利用葡萄糖代谢预测重度抑郁症患者对认知行为疗法或文拉法辛无反应的因素。
Predictors of nonresponse to cognitive behavioural therapy or venlafaxine using glucose metabolism in major depressive disorder.
作者信息
Konarski Jakub Z, Kennedy Sidney H, Segal Zindel V, Lau Mark A, Bieling Peter J, McIntyre Roger S, Mayberg Helen S
机构信息
University Health Network, Toronto General Hospital, 200 Elizabeth St., Eaton North Wing 8-222, Toronto ON M5G2C4.
出版信息
J Psychiatry Neurosci. 2009 May;34(3):175-80.
BACKGROUND
Longitudinal neuroimaging investigations of antidepressant treatment offer the opportunity to identify potential baseline biomarkers associated with poor outcome.
METHODS
To explore the neural correlates of nonresponse to cognitive behavioural therapy (CBT) or venlafaxine (VEN), we compared pretreatment (18)F-fluoro-2-deoxy-d-glucose positron emission tomography scans of participants with major depressive disorder responding to either 16 weeks of CBT (n = 7) or VEN treatment (n = 9) with treatment nonresponders (n = 8).
RESULTS
Nonresponders to CBT or VEN, in contrast to responders, exhibited pretreatment hypermetabolism at the interface of the pregenual and subgenual cingulate cortices.
LIMITATIONS
Limitations of our study include the small sample sizes and the absence of both arterial sampling to determine absolute glucose metabolism and high-resolution structural magnetic resonance imaging coregistration for region-of-interest analyses.
CONCLUSION
Our current findings are consistent with those reported in previous studies of relative hyperactivity in the ventral anterior cingulate cortex in treatment-resistant populations.
背景
对抗抑郁治疗进行纵向神经影像学研究，为识别与不良预后相关的潜在基线生物标志物提供了机会。
方法
为探究对认知行为疗法（CBT）或文拉法辛（VEN）无反应的神经关联，我们比较了重度抑郁症患者的治疗前（18）F - 氟 - 2 - 脱氧 - D - 葡萄糖正电子发射断层扫描，这些患者中，有7名对16周的CBT有反应，9名对VEN治疗有反应，还有8名治疗无反应者。
结果
与有反应者相比，CBT或VEN治疗无反应者在膝前扣带回和膝下扣带回皮质交界处表现出治疗前代谢亢进。
局限性
我们研究的局限性包括样本量小，以及缺乏用于确定绝对葡萄糖代谢的动脉采样和用于感兴趣区域分析的高分辨率结构磁共振成像配准。
结论
我们目前的研究结果与先前关于难治性人群腹侧前扣带回皮质相对多动的研究报告一致。
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