PMID- 29747140
OWN - NLM
STAT- MEDLINE
DCOM- 20190114
LR  - 20190114
IS  - 1573-2517 (Electronic)
IS  - 0165-0327 (Linking)
VI  - 236
DP  - 2018 Aug 15
TI  - Short-term escitalopram treatment normalizes aberrant self-referential processing 
      in major depressive disorder.
PG  - 222-229
LID - S0165-0327(17)32281-4 [pii]
LID - 10.1016/j.jad.2018.04.096 [doi]
AB  - 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.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Komulainen, Emma
AU  - Komulainen E
AD  - University of Helsinki and Helsinki University Hospital, Psychiatry, Helsinki, 
      Finland. Electronic address: emma.komulainen@helsinki.fi.
FAU - Heikkila, Roope
AU  - Heikkila R
AD  - University of Helsinki and Helsinki University Hospital, Psychiatry, Helsinki, 
      Finland.
FAU - Nummenmaa, Lauri
AU  - Nummenmaa L
AD  - Turku PET Centre and Department of Psychology, University of Turku, Finland.
FAU - Raij, Tuukka T
AU  - Raij TT
AD  - University of Helsinki and Helsinki University Hospital, Psychiatry, Helsinki, 
      Finland; Aalto University, School of Science, Department of Neuroscience and 
      Biomedical Engineering, Espoo, Finland; Aalto NeuroImaging, Aalto University, 
      Espoo, Finland.
FAU - Harmer, Catherine J
AU  - Harmer CJ
AD  - University Department of Psychiatry, Oxford, UK.
FAU - Isometsa, Erkki
AU  - Isometsa E
AD  - University of Helsinki and Helsinki University Hospital, Psychiatry, Helsinki, 
      Finland.
FAU - Ekelund, Jesper
AU  - Ekelund J
AD  - University of Turku and Turku University Hospital, Turku, Finland.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20180422
PL  - Netherlands
TA  - J Affect Disord
JT  - Journal of affective disorders
JID - 7906073
RN  - 0 (Antidepressive Agents)
RN  - 0 (Antidepressive Agents, Second-Generation)
RN  - 0DHU5B8D6V (Citalopram)
SB  - IM
MH  - Adult
MH  - Antidepressive Agents/*pharmacology
MH  - Antidepressive Agents, Second-Generation/*therapeutic use
MH  - Citalopram/*therapeutic use
MH  - Depressive Disorder, Major/*drug therapy/psychology
MH  - Double-Blind Method
MH  - Emotions/*drug effects
MH  - Female
MH  - Gyrus Cinguli/physiopathology
MH  - Humans
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Prefrontal Cortex/physiopathology
MH  - *Self Concept
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Antidepressant
OT  - Depression
OT  - Emotion
OT  - Escitalopram
OT  - Self-referential processing
OT  - fMRI
EDAT- 2018/05/11 06:00
MHDA- 2019/01/15 06:00
CRDT- 2018/05/11 06:00
PHST- 2017/11/13 00:00 [received]
PHST- 2018/03/25 00:00 [revised]
PHST- 2018/04/08 00:00 [accepted]
PHST- 2018/05/11 06:00 [pubmed]
PHST- 2019/01/15 06:00 [medline]
PHST- 2018/05/11 06:00 [entrez]
AID - S0165-0327(17)32281-4 [pii]
AID - 10.1016/j.jad.2018.04.096 [doi]
PST - ppublish
SO  - J Affect Disord. 2018 Aug 15;236:222-229. doi: 10.1016/j.jad.2018.04.096. Epub 
      2018 Apr 22.