Primjena protonske magnetske rezonancije u predviđanju terapijskog odgovora kod liječenja antidepresivima

master's thesis

• Title (english): Use of proton magnetic resonance imaging in the prediction of therapeutic response to antidepressant treatment
• Author: Filip Murn
• Mentor: Neven Henigsberg (mentor)
• Committee member: Ninoslav Mimica (predsjednik povjerenstva)
• Committee member: Dražen Begić (član povjerenstva)
• Committee member: Neven Henigsberg (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Psychiatry and Psychological Medicine); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry

Abstract

Velika depresivna epizoda je izrazito rasprostranjen psihijatrijski poremećaj sa značajnim ekonomskim utjecajem u društvu. Iako je razumijevanje prirode i uzroka depresije napredovalo tijekom stoljeća, ono je i dalje nepotpuno te su mnogi aspekti depresije i terapije predmet rasprave i istraživanja. Glavni pristup liječenju depresije je farmakološki. Istraživanje neuroloških biomarkera za dijagnozu i liječenje velike depresivne epizode, kao što je protonska magnetska rezonancijska spektroskopija, ima potencijal predvidjeti odgovor na liječenje kod bolesnika s depresijom. Protonska magnetska rezonancijska spektroskopija je neinvazivna tehnika za proučavanje razine metabolita mozga in vivo, koja se može koristiti za mjerenje biokemijskih spojeva ili koncentracije metabolita u određenim područjima mozga. Prethodna istraživanja su naglasila ulogu glija stanica u bijeloj tvari mozga. Pretpostavlja se da liječenje primjenom SIPPS antidepresiva ne utječe samo na neurone već aktivira i glija stanice. Pregledom literature, pronađeno je nekoliko istraživanja o primjeni protonske magnetske rezonancije u predviđanju terapijskog odgovora pri liječenja antidepresivima. Promjena koncentracije metabolita u bijeloj tvari ventralnog prefrontalnog korteksa vjerojatno sudjeluje u patofiziologiji velike depresivne epizode te podrazumijeva ključnu ulogu bijele tvari u velikoj depresivnoj epizodi. Studije opisane u pregledu pokazuju obećavajuće rezultate koji bi mogli rasvijetliti molekularne mehanizme velike depresivne epizode. Međutim, potrebna su daljnja istraživanja kako bi bolje razumjeli taj psihijatrijski poremećaj, kao i promicanje razvoja novih strategija liječenja.

Abstract (english)

Major depressive disorder (MDD) is a highly prevalent psychiatric disorder with a significant economic influence in society. The understanding of the nature and causes of depression has evolved over the centuries, although this understanding is incomplete and has left many aspects of depression and therapy as the subject of discussion and research. The main method of antidepressant treatment is pharmacological. Exploration of neurological biomarkers for diagnosis and treatment of MDD, such as proton magnetic resonance spectroscopy, has the potential to predict the response to treatment in patients with depression. Proton magnetic resonance spectroscopy provides a non-invasive technology to study brain metabolite levels in vivo, which can be used to measure biochemical compounds or metabolite concentrations in circumscribed brain regions. Previous research has highlighted the role of glial cells in brain white matter. It has been assumed that antidepressant treatment with SSRIs not only affects neurons but also activates glial cells. In a review of the literature, several studies were found on the use of proton magnetic resonance imaging in the prediction of the therapeutic response to antidepressant therapy. The alteration of ventral prefrontal white matter metabolite levels are likely involved in MDD pathophysiology and imply a crucial role of white matter in MDD. The studies presented in the review show promising results that could shed light on the molecular mechanisms of MDD. However, more work needs to be done to better understand this psychiatric disorder and promote the development of new treatment strategies.

• Keywords: protonska magnetska rezonancija; antidepresivi; depresija; velika depresivna epizoda; neurološki biomarkeri
• Keywords (english): proton magnetic resonance; antidepressant; depression; major depressive disorder; neurological biomarkers
• Language: croatian
• URN:NBN: urn:nbn:hr:105:400841
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-11-07 10:21:13