Brain Imaging Study on the Pathogenesisof Depression & Therapeutic Effect of SelectiveSerotonin Reuptake Inhibitors

읽은 날	2020.08.25	학술지	Psychiatry investigation
제목	Brain Imaging Study on the Pathogenesis of Depression & Therapeutic Effect of Selective Serotonin Reuptake Inhibitors
저자	Qi Meng1,2, Aixia Zhang1, Xiaohua Cao1, Ning Sun1, Xinrong Li1, YunQiao Zhang1,2, and Yanfang Wang1
한줄요약	MDD patient(항우울제 처방 x)와 control의 뇌구조 차이, 그리고 antidepressant responder와 non-responder 간의 gray matter volume reduction 차이 분석.
초록	-Objective   Predefining the most effective treatment for patients with depressive disorders remains a problem. We will examine the differential brain regions of gray matter (GM) in major depressive disorder (MDD) patients and the relationship between changes in their volume and the efficacy of early antidepressant treatment using magnetic resonance imaging (MRI). -Methods   159 never-medicated patients with first-episode MDD and 53 normal control subjects (NCs) were enrolled. The brains were scanned by MRI and measured with the 17-item Hamilton Depression Rating Scale (HAMD-17) at baseline and after 2 weeks of treatment with selective serotonin reuptake inhibitor (SSRI)s, and the non-responder group and responder group were obtained. The patients were analyzed by voxel-based morphological (VBM) and SPSS software. Receiver operator characteristics (ROC) analysis was performed for the difference between the responder group and the non-responder group in the differential brain regions, and Pearson correlations were computed between volume size and HAMD score reduction rate. -Results   Smaller GM volume of the right superior temporal gyrus (STG), and the orbital parts of the right medial frontal gyrus and right inferior frontal gyrus were observed in MDD versus the NCs. The non-responder group demonstrated a significant volume reduction at the right STG compared with the responders, but no corresponding change in orbital part of right medial frontal gyrus and right inferior frontal gyrus. ROC analysis showed that Accuracy=71.2%. There was a positive correlation between the STG gray matter volume and the HAMD-17 score reduction rate (r=0.347, p=0.002). -Conclusion   The study results confirmed the local changes in brain structure in MDD and may initially predict the early treatment response produced by SSRIs as antidepressants.
키워드	Major depressive disorder, Voxel-based morphometry, Gray matter, Predict efficacy
의의	Gray matter volume reduction을 비교하여 MDD와 control, 더 나아가서 MDD 중 antidepressant에 response 여부를 추측할 수 있을 것으로 보임.
비판점	Depression의 진행에 따라 gray matter volume reduction이 더 심해지는지(like hippocampus), 그럼 이를 통해 depression진행 정도와 항우울제 처방 판단에 도움을 줄 수 있을지 장기적인 연구가 필요함.