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Cortical Thickness Predicts Response Following 2 Weeks of SSRI Regimen in First-Episode, Drug-Naive Major Depressive Disorder: An MRI Study
OBJECTIVE: Major depression disorder (MDD) is a harmful disorder, and the pathological mechanism remains unclear. The primary pharmacotherapy regimen for MDD is selective serotonin reuptake inhibitors (SSRIs), but fewer than 40% of patients with MDD are in remission following initial treatment. Neur...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8902047/ https://www.ncbi.nlm.nih.gov/pubmed/35273524 http://dx.doi.org/10.3389/fpsyt.2021.751756 |
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author | Wu, Peiyi Zhang, Aixia Sun, Ning Lei, Lei Liu, Penghong Wang, Yikun Li, Hejun Yang, Chunxia Zhang, Kerang |
author_facet | Wu, Peiyi Zhang, Aixia Sun, Ning Lei, Lei Liu, Penghong Wang, Yikun Li, Hejun Yang, Chunxia Zhang, Kerang |
author_sort | Wu, Peiyi |
collection | PubMed |
description | OBJECTIVE: Major depression disorder (MDD) is a harmful disorder, and the pathological mechanism remains unclear. The primary pharmacotherapy regimen for MDD is selective serotonin reuptake inhibitors (SSRIs), but fewer than 40% of patients with MDD are in remission following initial treatment. Neuroimaging biomarkers of treatment efficacy can be used to guide personalized treatment in MDD. This study aims to determine if cortical thickness can be used as a predictor for SSRIs. METHODS: A total of 126 first-episode, drug-naive MDD patients (MDDs) and 71 healthy controls (HCs) were enrolled in our study. Demographic data were collected according to the self-made case report form (CRF) at the baseline of all subjects. Magnetic resonance imaging (MRI) scanning was performed for all the participants at baseline, and all imaging was processed using the DPABISurf software. All MDDs were treated with SSRIs, and symptoms were assessed at both the baseline and 2 weeks using the 17-item Hamilton Rating Scale (HAMD-17). According to HAMD-17 total score improvement from baseline to the end of 2 weeks, the MDDs were divided into the non-responder group (defined as ≤ 20% HAMD-17 reduction) and responder group (defined as ≥50% HAMD-17 reduction). The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of MDDs' and HCs' cortical thickness for MDD. Correlation analysis was performed for the responder group and the non-responder group separately to identify the relationship between cortical thickness and SSRI treatment efficacy. To analyze whether cortical thickness was sufficient to differentiate responders and non-responders at baseline, we used ROC curve analysis. RESULTS: Significant decreases were found in the cortical thickness of the right supplementary motor area (SMA) in MDDs at the baseline (corrected by the Monte Carlo permutation correction, cluster-wise significant threshold at p < 0.025 and vertex-wise threshold at p = 0.001), area under the curve (AUC) = 0.732 [95% confidence interval (CI) = 0.233–0.399]. In the responder group, the cortical thickness of the right SMA was significantly thinner than in the non-responder group at baseline. There was a negative correlation (r = −0.373, p = 0.044) between the cortical thickness of SMA (0 weeks) and HAMD-17 reductive rate (2 weeks) in the responder group. The results of ROC curve analyses of the responder and non-responder groups were AUC = 0.885 (95% CI = 0.803–0.968), sensitivity = 73.5%, and specificity = 96.6%, and the cutoff value was 0.701. CONCLUSION: Lower cortical thickness of the right SMA in MDD patients at the baseline may be a neuroimaging biomarker for MDD diagnosis, and a greater extent of thinner cortical thickness in the right SMA at baseline may predict improved SSRI treatment response. Our study shows the potential of cortical thickness as a possible biomarker that predicts a patient's clinical treatment response to SSRIs in MDD. |
format | Online Article Text |
