title: Effects of Escitalopram Administration on Face Processing in Intermittent Explosive Disorder: An fMRI Study.
abstract: The neurobiological underpinnings of intermittent explosive disorder (IED) are traditionally linked to deficiencies in the serotonergic system. In this study, we investigated the effects of escitalopram, a selective serotonin reuptake inhibitor (SSRI), on brain activation during face processing. We expected that escitalopram would reduce amygdala activity in IED and in addition, we explored the effect in other social-emotional-related brain regions. A total of 17 subjects with current IED and 14 healthy controls participated in a randomized, double-blind, placebo-controlled, counterbalanced fMRI face processing study. The analysis focused on the faces compared to a fixation baseline contrast, and a factorial model with Group as between-subject and Drug as within-subject factor was tested. Group × Drug interaction effects were found in the amygdala (small volume corrected) and the left temporal parietal junction (TPJ; whole-brain corrected). Escitalopram increased amygdala activation in controls, but surprisingly not in IED. However, the TPJ showed increased activity in IED on escitalopram compared with placebo. The TPJ is associated with social-cognitive processes, such as perspective taking and empathy. The TPJ findings suggest that SSRI administration may reduce aggressive tendencies towards other people by enhancing these social-cognitive processes. Future research should further elucidate the long-term effects of SSRIs on various social-emotional tasks in IED.
authors.affiliation: Biological Science Division, Department of Psychiatry, University of Chicago, Chicago, IL, USA.
authors.forename: Henk
authors.initials: H
authors.lastname: Cremers
authors.affiliation: Biological Science Division, Department of Psychiatry, University of Chicago, Chicago, IL, USA.
authors.forename: Royce
authors.initials: R
authors.lastname: Lee
authors.affiliation: Biological Science Division, Department of Psychiatry, University of Chicago, Chicago, IL, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Keedy
authors.affiliation: Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: K Luan
authors.initials: KL
authors.lastname: Phan
authors.affiliation: Biological Science Division, Department of Psychiatry, University of Chicago, Chicago, IL, USA.
authors.forename: Emil
authors.initials: E
authors.lastname: Coccaro
mesh_terms: D000328:Adult; D000339:Affect; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology; D001931:Brain Mapping; D015283:Citalopram / Q000627:therapeutic use*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D000066499:Facial Recognition / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors