Predictors of nonresponse to cognitive behavioural therapy or venlafaxine using glucose metabolism in major depressive disorder.
BACKGROUND
Longitudinal neuroimaging investigations of antidepressant treatment offer the opportunity to identify potential baseline biomarkers associated with poor outcome.


METHODS
To explore the neural correlates of nonresponse to cognitive behavioural therapy (CBT) or venlafaxine (VEN), we compared pretreatment (18)F-fluoro-2-deoxy-d-glucose positron emission tomography scans of participants with major depressive disorder responding to either 16 weeks of CBT (n = 7) or VEN treatment (n = 9) with treatment nonresponders (n = 8).


RESULTS
Nonresponders to CBT or VEN, in contrast to responders, exhibited pretreatment hypermetabolism at the interface of the pregenual and subgenual cingulate cortices.


CONCLUSIONS
Limitations of our study include the small sample sizes and the absence of both arterial sampling to determine absolute glucose metabolism and high-resolution structural magnetic resonance imaging coregistration for region-of-interest analyses.


CONCLUSIONS
Our current findings are consistent with those reported in previous studies of relative hyperactivity in the ventral anterior cingulate cortex in treatment-resistant populations.
Konarski
Jakub Z
JZ
University Health Network, Toronto General Hospital, 200 Elizabeth St., Eaton North Wing 8-222, Toronto ON M5G2C4.
Kennedy
Sidney H
SH
Segal
Zindel V
ZV
Lau
Mark A
MA
Bieling
Peter J
PJ
McIntyre
Roger S
RS
Mayberg
Helen S
HS
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001921:Brain / Q000000981:diagnostic imaging; D015928:Cognitive Behavioral Therapy; D003511:Cyclohexanols / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D000069470:Venlafaxine Hydrochloride; D055815:Young Adult
D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D019788:Fluorodeoxyglucose F18; D000069470:Venlafaxine Hydrochloride; D005947:Glucose