Single photon emission computed tomography (SPECT) of anxiety disorders before and after treatment with citalopram.

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dc.contributor.authorCarey, P.D.
dc.contributor.authorWarwick, J.
dc.contributor.authorNiehaus, D.J.H.
dc.contributor.authorvan der Linden, G.
dc.contributor.authorvan Heerden, B.B.
dc.contributor.authorHarvey, B.H.
dc.contributor.authorSeedat, S.
dc.contributor.authorStein, D.J.
dc.contributor.departmentMRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Tygerberg, 7505, Cape Town, South Africa. pcarey@sun.ac.zaen_US
dc.date.accessioned2020-03-11T06:56:48Z
dc.date.available2020-03-11T06:56:48Z
dc.date.epub2004
dc.date.issued2004
dc.description.abstractBackground: Several studies have now examined the effects of selective serotonin reuptake inhibitor (SSRI) treatment on brain function in a variety of anxiety disorders including obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social anxiety disorder (social phobia) (SAD). Regional changes in cerebral perfusion following SSRI treatment have been shown for all three disorders. The orbitofrontal cortex (OFC) (OCD), caudate (OCD), medial pre-frontal/cingulate (OCD, SAD, PTSD), temporal (OCD, SAD, PTSD) and, thalamic regions (OCD, SAD) are some of those implicated. Some data also suggests that higher perfusion pre-treatment in the anterior cingulate (PTSD), OFC, caudate (OCD) and antero-lateral temporal region (SAD) predicts subsequent treatment response. This paper further examines the notion of overlap in the neurocircuitry of treatment and indeed treatment response across anxiety disorders with SSRI treatment. Methods: Single photon emission computed tomography (SPECT) using Tc-99 m HMPAO to assess brain perfusion was performed on subjects with OCD, PTSD, and SAD before and after 8 weeks (SAD) and 12 weeks (OCD and PTSD) treatment with the SSRI citalopram. Statistical parametric mapping (SPM) was used to compare scans (pre- vs post-medication, and responders vs non-responders) in the combined group of subjects. Results: Citalopram treatment resulted in significant deactivation (p = 0.001) for the entire group in the superior (t = 4.78) and anterior (t = 4.04) cingulate, right thalamus (t = 4.66) and left hippocampus (t = 3.96). Deactivation (p = 0.001) within the left precentral (t = 4.26), right mid-frontal (t = 4.03), right inferior frontal (t = 3.99), left prefrontal (3.81) and right precuneus (t= 3.85) was more marked in treatment responders. No pattern of baseline activation distinguished responders from non-responders to subsequent pharmacotherapy. Conclusions: Although each of the anxiety disorders may be mediated by different neurocircuits, there is some overlap in the functional neuro-anatomy of their response to SSRI treatment. The current data are consistent with previous work demonstrating the importance of limbic circuits in this spectrum of disorders. These play a crucial role in cognitive-affective processing, are innervated by serotonergic neurons, and changes in their activity during serotonergic pharmacotherapy seem crucial.en_US
dc.description.sponsorshipThis study was supported by the Medical Research Council of South Africa. Medication was provided by Lundbeck South Africa.en_US
dc.identifier.citationCarey PD, Warwick J, Niehaus DJH, van der Linden G, van Heerden BB, Harvey BH, et al. Single photon emission computed tomography (SPECT) of anxiety disorders before and after treatment with citalopram. BMC Psychiatryen_US
dc.identifier.journalBioMed Centralen_US
dc.identifier.urihttps://infospace.mrc.ac.za/handle/11288/595226
dc.language.isoenen_US
dc.relation.urlhttp://hdl.handle.net/10019.1/5058en_US
dc.relation.urlhttps://doi.org/10.1186/1471-244X-4-30.en_US
dc.research.unitClosed Unitsen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.subjectAnxiety disorders -- Treatmenten_US
dc.subjectObsessive-compulsive disorder -- Treatmenten_US
dc.subjectSocial anxiety disorder --Treatment.en_US
dc.titleSingle photon emission computed tomography (SPECT) of anxiety disorders before and after treatment with citalopram.en_US
dc.typeArticleen_US
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