St. Elizabeth's Medical Center, Department of Psychiatry, Boston, MA 02135, USA.
Psychiatry Res. 2013 Sep 30;213(3):217-24. doi: 10.1016/j.pscychresns.2013.05.008. Epub 2013 Jul 9.
This study was designed to assess whether functional magnetic resonance imaging (fMRI) following antidepressant administration (pharmaco-fMRI) is sufficiently sensitive to detect differences in patterns of activation between enantiomers of the same compound. Healthy adult males (n=11) participated in a randomized, double-blind, cross-over trial with three medication periods during which they received citalopram (racemic mixture), escitalopram (S-citalopram alone), or placebo for 2 weeks. All participants had high expression serotonin transporter genotypes. An fMRI scan that included passive viewing of overt and covert affective faces and affective words was performed after each medication period. Activation in response to overt faces was greater following escitalopram than following citalopram in the right insula, thalamus, and putamen when the faces were compared with a fixation stimulus. For the rapid covert presentation, a greater response was observed in the left middle temporal gyrus in the happy versus fearful contrast following escitalopram than following citalopram. Thus, the combination of genomics and fMRI was successful in discriminating between two very similar drugs. However, the pattern of activation observed suggests that further studies are indicated to understand how to optimally combine the two techniques.
这项研究旨在评估抗抑郁药治疗后（药物 fMRI）是否足够敏感，以检测同一种化合物对映体之间的激活模式差异。健康成年男性（n=11）参加了一项随机、双盲、交叉试验，在三个用药期间接受西酞普兰（外消旋混合物）、艾司西酞普兰（S-西酞普兰单独）或安慰剂治疗 2 周。所有参与者均具有高表达的血清素转运体基因型。在每个用药期后，进行 fMRI 扫描，包括被动观察明显和隐蔽的情感面孔和情感词语。当将面孔与注视刺激进行比较时，艾司西酞普兰治疗后右侧岛叶、丘脑和壳核对明显面孔的反应大于西酞普兰。对于快速隐蔽呈现，艾司西酞普兰治疗后在快乐与恐惧对比中，左中颞叶的反应大于西酞普兰。因此，基因组学和 fMRI 的结合成功地区分了两种非常相似的药物。然而，观察到的激活模式表明，需要进一步研究以了解如何最佳地结合这两种技术。
