Differential effects of serotonergic and noradrenergic antidepressants on brain activity during a cognitive control task and neurofunctional prediction of treatment outcome in patients with depression

Differential effects of serotonergic and noradrenergic antidepressants on brain activity during a cognitive control task and neurofunctional prediction of treatment outcome in patients with depression

PDF

J Psychiatry Neurosci 2010; 35(5): 247-257

Gerd Wagner, PhD; Kathrin Koch, PhD; Claudia Schachtzabel; Thomas Sobanski, MD; Jürgen R. Reichenbach, PhD; Heinrich Sauer, MD; Ralf G.M Schlösser, MD

Wagner, Koch, Schachtzabel, Sobanski, Sauer, Schlösser — Department of Psychiatry and Psychotherapy; Reichenbach— Institute for Diagnostic and Interventional Radiology, University of Jena, Germany

Abstract

Background: We investigated the differential effects of serotonergic and noradrenergic antidepressants on brain activation in patients with major depressive disorder during a Stroop task. We predicted that pretreatment hyperactivity in the rostral anterior cingulate cortex
would predict better treatment outcomes.

Methods: We used magnetic resonance imaging to examine brain volume in 24 psychotic youth (13 male, 11 female) with EOSS (n = 12) or EOMD (n = 12) and 17 healthy controls (10 male, 7 female). We measured the volume of grey and white matter using an automated segmentation program.

Results: There were no significant group differences in clinical characteristics, treatment outcomes or baseline fMRI activations. The group by time interaction revealed significant voxels in the right amygdala–hippocampus complex (p < 0.05, family-wise error corrected by use of the bilateral amygdala and hippocampus mask image as a small volume), indicating a posttreatment blood oxygen level–dependent signal decrease in the citalopram group. Pretreatment hyperactivity in the rostral anterior cingulate cortex was not related to symptom improvement. Limitations: Our study was a nonrandomized clinical trial.

Conclusions: These results indicate that serotonergic
and noradrenergic antidepressants have a differential effect on brain activity, especially in the amygdala and hippocampus.


Submitted July 13, 2009; Revised Dec. 10, 2009, Jan. 21, 2010; Accepted Jan. 25, 2010.

Acknowledgments: This work was supported by the German Federal Ministry of Education and Research (grants AQ4 FKZ01ZZ0405 and 01GW0740), the Interdisciplinary Center for Clinical Research of the University of Jena and Thuringian Ministry of Science, Research, and Art (grant B307-04004).

Competing interests: None declared.

Contributors: Drs. Wagner, Sobanski, Sauer and Schlösser designed the study. Drs. Wagner and Reichenbach and Ms. Schachtzabel acquired the data, which Drs. Wagner, Koch and Schlösser analyzed. Drs. Wagner and Koch wrote the article, which Drs. Koch, Sobanski, Reichenbach, Sauer and Schlösser and Ms. Schachtzabel reviewed. All authors approved the final version submitted for publication.

DOI: 10.1503/jpn.090081

Correspondence to: Dr. G. Wagner, Department of Psychiatry and Psychotherapy, University of Jena, Centre for Neuroimaging, Jahnstr. 3 07740 Jena, Germany; fax 49(0)3641934755; wagner.gerd@uni-jena.de