Table 15.
Functional Analyses of the Orbitofrontal Cortex in MDD.
| Study | Sample | Age | Method | Age of Onset |
Duration of Illness/# Episodes |
Family History of Illness |
Clinical Status at Testing |
Medication Status | Comorbidity | Findings | Brodmann Map/Stereotaxic Coordinates |
|---|---|---|---|---|---|---|---|---|---|---|---|
| (Baxter et al 1987) | 14 MDD 14 HC |
35.3±12.3 31.6±4.5 |
18 F-FDG | NR | NR | NR | Depressed | Free of drugs for 1+ week | NR | No significant differences | NR |
| (Drevets et al 1992) | 13 depressed MDD 10 remitted MDD 33 HC |
36.2±8.9 33.6±10.0 30.1±7.8 |
15O-H2O voxel-wise | NR | NR | Yes | Depressed + euthymic | Depressed sample unmediated for 3+ weeks before scan. Remitted sample unmedicated for 4+ months. | No co-morbid conditions | Elevated BF in L PFC (which included a portion of the lateral OFC) of depressed MDD | 47; 41; 6 |
| (Biver et al 1994) | 12 MDD 12 HC |
37.6±13.2 31.08±5.4 |
18 F-FDG ROI |
NR | NR | NR | Depressed | Unmediated for 10+ days prior to scan | No neurological disorders or other medical conditions | Metabolic rate increased in OFC of MDD | NR |
| (Brody et al 1999) | 16 MDD | 39.3±9.5 |
18 F-FDG ROI |
NR | ± 1±1 (episodes) | NR | Depressed | No medication for 2+ weeks prior to scan | No axis I disorders, substance abuse, medical conditions | Decrease in metabolism from baseline of OFC in patients who responded to paroxetine | NR |
| (Drevets et al 2002a) | 20 MDD 14 HC |
36±10 34±9.1 |
18 F-FDG | NR | NR | NR | Depressed | Patients medication free for 3+ weeks prior to study. | No other psychiatric disorders or substance abuse | Greater baseline metabolic rate of lateral OFC in MDD | BA 47 |
| (Liotti et al 2002) | 10 remitted MDD 7 ill MDD 8 HC |
37±9 42±15 36±6 |
15O-H2O 6.5mm |
NR | NR | NR | Euthymic | AD | No other primary psychiatric or neurological disorder. No head injury, substance abuse | Mood provocation led to rCBF descreases in medial OFC in both MDD groups | BA 10+32 −4; 40; −2 4; 56; 8 4; 36; −10 2; 60; −2 0; 34; −14 |
| (Goldapple et al 2004) | 17 MDD | 41±9 | 18 F-FDG Voxel-wise | NR | NR | NR | Depressed | Unmedicated | No psychotic symptoms, axis I disorders and substance abuse | Successful treatment with CBT associated with decreased metabolism of medial OFC | BA 11 20; 52; −22 |
| (Mayberg et al 2005) | 6 MDD | 46±8 | 15O-H2O | 29.5±12 | 4.7±5 (episodes) | Yes - in 5 out of 6 subjects | Depressed | NR | No psychotic symptoms, substance abuse in last 3 months | Treatment with deep brain stimulation produced decreased metabolism of the OFC | BA 11 0; 34; −8 6; 46; 2 22; 60; −10 |
| (Chen et al 2007a) | 17 MDD | 44.06±8.36 | MRI 1.5T 3mm |
NR | NR | NR | Depressed | Scanned before and after treatment with fluoxetine. Patients off medication 4+ weeks before study. | No current axis I comorbidity or substance abuse within 2 months of study. Personality disorders not assessed. | Functional activation of OFC negatively associated with severity of depression at baseline | BA 11 5; 46; −14 −20; 46; −17 |