Effects of Escitalopram Administration on Face Processing in Intermittent Explosive Disorder: an fMRI Study.

Neuropsychopharmacology. 2015 Jun 24;

Authors: Cremers H, Lee R, Keedy S, Phan KL, Coccaro E

Abstract
The neurobiological underpinnings of Intermittent Explosive Disorder (IED) are traditionally linked to deficiencies in the serotonergic system. In this study, we investigated the effects of escitalopram, a Selective Serotonin Reuptake Inhibitor (SSRI), on brain activation during face processing. We expected that escitalopram would reduce amygdala activity in IED, and in addition, we explored the effect in other social-emotional related brain regions. Seventeen subjects with current Intermittent Explosive Disorder and fourteen healthy controls participated in a randomized, double-blind, placebo-controlled, counterbalanced fMRI face processing study. The analysis focused on the faces compared to a fixation baseline contrast, and a factorial model with Group as between and Drug as within subject factor was tested. Group x Drug interaction effects were found in the amygdala (small volume corrected) and the left temporal parietal junction (TPJ; whole-brain corrected). Escitalopram increased amygdala activation in controls, but surprisingly not in IED. However, the TPJ showed increased activity in IED on escitalopram compared to placebo. The TPJ is associated with social-cognitive processes, such as perspective taking and empathy. The TPJ findings suggest that SSRI administration may reduce aggressive tendencies towards other people by enhancing social-cognitive processing of empathy and perspective taking of others during emotional face processing. Future research should further elucidate the long-term effects of SSRIs on various social-emotional tasks in IED.Neuropsychopharmacology accepted article preview online, 24 June 2015. doi:10.1038/npp.2015.187.

PMID: 26105140 [PubMed - as supplied by publisher]