Cingulate function in depression: a potential predictor of treatment response.
The relationship between pretreatment regional cerebral glucose metabolism and eventual antidepressant drug response was measured using positron emission tomography (PET) in hospitalized patients with unipolar depression. Rostral anterior cingulate metabolism uniquely differentiated eventual treatment responders from non-responders. Hypometabolism characterized non-responders when compared with controls, in contrast to responders who were hypermetabolic. Metabolism in no other region discriminated the two groups, nor did associated demographic, clinical or behavioral measures, including motor speed, cognitive performance, depression severity or illness chronicity. Cingulate hypermetabolism may represent an important adaptive response to depression and failure of this response may underlie poor outcome. A critical role for rostral cingulate area 24a/b in the limbic-cortical network involved in abnormal mood states is proposed.
Mayberg
H S
HS
Research Imaging Center, University of Texas Health Science Center at San Antonio 78284-6240, USA.
Brannan
S K
SK
Mahurin
R K
RK
Jerabek
P A
PA
Brickman
J S
JS
Tekell
J L
JL
Silva
J A
JA
McGinnis
S
S
Glass
T G
TG
Martin
C C
CC
Fox
P T
PT
D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism*; D003847:Deoxyglucose / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D003866:Depressive Disorder / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging* / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D012016:Reference Values; D014055:Tomography, Emission-Computed
D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose; D005947:Glucose