title: Incongruent reduction of serotonin transporter associated with suicide attempts in patients with major depressive disorder: a positron emission tomography study with 4-[18F]-ADAM.
abstract: BACKGROUND
  Much evidence supports the role of the serotonin transporter (SERT) in the pathophysiology and pharmacotherapy of major depressive disorder (MDD) and suicidal behaviors.
  
  
  METHODS
  In this study, we recruited 17 antidepressant-naïve patients with MDD and 17 age- and gender-matched healthy controls. SERT availability was measured in vivo with N,N-dimethyl-2-(2-amino-4-[(18)F]fluorophenylthio)benzylamine (4-[(18)F]-ADAM) positron emission tomography (PET) imaging. The 21-item Hamilton Depression Rating Scale (HDRS) and Beck Scale for Suicide Ideation were used to assess the severity of depression and the intent of suicide ideation prior to PET imaging. All subjects with MDD were in a current state of depression with HDRS scores ≧18. Subjects who attempted suicide within two weeks of the study onset were recruited in the depressed suicidal group (n = 8). Subjects with MDD who denied any prior suicide attempt were recruited into the depressed non-suicidal group (n = 9).
  
  
  RESULTS
  A significant reduction of SERT availability in the midbrain, thalamus, and striatum was noted in the MDD group relative to the control group (Bonferroni-adjusted p-value < 0.05). Moreover, this effect was more pronounced in the depressed suicidal group compared to the control group (Bonferroni-adjusted p-value < 0.01). Relative to both the depressed non-suicidal and control groups, the depressed suicidal group showed an increased prefrontal cortex (PFC)/midbrain SERT binding ratio (Bonferroni-adjusted p-value < 0.01).
  
  
  CONCLUSIONS
  This study suggests an incongruent reduction of PFC SERT binding relative to the midbrain might discriminate between depressed suicide attempters and non-attempters in patients with MDD and may be involved in the pathophysiology of suicide behaviors.
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
authors.forename: Yi-Wei
authors.initials: YW
authors.lastname: Yeh
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
authors.forename: Pei-Shen
authors.initials: PS
authors.lastname: Ho
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
authors.forename: Chun-Yen
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
authors.forename: Shin-Chang
authors.initials: SC
authors.lastname: Kuo
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
authors.forename: Chih-Sung
authors.initials: CS
authors.lastname: Liang
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
authors.forename: Kuo-Hsing
authors.initials: KH
authors.lastname: Ma
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
authors.forename: Chyng-Yann
authors.initials: CY
authors.lastname: Shiue
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Huang
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
authors.forename: Cheng-Yi
authors.initials: CY
authors.lastname: Cheng
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
authors.forename: Tzu-Yun
authors.initials: TY
authors.lastname: Wang
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
authors.forename: Ru-Band
authors.initials: RB
authors.lastname: Lu
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Chen, Kuo, Liang, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Prof Ma); Department of Nuclear Medicine Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Prof Shiue, Drs W-S Huang and Cheng); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan (Dr Wang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu). hsy@ndmctsgh.edu.tw.
authors.forename: San-Yuan
authors.initials: SY
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D001596:Benzylamines; D016009:Chi-Square Distribution; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011569:Psychiatric Status Rating Scales; D019275:Radiopharmaceuticals; D050486:Serotonin Plasma Membrane Transport Proteins / Q000378:metabolism*; D013406:Suicide, Attempted / Q000523:psychology*; D055815:Young Adult
chemical_list: D001596:Benzylamines; C475911:N,N-dimethyl-2-(2-amino-4-fluorophenylthio)benzylamine; D019275:Radiopharmaceuticals; D050486:Serotonin Plasma Membrane Transport Proteins
keywords: 4-[18F]-ADAM; major depressive disorder; positron emission tomography; serotonin transporter; suicide