University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Stöckli, Bolligenstrasse 111, 3000, Bern 60, Switzerland; Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Blumenstr. 8, 69115, Heidelberg, Germany.
Department of Psychology, University of Minnesota, College of Liberal Arts, N218 Elliott Hall, 75 East River Road, Minneapolis, MN, USA.
Psychiatry Res Neuroimaging. 2018 Nov 30;281:35-42. doi: 10.1016/j.pscychresns.2018.08.013. Epub 2018 Aug 24.
In adults with major depressive disorder (MDD), effective treatment has been associated with increases in both heart rate variability (HRV) and cortical thickness. However, the impact of treatment on these indices has not yet been examined in adolescents. Cortical thickness and HRV were measured in twelve adolescents with MDD before and after 8 weeks of treatment with a selective serotonin reuptake inhibitor (SSRI). We examined treatment-related changes in depression symptoms, HRV, heart rate (HR), and cortical thickness, and analyzed correlations among these change indices. At follow-up, patients showed significantly decreased depression severity, increased HRV and increased thickness of the left medial orbitofrontal cortex (OFC). Clinical improvement was associated with increased HRV and decreased HR. Increased HRV was associated with increased cortical thickness of left lateral OFC and superior frontal cortex. Due to the small sample size, results represent preliminary findings that need replication. Further, in the absence of a placebo arm, we cannot confirm that the observed effects are due solely to medication. These preliminary findings suggest that SSRI treatment in adolescents impacts both cortical thickness and autonomic functioning. Confirmation of these findings would support OFC thickness and HRV as neurobiological mediators of treatment outcome.
在患有重度抑郁症（MDD）的成年人中，有效的治疗与心率变异性（HRV）和皮质厚度的增加有关。然而，治疗对这些指标的影响尚未在青少年中进行研究。在接受选择性 5-羟色胺再摄取抑制剂（SSRI）治疗 8 周前后，我们测量了 12 名患有 MDD 的青少年的皮质厚度和 HRV。我们检查了抑郁症状、HRV、心率（HR）和皮质厚度的治疗相关变化，并分析了这些变化指标之间的相关性。随访时，患者的抑郁严重程度显著降低，HRV 增加，左内侧眶额皮质（OFC）厚度增加。临床改善与 HRV 增加和 HR 降低有关。HRV 的增加与左外侧 OFC 和额上回皮质厚度的增加有关。由于样本量小，结果代表需要复制的初步发现。此外，由于没有安慰剂组，我们不能确定观察到的效果仅归因于药物治疗。这些初步发现表明，青少年的 SSRI 治疗会影响皮质厚度和自主功能。这些发现的确认将支持 OFC 厚度和 HRV 作为治疗结果的神经生物学中介。
