Prognostic and Diagnostic Potential of the Structural Neuroanatomy of Depression 英文参考文献.docVIP

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Prognostic and Diagnostic Potential of the Structural Neuroanatomy of Depression 英文参考文献.doc

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Prognostic and Diagnostic Potential of the Structural Neuroanatomy of Depression 英文参考文献

PrognosticandDiagnosticPotentialoftheStructural NeuroanatomyofDepression SergiG.Costafreda1,CarltonChu2,JohnAshburner2,CynthiaH.Y.Fu1* 1InstituteofPsychiatry,King’sCollegeLondon,London,UnitedKingdom,2WellcomeTrustCentreforNeuroimaging,InstituteofNeurology,UniversityCollegeLondon, London,UnitedKingdom Abstract Background:Depressionisexperiencedasapersistentlowmoodoranhedoniaaccompaniedbybehaviouralandcognitive disturbanceswhichimpairdaytodayfunctioning.However,thediagnosisislargelybasedonself-reportedsymptoms,and therearenoneurobiologicalmarkerstoguidethechoiceoftreatment.Inthepresentstudy,weexaminedtheprognostic anddiagnosticpotentialofthestructuralneuralcorrelatesofdepression. Methodology and Principal Findings: Subjects were 37 patients with major depressive disorder (mean age 43.2 years), medication-free,inanacutedepressiveepisode,and37healthyindividuals.FollowingtheMRIscan,30patientsunderwent 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 predicted88.9%oftheclinicalresponse,priortotheinitiationoftreatment(88.9%patientsinclinicalremission(sensitivity) and88.9%patientswithresidualsymptoms(specificity),p=0.01).Accuracyofthestructuralneuroanatomyasadiagnostic markerthoughwas67.6%(64.9%patients(sensitivity)and70.3%healthyindividuals(specificity),p =0.027). Conclusions and Significance: The structural neuroanatomy of depression shows high predictive potential for clinical responsetoantidepressantmedication,whileitsdiagnosticpotentialismorelimited.Thepresentfindingsprovideinitial stepstowardsthedevelopmentofneurobiologicalprognosticmarkersfordepression. Citation:CostafredaSG,ChuC,AshburnerJ,FuCHY(2009)PrognosticandDiagnosticPotentialoftheStructuralNeuroanatomyofDepression.PLoSONE4(7): e6353.doi:10.1371/journal.pone.0006353 Editor:KatharinaDomschke,UniversityofMuenster,Germany ReceivedMay6