title: Meta-analysis of molecular imaging of serotonin transporters in major depression.
abstract: The success of serotonin-selective reuptake inhibitors has lent support to the monoamine theory of major depressive disorder (MDD). This issue has been addressed in a number of molecular imaging studies by positron emission tomography or single-photon emission computed tomography of serotonin reuptake sites (5-HTT) in the brain of patients with MDD, with strikingly disparate conclusions. Our meta-analysis of the 18 such studies, totaling 364 MDD patients free from significant comorbidities or medication and 372 control subjects, revealed reductions in midbrain 5-HTT (Hedges' g=-0.49; 95% CI: (-0.84, -0.14)) and amygdala (Hedges' g=-0.50; 95% CI: (-0.78, -0.22)), which no individual study possessed sufficient power to detect. Only small effect sizes were found in other regions with high binding (thalamus: g=-0.24, striatum: g=-0.32, and brainstem g=-0.22), and no difference in the frontal or cingulate cortex. Age emerged as an important moderator of 5-HTT availability in MDD, with more severe reductions in striatal 5-HTT evident with greater age of the study populations (P<0.01). There was a strong relationship between severity of depression and 5-HTT reductions in the amygdala (P=0.01). Thus, molecular imaging findings indeed reveal widespread reductions of ∼10% in 5-HTT availability in MDD, which may predict altered spatial-temporal dynamics of serotonergic neurotransmission.
authors.affiliation: Functional, Molecular & Translational Neuroimaging Lab, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Gregor
authors.initials: G
authors.lastname: Gryglewski
authors.affiliation: Functional, Molecular & Translational Neuroimaging Lab, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Rupert
authors.initials: R
authors.lastname: Lanzenberger
authors.affiliation: Functional, Molecular & Translational Neuroimaging Lab, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Georg S
authors.initials: GS
authors.lastname: Kranz
authors.affiliation: Department of Nuclear Medicine, Friederich-Alexanders Universitaet, Erlangen/Nurenberg, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Cumming
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D049268:Positron-Emission Tomography; D012701:Serotonin / Q000378:metabolism; D050486:Serotonin Plasma Membrane Transport Proteins / Q000032:analysis / Q000378:metabolism*; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D050486:Serotonin Plasma Membrane Transport Proteins; D012701:Serotonin