Prediction of antidepressant treatment response from gray matter volume across diagnostic categories.
Dysfunctional limbic, paralimbic and prefrontal brain circuits represent neural substrates of major depression that are targeted by pharmacotherapy. In a high resolution structural magnetic resonance imaging (MRI) study we investigated the potential of variability of the cortex volume to predict the response to antidepressant treatment among patients with major depression. We enrolled 167 patients participating in the Munich Antidepressant Response Signature (MARS) study and employed voxel based morphometry to investigate covariation of gray matter (GM) maps with changes of depression severity over 5 weeks. Larger left hippocampal and bilateral posterior cingulate GM volumes and lower right temporolateral GM volumes were associated with beneficial treatment response. Subcallosal/orbitofrontal GM volumes were associated with treatment response mainly through gender-by-region interactions. A hippocampal/temporolateral composite marker proved robust in both first episode and recurrent unipolar patients and in bipolar patients. Compared with 92 healthy controls, abnormally low volumes were only detected in the left hippocampal area, particularly in recurrent unipolar patients. These findings indicate that variability of the cortex volume of specific brain areas is associated with different response to antidepressants. In addition, hippocampal findings recursively link together unfavorable treatment response and progressive hippocampal structural changes in recurrent depression.
Max Planck Institute of Psychiatry, Munich, Germany. Electronic address: saemann@mpipsykl.mpg.de.
Philipp G
PG
Sämann
David
D
Höhn
Natalya
N
Chechko
Stefan
S
Kloiber
Susanne
S
Lucae
Marcus
M
Ising
Florian
F
Holsboer
Michael
M
Czisch
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001284:Atrophy / Q000473:pathology; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D036421:Nerve Fibers, Unmyelinated / Q000473:pathology*; D059906:Neuroimaging; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
D000928:Antidepressive Agents
Biomarker; Cingulate cortex; Depression; Hippocampus; Structural magnetic resonance imaging; Treatment response; Voxel based morphometry