Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle, ICM, Social and Affective Neuroscience (SAN) Laboratory, Paris, France.
Institut de Recherches Internationales Servier, Suresnes, France.
Psychiatry Res Neuroimaging. 2016 Jan 30;247:17-24. doi: 10.1016/j.pscychresns.2015.11.007. Epub 2015 Nov 28.
Acute depression is associated with impaired self-referential processing. Antidepressant effects on the neural bases of self-referential processing in depression are unknown. This study aimed to assess short- and long-term effects of agomelatine on these neural bases in depressed patients and the association between pre-treatment brain activation and remission of depression 6 months later. We conducted a randomized double-blind, placebo-controlled, functional magnetic resonance imaging (fMRI) study during an emotional self-referential task, including three scanning sessions (baseline, after 1 week, and after 7 weeks). Twenty-five depressed outpatients were included, all treated with agomelatine or placebo for 1 week. Then, all patients received agomelatine for 24 weeks. Fourteen matched healthy volunteers (HV) who received placebo for 1 week were also included. After 7 days, only depressed patients receiving agomelatine significantly deactivated the ventrolateral prefrontal cortex during self-referential processing, as observed in HV at baseline. After 7 weeks, depressed patients significantly increased the activation of the ventral anterior cingulate cortex. Finally dorsomedial prefrontal cortex and precuneus activations at baseline significantly separated remitters from non-remitters at 24 weeks. In depressed patients, agomelatine had short- and long-term effects on brain structures involved in anhedonia and emotional regulation during self-referential processing. Activation of the dorsomedial prefrontal cortex and precuneus could be informative in the development of biomarker-based treatment of major depression.
急性抑郁症与自我参照加工受损有关。抗抑郁药对抑郁症患者自我参照加工的神经基础的影响尚不清楚。本研究旨在评估阿戈美拉汀对抑郁症患者这些神经基础的短期和长期影响，以及治疗前大脑激活与 6 个月后抑郁缓解之间的关系。我们在一项情绪自我参照任务中进行了一项随机、双盲、安慰剂对照的功能磁共振成像（fMRI）研究，包括三个扫描阶段（基线、1 周后和 7 周后）。共纳入 25 例抑郁门诊患者，均接受阿戈美拉汀或安慰剂治疗 1 周。然后，所有患者接受阿戈美拉汀治疗 24 周。还纳入了 14 名匹配的健康志愿者（HV），他们接受安慰剂治疗 1 周。治疗 7 天后，仅接受阿戈美拉汀治疗的抑郁患者在自我参照处理过程中显著失活了腹外侧前额叶皮层，HV 在基线时就是如此。治疗 7 周后，抑郁患者的前扣带皮层腹侧激活显著增加。最后，基线时背内侧前额叶皮层和楔前叶的激活在 24 周时将缓解者与未缓解者明显区分开来。在抑郁患者中，阿戈美拉汀对自我参照处理过程中与快感缺失和情绪调节相关的脑结构具有短期和长期影响。背内侧前额叶皮层和楔前叶的激活可能为基于生物标志物的重度抑郁症治疗的发展提供信息。
