Imbalance between left and right dorsolateral prefrontal cortex in major depression is linked to negative emotional judgment: an fMRI study in severe major depressive disorder.
BACKGROUND
Although recent neuroimaging and therapeutic transcranial magnetic cortex stimulation (TMS) studies suggest imbalance between left and right dorsolateral prefrontal cortex (DLPFC) in major depressive disorder (MDD) the fundamental neuropsychological characterization of left DLPFC hypoactivity and right DLPFC hyperactivity in MDD remains poorly understood.


METHODS
We used event-related functional magnetic resonance imaging (fMRI) to investigate neural activity in left and right DLPFC related to unattended (unexpected) and attended (expected) judgment of emotions. Participating in the study were 20 medication-free patients with MDD and 30 healthy subjects.


RESULTS
The MDD patients showed hypoactivity in the left DLPFC during both unattended and attended emotional judgment and hyperactivity in the right DLPFC during attended emotional judgment. In contrast to healthy subjects, left DLPFC activity during emotional judgment was not parametrically modulated by negative emotional valence and was inversely modulated by positive emotional valence in MDD patients. Hyperactivity in the right DLPFC correlated with depression severity.


CONCLUSIONS
Results demonstrate that left DLPFC hypoactivity is associated with negative emotional judgment rather than with emotional perception or attention while right DLPFC hyperactivity is linked to attentional modulation. Left-right DLPFC imbalance is characterized in neuropsychological regard, which bridges the gap from resting metabolism and therapeutic repetitive transcranial magnetic stimulation effects to functional neuroanatomy of altered emotional-cognitive interaction in MDD.
Grimm
Simone
S
Department of Psychiatry, University of Zurich, Switzerland.
Beck
Johannes
J
Schuepbach
Daniel
D
Hell
Daniel
D
Boesiger
Peter
P
Bermpohl
Felix
F
Niehaus
Ludwig
L
Boeker
Heinz
H
Northoff
Georg
G
D000328:Adult; D000339:Affect; D000679:Amygdala / Q000503:physiopathology; D002540:Cerebral Cortex / Q000503:physiopathology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000503:physiopathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007600:Judgment; D008279:Magnetic Resonance Imaging; D008297:Male; D009778:Occipital Lobe / Q000503:physiopathology; D010296:Parietal Lobe / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000503:physiopathology*; D011930:Reaction Time; D012720:Severity of Illness Index