Brain metabolic changes associated with symptom factor improvement in major depressive disorder.
BACKGROUND
Symptoms of major depressive disorder (MDD) have been linked to regional brain function through imaging studies of symptom provocation in normal control subjects and baseline studies of subjects with MDD. We examined associations between change in depressive symptom factors and change in regional brain metabolism from before to after treatment of MDD.


METHODS
Thirty-nine outpatients with MDD underwent 18F-fluorodeoxyglucose positron emission tomography scanning before and after treatment with either paroxetine or interpersonal psychotherapy. Associations were determined between changes in regional brain metabolism and changes in four Hamilton Depression Rating Scale factors (anxiety/somatization [ANX], psychomotor retardation [PR], cognitive disturbance [COGN], and sleep disturbance) and two corresponding Profile of Mood States subscales (tension [TENS] and fatigue [FATIG]).


RESULTS
Improvement in ANX, PR, TENS, and FATIG factors was associated with decreasing ventral frontal lobe metabolism. Improvement in ANX and TENS was also associated with decreasing ventral anterior cingulate gyrus (AC) and anterior insula activity, whereas improvement in PR was associated with increasing dorsal AC activity. COGN improvement was associated with increasing dorsolateral prefrontal cortex metabolism.


CONCLUSIONS
Brain regions that show significant relationships with symptom provocation in normal control subjects have similar relationships with MDD symptoms as they improve with treatment.
Brody
A L
AL
Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, California 90095, USA.
Saxena
S
S
Mandelkern
M A
MA
Fairbanks
L A
LA
Ho
M L
ML
Baxter
L R
LR
D003865:Major Depressive Disorder / Q000175:diagnosis / Q000378:metabolism* / Q000628:therapy; D019788:Fluorodeoxyglucose F18; D006179:Gyrus Cinguli / Q000378:metabolism; D006801:Humans; D017374:Paroxetine / Q000627:therapeutic use; D017397:Prefrontal Cortex / Q000378:metabolism*; D011596:Psychomotor Disorders / Q000378:metabolism; D011613:Psychotherapy; D019275:Radiopharmaceuticals; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D014055:Tomography, Emission-Computed
D019788:Fluorodeoxyglucose F18; D017374:Paroxetine; D019275:Radiopharmaceuticals; D017367:Selective Serotonin Reuptake Inhibitors