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Anterior Cingulate Activity as a Predictor of Degree of Treatment Response in Major Depression: Evidence From Brain Electrical Tomography Analysis
- Source :
- American Journal of Psychiatry. 158:405-415
- Publication Year :
- 2001
- Publisher :
- American Psychiatric Association Publishing, 2001.
-
Abstract
- Objective: The anterior cingulate cortex has been implicated in depression. Results are best interpreted by considering anatomic and cytoarchitectonic subdivisions. Evidence suggests depression is characterized by hypoactivity in the dorsal anterior cingulate, whereas hyperactivity in the rostral anterior cingulate is associated with good response to treatment. The authors tested the hypothesis that activity in the rostral anterior cingulate during the depressed state has prognostic value for the degree of eventual response to treatment. Whereas prior studies used hemodynamic imaging, this investigation used EEG. Method: The authors recorded 28-channel EEG data for 18 unmedicated patients with major depression and 18 matched comparison subjects. Clinical outcome was assessed after nortriptyline treatment. Of the 18 depressed patients, 16 were considered responders 4–6 months after initial assessment. A median split was used to classify response, and the pretreatment EEG data of patients showing better (N=9) and worse (N=9) responses were analyzed with low-resolution electromagnetic tomography, a new method to compute three-dimensional cortical current density for given EEG frequency bands according to a Talairach brain atlas. Results: The patients with better responses showed hyperactivity (higher theta activity) in the rostral anterior cingulate (Brodmann’s area 24/32). Follow-up analyses demonstrated the specificity of this finding, which was not confounded by age or pretreatment depression severity. Conclusions: These results, based on electrophysiological imaging, not only support hemodynamic findings implicating activation of the anterior cingulate as a predictor of response in depression, but they also suggest that differential activity in the rostral anterior cingulate is associated with gradations of response.
- Subjects :
- Adult
Male
Cingulate cortex
medicine.medical_specialty
Personality Inventory
Nortriptyline
Antidepressive Agents, Tricyclic
Electroencephalography
Gyrus Cinguli
Brain mapping
Imaging, Three-Dimensional
Internal medicine
medicine
Humans
Theta Rhythm
Tomography
Depression (differential diagnoses)
Anterior cingulate cortex
Brain Mapping
Depressive Disorder
medicine.diagnostic_test
Cordance
Prognosis
Psychiatry and Mental health
Treatment Outcome
medicine.anatomical_structure
Cardiology
Female
Hypoactivity
Psychology
Electromagnetic Phenomena
Neuroscience
medicine.drug
Subjects
Details
- ISSN :
- 15357228 and 0002953X
- Volume :
- 158
- Database :
- OpenAIRE
- Journal :
- American Journal of Psychiatry
- Accession number :
- edsair.doi.dedup.....4830d3f4e302bf5206dae5077133dfaa
- Full Text :
- https://doi.org/10.1176/appi.ajp.158.3.405