Filed under: Depression Treatment

Depress Anxiety. 2013 Feb 13;
Sullivan GM, Ogden RT, Huang YY, Oquendo MA, Mann JJ, Parsey RV

BACKGROUND: Brain serotonin-1A receptors (5-HT(1A) ) are implicated in anxiety. We compared regional brain 5-HT(1A) binding in medication-free participants with posttraumatic stress disorder (PTSD) and healthy volunteers using fully quantitative positron emission tomography (PET) methods. METHODS: Twenty patients with DSM-IV PTSD (13 with comorbid major depressive disorder, [MDD]) and 49 healthy volunteers underwent PET imaging with 5-HT(1A) antagonist radioligand [C-11]WAY100635. Arterial blood sampling provided a metabolite-corrected input function and the concentration of free ligand in plasma (f(P) ) for estimation of regional binding potential, BP(F) ( = B(available) / K(D) ). Linear mixed modeling compared BP(F) between groups across regions of interest (ROIs). RESULTS: The PTSD group had higher 5-HT(1A) BP(F) across brain ROIs (P = .0006). Post hoc comparisons showed higher 5-HT(1A) BP(F) in PTSD in all cortical ROIs (26-33%), amygdala (34%), and brainstem raphe nuclei (43%), but not hippocampus. The subgroup of seven PTSD patients without comorbid MDD had higher 5-HT(1A) BP(F) compared with healthy volunteers (P = .03). CONCLUSIONS: This is the first report of higher brainstem and forebrain 5-HT(1A) binding in vivo in PTSD. The finding is independent of MDD. PTSD and MDD have in common an upregulation of 5-HT(1A) binding including midbrain autoreceptors that would favor less firing and serotonin release. This abnormality may represent a common biomarker of these stress-associated brain disorders.
HubMed – depression


Overlapping and segregated resting-state functional connectivity in patients with major depressive disorder with and without childhood neglect.

Filed under: Depression Treatment

Hum Brain Mapp. 2013 Feb 13;
Wang L, Dai Z, Peng H, Tan L, Ding Y, He Z, Zhang Y, Xia M, Li Z, Li W, Cai Y, Lu S, Liao M, Zhang L, Wu W, He Y, Li L

Many studies have suggested that childhood maltreatment increase risk of adulthood major depressive disorder (MDD) and predict its unfavorable treatment outcome, yet the neural underpinnings associated with childhood maltreatment in MDD remain poorly understood. Here, we seek to investigate the whole-brain functional connectivity patterns in MDD patients with childhood maltreatment. Resting-state functional magnetic resonance imaging was used to explore intrinsic or spontaneous functional connectivity networks of 18 MDD patients with childhood neglect, 20 MDD patients without childhood neglect, and 20 healthy controls. Whole-brain functional networks were constructed by measuring the temporal correlations of every pairs of brain voxels and were further analyzed by using graph-theory approaches. Relative to the healthy control group, the two MDD patient groups showed overlapping reduced functional connectivity strength in bilateral ventral medial prefrontal cortex/ventral anterior cingulate cortex. However, compared with MDD patients without a history of childhood maltreatment, those patients with such a history displayed widespread reduction of functional connectivity strength primarily in brain regions within the prefrontal-limbic-thalamic-cerebellar circuitry, and these reductions significantly correlated with measures of childhood neglect. Together, we showed that the MDD groups with and without childhood neglect exhibited overlapping and segregated functional connectivity patterns in the whole-brain networks, providing empirical evidence for the contribution of early life stress to the pathophysiology of MDD. Hum Brain Mapp, 2013. © 2013 Wiley Periodicals, Inc.
HubMed – depression


Initial Assessment of Patients Without Cognitive Failure Admitted in Palliative Care.

Filed under: Depression Treatment

Am J Hosp Palliat Care. 2013 Feb 12;
Gonçalves F

Aim: To develop a screening tool that was short, not time consuming but able to detect the patients’ main problems at admission. METHODS: A list of 106 symptoms/problems derived from a review of the literature was created and shortened using a Delphi process. RESULTS: Thirteen experts scored each item with a numeric rating scale of 0 to 10 for relevance. After 3 rounds, the list was shortened to 14 items: general question- what bothers you the most? symptoms/problems- pain, lack of appetite, vomiting, tiredness/fatigue, nausea, constipation, shortness of breath, depression, anxiety, difficulty sleeping; activity (dressing, washing, etc); support from family/friends; and well-being. Conclusion: The final tool is short and seems to include the relevant items that would make it useful for clinical practice.
HubMed – depression


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