R. Todd Ogden

Altered serotonin 1A binding in major depression: a [carbonyl-C-11]WAY100635 positron emission tomography study.

BACKGROUND Serotonin 1A receptors (5-HT(1A)) are implicated in the pathophysiology of major depressive disorder (MDD) and in the action of selective serotonin reuptake inhibitors (SSRI). SSRI desensitize 5-HT(1A) and down-regulate 5-HT transporters (5-HTT) with the latter persisting for weeks after discontinuation of SSRI. MDD subjects are more likely to be homozygous for the functional 5-HT(1A) G(-1019) allele of the promoter polymorphism and are postulated to have higher 5-HT(1A) than healthy volunteers (controls). We measure 5-HT(1A) in MDD, assess the effects of antidepressant exposure (AE), and examine the role of the C(-1019)G polymorphism. METHODS Genotyped and determined 5-HT(1A) binding potential (BP) by positron emission tomography (PET) using [carbonyl-C-11]-WAY-100635 in 28 medication-free MDD subjects during a current major depressive episode and 43 controls. RESULTS No difference in BP between controls and MDD subjects (p = .235). There was a difference in BP comparing the controls, antidepressant naive (AN) MDD subjects, and subjects with AE across all regions (p = .013). Post hoc testing reveals higher BP in AN compared to controls (p = .008) and to AE (p = .007). The GG genotype is overrepresented in MDD subjects (p = .059), and BP appears higher with the G allele. CONCLUSIONS AN have higher 5-HT(1A) than controls and AE suggesting a model of depression characterized by an over expression of autoinhibitory somatodendritic 5-HT(1A) receptors, perhaps due to the higher expressing G allele, that may result in reduced terminal field 5-HT release. AE appears to have long-term effects on 5-HT(1A).

Effects of sex, age, and aggressive traits in man on brain serotonin 5-HT1A receptor binding potential measured by PET using [C-11]WAY-100635.

Serotonin (5-HT) 1A receptors have been implicated in a variety of conditions including, depression, suicidal behavior, and aggression. Post-mortem brain studies and in vivo imaging studies report a variety of age and sex effects on brain 5-HT(1A) binding. Behavioral data from 5-HT(1A) specific pharmacological challenges suggest a role for 5-HT(1A) receptors in aggression. The goal of the present study was to determine age, sex, and severity of life-time aggression effects on 5-HT(1A) binding potential (BP) in vivo using positron emission tomography (PET) and the high affinity 5-HT(1A) antagonist, [carbonyl-C-11]WAY-100635 in 12 healthy females (ages 41.0+/-15.7 years) and 13 healthy males (ages 39.6+/-15.5 years). Regions of interest included the dorsal raphe, anterior cingulate cortex, cingulate body, hippocampus, amygdala, medial prefrontal cortex (PFC), and orbital PFC. No significant correlation between age and BP was detected in any brain region. MANOVA of the first three principle components demonstrated a significantly higher BP in females compared with males (P=0.0127). Post-hoc tests confirmed sex differences (P<0.05) in the following regions: dorsal raphe, amygdala, anterior cingulate, cingulate body, medial PFC, and orbital PFC. The cerebellar volume of distribution was also significantly higher in females. There is a significant negative correlation between binding in several regions and lifetime aggression. We have replicated our post-mortem finding of higher 5-HT(1A) binding in females compared to males. We did not detect an age dependent decrease in binding in males or females. Lower 5-HT(1A) binding in more aggressive individuals is consistent with pharmacological challenge studies. Future studies should determine whether the binding is a state or trait effect.

Higher 5-HT1A receptor binding potential during a major depressive episode predicts poor treatment response: preliminary data from a naturalistic study.

Serotonin 1A (5-HT1A) binding potential (BP) as assessed by positron emission tomography (PET) is higher in major depressive disorder (MDD) in association with the higher expressing GG genotype of the 5-HT1A C-1019G polymorphism. We hypothesize that higher 5-HT1A BP and the GG genotype predict remission failure on antidepressant treatment. We determined 5-HT1A BP by PET and 5-HT1A C-1019G genotype in 43 controls and 22 medication-free MDD subjects. MDD was treated naturalistically and remission was defined as >50% reduction and a score of ⩽10 on the 24 item Hamilton Scale 1 year after initiation of treatment after scanning. Despite equivalent treatment, nonremitters have higher pretreatment cortical BP and the GG genotype is over-represented compared with remitters. Higher 5-HT1A BP, perhaps due to greater gene expression, may predict antidepressant medication nonremission. The findings should be tested in a controlled prospective treatment study.

