Open AccessPrediction of lithium treatment response in bipolar depression using 5-HTT and 5-HT1A PET
Author(s) -
Mala Ananth,
Elizabeth Bartlett,
Christine DeLorenzo,
Xuejing Lin,
Laura Kunkel,
Nehal P. Vadhan,
Greg Perlman,
Michala Godstrey,
Daniel Holzmacher,
R. Todd Ogden,
Ramin V. Parsey,
Chuan Huang
Publication year - 2020
Publication title -
european journal of nuclear medicine and molecular imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.313
H-Index - 163
eISSN - 1619-7089
pISSN - 1619-7070
DOI - 10.1007/s00259-020-04681-6
Subject(s) - serotonergic , serotonin transporter , lithium (medication) , binding potential , 5 ht1a receptor , positron emission tomography , medicine , bipolar disorder , oncology , psychology , serotonin , nuclear medicine , 5 ht receptor , receptor
Lithium, one of the few effective treatments for bipolar depression (BPD), has been hypothesized to work by enhancing serotonergic transmission. Despite preclinical evidence, it is unknown whether lithium acts via the serotonergic system. Here we examined the potential of serotonin transporter (5-HTT) or serotonin 1A receptor (5-HT 1A ) pre-treatment binding to predict lithium treatment response and remission. We hypothesized that lower pre-treatment 5-HTT and higher pre-treatment 5-HT 1A binding would predict better clinical response. Additional analyses investigated group differences between BPD and healthy controls and the relationship between change in binding pre- to post-treatment and clinical response. Twenty-seven medication-free patients with BPD currently in a depressive episode received positron emission tomography (PET) scans using 5-HTT tracer [ 11 C]DASB, a subset also received a PET scan using 5-HT 1A tracer [ 11 C]-CUMI-101 before and after 8 weeks of lithium monotherapy. Metabolite-corrected arterial input functions were used to estimate binding potential, proportional to receptor availability. Fourteen patients with BPD with both [ 11 C]DASB and [ 11 C]-CUMI-101 pre-treatment scans and 8 weeks of post-treatment clinical scores were included in the prediction analysis examining the potential of either pre-treatment 5-HTT or 5-HT1A or the combination of both to predict post-treatment clinical scores.