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Edward Bullmore talks with
ScienceWatch.com and answers a few questions about
this month's Emerging Research Front Paper in the field of
Psychiatry/Psychology.
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Article: Attenuation of the neural response to sad
faces in major depression by antidepressant treatment - A
prospective, event-related functional magnetic resonance
imaging study
Authors: Fu, CHY;Williams, SCR;Cleare, AJ;Brammer, MJ;Walsh,
ND;Kim, J;Andrew, CM;Pich, EM;Williams, PM;Reed,
LJ;Mitterschiffthaler, MT;Suckling, J;Bullmore,
ET
Journal: ARCH GEN PSYCHIAT, 61 (9): 877-889, SEP 2004
Addresses: Univ Cambridge, Dept Psychiat, Brain Mapping Unit,
Addenbrookes Hosp, Hills Rd, Cambridge CB2 2QQ, England.
Univ Cambridge, Dept Psychiat, Brain Mapping Unit, Addenbrookes
Hosp, Cambridge CB2 2QQ, England.
(addresses have been
truncated.)
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Why do you think your paper is highly
cited?
I think the paper has been well cited because it was one of the first
event-related fMRI studies to show the effects of depression and
antidepressant drug treatment on brain activation elicited by "events"
consisting of emotional faces showing different intensities of sadness.
More generally, it was one of the first generation of fMRI studies to look
at any drug effects on brain function in any clinical disorder.
Does it describe a new discovery, methodology, or
synthesis of knowledge?
We showed that depression is associated with enhanced limbic activation by
negative affectively valent visual stimuli and that antidepressants are
associated with normalization of limbic over-activation.
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"...mental health disorders are brain disorders and the
aspiration that one day we may do a better job for
psychiatric patients by using the power of modern
neuroscience for more decisive therapeutic impact."
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In this original paper and some additional papers that further investigated
the same data, we found correlations between brain functional response and
symptomatic response to antidepressant treatment, and we confirmed
important prior work suggesting that brain imaging markers of anterior
cingulate structure and function can be used to predict antidepressant
treatment response.
Would you summarize the significance of your paper
in layman’s terms?
Modern brain-scanning techniques can show how antidepressant drugs may act
on the brain to correct the bias towards negative thinking associated with
depression. One important future use of brain scanning may be to predict
which patients are likely to respond best to antidepressant treatment.
How did you become involved in this research and
were any particular problems encountered along the way?
This study was an academic-industrial collaboration between the Institute
of Psychiatry (IoP), London, and GlaxoSmithKline. At the time, I was a
research fellow at the IoP and I got involved initially on design and
analysis issues.
My colleagues Cynthia Fu and Steve Williams led on clinical and MRI
aspects, respectively. Clinical research is never all that easy and it was
challenging to find patients and conduct what was a technically advanced
trial at the time.
Where do you see your research leading in the
future?
I am interested in using fMRI among other experimental medicine approaches
to drug discovery for central nervous system and metabolic disorders. I am
also interested in analyzing the topological and physical properties of
brain networks represented in human neuroimaging and electrophysiological
data.
Do you foresee any social or political
implications for your research?
I hope that this study is one small additional piece of evidence in support
of the idea that mental health disorders are brain disorders and the
aspiration that one day we may do a better job for psychiatric patients by
using the power of modern neuroscience for more decisive therapeutic
impact.
Edward T. Bullmore
University of Cambridge
Department of Psychiatry
Brain Mapping Unit
Addenbrookes Hospital
Cambridge, UK
KEYWORDS: CEREBRAL-BLOOD-FLOW; POSITRON-EMISSION-TOMOGRAPHY; HUMAN
EXTRASTRIATE CORTEX; BRAIN GLUCOSE-METABOLISM; FACIAL EXPRESSIONS;
AFFECTIVE-DISORDER; HUMAN AMYGDALA; SYMPTOM PROVOCATION; UNIPOLAR
DEPRESSION; ANTERIOR CINGULATE.
