Maron Eduard, Wall Matt, Norbury Ray, Godlewska Beata, Terbeck Sylvia, Cowen Philip, Matthews Paul, Nutt David J
Research and Development Service, and Department of Psychiatry, North Estonia Medical Centre, Tallinn, Estonia Department of Psychiatry, University of Tartu, Tartu, Estonia Faculty of Medicine, Division of Brain Sciences, Imperial College London, London, UK
Faculty of Medicine, Division of Brain Sciences, Imperial College London, London, UK.
J Psychopharmacol. 2016 Jan;30(1):33-9. doi: 10.1177/0269881115620462. Epub 2015 Dec 8.
Recent functional magnetic resonance (fMRI) imaging studies have revealed that subchronic medication with escitalopram leads to significant reduction in both amygdala and medial frontal gyrus reactivity during processing of emotional faces, suggesting that escitalopram may have a distinguishable modulatory effect on neural activation as compared with other serotonin-selective antidepressants. In this fMRI study we aimed to explore whether short-term medication with escitalopram in healthy volunteers is associated with reduced neural response to emotional processing, and whether this effect is predicted by drug plasma concentration. The neural response to fearful and happy faces was measured before and on day 7 of treatment with escitalopram (10mg) in 15 healthy volunteers and compared with those in a control unmedicated group (n=14). Significantly reduced activation to fearful, but not to happy facial expressions was observed in the bilateral amygdala, cingulate and right medial frontal gyrus following escitalopram medication. This effect was not correlated with plasma drug concentration. In accordance with previous data, we showed that escitalopram exerts its rapid direct effect on emotional processing via attenuation of neural activation in pathways involving medial frontal gyrus and amygdala, an effect that seems to be distinguishable from that of other SSRIs.
近期的功能磁共振成像（fMRI）研究显示，艾司西酞普兰的亚慢性用药可使在处理情绪面孔期间杏仁核和内侧前额叶回的反应性显著降低，这表明与其他5-羟色胺选择性抗抑郁药相比，艾司西酞普兰可能对神经激活具有独特的调节作用。在这项fMRI研究中，我们旨在探究健康志愿者短期服用艾司西酞普兰是否与情绪加工的神经反应降低有关，以及这种效应是否由药物血浆浓度预测。在15名健康志愿者中，于服用艾司西酞普兰（10mg）治疗前及治疗第7天测量对恐惧和快乐面孔的神经反应，并与未用药的对照组（n = 14）进行比较。服用艾司西酞普兰后，在双侧杏仁核、扣带回和右侧内侧前额叶回中观察到对恐惧面部表情的激活显著降低，但对快乐面部表情的激活未降低。这种效应与血浆药物浓度无关。与先前的数据一致，我们表明艾司西酞普兰通过减弱涉及内侧前额叶回和杏仁核的通路中的神经激活，对情绪加工发挥快速直接作用，这种效应似乎与其他选择性5-羟色胺再摄取抑制剂（SSRI）不同。
