Serotonin transporter binding as a possible predictor of one-year remission in major depressive disorder.
OBJECTIVE
Lower serotonin transporter (5-HTT) binding (BP(P)=f(P)B(avail)/K(D)) is reported during a major depressive episode (MDE) compared to healthy controls. Higher 5-HTT binding in the diencephalon has previously been associated with acute response to antidepressant treatment. We assessed baseline 5-HTT binding as a predictor of one-year remission from a MDE, examining binding in brain regions implicated in the pathophysiology of major depressive disorder (MDD).


METHODS
5-HTT binding was quantified using positron emission tomography (PET) with [(11)C]McN5652 in 19 currently depressed subjects with MDD and 41 healthy controls. Depressed subjects received open, naturalistic antidepressant treatment. Remission status was determined one year after PET scan and treatment initiation.


RESULTS
Significant differences in 5-HTT binding among the three groups (healthy controls, remitters, and non-remitters) were observed in a linear mixed-effects model. Post hoc, non-remitters had lower 5-HTT binding than controls in midbrain, amygdala, and anterior cingulate. Remitters did not differ significantly from controls or non-remitters in 5-HTT binding. Remitters did not differ from non-remitters in clinical characteristics apart from greater family history of depression among non-remitters. A logistic regression model fit to determine the capacity of baseline 5-HTT binding to predict remission status at one year yielded a coefficient that was suggestive but not significant (p=0.057).


CONCLUSIONS
The small sample size and heterogeneous treatments received reduced statistical power to detect differences in binding based on clinical outcome.


CONCLUSIONS
Lower pretreatment 5-HTT binding may be predictive of non-remission from major depression following one year of naturalistic antidepressant treatment. Future studies using standardized treatment are warranted.
Miller
Jeffrey M
JM
Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, Unit 42, New York, NY, United States. jm2233@columbia.edu
Oquendo
Maria A
MA
Ogden
R Todd
RT
Mann
J John
JJ
Parsey
Ramin V
RV
D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D000928:Antidepressive Agents / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D002250:Carbon Radioisotopes; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D026901:Membrane Transport Proteins / Q000378:metabolism*; D008636:Mesencephalon / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012075:Remission, Spontaneous; D012701:Serotonin / Q000378:metabolism; D050486:Serotonin Plasma Membrane Transport Proteins / Q000378:metabolism*; D055815:Young Adult
D000928:Antidepressive Agents; D002250:Carbon Radioisotopes; D026901:Membrane Transport Proteins; D050486:Serotonin Plasma Membrane Transport Proteins; D012701:Serotonin