A longitudinal functional magnetic resonance imaging study of verbal working memory in depression after antidepressant therapy

TY - JOUR

T1 - A longitudinal functional magnetic resonance imaging study of verbal working memory in depression after antidepressant therapy

AU - Walsh, Nicholas D

AU - Williams, Steven C R

AU - Brammer, Michael J

AU - Bullmore, Edward T

AU - Kim, Jieun

AU - Suckling, John

AU - Mitterschiffthaler, Martina T

AU - Cleare, Anthony J

AU - Pich, Emilio Merlo

AU - Mehta, Mitul A

AU - Fu, Cynthia H Y

PY - 2007/12/1

Y1 - 2007/12/1

N2 - BACKGROUND: Impairments in the neural circuitry of verbal working memory are evident in depression. Factors of task demand and depressive state might have significant effects on its functional neuroanatomy.METHODS: Two groups underwent functional magnetic resonance imaging while performing a verbal working memory task of varying cognitive load (n-back). The patient group comprised 20 medication-free individuals in an acute episode of unipolar major depression and the control group comprised 20 healthy individuals. Scans were acquired at weeks 0 (baseline), 2, and 8. Patients received treatment with fluoxetine after the baseline scan. Cerebral activations were measured for mean overall activation as well as the linear and quadratic load-response activity with increasing task demand (1-, 2-, 3-back).RESULTS: There were no significant differences in performance accuracy between groups. However, a main effect of group was observed in the load-response activity in frontal and posterior cortical regions within the verbal working memory network in which patients showed a greater load-response relative to control subjects. Group by time effects were revealed in the load-response activity in the caudate and thalamus. As a marker of treatment response, a lower linear load-response at baseline in the dorsal anterior cingulate, left middle frontal, and lateral temporal cortices was associated with an improved clinical outcome.CONCLUSIONS: Maintenance of performance accuracy in patients was accompanied by a significant increase in the load-response activity in frontal and posterior cortical regions within the verbal working memory network. These data also provide further support for resilience of activity in the anterior cingulate as a predictor of treatment response in depression.

AB - BACKGROUND: Impairments in the neural circuitry of verbal working memory are evident in depression. Factors of task demand and depressive state might have significant effects on its functional neuroanatomy.METHODS: Two groups underwent functional magnetic resonance imaging while performing a verbal working memory task of varying cognitive load (n-back). The patient group comprised 20 medication-free individuals in an acute episode of unipolar major depression and the control group comprised 20 healthy individuals. Scans were acquired at weeks 0 (baseline), 2, and 8. Patients received treatment with fluoxetine after the baseline scan. Cerebral activations were measured for mean overall activation as well as the linear and quadratic load-response activity with increasing task demand (1-, 2-, 3-back).RESULTS: There were no significant differences in performance accuracy between groups. However, a main effect of group was observed in the load-response activity in frontal and posterior cortical regions within the verbal working memory network in which patients showed a greater load-response relative to control subjects. Group by time effects were revealed in the load-response activity in the caudate and thalamus. As a marker of treatment response, a lower linear load-response at baseline in the dorsal anterior cingulate, left middle frontal, and lateral temporal cortices was associated with an improved clinical outcome.CONCLUSIONS: Maintenance of performance accuracy in patients was accompanied by a significant increase in the load-response activity in frontal and posterior cortical regions within the verbal working memory network. These data also provide further support for resilience of activity in the anterior cingulate as a predictor of treatment response in depression.

KW - Adult

KW - Antidepressive Agents/therapeutic use

KW - Antidepressive Agents, Second-Generation/therapeutic use

KW - Caudate Nucleus/pathology

KW - Cerebral Cortex/pathology

KW - Cognition/drug effects

KW - Depressive Disorder, Major/drug therapy

KW - Echo-Planar Imaging

KW - Female

KW - Fluoxetine/therapeutic use

KW - Humans

KW - Image Processing, Computer-Assisted

KW - Longitudinal Studies

KW - Magnetic Resonance Imaging

KW - Male

KW - Memory, Short-Term/drug effects

KW - Middle Aged

KW - Psychiatric Status Rating Scales

KW - Psychomotor Performance/physiology

KW - Thalamus/pathology

KW - Verbal Behavior

U2 - 10.1016/j.biopsych.2006.12.022

DO - 10.1016/j.biopsych.2006.12.022

M3 - Article

C2 - 17601497

SN - 0006-3223

VL - 62

SP - 1236

EP - 1243

JO - Biological psychiatry

JF - Biological psychiatry

IS - 11

ER -