Department of Psychiatry, Ulm University, Ulm, Germany.
Int J Neuropsychopharmacol. 2013 Jul;16(6):1219-30. doi: 10.1017/S1461145712001368. Epub 2012 Dec 3.
While antidepressants are supposed to exert similar effects on mood and drive via various mechanisms of action, diverging effects are observed regarding side-effects and accordingly on neural correlates of motivation, emotion, reward and salient stimuli processing as a function of the drugs impact on neurotransmission. In the context of erotic stimulation, a unidirectional modulation of attentional functioning despite opposite effects on sexual arousal has been suggested for the selective serotonin reuptake-inhibitor (SSRI) paroxetine and the selective dopamine and noradrenaline reuptake-inhibitor (SDNRI) bupropion. To further elucidate the effects of antidepressant-related alterations of neural attention networks, we investigated 18 healthy males under subchronic administration (7 d) of paroxetine (20 mg), bupropion (150 mg) and placebo within a randomized placebo-controlled cross-over double-blind functional magnetic resonance imaging (fMRI) design during an established preceding attention task. Neuropsychological effects beyond the fMRI-paradigm were assessed by measuring alertness and divided attention. Comparing preceding attention periods of salient vs. neutral pictures, we revealed congruent effects of both drugs vs. placebo within the anterior midcingulate cortex, dorsolateral prefrontal cortex, anterior prefrontal cortex, superior temporal gyrus, anterior insula and the thalamus. Relatively decreased activation in this network was paralleled by slower reaction times in the divided attention task in both verum conditions compared to placebo. Our results suggest similar effects of antidepressant treatments on behavioural and neural attentional functioning by diverging neurochemical pathways. Concurrent alterations of brain regions within a fronto-parietal and cingulo-opercular attention network for top-down control could point to basic neural mechanisms of antidepressant action irrespective of receptor profiles.
虽然抗抑郁药通过各种作用机制理应对情绪和驱动力产生相似的影响，但观察到的副作用却存在差异，因此在动机、情感、奖励和突显刺激处理的神经相关性方面也存在差异，这取决于药物对神经递质传递的影响。在性刺激的背景下，有人提出选择性 5-羟色胺再摄取抑制剂（SSRI）帕罗西汀和选择性多巴胺和去甲肾上腺素再摄取抑制剂（SDNRI）安非他酮的注意力功能存在单向调制，尽管它们对性唤起的作用相反。为了进一步阐明与抗抑郁药相关的神经注意力网络改变的影响，我们在一项既定的注意力任务中，在随机安慰剂对照交叉双盲功能磁共振成像（fMRI）设计中，对 18 名健康男性进行了亚慢性给药（7 天）帕罗西汀（20mg）、安非他酮（150mg）和安慰剂的治疗，并对神经心理学效应进行了评估。除了 fMRI 范式之外，还通过测量警觉性和分散注意力来评估。在比较显著和中性图片的注意力前期期间，我们发现两种药物与安慰剂在中前扣带回皮质、背外侧前额叶皮质、前额叶皮质、颞上回、前岛叶和丘脑内都存在一致的影响。在这个网络中，与安慰剂相比，在注意力分散任务中，相对较低的激活与两种药物的反应时间较慢相对应。我们的结果表明，抗抑郁治疗通过不同的神经化学途径对行为和神经注意力功能产生相似的影响。在前顶叶和扣带回-操作注意力网络中，大脑区域的同时改变可能指向抗抑郁作用的基本神经机制，而与受体特征无关。
