Universität zu Köln

Lueken, Ulrike ORCID: 0000-0003-1564-4012, Straube, Benjamin ORCID: 0000-0002-9837-0944, Yang, Yunbo, Hahn, Tim ORCID: 0000-0002-8929-4134, Beesdo-Baum, Katja, Wittchen, Hans-Ulrich ORCID: 0000-0002-6311-7711, Konrad, Carsten, Stroehle, Andreas, Wittmann, Andre, Gerlach, Alexander L. ORCID: 0000-0001-6794-5349, Pfleiderer, Bettina, Arolt, Volker and Kircher, Tilo ORCID: 0000-0002-2514-2625 (2015). Separating depressive comorbidity from panic disorder: A combined functional magnetic resonance imaging and machine learning approach. J. Affect. Disord., 184. S. 182 - 193. AMSTERDAM: ELSEVIER SCIENCE BV. ISSN 1573-2517

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Abstract

Background: Depression is frequent in panic disorder (PD); yet, little is known about its influence on the neural substrates of PD. Difficulties in fear inhibition during safety signal processing have been reported as a pathophysiological feature of PD that is attenuated by depression. We investigated the impact of comorbid depression in PD with agoraphobia (AG) on the neural correlates of fear conditioning and the potential of machine learning to predict comorbidity status on the individual patient level based on neural characteristics. Methods: Fifty-nine PD/AG patients including 26 (44%) with a comorbid depressive disorder (PD/AG+DEP) underwent functional magnetic resonance imaging (fMRI). Comorbidity status was predicted using a random undersampling tree ensemble in a leave-one-out cross validation framework. Results: PD/AG-DEP patients showed altered neural activation during safety signal processing, while DEP patients exhibited generally decreased dorsolaleral prefrontal and insular activation. Comorbidity status was correctly predicted in 79% of patients (sensitivity: 73%; specificity: 85%) based on brain activation during fear conditioning (corrected for potential confounders: accuracy: 73%; sensitivity: 77%; specificity: 70%). Limitations: No primary depressed patients were available; only medication free patients were included. Major depression and dysthymia were collapsed (power considerations). Conclusions: Neurofunctional activation during safety signal processing differed between patients with or without comorbid depression, a Finding which may explain heterogeneous results across previous studies. These Findings demonstrate the relevance of comorbidity when investigating neurofunctional substrates of anxiety disorders. Predicting individual comorbidity status may translate neurofunctional data into clinically relevant information which might aid in planning individualized treatment. The study was registered with the ISRCTN: ISRCTN80046034. (C) 2015 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lueken, Ulrike UNSPECIFIED orcid.org/0000-0003-1564-4012 UNSPECIFIED Straube, Benjamin UNSPECIFIED orcid.org/0000-0002-9837-0944 UNSPECIFIED Yang, Yunbo UNSPECIFIED UNSPECIFIED UNSPECIFIED Hahn, Tim UNSPECIFIED orcid.org/0000-0002-8929-4134 UNSPECIFIED Beesdo-Baum, Katja UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittchen, Hans-Ulrich UNSPECIFIED orcid.org/0000-0002-6311-7711 UNSPECIFIED Konrad, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Stroehle, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittmann, Andre UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerlach, Alexander L. UNSPECIFIED orcid.org/0000-0001-6794-5349 UNSPECIFIED Pfleiderer, Bettina UNSPECIFIED UNSPECIFIED UNSPECIFIED Arolt, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Kircher, Tilo UNSPECIFIED orcid.org/0000-0002-2514-2625 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-392988
DOI:	10.1016/j.jad.2015.05.052
Journal or Publication Title:	J. Affect. Disord.
Volume:	184
Page Range:	S. 182 - 193
Date:	2015
Publisher:	ELSEVIER SCIENCE BV
Place of Publication:	AMSTERDAM
ISSN:	1573-2517
Language:	English
Faculty:	Faculty of Human Sciences
Divisions:	Faculty of Human Sciences > Department Psychologie
Subjects:	Psychology
Uncontrolled Keywords:	Keywords Language COGNITIVE-BEHAVIORAL THERAPY; SUPPORT VECTOR MACHINE; TREATMENT RESPONSE; MAJOR DEPRESSION; CONDITIONED FEAR; MRI DATA; AGORAPHOBIA; ANXIETY; FMRI; ACTIVATION Multiple languages Clinical Neurology; Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/39298