Limbic-frontal circuitry in major depression: a path modeling metanalysis.
Neuroimage
; 22(1): 409-18, 2004 May.
Article
en En
| MEDLINE
| ID: mdl-15110034
ABSTRACT
This paper reports the results of an across lab metanalysis of effective connectivity in major depression (MDD). Using FDG PET data and Structural Equation Modeling, a formal depression model was created to explicitly test current theories of limbic-cortical dysfunction in MDD and to characterize at the path level potential sources of baseline variability reported in this patient population. A 7-region model consisting of lateral prefrontal cortex (latF9), anterior thalamus (aTh), anterior cingulate (Cg24), subgenual cingulate (Cg25), orbital frontal cortex (OF11), hippocampus (Hc), and medial frontal cortex (mF10) was tested in scans of 119 depressed patients and 42 healthy control subjects acquired during three separate studies at two different institutions. A single model, based on previous theory and supported by anatomical connectivity literature, was stable for the three groups of depressed patients. Within the context of this model, path differences among groups as a function of treatment response characteristics were also identified. First, limbic-cortical connections (latF9-Cg25-OF11-Hc) differentiated drug treatment responders from nonresponders. Second, nonresponders showed additional abnormalities in limbic-subcortical pathways (aTh-Cg24-Cg25-OF11-Hc). Lastly, more limited limbic-cortical (Hc-latF9) and cortical-cortical (OF11-mF10) path differences differentiated responders to cognitive behavioral therapy (CBT) from responders to pharmacotherapy. We conclude that the creation of such models is a first step toward full characterization of the depression phenotype at the neural systems level, with implications for the future development of brain-based algorithms to determine optimal treatment selection for individual patients.
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Trastorno Depresivo Mayor
/
Lóbulo Frontal
/
Sistema Límbico
/
Red Nerviosa
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Neuroimage
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
Año:
2004
Tipo del documento:
Article