Functional neuroimaging biomarkers of anhedonia response to escitalopram plus adjunct aripiprazole treatment for major depressive disorder

被引:3
|
作者
Vaccarino, Sophie R. [1 ,2 ,3 ]
Wang, Shijing [1 ,2 ]
Rizvi, Sakina J. [1 ,2 ,4 ,5 ,6 ]
Lou, Wendy [7 ,8 ]
Hassel, Stefanie [3 ,9 ]
MacQueen, Glenda M. [3 ,9 ]
Ho, Keith [2 ,5 ,6 ]
Frey, Benicio N. [10 ]
Lam, Raymond W. [11 ]
Milev, Roumen V. [12 ]
Rotzinger, Susan [2 ]
Ravindran, Arun V. [4 ]
Strother, Stephen C. [1 ,13 ,14 ]
Kennedy, Sidney H. [1 ,2 ,4 ,5 ,6 ,15 ]
机构
[1] Univ Toronto, Inst Med Sci, Toronto, ON, Canada
[2] Unity Hlth Toronto, Ctr Depress & Suicide Studies, Toronto, ON, Canada
[3] Univ Calgary, Cumming Sch Med, Calgary, AB, Canada
[4] Univ Toronto, Dept Psychiat, Toronto, ON, Canada
[5] Unity Hlth Toronto, Dept Psychiat, Toronto, ON, Canada
[6] Unity Hlth Toronto, Li Ka Shing Knowledge Inst, Toronto, ON, Canada
[7] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada
[8] Univ Toronto, Dept Biostat, Toronto, ON, Canada
[9] Univ Calgary, Dept Psychiat, Calgary, AB, Canada
[10] McMaster Univ, Dept Psychiat & Behav Neurosci, Hamilton, ON, Canada
[11] Univ British Columbia, Dept Psychiat, Vancouver, BC, Canada
[12] Queens Univ, Dept Psychiat, Providence Care, Kingston, ON, Canada
[13] Rotman Res Inst, Baycrest Ctr, Toronto, ON, Canada
[14] Univ Toronto, Dept Med Biophys, Toronto, ON, Canada
[15] Univ Hlth Network, Krembil Res Inst, Toronto, ON, Canada
来源
BJPSYCH OPEN | 2024年 / 10卷 / 01期
基金
加拿大健康研究院;
关键词
Antidepressants; antipsychotics; depressive disorders; other imaging; anhedonia; INDEPENDENT COMPONENT ANALYSIS; ANTIDEPRESSANT RESPONSE; NUCLEUS-ACCUMBENS; CINGULATE CORTEX; DOPAMINE; NETWORK; VISUALIZATION; PRAMIPEXOLE; SOFTWARE; EFFICACY;
D O I
10.1192/bjo.2023.588
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
BackgroundIdentifying neuroimaging biomarkers of antidepressant response may help guide treatment decisions and advance precision medicine.AimsTo examine the relationship between anhedonia and functional neurocircuitry in key reward processing brain regions in people with major depressive disorder receiving aripiprazole adjunct therapy with escitalopram.MethodData were collected as part of the CAN-BIND-1 study. Participants experiencing a current major depressive episode received escitalopram for 8 weeks; escitalopram non-responders received adjunct aripiprazole for an additional 8 weeks. Functional magnetic resonance imaging (on weeks 0 and 8) and clinical assessment of anhedonia (on weeks 0, 8 and 16) were completed. Seed-based correlational analysis was employed to examine the relationship between baseline resting-state functional connectivity (rsFC), using the nucleus accumbens (NAc) and anterior cingulate cortex (ACC) as key regions of interest, and change in anhedonia severity after adjunct aripiprazole.ResultsAnhedonia severity significantly improved after treatment with adjunct aripiprazole.There was a positive correlation between anhedonia improvement and rsFC between the ACC and posterior cingulate cortex, ACC and posterior praecuneus, and NAc and posterior praecuneus. There was a negative correlation between anhedonia improvement and rsFC between the ACC and anterior praecuneus and NAc and anterior praecuneus.ResultsAnhedonia severity significantly improved after treatment with adjunct aripiprazole.There was a positive correlation between anhedonia improvement and rsFC between the ACC and posterior cingulate cortex, ACC and posterior praecuneus, and NAc and posterior praecuneus. There was a negative correlation between anhedonia improvement and rsFC between the ACC and anterior praecuneus and NAc and anterior praecuneus.ConclusionsEight weeks of aripiprazole, adjunct to escitalopram, was associated with improved anhedonia symptoms. Changes in functional connectivity between key reward regions were associated with anhedonia improvement, suggesting aripiprazole may be an effective treatment for individuals experiencing reward-related deficits. Future studies are required to replicate our findings and explore their generalisability, using other agents with partial dopamine (D2) agonism and/or serotonin (5-HT2A) antagonism.
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页数:8
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