title: Prefrontal glucose metabolism in medication-resistant major depression.
abstract: BACKGROUND
  Medication-resistant depression (MRD) is associated with poorer attentional performance and immense socioeconomic costs.
  
  
  OBJECTIVE
  We aimed to investigate the central pathophysiology of MRD, previously linked to impaired prefrontal cortex function.
  
  
  METHODS
  A total of 54 participants (22 with MRD, 16 with non-resistant depression, 16 healthy controls) were recruited. Non-MRD status was confirmed by a prospective 6-week antidepressant trial. All medication-free participants underwent a go/no-go task to study prefrontal cortical function (attention) and positron emission tomography scans to study regional cerebral glucose metabolism (rCMglu) at rest.
  
  
  RESULTS
  The MRD group had worse attentional ratings and decreased rCMglu compared with the non-MRD and control groups. Attentional performance was positively associated with prefrontal cortex rCMglu. The prefrontal cortex differences between MRD and non-MRD groups remained after adjusting for past depressive episodes (F(1,35) = 4.154, P = 0.043).
  
  
  CONCLUSIONS
  Pronounced hypofrontality, with the associated attentional deficits, has a key role in the neuropathology of medication-resistant depression.
authors: Cheng-Ta Li, MD, PhD, Tung-Ping Su, MD, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Institute of Brain Science, and Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei; Shyh-Jen Wang, MD, Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei; Pei-Chi Tu, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, and Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei; Jen-Chuen Hsieh, MD, PhD, Institute of Brain Science, National Yang-Ming University, Taipei, Integrated Brain Research Unit, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, and Centre of Neuropsychiatric Research, National Health and Research Institute, ChuNan, Taiwan.
authors: Cheng-Ta
authors: CT
authors: Li
authors: Cheng-Ta Li, MD, PhD, Tung-Ping Su, MD, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Institute of Brain Science, and Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei; Shyh-Jen Wang, MD, Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei; Pei-Chi Tu, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, and Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei; Jen-Chuen Hsieh, MD, PhD, Institute of Brain Science, National Yang-Ming University, Taipei, Integrated Brain Research Unit, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, and Centre of Neuropsychiatric Research, National Health and Research Institute, ChuNan, Taiwan.
authors: Tung-Ping
authors: TP
authors: Su
authors: Cheng-Ta Li, MD, PhD, Tung-Ping Su, MD, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Institute of Brain Science, and Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei; Shyh-Jen Wang, MD, Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei; Pei-Chi Tu, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, and Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei; Jen-Chuen Hsieh, MD, PhD, Institute of Brain Science, National Yang-Ming University, Taipei, Integrated Brain Research Unit, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, and Centre of Neuropsychiatric Research, National Health and Research Institute, ChuNan, Taiwan.
authors: Shyh-Jen
authors: SJ
authors: Wang
authors: Cheng-Ta Li, MD, PhD, Tung-Ping Su, MD, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Institute of Brain Science, and Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei; Shyh-Jen Wang, MD, Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei; Pei-Chi Tu, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, and Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei; Jen-Chuen Hsieh, MD, PhD, Institute of Brain Science, National Yang-Ming University, Taipei, Integrated Brain Research Unit, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, and Centre of Neuropsychiatric Research, National Health and Research Institute, ChuNan, Taiwan.
authors: Pei-Chi
authors: PC
authors: Tu
authors: Cheng-Ta Li, MD, PhD, Tung-Ping Su, MD, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Institute of Brain Science, and Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei; Shyh-Jen Wang, MD, Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei; Pei-Chi Tu, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, and Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei; Jen-Chuen Hsieh, MD, PhD, Institute of Brain Science, National Yang-Ming University, Taipei, Integrated Brain Research Unit, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, and Centre of Neuropsychiatric Research, National Health and Research Institute, ChuNan, Taiwan.
authors: Jen-Chuen
authors: JC
authors: Hsieh
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001288:Attention / Q000502:physiology; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000378:metabolism*; D061218:Depressive Disorder, Treatment-Resistant / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D017397:Prefrontal Cortex / Q000503:physiopathology*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D005947:Glucose