Böker
Fakultäten » Medizinische Fakultät » Psychiatrische Universitätsklinik » Affektive Erkrankungen und Allgemeinpsychiatrie Zürich Ost, Klinik für » Prof. Dr. Erich Seifritz » Böker
Completed research project
| Title / Titel | Functional neuroanatomy and regional metabolism before and after treatment with duloxetine: a combined fMRI/MRS study in major depression | ||||
|---|---|---|---|---|---|
| Abstract (PDF, 14 KB) | |||||
| Original title / Originaltitel | Funktionelle Neuroanatomie der emotionalen Prozessierung vor und nach Behandlung mit Duloxetine: Eine fMRT/MRS Studie bei Major Depression | ||||
| Summary / Zusammenfassung | The general aim is the investigation of the functional neuroanatomy, regional metabolism and EEG activity in healthy subjects and patients with major depression. Depressed patients shall include both those with and without vegetative-somatic symptoms and will be investigated before and after treatment with duloxetine. Functional neuroanatomy will be investigated with functional magnetic resonance imaging (fMRI) magntoresonancespectroscopy (MRS) reveals regional metabolism and Electroencephalography the neural activity. The specific aims are the following. First, the activation paradigm in fMRI shall reveal the functional neuroanatomy of affective and vegetative-somatic processing and its alterations in depressed subjects. Emotional pictures are used to induce affective processing. As such distinct markers of functional neuroanatomy of affective and vegetative-somatic processing can be revealed. Second, the MRS shall focus on metabolites of Glutamate, Glutamine, GABA, NAA-NAAG, Taurin, and GSH. MRS measurement will focus on those regions obtained in fMRI associated with affective and vegetative-somatic processing respectively and the respective alterations in MD patients; one can therefore speak of fMRI guided MRS. As such the specific markers of metabolic concentrations (and their alterations in MD patients) in those regions involved in affective and vegetative-somatic processing can be revealed. The concentrations of metabolites like Glutamate, Glutamine, and GABA are supposed to be altered in the respective region in MD patients with vegetative-somatic symptoms. Third, cortical and subcortical alterations in fMRI shall be directly related to types of symptoms and metabolites in depressed patients. As such the different types of symptoms like for example affective and vegetative-somatic can be related to specific regional cortical and subcortical patterns of activation and metabolism. In conjunction with the first and second specific aim, this allows to identify the diagnostic, i.e., regional and metabolic markers in those MD patients with co-occurrence of affective and vegetative-somatic symptoms. We assume that affective and vegetative-somatic symptoms show a differential correlation pattern including distinct cortical-subcortical regions as revealed in fMRI and distinct metabolite concentrations as obtained in MRS. Fourth, depressed patients shall be investigated in fMRI and MRS before and after treatment with duloxetine. As such those neuroanatomical and metabolic alterations which are specifically related to the treatment effects of duloxetine can be revealed. This allows identifying the therapeutic markers associated with response and non-response to duloxetine. Therapeutic responders and non-responders to duloxetine are supposed to show differences in those regional alterations and metabolite concentrations which are associated with vegetative-somatic changes in MD patients. Signal intensities during Interoception/ Exteroception: In order to reveal regions engaged by the intero- and exteroceptive task, we compared these conditions. For the contrast Interoception > Exteroception we found larger signal intensities in the bilateral insula. While the interoceptive task induced positive BOLD responses (PBRs) in left and right insula, the exteroceptive task was accompanied by negative BOLD responses (NBRs). In all other regions investigated in the ROI analyses (precuneus, dACC, SACC, DMPFC, PCC and VMPFC) interoception as well as exteroception were accompanied by NBRs. These were lower in posterior cingulate cortex (PCC), ventromedial prefrontal cortex (VMPFC), and medial parietal cortex (MPC) as obtained in the contrast Exteroception > Interoception. Empathy after Interoception/ Exteroception: A comparison of the empathy condition after the intero- versus the exteroceptive task (EaI > EaE) yielded stronger signal intensities (PBRs) in precuneus, dorsal anterior cingulate cortex (dACC), dorsomedial prefrontal cortex (DMPFC) and supragenual cingulate cortex (SACC). Furthermore, in the bilateral insula the empathy condition presented after the interoceptive task (EaI) also yielded stronger PBRs. Empathy: The empathy condition presented after the rest period (Empathy) yielded PBRs in left insula, precuneus, dACC and DMPFC. NBRs during this condition were obtained in right insula, SACC, PCC, and VMPFC . The control condition (Smooth) was associated with NBRs in all regions investigated in the ROI analyses. |
||||
| Keywords / Suchbegriffe | Major depression, fMRI, MRS, Duloxetine | ||||
| Project leadership and contacts / Projektleitung und Kontakte |
|
||||
| Funding source(s) / Unterstützt durch |
Universität Zürich (position pursuing an academic career), Private Sector (e.g. Industry) |
||||
| In collaboration with / In Zusammenarbeit mit |
|
||||
| Duration of Project / Projektdauer | May 2008 to Dec 2011 |