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.

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Available from: Cédric Lemogne, Apr 17, 2014
    • "Recently, the activation likelihood estimation (ALE) method has become the standard for neuroimaging meta-analyses. ALE meta-analyses have been used to investigate emotional processing in depression (Delaveau et al. 2011; Diener et al. 2012) and schizophrenia (Li et al. 2010), as well as in assessing white matter abnormalities in schizophrenia (Di et al. 2009; Yao et al. 2013) and depression (Liao et al. 2013). The ALE meta-analytic tool models three-dimensional coordinates (from reported activations in a standard space) as the centre of a three-dimensional Gaussian distribution (Laird et al. 2005). "
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    ABSTRACT: Objectives: To identify activation changes assessed in functional magnetic resonance imaging (fMRI) studies of obsessive–compulsive disorder (OCD) through Activation Likelihood Estimate meta-analysis. Methods: We included 28 peer-reviewed standard stereotactic space studies assessing adult OCD patients (OCDpts) vs. healthy controls (HCs) with fMRI during executive task performance. Results: In within-group analyses, HCs showed task-related activations in bilateral inferior frontal gyri, right middle frontal gyrus, right inferior parietal lobule, right claustrum, bilateral cingulate gyri, and left caudate body. OCDpts showed task-related left-sided activations in the superior, medial, and inferior frontal gyri, and thalamus, and bilateral activations in the middle frontal gyri, inferior parietal lobule, and insular cortices. Subtraction analysis showed increased left middle frontal gyrus activation in OCDpts. In between-groups analyses, OCDpts hypoactivated the right caudate body, left putamen, left ACC, and right medial and middle frontal gyri. Right caudate hypoactivation persisted also after applying Family‐wise error algorithms. Conclusions: This meta-analysis confirms that during executive functioning OCDpts show a functional deficit of the right caudate body, which could represent a major neural functional correlate of their illness.
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    • "It has been reported that both antidepressant (Delaveau et al., 2011) and CBT (Kennedy et al., 2007) can alter the activation and metabolism of orbitofrontal cortex. Although limited participant numbers preclude statistical testing, our preliminary results suggested that combining antidepressant medication with CBT did not appear to exert an additive treatment effect (Fig. 3). "
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