Abstract:
BACKGROUND:Despite cognitive function impairment in depression, its relationship to treatment outcome is not well understood. Here, we examined whether pretreatment activation of cortical circuitry during test of cognitive functions predicts outcomes for three commonly used antidepressants. METHODS:Eighty medication-free outpatients with major depression and 34 matched healthy controls were included as participants in the International Study to Predict Optimized Treatment in Depression (iSPOT-D) trial. During functional magnetic resonance imaging, participants completed three tasks that assessed core domains of cognitive functions: response inhibition (Go/NoGo), selective attention (oddball), and selective working memory updating (1-back). Participants were randomized to 1 of 3 arms: escitalopram, sertraline (serotonin-specific reuptake inhibitors [SSRI]), or venlafaxine-extended release (serotonin and norepinephrine reuptake inhibitor [SNRI]) therapy. Functional magnetic resonance imaging scans were repeated after 8 weeks of treatment, and remission was assessed using the Hamilton Rating Scale for Depression. RESULTS:Dorsolateral prefrontal cortex activation during inhibitory "no go" responses was a general predictor of remission, with remitters having the same pretreatment activation as control participants and nonremitters hypoactivating relative to controls. Posttreatment dorsolateral prefrontal cortex activation was reduced in both remitters and controls but not in nonremitters. By contrast, inferior parietal activation differentially predicted remission between SSRI and SNRI medications, with SSRI remitters showing greater pretreatment activation than SSRI nonremitters and the SNRI group showing the opposite pattern. CONCLUSIONS:Intact activation in the frontoparietal network during response inhibition, a core cognitive function, predicts remission with antidepressant treatment, particularly for SSRIs, and may be a potential substrate of the clinical effect of treatment.
journal_name
Biol Psychiatryjournal_title
Biological psychiatryauthors
Gyurak A,Patenaude B,Korgaonkar MS,Grieve SM,Williams LM,Etkin Adoi
10.1016/j.biopsych.2015.02.037subject
Has Abstractpub_date
2016-02-15 00:00:00pages
274-81issue
4eissn
0006-3223issn
1873-2402pii
S0006-3223(15)00253-Xjournal_volume
79pub_type
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