Modulation of amygdala reactivity following rapidly acting interventions for major depression
Electroconvulsive therapy (ECT) and ketamine treatment both induce rapidly acting antidepressant effects in patients with major depressive disorder unresponsive to standard treatments, yet their specific impact on emotion processing is unknown. Here, we examined the neural underpinnings of emotion p...
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| Veröffentlicht in: | Human brain mapping 2020-05, Vol.41 (7), p.1699-1710 |
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| creator | Loureiro, Joana R. A. Leaver, Amber Vasavada, Megha Sahib, Ashish K. Kubicki, Antoni Joshi, Shantanu Woods, Roger P. Wade, Benjamin Congdon, Eliza Espinoza, Randall Narr, Katherine L. |
| description | Electroconvulsive therapy (ECT) and ketamine treatment both induce rapidly acting antidepressant effects in patients with major depressive disorder unresponsive to standard treatments, yet their specific impact on emotion processing is unknown. Here, we examined the neural underpinnings of emotion processing within and across patients (N = 44) receiving either ECT (N = 17, mean age: 36.8, 11.0 SD) or repeated subanesthetic (0.5 mg/kg) intravenous ketamine therapy (N = 27, mean age: 37.3, 10.8 SD) using a naturalistic study design. MRI and clinical data were collected before (TP1) and after treatment (TP2); healthy controls (N = 31, mean age: 34.5, 13.5 SD) completed one MRI session (TP1). An fMRI face‐matching task probed negative‐ and positive‐valence systems. Whole‐brain analysis, comparing neurofunctional changes within and across treatment groups, targeted brain regions involved in emotional facial processing, and included regions‐of‐interest analysis of amygdala responsivity. Main findings revealed a decrease in amygdalar reactivity after both ECT and ketamine for positive and negative emotional face processing (p |
| doi_str_mv | 10.1002/hbm.24895 |
| format | Article |
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A. ; Leaver, Amber ; Vasavada, Megha ; Sahib, Ashish K. ; Kubicki, Antoni ; Joshi, Shantanu ; Woods, Roger P. ; Wade, Benjamin ; Congdon, Eliza ; Espinoza, Randall ; Narr, Katherine L.</creator><creatorcontrib>Loureiro, Joana R. A. ; Leaver, Amber ; Vasavada, Megha ; Sahib, Ashish K. ; Kubicki, Antoni ; Joshi, Shantanu ; Woods, Roger P. ; Wade, Benjamin ; Congdon, Eliza ; Espinoza, Randall ; Narr, Katherine L.</creatorcontrib><description>Electroconvulsive therapy (ECT) and ketamine treatment both induce rapidly acting antidepressant effects in patients with major depressive disorder unresponsive to standard treatments, yet their specific impact on emotion processing is unknown. Here, we examined the neural underpinnings of emotion processing within and across patients (N = 44) receiving either ECT (N = 17, mean age: 36.8, 11.0 SD) or repeated subanesthetic (0.5 mg/kg) intravenous ketamine therapy (N = 27, mean age: 37.3, 10.8 SD) using a naturalistic study design. MRI and clinical data were collected before (TP1) and after treatment (TP2); healthy controls (N = 31, mean age: 34.5, 13.5 SD) completed one MRI session (TP1). An fMRI face‐matching task probed negative‐ and positive‐valence systems. Whole‐brain analysis, comparing neurofunctional changes within and across treatment groups, targeted brain regions involved in emotional facial processing, and included regions‐of‐interest analysis of amygdala responsivity. Main findings revealed a decrease in amygdalar reactivity after both ECT and ketamine for positive and negative emotional face processing (p < .05 family wise‐error (FWE) corrected). Subthreshold changes were observed between treatments within the dorsolateral prefrontal cortex and insula (p < .005, uncorrected). BOLD change for positive faces in the inferior parietal cortex significantly correlated with overall symptom improvement, and BOLD change in frontal regions correlated with anxiety for negative faces, and anhedonia for positive faces (p < .05 FWE corrected). Both serial ketamine and ECT treatment modulate amygdala response, while more subtle treatment‐specific changes occur in the larger functional network. Findings point to both common and differential mechanistic upstream systems‐level effects relating to fast‐acting antidepressant response, and symptoms of anxiety and anhedonia, for the processing of emotionally valenced stimuli.