title: Individualized and clinically derived stimuli activate limbic structures in depression: an fMRI study.
abstract: OBJECTIVE
  In the search for neurobiological correlates of depression, a major finding is hyperactivity in limbic-paralimbic regions. However, results so far have been inconsistent, and the stimuli used are often unspecific to depression. This study explored hemodynamic responses of the brain in patients with depression while processing individualized and clinically derived stimuli.
  
  
  METHODS
  Eighteen unmedicated patients with recurrent major depressive disorder and 17 never-depressed control subjects took part in standardized clinical interviews from which individualized formulations of core interpersonal dysfunction were derived. In the patient group such formulations reflected core themes relating to the onset and maintenance of depression. In controls, formulations reflected a major source of distress. This material was thereafter presented to subjects during functional magnetic resonance imaging (fMRI) assessment.
  
  
  RESULTS
  Increased hemodynamic responses in the anterior cingulate cortex, medial frontal gyrus, fusiform gyrus and occipital lobe were observed in both patients and controls when viewing individualized stimuli. Relative to control subjects, patients with depression showed increased hemodynamic responses in limbic-paralimbic and subcortical regions (e.g. amygdala and basal ganglia) but no signal decrease in prefrontal regions.
  
  
  CONCLUSIONS
  This study provides the first evidence that individualized stimuli derived from standardized clinical interviewing can lead to hemodynamic responses in regions associated with self-referential and emotional processing in both groups and limbic-paralimbic and subcortical structures in individuals with depression. Although the regions with increased responses in patients have been previously reported, this study enhances the ecological value of fMRI findings by applying stimuli that are of personal relevance to each individual's depression.
authors.affiliation: Hanse Institute for Advanced Study, Delmenhorst, Germany. henrik.kessler@ukb.uni-bonn.de
authors.forename: Henrik
authors.initials: H
authors.lastname: Kessler
authors.forename: Svenja
authors.initials: S
authors.lastname: Taubner
authors.forename: Anna
authors.initials: A
authors.lastname: Buchheim
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Münte
authors.forename: Michael
authors.initials: M
authors.lastname: Stasch
authors.forename: Horst
authors.initials: H
authors.lastname: Kächele
authors.forename: Gerhard
authors.initials: G
authors.lastname: Roth
authors.forename: Armin
authors.initials: A
authors.lastname: Heinecke
authors.forename: Peter
authors.initials: P
authors.lastname: Erhard
authors.forename: Manfred
authors.initials: M
authors.lastname: Cierpka
authors.forename: Daniel
authors.initials: D
authors.lastname: Wiswede
mesh_terms: D000328:Adult; D001931:Brain Mapping; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000502:physiology; D003863:Depression / Q000503:physiopathology*; D003866:Depressive Disorder / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D066298:In Vitro Techniques; D008032:Limbic System / Q000098:blood supply / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D055815:Young Adult