Improved anatomic delineation of the antidepressant response to partial sleep deprivation in medial frontal cortex using perfusion-weighted functional MRI.
This study used functional magnetic resonance imaging (fMRI) to clarify the sites of brain activity associated with the antidepressant effects of sleep deprivation (SD). We hypothesized: 1) depressed responders' baseline ventral anterior cingulate (AC) perfusion will be greater than that of nonresponders and controls; 2) following partial sleep deprivation (PSD), ventral AC perfusion will significantly decrease in responders only. Seventeen unmedicated outpatients with current major depression and eight controls received perfusion-weighted fMRI and structural MRI at baseline and following 1 night of late-night PSD. Talairach-transformed gray matter masks were merged with Talairach Daemon-based region of interest (ROI) templates. Baseline left ventral AC (LVAC) perfusion was greater in responders than nonresponders. There was no difference involving the medial frontal cortex. Responders' LVAC perfusion dropped from baseline to PSD scans compared with nonresponders and controls, as did perfusion in the right dorsal AC. In the patient group as a whole, decrease in LVAC perfusion from baseline to PSD scans correlated directly with the decrease in the modified 17-item Hamilton Depression Rating Scale (HDRS17) between baseline and PSD conditions. These data--the first using fMRI--show greater anatomic specificity than previous findings of SD and depression in linking decreased brain activity in this area with clinical improvement.
Department of Psychiatry, University of California-San Diego, La Jolla, CA 92093, USA. cclark@vapop.ucsd.edu
Camellia P
CP
Clark
Gregory G
GG
Brown
Lawrence
L
Frank
Linda
L
Thomas
Ashley N
AN
Sutherland
J Christian
JC
Gillin
D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D005625:Frontal Lobe / Q000033:anatomy & histology* / Q000187:drug effects* / Q000378:metabolism; D007839:Functional Laterality / Q000502:physiology; D005682:Gadolinium / Q000493:pharmacokinetics; D006179:Gyrus Cinguli / Q000033:anatomy & histology / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012720:Severity of Illness Index; D012892:Sleep Deprivation / Q000175:diagnosis / Q000503:physiopathology*; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents; D019275:Radiopharmaceuticals; D005682:Gadolinium