Functional Principal Component Regression and Functional Partial Least Squares

Regression of a scalar response on signal predictors, such as near-infrared (NIR) spectra of chemical samples, presents a major challenge when, as is typically the case, the dimension of the signals far exceeds their number. Most solutions to this problem reduce the dimension of the predictors either by regressing on components [e.g., principal component regression (PCR) and partial least squares (PLS)] or by smoothing methods, which restrict the coefficient function to the span of a spline basis. This article introduces functional versions of PCR and PLS, which combine both of the foregoing dimension-reduction approaches. Two versions of functional PCR are developed, both using B-splines and roughness penalties. The regularized-components version applies such a penalty to the construction of the principal components (i.e., it uses functional principal components), whereas the regularized-regression version incorporates a penalty in the regression. For the latter form of functional PCR, the penalty parameter may be selected by generalized cross-validation, restricted maximum likelihood (REML), or a minimum mean integrated squared error criterion. Proceeding similarly, we develop two versions of functional PLS. Asymptotic convergence properties of regularized-regression functional PCR are demonstrated. A simulation study and split-sample validation with several NIR spectroscopy data sets indicate that functional PCR and functional PLS, especially the regularized-regression versions with REML, offer advantages over existing methods in terms of both estimation of the coefficient function and prediction of future observations.

Higher Serotonin 1A Binding in a Second Major Depression Cohort: Modeling and Reference Region Considerations

BACKGROUND Serotonin 1A receptors (5-HT(1A)) are implicated in major depressive disorder (MDD). We previously reported higher 5-HT(1A) binding potential (BP(F)) in antidepressant naive MDD subjects compared with control subjects, while other studies report lower BP(ND). Discrepancies can be related to differences in study population or methodology. We sought to replicate our findings in a novel cohort and determine whether choice of reference region and outcome measure could explain discrepancies. METHODS Nine new control subjects and 22 new not recently medicated (NRM) MDD subjects underwent positron emission tomography. BP(F) and BP(ND) were determined using a metabolite and free fraction corrected arterial input function. BP(ND) was also determined using cerebellar gray matter (CGM) and cerebellar white matter (CWM) reference regions as input functions. RESULTS BP(F) was higher in the new NRM cohort (p = .037) compared with new control subjects, comparable to the previous cohort (p = .04). Cohorts were combined to examine the reference region and outcome measure. BP(F) was higher in the NRM compared with control subjects (p = .0001). Neither BP(ND) using CWM (p = .86) nor volume of distribution (V(T)) (p = .374) differed between groups. When CGM was used, the NRM group had lower 5-HT(1A) BP(ND) compared with control subjects (p = .03); CGM V(T) was higher in NRM compared with control subjects (p = .007). CONCLUSIONS Choice of reference region and outcome measure can produce different 5-HT(1A) findings. Higher 5-HT(1A) BP(F) in MDD was found with the method with fewest assumptions about nonspecific binding and a reference region without receptors.

Positron emission tomography quantification of serotonin-1A receptor binding in medication-free bipolar depression.

BACKGROUND Little is known about the serotonin-1A receptor (5-HT1A) in bipolar depression despite altered 5-HT1A binding in major depressive disorder. Utilizing positron emission tomography (PET) and the radioligand N-(2-(4-(2-methoxyphenyl)-1-piperazinyl)ethyl)-N-(2-pyridinyl)cyclohexanecarboxamide ([Carbonyl-C-11]WAY-100635), 5-HT1A binding was compared between depressed bipolar disorder (BD) and controls. METHODS Brain 5-HT1A binding potential (BP(F) = B(max)/K(D), where B(max) = total available receptors, and 1/K(D) = ligand affinity) was measured in 32 currently depressed, medication-free BD subjects and 47 controls. Participants were genotyped for the 5-HT1A promoter polymorphism C(-1019)G. RESULTS The bipolar depressed group demonstrated higher 5-HT1A BP(F) across all regions of interest (ROIs; p = .022). Post hoc analyses indicated that male BD patients had higher 5-HT1A BP(F) than male controls (p = .025), with higher 5-HT1A BP(F) found in every region (by 102% in raphe nuclei and 29% to 50% in the forebrain ROIs); whereas, female subgroups did not differ in 5-HT1A BP(F) (p = .32). Serotonin-1A BP(F) did not correlate with depression severity. The GG genotype was overrepresented at trend level in the BD group (p = .057). Number of G-allele copies was associated with higher 5-HT1A BP(F) in raphe (p = .0050), amygdala (p = .022), and hippocampus (p = .041). CONCLUSIONS Higher 5-HT1A BP(F) in bipolar depressed males suggests higher raphe autoreceptor binding, potentially causing less serotonin release and compensatory upregulation of forebrain postsynaptic 5-HT1A receptors. The raphe effect may be partly genetic. No difference in 5-HT1A BP(F) between BD and control females may reflect greater effect of prior antidepressant exposure in BD females.

Functional Generalized Linear Models with Images as Predictors

Functional principal component regression (FPCR) is a promising new method for regressing scalar outcomes on functional predictors. In this article, we present a theoretical justification for the use of principal components in functional regression. FPCR is then extended in two directions: from linear to the generalized linear modeling, and from univariate signal predictors to high-resolution image predictors. We show how to implement the method efficiently by adapting generalized additive model technology to the functional regression context. A technique is proposed for estimating simultaneous confidence bands for the coefficient function; in the neuroimaging setting, this yields a novel means to identify brain regions that are associated with a clinical outcome. A new application of likelihood ratio testing is described for assessing the null hypothesis of a constant coefficient function. The performance of the methodology is illustrated via simulations and real data analyses with positron emission tomography images as predictors.

