Amygdala response to fearful faces in anxious and depressed children.
BACKGROUND
Alterations in amygdala function have been implicated in the pathophysiological characteristics of adult anxiety and depressive disorders. Studies with healthy adults and children, as well as with adults who have amygdala lesions, have found facial expressions of emotion to be useful probes of amygdala activity. Our study examined the amygdala response to fearful and neutral facial expressions in healthy, anxious, and depressed children. We hypothesized that children with anxiety and depression may show atypical amygdala responses to emotional stimuli.


METHODS
Twelve children (8-16 years of age) with generalized anxiety or panic disorder and 12 healthy comparison children underwent noninvasive functional magnetic resonance imaging while viewing photographs of fearful and neutral facial expressions. In a second comparison, 5 girls with major depressive disorder were compared with 5 anxious and 5 healthy girls from the previous sample.


RESULTS
Children with anxiety disorders showed an exaggerated amygdala response to fearful faces compared with healthy children, whereas depressed children showed a blunted amygdala response to these faces. In addition, the magnitude of the amygdala's signal change between fearful and neutral faces was positively correlated with the severity of everyday anxiety symptoms.


CONCLUSIONS
Our results suggest that amygdala function is affected in both anxiety and depression during childhood and adolescence. Moreover, this disruption appears to be specific to the child's own rating of everyday anxiety.
Thomas
K M
KM
Sackler Institute for Developmental Psychobiology, Weill Medical College of Cornell University, 1300 York Ave, Box 140, Suite F-1332, New York, NY 10021. kmt2001@med.cornell.edu
Drevets
W C
WC
Dahl
R E
RE
Ryan
N D
ND
Birmaher
B
B
Eccard
C H
CH
Axelson
D
D
Whalen
P J
PJ
Casey
B J
BJ
D000293:Adolescent; D000679:Amygdala / Q000002:abnormalities / Q000098:blood supply* / Q000378:metabolism*; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology*; D002648:Child; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005149:Facial Expression; D005239:Fear; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D014055:Tomography, Emission-Computed; D014796:Visual Perception