment groups, targeted brain regions involved in emotional facial processing, and included regions-of-interest analysis of amygdala responsivity. Main findings revealed a decrease in amygdalar reactivity after both ECT and ketamine for positive and negative emotional face processing (p < .05 family wise-error (FWE) corrected). Subthreshold changes were observed between treatments within the dorsolateral prefrontal cortex and insula (p < .005, uncorrected). BOLD change for positive faces in the inferior parietal cortex significantly correlated with overall symptom improvement, and BOLD change in frontal regions correlated with anxiety for negative faces, and anhedonia for positive faces (p < .05 FWE corrected). Both serial ketamine and ECT treatment modulate amygdala response, while more subtle treatment-specific changes occur in the larger functional network. Findings point to both common and differential mechanistic upstream systems-level effects relating to fast-acting antidepressant response, and symptoms of anxiety and anhedonia, for the processing of emotionally valenced stimuli.
Identifiants
pubmed: 32115848
doi: 10.1002/hbm.24895
pmc: PMC7268016
doi:
Substances chimiques
Antidepressive Agents
0
Ketamine
690G0D6V8H
Oxygen
S88TT14065
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1699-1710Subventions
Organisme : NIMH NIH HHS
ID : K24 MH102743
Pays : United States
Organisme : NIMH NIH HHS
ID : U01 MH110008
Pays : United States
Informations de copyright
© 2020 The Authors. Human Brain Mapping published by Wiley Periodicals, Inc.
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