Reported childhood abuse is associated with low serotonin transporter binding in vivo in major depressive disorder

Background: Physical or psychological adversity in childhood is associated with a higher risk for depression in adulthood, and with persistent serotonergic abnormalities in humans and in animal models. We hypothesized that reported childhood abuse would be associated with lower brain serotonin transporter (5‐HTT) binding potential (BPP, proportional to the number of available transporters) in adults. We examined healthy volunteers and subjects with major depressive disorder, a sample enriched for childhood abuse. Methods: Regional brain 5‐HTT BPP was measured using positron emission tomography (PET) with [11C]McN 5652 and a metabolite‐corrected arterial input function in 43 healthy volunteers and 23 subjects in a major depressive episode, ten of whom reported a history of sexual and/or physical abuse before age 15, and 13 of whom did not. As only two healthy volunteers reported childhood abuse, primary analyses were restricted to the depressed sample, with healthy controls presented as comparators. Results: Depressed subjects reporting childhood abuse had lower 5‐HTT BPP than nonabused depressed subjects across all brain regions examined (P = 0.017). The groups did not differ in relevant demographic or clinical variables. Genotype frequencies of a functional polymorphism in the 5‐HTT gene promoter (5‐HTTLPR) did not differ between the groups. Conclusions: Reported childhood abuse is associated with lower 5‐HTT BPP in this sample of subjects with major depression, consistent with other reports that childhood adversity can lower serotonergic function permanently. Lower 5‐HTT BPP may represent a biological pathway through which early life stress predisposes to the development of subsequent psychiatric illness, including major depressive disorder. Synapse 63:565–573, 2009.

In vivo quantification of serotonin transporters using [11C]DASB and positron emission tomography in humans: modeling considerations

Positron emission tomography (PET) studies of the serotonin transporter (5-HTT) in the human brain are increasingly using the radioligand [11C]N, N-dimethyl-2-(2-amino-4-cyanophenylthio) benzylamine. A variety of models have been applied to such data in several published articles; however to date, these models have not been validated with test–retest data. We recruited 11 healthy subjects and conducted two identical scans on each subject on the same day. We considered four different models (one- and two-tissue compartment kinetic models, likelihood estimation in graphical analysis (LEGA; a bias-free alternative to the graphical method), and basis pursuit) along with fast noniterative approximations to the kinetic models. We considered four different outcome measures (total volume of distribution (VT), binding potential with (BP) and without (BP1), free-fraction adjustment, and specific-to-nonspecific equilibrium partition coefficient (BP2)). To assess the performance of each model, we compared results using six different metrics (percent difference (PD) and within-subject mean sum of squares for reproducibility, interclass coefficient for reliability, variance across subjects, identifiability based on bootstrap resampling of residuals for each method, and time stability analysis to determine minimal required scanning time). We considered analysis of both at the voxel level and at the region of interest (ROI) level and compared results from these two approaches to assess agreement. We determined that 100 mins of scanning time is adequate and that for ROI-level analysis, LEGA gives best results. Average PD is 5.51 for VT, 20.7 for BP, 17.2 for BP1, and 16.5 for BP2 across all regions. For voxel-level analysis we determined that the one-tissue compartment noniterative model is best.

Positron emission tomography quantification of serotonin transporter in suicide attempters with major depressive disorder.

BACKGROUND Several lines of evidence implicate abnormal serotonergic function in suicidal behavior and completed suicide, including low serotonin transporter binding in postmortem studies of completed suicide. We have also reported low in vivo serotonin transporter binding in major depressive disorder (MDD) during a major depressive episode using positron emission tomography (PET) with [(11)C]McN5652. We quantified regional brain serotonin transporter binding in vivo in depressed suicide attempters, depressed nonattempters, and healthy controls using PET and a superior radiotracer, [(11)C]DASB. METHODS Fifty-one subjects with DSM-IV current MDD, 15 of whom were past suicide attempters, and 32 healthy control subjects underwent PET scanning with [(11)C]DASB to quantify in vivo regional brain serotonin transporter binding. Metabolite-corrected arterial input functions and plasma free-fraction were acquired to improve quantification. RESULTS Depressed suicide attempters had lower serotonin transporter binding in midbrain compared with depressed nonattempters (p = .031) and control subjects (p = .0093). There was no difference in serotonin transporter binding comparing all depressed subjects with healthy control subjects considering six a priori regions of interest simultaneously (p = .41). CONCLUSIONS Low midbrain serotonin transporter binding appears to be related to the pathophysiology of suicidal behavior rather than of major depressive disorder. This is consistent with postmortem work showing low midbrain serotonin transporter binding capacity in depressed suicides and may partially explain discrepant in vivo findings quantifying serotonin transporter in depression. Future studies should investigate midbrain serotonin transporter binding as a predictor of suicidal behavior in MDD and determine the cause of low binding.