Area-specific modulation of neural activation comparing escitalopram and citalopram revealed by pharmaco-fMRI: A randomized cross-over study

被引:102
作者
Windischberger, Christian [2 ]
Lanzenberger, Rupert [1 ]
Holik, Alexander [1 ]
Spindelegger, Christoph [1 ]
Stein, Patrycja [1 ]
Moser, Ulrike [1 ]
Gerstl, Florian [2 ]
Fink, Martin [1 ]
Moser, Ewald [2 ]
Kasper, Siegfried [1 ]
机构
[1] Med Univ Vienna, Dept Psychiat & Psychotherapy, AKH, A-1090 Vienna, Austria
[2] Med Univ Vienna, MR Ctr Excellence, Ctr Biomed Engn & Phys, A-1090 Vienna, Austria
关键词
SSRI; Pharmacological fMRI; Citalopram; Escitalopram; Serotonin; SEROTONIN TRANSPORTER OCCUPANCY; MAJOR DEPRESSIVE DISORDER; AMYGDALA ACTIVATION; FUNCTIONAL MRI; IN-VIVO; ANTIDEPRESSANT TREATMENT; FACIAL EXPRESSIONS; NEURONAL RESPONSES; CLINICAL-EFFICACY; EMOTIONAL STIMULI;
D O I
10.1016/j.neuroimage.2009.10.013
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Area-specific and stimulation-dependent changes of human brain activation by selective serotonin reuptake inhibitors (SSRI) are an important issue for improved understanding of treatment mechanisms, given the frequent prescription of these drugs in depression and anxiety disorders. The aim of this neuroimaging study was to investigate differences in BOLD-signal caused by administration of the SSRIs escitalopram and citalopram using pharmacological functional magnetic resonance imaging (pharmaco-fMRI). Eighteen healthy subjects participated in a placebo-controlled, randomized, double-blind study in cross-over repeated measures design. Each volunteer performed facial emotional discrimination and a sensorimotor control paradigm during three scanning sessions. Citalopram (20 mg/d), escitaloprarn (10 mg/d) and placebo were administered for 10 days each with a drug-free period of at least 21 days. Significant pharmacological effects on BOLD-signal were found in the amygdala, medial frontal gyrus, parahippocampal, fusiform and middle temporal gyri. Post-hoc t-tests revealed decreased BOLD-signal in the right amygdala and left parahippocampal gyrus in both pharmacological conditions, compared to placebo. Escitalopram, compared to citalopram, induced a decrease of BOLD-signal in the medial frontal gyrus and an increase in the right fusiform and left parahippocampal gyri. Drug effects were concentrated in brain regions with dense serotonergic projections. Both escitalopram and citalopram attenuated BOLD-signal in the amygdala and parahippocampal cortex to emotionally significant stimuli compared to control stimuli. We believe that reduced reactivity in the medial frontal gyrus found for escitalopram compared to citalopram administration might explain the response differences between Study drugs as demonstrated in previous clinical trials. (C) 2009 Elsevier Inc. All rights reserved.
引用
收藏
页码:1161 / 1170
页数:10
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