Prognostic and Diagnostic Potential of the Structural Neuroanatomy of Depression

被引:178
作者
Costafreda, Sergi G.
Chu, Carlton
Ashburner, John
Fu, Cynthia H. Y.
机构
[1] Institute of Psychiatry, King's College London, London
[2] Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London
来源
PLOS ONE | 2009年 / 4卷 / 07期
关键词
POSITRON-EMISSION-TOMOGRAPHY; VOXEL-BASED MORPHOMETRY; MAJOR DEPRESSION; FACIAL EXPRESSIONS; PREFRONTAL CORTEX; NEURAL RESPONSES; SAD FACES; AMYGDALA; HIPPOCAMPAL; DISORDER;
D O I
10.1371/journal.pone.0006353
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: Depression is experienced as a persistent low mood or anhedonia accompanied by behavioural and cognitive disturbances which impair day to day functioning. However, the diagnosis is largely based on self-reported symptoms, and there are no neurobiological markers to guide the choice of treatment. In the present study, we examined the prognostic and diagnostic potential of the structural neural correlates of depression. Methodology and Principal Findings: Subjects were 37 patients with major depressive disorder (mean age 43.2 years), medication-free, in an acute depressive episode, and 37 healthy individuals. Following the MRI scan, 30 patients underwent treatment with the antidepressant medication fluoxetine or cognitive behavioural therapy (CBT). Of the patients who subsequently achieved clinical remission with antidepressant medication, the whole brain structural neuroanatomy predicted 88.9% of the clinical response, prior to the initiation of treatment (88.9% patients in clinical remission (sensitivity) and 88.9% patients with residual symptoms (specificity), p = 0.01). Accuracy of the structural neuroanatomy as a diagnostic marker though was 67.6% (64.9% patients (sensitivity) and 70.3% healthy individuals (specificity), p = 0.027). Conclusions and Significance: The structural neuroanatomy of depression shows high predictive potential for clinical response to antidepressant medication, while its diagnostic potential is more limited. The present findings provide initial steps towards the development of neurobiological prognostic markers for depression.
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页数:5
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