</description><identifier>ISSN: 1065-9471</identifier><identifier>EISSN: 1097-0193</identifier><identifier>DOI: 10.1002/hbm.24895</identifier><identifier>PMID: 32115848</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Age ; Amygdala ; Analysis ; Antidepressants ; Anxiety ; Attentional bias ; Brain ; Brain mapping ; Care and treatment ; Cortex (parietal) ; ECT ; Electroconvulsive therapy ; emotion processing ; Emotions ; Error correction ; Functional magnetic resonance imaging ; Hedonic response ; Information processing ; Intravenous administration ; Ketamine ; Major depressive disorder ; MDD ; Mental depression ; Patients ; Pattern recognition ; Prefrontal cortex ; tfMRI</subject><ispartof>Human brain mapping, 2020-05, Vol.41 (7), p.1699-1710</ispartof><rights>2020 The Authors. published by Wiley Periodicals, Inc.</rights><rights>2020 The Authors. 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A.</creatorcontrib><creatorcontrib>Leaver, Amber</creatorcontrib><creatorcontrib>Vasavada, Megha</creatorcontrib><creatorcontrib>Sahib, Ashish K.</creatorcontrib><creatorcontrib>Kubicki, Antoni</creatorcontrib><creatorcontrib>Joshi, Shantanu</creatorcontrib><creatorcontrib>Woods, Roger P.</creatorcontrib><creatorcontrib>Wade, Benjamin</creatorcontrib><creatorcontrib>Congdon, Eliza</creatorcontrib><creatorcontrib>Espinoza, Randall</creatorcontrib><creatorcontrib>Narr, Katherine L.</creatorcontrib><title>Modulation of amygdala reactivity following rapidly acting interventions for major depression</title><title>Human brain mapping</title><addtitle>Hum Brain Mapp</addtitle><description>Electroconvulsive therapy (ECT) and ketamine treatment both induce rapidly acting antidepressant effects in patients with major depressive disorder unresponsive to standard treatments, yet their specific impact on emotion processing is unknown. 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Subthreshold changes were observed between treatments within the dorsolateral prefrontal cortex and insula (p < .005, uncorrected). BOLD change for positive faces in the inferior parietal cortex significantly correlated with overall symptom improvement, and BOLD change in frontal regions correlated with anxiety for negative faces, and anhedonia for positive faces (p < .05 FWE corrected). Both serial ketamine and ECT treatment modulate amygdala response, while more subtle treatment‐specific changes occur in the larger functional network. 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A.</au><au>Leaver, Amber</au><au>Vasavada, Megha</au><au>Sahib, Ashish K.</au><au>Kubicki, Antoni</au><au>Joshi, Shantanu</au><au>Woods, Roger P.</au><au>Wade, Benjamin</au><au>Congdon, Eliza</au><au>Espinoza, Randall</au><au>Narr, Katherine L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Modulation of amygdala reactivity following rapidly acting interventions for major depression</atitle><jtitle>Human brain mapping</jtitle><addtitle>Hum Brain Mapp</addtitle><date>2020-05</date><risdate>2020</risdate><volume>41</volume><issue>7</issue><spage>1699</spage><epage>1710</epage><pages>1699-1710</pages><issn>1065-9471</issn><eissn>1097-0193</eissn><abstract>Electroconvulsive therapy (ECT) and ketamine treatment both induce rapidly acting antidepressant effects in patients with major depressive disorder unresponsive to standard treatments, yet their specific impact on emotion processing is unknown. 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Subthreshold changes were observed between treatments within the dorsolateral prefrontal cortex and insula (p < .005, uncorrected). BOLD change for positive faces in the inferior parietal cortex significantly correlated with overall symptom improvement, and BOLD change in frontal regions correlated with anxiety for negative faces, and anhedonia for positive faces (p < .05 FWE corrected). Both serial ketamine and ECT treatment modulate amygdala response, while more subtle treatment‐specific changes occur in the larger functional network. Findings point to both common and differential mechanistic upstream systems‐level effects relating to fast‐acting antidepressant response, and symptoms of anxiety and anhedonia, for the processing of emotionally valenced stimuli.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>32115848</pmid><doi>10.1002/hbm.24895</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-9679-9571</orcidid><orcidid>https://orcid.org/0000-0001-9550-804X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Amygdala Analysis Antidepressants Anxiety Attentional bias Brain Brain mapping Care and treatment Cortex (parietal) ECT Electroconvulsive therapy emotion processing Emotions Error correction Functional magnetic resonance imaging Hedonic response Information processing Intravenous administration Ketamine Major depressive disorder MDD Mental depression Patients Pattern recognition Prefrontal cortex tfMRI |
| title | Modulation of amygdala reactivity following rapidly acting interventions for major depression |
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