Article

Neural mechanisms of cognitive reappraisal in remitted major depressive disorder

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. Electronic address: .
Journal of Affective Disorders (Impact Factor: 3.38). 06/2013; DOI: 10.1016/j.jad.2013.05.073
Source: PubMed

ABSTRACT

Down-regulation of negative emotions by cognitive strategies relies on prefrontal cortical modulation of limbic brain regions, and impaired frontolimbic functioning during cognitive reappraisal has been observed in affective disorders. However, no study to date has examined cognitive reappraisal in unmedicated euthymic individuals with a history of major depressive disorder relative to symptom-matched controls. Given that a history of depression is a critical risk factor for future depressive episodes, investigating the neural mechanisms of emotion regulation in remitted major depressive disorder (rMDD) may yield novel insights into depression risk.
We assessed 37 individuals (18 rMDD, 19 controls) with functional magnetic resonance imaging (fMRI) during a task requiring cognitive reappraisal of sad images.
Both groups demonstrated decreased self-reported negative affect after cognitive reappraisal and no group differences in the effects of cognitive reappraisal on mood were evident. Functional MRI results indicated greater paracingulate gyrus (rostral anterior cingulate cortex, Brodmann area 32) activation and decreased right midfrontal gyrus (Brodmann area 6) activation during the reappraisal of sad images.
Trial-by-trial ratings of pre-regulation affect were not collected, limiting the interpretation of post-regulation negative affect scores.
Results suggest that activation of rostral anterior cingulate cortex, a region linked to the prediction of antidepressant treatment response, and of the right midfrontal gyrus, a region involved in cognitive control in the context of cognitive reappraisal, may represent endophenotypic markers of future depression risk. Future prospective studies will be needed to validate the predictive utility of these neural markers.

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Available from: Shian-Ling Keng
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    • "The key finding of this study is the reduced DMN suppression in MDD patients existing even after full recovery, which mirrors findings in symptomatic-(Rose et al., 2006; Greicius et al., 2007; Sheline et al., 2009; Sheline et al., 2010; Disner et al., 2011; Zhang et al., 2011; Anticevic et al., 2012; Davey et al., 2012a; Zhu et al., 2012; Connolly et al., 2013; Guo et al., 2013; Li et al., 2013; Sambataro et al., 2013; Dutta et al., 2014; Rodriguez-Cano et al., 2014) and euthymic-(Walsh et al., 2007; Schoning et al., 2009; Smoski et al., 2013) MDD patients. This reduction of DMN suppression , which is accompanied by increased ruminative response style in our study, might therefore be interpreted as increased selfreferential processing as well as insufficient inhibition of conflicting computations in line with previous literature (Mason et al., 2007; Hamilton et al., 2011; Anticevic et al., 2012; Marchetti et al., 2012; Nejad et al., 2013). "
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    • "Functional magnetic resonance imaging (fMRI) studies of emotion regulation have focused on a top-down frontolimbic regulatory network (Ochsner et al., 2004). As we have summarized previously (Smoski et al., 2013), prefrontal cortical regions, including dorsolateral prefrontal cortex (dlPFC), ventrolateral prefrontal cortex (vlPFC) and anterior cingulate cortex (ACC), mediate the modulation of emotionelicited activation in limbic regions (Ochsner and Gross, 2008). Within this regulatory circuit, activation in prefrontal cognitive control regions is negatively associated with changes in limbic activation while processing negative stimuli (Siegle et al., 2006; Urry et al., 2006). "
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    • "Depressed patients do not show this pattern, and instead show inappropriate activation of both PFC and amygdala. Indeed, even in remitted depression patients, deficits in vmPFC mediated amygdalar deactivation and increased ACC activity, have been demonstrated during cognitive reappraisal (Kanske, Heissler, Schonfelder, & Wessa, 2012;Smoski, Keng, Schiller, Minkel, & Dichter, 2013). Those who habitually used reappraisal tactics to deal with negative emotions, were also most likely to see reductions in amygdala activity. "
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