Neural abnormalities during cognitive generation of affect in treatment-resistant depression.
BACKGROUND
Dysfunctions in brain regions known to be involved in affect and mood states are thought to be implicated in depression and may have a role in determining the type and symptoms of this illness.


METHODS
Functional magnetic resonance imaging was used to elucidate neural correlates of cognitive generation of affect, using a previously published paradigm of evoking affect with picture-caption pairs, in patients with unipolar, treatment-resistant depression.


RESULTS
Compared with control participants, patients showed relatively decreased response in the anterior cingulate (rostral; right) with both negative and positive picture-caption pairs and in the medial frontal gyrus and hippocampus (all left) with positive picture-caption pairs. They demonstrated increased response in the inferior (right) and middle temporal gyri (left) with negative picture-caption pairs, and in the parahippocampal gyrus (right), inferior frontal gyrus (left), subgenual cingulate (right), striatum (right), and brain stem (left) with positive picture-caption pairs.


CONCLUSIONS
Reduced medial/middle prefrontal and hippocampal activity may account for positive affect disturbances and temporal lobe hyperactivity for negative affect disturbances in treatment-resistant depression. The results also corroborate previous observations from resting positron emission tomography studies and further elucidate the association between hypoactive rostral cingulate and nonresponsiveness to treatment in depression.
Kumari
Veena
V
Section of Cognitive Psychopharmacology, Institute of Psychiatry, King's College, London, UK.
Mitterschiffthaler
Martina T
MT
Teasdale
John D
JD
Malhi
Gin S
GS
Brown
Richard G
RG
Giampietro
Vincent
V
Brammer
Michael J
MJ
Poon
Lucia
L
Simmons
Andrew
A
Williams
Steven C R
SC
Checkley
Stuart A
SA
Sharma
Tonmoy
T
D000328:Adult; D000339:Affect; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001921:Brain / Q000033:anatomy & histology / Q000378:metabolism* / Q000503:physiopathology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged
D000928:Antidepressive Agents