Article

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: 3.71). 10/2010; 130(1-2):66-74. DOI: 10.1016/j.jad.2010.09.032
Source: PubMed

ABSTRACT 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.

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Available from: Cédric Lemogne, Apr 17, 2014
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    • "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). "
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