id | pubmed-8902047 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89020472022-03-09 Cortical Thickness Predicts Response Following 2 Weeks of SSRI Regimen in First-Episode, Drug-Naive Major Depressive Disorder: An MRI Study Wu, Peiyi Zhang, Aixia Sun, Ning Lei, Lei Liu, Penghong Wang, Yikun Li, Hejun Yang, Chunxia Zhang, Kerang Front Psychiatry Psychiatry OBJECTIVE: Major depression disorder (MDD) is a harmful disorder, and the pathological mechanism remains unclear. The primary pharmacotherapy regimen for MDD is selective serotonin reuptake inhibitors (SSRIs), but fewer than 40% of patients with MDD are in remission following initial treatment. Neuroimaging biomarkers of treatment efficacy can be used to guide personalized treatment in MDD. This study aims to determine if cortical thickness can be used as a predictor for SSRIs. METHODS: A total of 126 first-episode, drug-naive MDD patients (MDDs) and 71 healthy controls (HCs) were enrolled in our study. Demographic data were collected according to the self-made case report form (CRF) at the baseline of all subjects. Magnetic resonance imaging (MRI) scanning was performed for all the participants at baseline, and all imaging was processed using the DPABISurf software. All MDDs were treated with SSRIs, and symptoms were assessed at both the baseline and 2 weeks using the 17-item Hamilton Rating Scale (HAMD-17). According to HAMD-17 total score improvement from baseline to the end of 2 weeks, the MDDs were divided into the non-responder group (defined as ≤ 20% HAMD-17 reduction) and responder group (defined as ≥50% HAMD-17 reduction). The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of MDDs' and HCs' cortical thickness for MDD. Correlation analysis was performed for the responder group and the non-responder group separately to identify the relationship between cortical thickness and SSRI treatment efficacy. To analyze whether cortical thickness was sufficient to differentiate responders and non-responders at baseline, we used ROC curve analysis. RESULTS: Significant decreases were found in the cortical thickness of the right supplementary motor area (SMA) in MDDs at the baseline (corrected by the Monte Carlo permutation correction, cluster-wise significant threshold at p < 0.025 and vertex-wise threshold at p = 0.001), area under the curve (AUC) = 0.732 [95% confidence interval (CI) = 0.233–0.399]. In the responder group, the cortical thickness of the right SMA was significantly thinner than in the non-responder group at baseline. There was a negative correlation (r = −0.373, p = 0.044) between the cortical thickness of SMA (0 weeks) and HAMD-17 reductive rate (2 weeks) in the responder group. The results of ROC curve analyses of the responder and non-responder groups were AUC = 0.885 (95% CI = 0.803–0.968), sensitivity = 73.5%, and specificity = 96.6%, and the cutoff value was 0.701. CONCLUSION: Lower cortical thickness of the right SMA in MDD patients at the baseline may be a neuroimaging biomarker for MDD diagnosis, and a greater extent of thinner cortical thickness in the right SMA at baseline may predict improved SSRI treatment response. Our study shows the potential of cortical thickness as a possible biomarker that predicts a patient's clinical treatment response to SSRIs in MDD. Frontiers Media S.A. 2022-02-22 /pmc/articles/PMC8902047/ /pubmed/35273524 http://dx.doi.org/10.3389/fpsyt.2021.751756 Text en Copyright © 2022 Wu, Zhang, Sun, Lei, Liu, Wang, Li, Yang and Zhang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Psychiatry Wu, Peiyi Zhang, Aixia Sun, Ning Lei, Lei Liu, Penghong Wang, Yikun Li, Hejun Yang, Chunxia Zhang, Kerang Cortical Thickness Predicts Response Following 2 Weeks of SSRI Regimen in First-Episode, Drug-Naive Major Depressive Disorder: An MRI Study |
title | Cortical Thickness Predicts Response Following 2 Weeks of SSRI Regimen in First-Episode, Drug-Naive Major Depressive Disorder: An MRI Study |
title_full | Cortical Thickness Predicts Response Following 2 Weeks of SSRI Regimen in First-Episode, Drug-Naive Major Depressive Disorder: An MRI Study |
title_fullStr | Cortical Thickness Predicts Response Following 2 Weeks of SSRI Regimen in First-Episode, Drug-Naive Major Depressive Disorder: An MRI Study |
title_full_unstemmed | Cortical Thickness Predicts Response Following 2 Weeks of SSRI Regimen in First-Episode, Drug-Naive Major Depressive Disorder: An MRI Study |
title_short | Cortical Thickness Predicts Response Following 2 Weeks of SSRI Regimen in First-Episode, Drug-Naive Major Depressive Disorder: An MRI Study |
title_sort | cortical thickness predicts response following 2 weeks of ssri regimen in first-episode, drug-naive major depressive disorder: an mri study |
topic | Psychiatry |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8902047/ https://www.ncbi.nlm.nih.gov/pubmed/35273524 http://dx.doi.org/10.3389/fpsyt.2021.751756 |
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