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International Patent Classification
  • HUMAN NECESSITIES
    • MEDICAL OR VETERINARY SCIENCE; HYGIENE
      • ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY (measurement of bio-electric currents A61B; electrosurgical apparatus or circuits therefor A61B17/36; physical therapy arrangements in general A61H; anaesthetic apparatus in general A61M; incandescent lamps H01K; infra-red radiators for heating H05B)
      • PREPARATIONS FOR MEDICAL, DENTAL, OR TOILET PURPOSES (bringing into special physical form A61J [N: mechanical aspects]; chemical aspects of, or use of materials for deodorisation of air, for disinfection or sterilisation, or for bandages, dressings, absorbent pads or surgical articles A61L; compounds per se C01, C07, C08, C12N; soap compositions C11D; micro-organisms per se C12N) [C0203]
      • THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
Geographical classification
Keywords
BIPOLAR DISORDER; DEPRESSION; PHARMACOGENTICS; NEUROIMAGING

Genetic and neural imaging aspects of antidepressant response

Libera Università "Vita Salute S. Raffaele" - Milano
Abstract
Major psychoses are serious disorders with an heavy social impact on world population. Although causes are mostly unknown, an interaction between genetic liability and environmental situations has been demonstrated.
The aim of the present study is to evaluate changes in the neural response to emotionally toned stimuli before and after antidepressant treatment with Selective Serotonin Reuptake Inibitors (SSRIs) or total sleep deprivation in patients affected by mood disorders selected on the basis of their genetic profile (5HTTLPR).
The final aim is to be able to predict the development of the illness and the best therapeutic tools on the basis of genotype of a single patient.

Principal Investigator
Enrico SMERALDI Libera Università "Vita Salute S.Raffaele" MILANO
Research Objectives
The aims of the present study are to evaluate:
· Changes in the neural response to emotionally tuned stimuli before and after antidepressant treatment in patients affected by major depression.
· The influence of 5-HTTLPR on treatment response and neural processing of emotionally tuned stimuli.

Timescale
24 months
National and international background
A recent study suggested a neural basis of mood-congruent neuropsychologic dysfunction in major depression, using a go-no go task
where depressed patients showed a facilitation of performance when responding to stimuli with a negative emotional tone (Murphy
et al., 1999). 2.0 T Functional magnetic resonance imaging (BOLD activation) during performance to this emotional go-no go task
showed that depressed patients, in respect to control subjects, showed elevated neural responses specific to sad targets in rostral
anterior cingulate extending to anterior medial prefrontal cortex, and, unlike controls, showed attenuated responses to emotional
relative to neutral stimuli in ventral cingulate and posterior orbitofrontal cortices (Elliott et al., 2002). In particular, depressed
patients showed a general attenuation of neural responses to emotional words in cortical and subcortical structures, including a
ventral cingulate region adjacent to the subgenual cingulate. More specifically, a double dissociation of valence-specific response
was observed in the rostral anterior cingulate cortex extending to the anterior medial prefrontal cortex (BA 24/32). This region
responded more strongly to happy words in controls and, conversely, to sad words in patients.
These same regions are strongly involved in the mechanism of action of antidepressant treatments: serotoninergic and noradrenergic
drugs, and total sleep >>>