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Prognostic and Diagnostic Potential of the Structural Neuroanatomy of Depression

Costafreda, SG; Chu, C; Ashburner, J; Fu, CHY; (2009) Prognostic and Diagnostic Potential of the Structural Neuroanatomy of Depression. PLOS ONE , 4 (7) , Article e6353. 10.1371/journal.pone.0006353. Green open access

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Abstract

Background: Depression is experienced as a persistent low mood or anhedonia accompanied by behavioural and cognitive disturbances which impair day to day functioning. However, the diagnosis is largely based on self-reported symptoms, and there are no neurobiological markers to guide the choice of treatment. In the present study, we examined the prognostic and diagnostic potential of the structural neural correlates of depression.Methodology and Principal Findings: Subjects were 37 patients with major depressive disorder (mean age 43.2 years), medication-free, in an acute depressive episode, and 37 healthy individuals. Following the MRI scan, 30 patients underwent treatment with the antidepressant medication fluoxetine or cognitive behavioural therapy (CBT). Of the patients who subsequently achieved clinical remission with antidepressant medication, the whole brain structural neuroanatomy predicted 88.9% of the clinical response, prior to the initiation of treatment (88.9% patients in clinical remission (sensitivity) and 88.9% patients with residual symptoms (specificity), p = 0.01). Accuracy of the structural neuroanatomy as a diagnostic marker though was 67.6% (64.9% patients (sensitivity) and 70.3% healthy individuals (specificity), p = 0.027).Conclusions and Significance: The structural neuroanatomy of depression shows high predictive potential for clinical response to antidepressant medication, while its diagnostic potential is more limited. The present findings provide initial steps towards the development of neurobiological prognostic markers for depression.

Type: Article
Title: Prognostic and Diagnostic Potential of the Structural Neuroanatomy of Depression
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0006353
Publisher version: http://dx.doi.org/10.1371/journal.pone.0006353
Language: English
Additional information: © 2009 Costafreda et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. SC was supported by a Wellcome Trust Value in People Award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Keywords: POSITRON-EMISSION-TOMOGRAPHY, COGNITIVE-BEHAVIORAL THERAPY, VOXEL-BASED MORPHOMETRY, MAJOR DEPRESSION, ANTIDEPRESSANT TREATMENT, FACIAL EXPRESSIONS, PREFRONTAL CORTEX, NEURAL RESPONSES, MOOD DISORDERS, SAD FACES
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Imaging Neuroscience
URI: https://discovery.ucl.ac.uk/id/eprint/192543
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