Short-term escitalopram treatment normalizes aberrant self-referential processing in major depressive disorder

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http://hdl.handle.net/10138/301887

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Komulainen , E , Heikkilä , R , Nummenmaa , L , Raij , T T , Harmer , C J , Isometsä , E & Ekelund , J 2018 , ' Short-term escitalopram treatment normalizes aberrant self-referential processing in major depressive disorder ' , Journal of Affective Disorders , vol. 236 , pp. 222-229 . https://doi.org/10.1016/j.jad.2018.04.096

Title: Short-term escitalopram treatment normalizes aberrant self-referential processing in major depressive disorder
Author: Komulainen, Emma; Heikkilä, Roope; Nummenmaa, Lauri; Raij, Tuukka T.; Harmer, Catherine J.; Isometsä, Erkki; Ekelund, Jesper
Contributor: University of Helsinki, Clinicum
University of Helsinki, University of Helsinki
University of Helsinki, Clinicum
University of Helsinki, Department of Psychiatry
Date: 2018-08-15
Number of pages: 8
Belongs to series: Journal of Affective Disorders
ISSN: 0165-0327
URI: http://hdl.handle.net/10138/301887
Abstract: Background: Increased self-focus and negative self-concept play an important role in depression. Antidepressants influence self-referential processing in healthy volunteers, but their function in self-processing of depressed patients remains unknown. Methods: Thirty-two depressed patients were randomly allocated to receive either escitalopram 10 mg or placebo for one week. After one week, neural responses to positive and negative self-referential adjectives and neutral control stimuli were assessed with functional magnetic resonance imaging. A group of matched healthy volunteers served as a control group. Results: Escitalopram decreased responses of medial fronto-parietal regions to self-referential words relative to non-emotional control stimuli, driven by increased responses to the control condition. Escitalopram also increased responses in the pre-defined region of the medial prefrontal cortex (MPFC) and the anterior cingulate cortex (ACC) to positive relative to negative words. Importantly, the changes in neural responses occurred before any effect on depressive symptoms, implying a direct effect of escitalopram. Furthermore, the placebo group had decreased responses of the MPFC and the ACC to positive self-referential processing relative to the matched healthy controls. However, neural responses of the escitalopram group and the healthy unmedicated controls were similar. Limitations: Differences between the groups in self-reported depression symptoms and personality traits may have influenced the results. Conclusion: One-week treatment with escitalopram normalized aberrant self-referential processing in depressed patients, shifting the focus from the self to the external environment and potentiating positive self-referential processing. This may be an important factor in mechanism of action of antidepressants.
Subject: Depression
Antidepressant
Escitalopram
fMRI
Emotion
Self-referential processing
DEFAULT-MODE NETWORK
MEDIAL PREFRONTAL CORTEX
HEALTHY-VOLUNTEERS
FUNCTIONAL CONNECTIVITY
BRAIN
METAANALYSIS
DISEASE
FMRI
MRI
RECOGNITION
3112 Neurosciences
3124 Neurology and psychiatry
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