Wayne Drevets, MD, Section Chief

OVERVIEW

The NIMH Mood and Anxiety Disorders Neuroimaging Section applies brain imaging technologies to investigate the neurobiological bases of mood and anxiety disorders. Because different imaging technologies have distinct capabilities, strengths and limitations, studies are designed so that the same subjects are iteratively studied using multiple techniques to provide complementary information about pathophysiology. Positron emission tomography (PET) and magnetic resonance spectroscopy (MRS) are applied to measure brain receptor pharmacology, chemistry and neurotransmitter function. PET and functional magnetic resonance imaging (fMRI) are employed to map brain regions where physiology changes during normal and pathological emotional states. Anatomical MRI is employed to characterize brain structure and localize pathology in mood and anxiety syndromes arising secondary to brain lesions. Such assessments are integrated with state-of-the-art genetic, clinical and laboratory information within the NIMH Mood and Anxiety Disorders Program.

The overarching goals of these studies are to elucidate the pathophysiology of and improve treatment for serious and disabling mood and anxiety disorders such as major depressive disorder, bipolar disorder, post-traumatic stress disorder, panic disorder, and obsessive compulsive disorder. Studies are conducted with the following aims:

1) To characterize mood and anxiety disorder phenotypes based upon abnormalities of brain physiology, structure, receptor pharmacology, and chemistry (so that these psychiatric syndromes can be diagnosed using biological markers rather than by nonspecific, subjective, clinical symptoms alone).
2) To determine how the brain normally modulates or inhibits emotional and stress responses, and examine whether abnormalities of these processes underlie the development of depressive and anxiety disorders.
3) To delineate the extended neural circuits where dysfunction produces the emotional, endocrine, autonomic and psychological manifestations of depressive and anxiety disorders.
4) To identify abnormalities of brain receptors and chemistry in mood and anxiety disorders.
5). To assess the effects of estrogen, progesterone and testosterone on brain chemistry and function, in order to understand the greater risk of depressive and anxiety disorders in women, the increased risk for depression onset in the post partum period, and the exacerbation of depression in relation to the menstrual cycle.
6) To elucidate the mechanisms of antidepressant, mood stabilizing, and antianxiety treatments to an extent that can guide development of more effective therapies. Images obtained before and after treatment are compared to demonstrate the brain correlates of treatment-response and distinguish abnormalities that depend on emotional state from those which persist across illness episodes.
7) To establish where in the course of chronic or recurrent illness the latter type of neuroimaging abnormalities become apparent. Early onset markers identified in such studies (which may potentially underlie the vulnerability to illness) are further characterized in samples at high familial risk for developing mood disorders.

Contact Information

Wayne C. Drevets, M.D.
Neuroimaging Section
Mood and Anxiety Disorders Program, NIMH
Building 15K, Room 203
15 North Drive MSC 2070
Bethesda, MD 20892-2070

Telephone: (301) 594-1367 (office), (301) 594-9959 (fax)
Email: drevetsw@intra.nimh.nih.gov

PEOPLE

ON GOING PROJECTS

The Mood and Anxiety Disorders Imaging Section consists of a multidisciplinary team, which applies functional, and structural neuroimaging measures to investigate the biological mechanisms of normal and pathological emotional states. Multimodal imaging studies in which subject samples are studied using various imaging techniques are conducted in order to provide complementary information about pathophysiology. Positron emission tomography (PET), functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS) and morphological MRI are iteratively applied to investigate abnormalities of function or structure in mood and anxiety disorders. Areas of concentration include:
1) investigating the anatomical, neurophysiological and neurochemical substrates of normal emotional expression, evaluation, learning or experience.
2) characterizing the anatomical and neurochemical systems involved in modulating emotional responses, and assessing how these systems function in mood and anxiety disorders.
3) examining the effects of psychotropic medications on brain structure and function in adults with mood and anxiety disorders.
4)assessing the receptor pharmacology of mood and anxiety disorders using a variety of newly developed PET radioligands.
5) distinguishing abnormalities that are trait-like and stable across mood states from those that are mood-state dependent, and
6) delineating phenotypic differences between major depressive subtypes in order to refine the nosology of mood disorders.

PUBLICATIONS

Drevets WC, Gautier CH, Price JC, Kupfer DJ, Kinahan PE, Grace AA, Price JL, Mathis CA (2001)
Amphetamine-induced dopamine release in human ventral striatum correlates with euphoria, Biol. Psychiatry 49, 81-96.

Drevets WC (2000)
Neuroimaging Studies of Mood Disorders: Implications for a neural model of major depression, Biol. Psychiatry 48, 813-829.

Drevets WC, Frank E, Price JC, Kupfer DJ, Holt D, Greer PJ, Huang H, Gautier C, Mathis C (1999)
PET imaging of serotonin 1A receptor binding in depression, Biol. Psychiatry 46, 1375-1387.

Drevets WC, Price JL, Simpson JR, Todd RD, Reich T, Vannier M, Raichle ME (1997)
Subgenual prefrontal cortex abnormalities in mood disorders, Nature 386, 824-827.

Drevets WC, Burton H, Simpson JR, Videen TO, Snyder AZ, Raichle ME (1995)
Blood flow changes in human somatosensory cortex during anticipated stimulation, Nature 373, 249-252.