The Neural Substrates of Affective Processing in Depressed Patients Treated With Venlafaxine

OBJECTIVE: The purpose of this study was to use functional magnetic resonance imaging (fMRI) to probe the neural circuitry associated with reactivity to negative and positive affective stimuli in patients with major depressive disorder before treatment and after 2 and 8 weeks of treatment with venla...

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Bibliographic Details
Published in:The American journal of psychiatry 2003-01, Vol.160 (1), p.64-75
Main Authors: Davidson, Richard J., Irwin, William, Anderle, Michael J., Kalin, Ned H.
Format: Article
Language:English
Subjects:
Adult
Affect - drug effects
Affect - physiology
Amygdala - drug effects
Amygdala - pathology
Amygdala - physiopathology
Biological and medical sciences
Brain Mapping
Cerebral Cortex - drug effects
Cerebral Cortex - pathology
Cerebral Cortex - physiopathology
Cyclohexanols - adverse effects
Cyclohexanols - therapeutic use
Depressive Disorder, Major - drug therapy
Depressive Disorder, Major - physiopathology
Drug Administration Schedule
Drug therapy
Female
Follow-Up Studies
Gyrus Cinguli - drug effects
Gyrus Cinguli - pathology
Gyrus Cinguli - physiopathology
Humans
Magnetic Resonance Imaging
Male
Medical sciences
Mental disorders
Middle Aged
Nerve Net - drug effects
Nerve Net - physiopathology
Neuropharmacology
NMR
Nuclear magnetic resonance
Pharmacology. Drug treatments
Psychiatry
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
Treatment Outcome
Venlafaxine Hydrochloride
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Summary:OBJECTIVE: The purpose of this study was to use functional magnetic resonance imaging (fMRI) to probe the neural circuitry associated with reactivity to negative and positive affective stimuli in patients with major depressive disorder before treatment and after 2 and 8 weeks of treatment with venlafaxine. Relations between baseline neural activation and response to treatment were also evaluated. METHOD: Patients with major depressive disorder (N=12) and healthy comparison subjects (N=5) were scanned on three occasions, during which trials of alternating blocks of affective and neutral pictorial visual stimuli were presented. Symptoms were evaluated at each testing occasion, and both groups completed self-report measures of mood. Statistical parametric mapping was used to examine the fMRI data with a focus on the group-by-time interactions. RESULTS: Patients showed a significant reduction in depressive symptoms with treatment. Group-by-time interactions in response to the negative versus neutral stimuli were found in the left insular cortex and the left anterior cingulate. At baseline, both groups showed bilateral activation in the visual cortices, lateral prefrontal cortex, and amygdala in response to the negative versus neutral stimuli, with patients showing greater activation in the visual cortex and less activation in the left lateral prefrontal cortex. Patients with greater relative anterior cingulate activation at baseline in response to the negative versus neutral stimuli showed the most robust treatment response. CONCLUSIONS: The findings underscore the importance of the neural circuitry activated by negative affect in depression and indicate that components of this circuitry can be changed within 2 weeks of treatment with antidepressant medication.
ISSN:0002-953X
1535-7228
DOI:10.1176/appi.ajp.160.1.64