title: Partial Amelioration of Medial Visceromotor Network Dysfunction in Major Depression by Sertraline.
abstract: OBJECTIVE
  Major depression is associated with reduced cardiac vagal control, most commonly indexed by heart rate variability. To examine the dynamics of this abnormality, we examined within-participant covariation over time between brain activity, cardiac vagal control, and depressive symptoms in depressed patients treated with sertraline and in healthy volunteers.
  
  
  METHODS
  Patients with depression and nondepressed control participants were enrolled in a 12-week protocol. After Week 0 assessment, patients began treatment with sertraline. Neural activity and vagal control were measured for all participants at Weeks 0, 2, 6, and 12 using functional magnetic resonance imaging and synchronized electrocardiographic recordings. At each of the four assessments, a moving window analysis was used to estimate vagal control as assessed by respiratory sinus arrhythmia (RSA) from the electrocardiographic data, which was then regressed onto functional magnetic resonance imaging activity.
  
  
  RESULTS
  At baseline, patients showed reduced blood oxygen level-dependent RSA covariation compared with controls within multiple a priori brain regions associated with vagal control, collectively described as the medial visceromotor network (MVN). Sertraline treatment led to a significant increase in brain-RSA covariation for patients compared with controls, despite a lack of improvement in mean RSA.
  
  
  CONCLUSIONS
  These data suggest a partial normalization of MVN dysfunction in depression during sertraline treatment. Specifically, results indicate a partial recovery of MVN function. However, this recovery was insufficient to cause a significant change in RSA levels. These results may help to explain both improvements with and limitations of sertraline treatment of depression.
authors.affiliation: From the University of Colorado Boulder (Schafer, Wager), Boulder, Colorado; The University of Arizona (Mercado, Allen, Lane), Tucson, Arizona; and The Ohio State University (Thayer), Columbus, Ohio.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Schafer
authors.forename: Tor D
authors.initials: TD
authors.lastname: Wager
authors.forename: Ramon A
authors.initials: RA
authors.lastname: Mercado
authors.forename: Julian F
authors.initials: JF
authors.lastname: Thayer
authors.forename: John J B
authors.initials: JJ
authors.lastname: Allen
authors.forename: Richard D
authors.initials: RD
authors.lastname: Lane
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000187:drug effects* / Q000503:physiopathology; D017063:Outcome Assessment, Health Care; D065809:Respiratory Sinus Arrhythmia / Q000187:drug effects*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D020280:Sertraline / Q000008:administration & dosage / Q000494:pharmacology*; D014630:Vagus Nerve / Q000187:drug effects*
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline