Brain Effects of Antidepressants in Major Depression: A Meta-Analysis of Emotional Processing Studies

CNRS USR 3246, Emotion Center, Groupe Hospitalier Pitié-Salpétrière, Paris, France.
Journal of Affective Disorders (Impact Factor: 3.38). 10/2010; 130(1-2):66-74. DOI: 10.1016/j.jad.2010.09.032
Source: PubMed


A consistent brain activity pattern has been identified in major depression across many resting positron emission tomography (PET) studies. This dysfunctional pattern seems to be normalized by antidepressant treatment. The aim of this meta-analysis was to identify more clearly the pattern associated with clinical improvement of depression following an antidepressant drug treatment, in emotional activation studies using functional magnetic resonance imaging (fMRI).
A quantitative Activation Likelihood Estimation (ALE) meta-analysis was performed across 9 emotional activation fMRI and PET studies (126 patients) using the Activation Likelihood Estimation technique.
Following the antidepressant drug treatment, the activation of dorsolateral, dorsomedial and ventrolateral prefrontal cortices was increased whereas the activation of the amygdala, hippocampus, parahippocampal region, ventral anterior cingulate cortex, orbitofrontal cortex, and insula was decreased. Additionally, there was a decreased activation in the anterior (BA 32) and posterior cingulate cortices, as well as in the precuneus and inferior parietal lobule, which could reflect a restored deactivation of the default mode network.
The small number of emotional activation studies, using heterogeneous tasks, included in the ALE analysis.
The activation of several brain regions involved in major depression, in response to emotional stimuli, was normalized after antidepressant treatment. To refine our knowledge of antidepressants' effect on the neural bases of emotional processing in major depression, neuroimaging studies should use consistent emotional tasks related to depressive symptoms and that involve the default mode network, such as self-referential processing tasks.

Download full-text


Available from: Cédric Lemogne, Apr 17, 2014
196 Reads
  • Source
    • "With such stimuli, different theories of emotion processing and their applicability to affective processing studies have also been examined (Briesemeister et al., 2015). Moreover, basic emotion ratings have enabled researchers to select pictures in order to study the neural correlates of affective experience and therapeutic effects in different clinical populations (Delaveau et al., 2011). In this way, a combination of the dimensional approach, useful to describe a number of broad features of emotion, and the categorical approach, focused on capturing discrete emotional responses, is supplying researchers with a more complete view of affect. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The Nencki Affective Picture System (NAPS; Marchewka, Żurawski, Jednoróg, & Grabowska, Behavior Research Methods, 2014) is a standardized set of 1,356 realistic, high-quality photographs divided into five categories (people, faces, animals, objects, and landscapes). NAPS has been primarily standardized along the affective dimensions of valence, arousal, and approach–avoidance, yet the characteristics of discrete emotions expressed by the images have not been investigated thus far. The aim of the present study was to collect normative ratings according to categorical models of emotions. A subset of 510 images from the original NAPS set was selected in order to proportionally cover the whole dimensional affective space. Among these, using three available classification methods, we identified images eliciting distinguishable discrete emotions. We introduce the basic-emotion normative ratings for the Nencki Affective Picture System (NAPS BE), which will allow researchers to control and manipulate stimulus properties specifically for their experimental questions of interest. The NAPS BE system is freely accessible to the scientific community for noncommercial use as supplementary materials to this article.
    Behavior Research Methods 07/2015; DOI:10.3758/s13428-015-0620-1 · 2.12 Impact Factor
  • Source
    • "One consistent finding is that depressed and anxious patients show stronger amygdala responsivity than controls (Drevets et al., 2008; Etkin and Wager, 2007; Hamilton et al., 2012). This enhanced amygdala responsivity is not a fixed trait, but dependent on the current state of the subject (Delaveau et al., 2011; van Wingen et al., 2011b). For example, a critical precipitating factor for depression is stress, which could potentially be responsible for a shift from vulnerability to maladaptation (Caspi et al., 2003). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Increased amygdala reactivity in response to salient stimuli is seen in patients with affective disorders, in healthy subjects at risk for these disorders, and in stressed individuals, making it a prime target for mechanistic studies into the pathophysiology of affective disorders. However, whereas individual differences in neuroticism are thought to modulate the effect of stress on mental health, the mechanistic link between stress, neuroticism and amygdala responsivity is unknown. Thus, we studied the relationship between experimentally induced stress, individual differences in neuroticism, and amygdala responsivity. To this end, fearful and happy faces were presented to a large cohort of young, healthy males (n=120) in two separate functional MRI sessions (stress versus control) in a randomized, controlled cross-over design. We revealed that amygdala reactivity was modulated by an interaction between the factors of stress, neuroticism, and the emotional valence of the facial stimuli. Follow-up analysis showed that neuroticism selectively enhanced amygdala responses to fearful faces in the stress condition. Thus, we show that stress unmasks an association between neuroticism and amygdala responsivity to potentially threatening stimuli. This effect constitutes a possible mechanistic link within the complex pathophysiology of affective disorders, and our novel approach appears suitable for further studies targeting the underlying mechanisms. Copyright © 2015 Elsevier Inc. All rights reserved.
    NeuroImage 03/2015; 112. DOI:10.1016/j.neuroimage.2015.03.014 · 6.36 Impact Factor
  • Source
    • "Depressed individuals have shown greater activation in the left parahippocampal gyrus relative to controls, during encoding of an associative learning paradigm (Werner et al. 2009) and in processing negative pictures (Sheline et al. 2009). Reductions in parahippocampal activation have similarly been observed in MDD patient following treatment with antidepressant medication (Kennedy et al. 2001; Delaveau et al. 2011). Behavioural studies of dysfunctional attitudes also show higher endorsement of dysfunctional attitudes by patients relative to controls during negative mood induction (Lau et al. 2012) and significant improvement in dysfunctional thinking in patients following CBT (Warmerdam et al. 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Dysfunctional attitudes are a feature of depression that has been correlated with receptor binding abnormalities in limbic and cortical regions. We sought to investigate the functional neuroanatomy of dysfunctional attitudes in major depressive disorder (MDD) and the effects of treatment with cognitive-behavioural therapy (CBT). Method: Participants were 16 patients with unipolar depression in an acute depressive episode (mean age 40.0 years) and 16 matched healthy controls (mean age 39.9 years). Patients were medication free and received a course of treatment with CBT. All participants underwent functional magnetic resonance imaging (fMRI) scans at baseline and at week 16, prior to the initiation of therapy and following the course of CBT for patients. During each fMRI scan, participants indicated their attributions to statements from a modified Dysfunctional Attitudes Scale (mDAS-48). Results: MDD patients in an acute depressive episode endorsed a greater number of extreme responses to DAS statements, which normalized following CBT treatment. Extreme attributions were associated with greater activation in the left hippocampal region, inferior parietal lobe and precuneus in MDD patients as compared with healthy controls as a main effect of group. An interaction effect was found in the left parahippocampal region, which showed less attenuation in MDD patients at the follow-up scan relative to healthy controls. Conclusions: Attenuation of activity in the parahippocampal region may be indicative of an improvement in dysfunctional thinking following CBT treatment in depression, while persistent engagement of regions involved in attentional processing and memory retrieval with extreme attributions reflects a trait feature of depression.
    Psychological Medicine 10/2014; 45(07):1-9. DOI:10.1017/S0033291714002529 · 5.94 Impact Factor
Show more