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Low-dose augmentation with buprenorphine increases emotional reactivity but not reward activity in treatment resistant mid- and late-life depression.

Publication ,  Journal Article
Lin, C; Karim, HT; Pecina, M; Aizenstein, HJ; Lenze, EJ; Blumberger, DM; Mulsant, BH; Kharasch, ED; Reynolds Iii, CF; Karp, JF
Published in: Neuroimage Clin
2019

Buprenorphine is currently being studied for treatment-resistant depression because of its rapid effect, relative safety, and unique pharmacodynamics. To understand the neural impact of buprenorphine in depression, we examined acute limbic and reward circuit changes during an intervention with low-dose buprenorphine augmentation pharmacotherapy. Mid and late-life adults with major depression (N = 31) who did not completely respond to an adequate trial of venlafaxine were randomized to augmentation with low-dose buprenorphine or matching placebo. We investigated early neural changes using functional magnetic resonance imaging (fMRI) from pre-randomization to 3 weeks using both an emotional reactivity task and a gambling task. We tested if: 1) there were significant neural changes acutely per intervention group, and 2) if acute neural changes were associated with depressive symptom change over 8 weeks using both the total score and the dysphoria subscale of the Montgomery Asberg Depression Rating Scale. Participants in both the buprenorphine and placebo groups showed similar changes in depressive symptoms. Neither the emotional reactivity nor gambling task resulted in significant neural activation changes from pre-randomization to 3-weeks. In both groups, increases in rostral anterior cingulate (rACC) and ventromedial prefrontal cortex (vmPFC) activation during the emotional reactivity task were associated with overall symptom improvement. In the buprenorphine but not the placebo group, increased activation in left anterior insula (aINS) and bilateral middle frontal gyrus (MFG) was associated with improvement on the dysphoria subscale. Activation changes in the reward task were not associated with buprenorphine. This is the first study to show an association between acute neural changes during emotion reactivity and changes in depression severity with buprenorphine treatment.

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Published In

Neuroimage Clin

DOI

EISSN

2213-1582

Publication Date

2019

Volume

21

Start / End Page

101679

Location

Netherlands

Related Subject Headings

  • Reward
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Female
  • Emotions
  • Double-Blind Method
  • Depressive Disorder, Major
  • Depression
  • Buprenorphine
 

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ICMJE
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Lin, C., Karim, H. T., Pecina, M., Aizenstein, H. J., Lenze, E. J., Blumberger, D. M., … Karp, J. F. (2019). Low-dose augmentation with buprenorphine increases emotional reactivity but not reward activity in treatment resistant mid- and late-life depression. Neuroimage Clin, 21, 101679. https://doi.org/10.1016/j.nicl.2019.101679
Lin, Chemin, Helmet T. Karim, Marta Pecina, Howard J. Aizenstein, Eric J. Lenze, Daniel M. Blumberger, Benoit H. Mulsant, Evan D. Kharasch, Charles F. Reynolds Iii, and Jordan F. Karp. “Low-dose augmentation with buprenorphine increases emotional reactivity but not reward activity in treatment resistant mid- and late-life depression.Neuroimage Clin 21 (2019): 101679. https://doi.org/10.1016/j.nicl.2019.101679.
Lin C, Karim HT, Pecina M, Aizenstein HJ, Lenze EJ, Blumberger DM, et al. Low-dose augmentation with buprenorphine increases emotional reactivity but not reward activity in treatment resistant mid- and late-life depression. Neuroimage Clin. 2019;21:101679.
Lin, Chemin, et al. “Low-dose augmentation with buprenorphine increases emotional reactivity but not reward activity in treatment resistant mid- and late-life depression.Neuroimage Clin, vol. 21, 2019, p. 101679. Pubmed, doi:10.1016/j.nicl.2019.101679.
Lin C, Karim HT, Pecina M, Aizenstein HJ, Lenze EJ, Blumberger DM, Mulsant BH, Kharasch ED, Reynolds Iii CF, Karp JF. Low-dose augmentation with buprenorphine increases emotional reactivity but not reward activity in treatment resistant mid- and late-life depression. Neuroimage Clin. 2019;21:101679.
Journal cover image

Published In

Neuroimage Clin

DOI

EISSN

2213-1582

Publication Date

2019

Volume

21

Start / End Page

101679

Location

Netherlands

Related Subject Headings

  • Reward
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Female
  • Emotions
  • Double-Blind Method
  • Depressive Disorder, Major
  • Depression
  • Buprenorphine