title: Neural correlates of perception of emotional facial expressions in out-patients with mild-to-moderate depression and anxiety. A multicenter fMRI study.
abstract: BACKGROUND
  Depression has been associated with limbic hyperactivation and frontal hypoactivation in response to negative facial stimuli. Anxiety disorders have also been associated with increased activation of emotional structures such as the amygdala and insula. This study examined to what extent activation of brain regions involved in perception of emotional faces is specific to depression and anxiety disorders in a large community-based sample of out-patients.
  
  
  METHODS
  An event-related functional magnetic resonance imaging (fMRI) paradigm was used including angry, fearful, sad, happy and neutral facial expressions. One hundred and eighty-two out-patients (59 depressed, 57 anxiety and 66 co-morbid depression-anxiety) and 56 healthy controls selected from the Netherlands Study of Depression and Anxiety (NESDA) were included in the present study. Whole-brain analyses were conducted. The temporal profile of amygdala activation was also investigated.
  
  
  RESULTS
  Facial expressions activated the amygdala and fusiform gyrus in depressed patients with or without anxiety and in healthy controls, relative to scrambled faces, but this was less evident in patients with anxiety disorders. The response shape of the amygdala did not differ between groups. Depressed patients showed dorsolateral prefrontal cortex (PFC) hyperactivation in response to happy faces compared to healthy controls.
  
  
  CONCLUSIONS
  We suggest that stronger frontal activation to happy faces in depressed patients may reflect increased demands on effortful emotion regulation processes triggered by mood-incongruent stimuli. The lack of strong differences in neural activation to negative emotional faces, relative to healthy controls, may be characteristic of the mild-to-moderate severity of illness in this sample and may be indicative of a certain cognitive-emotional processing reserve.
authors.affiliation: Neuroimaging Center, Department of Neuroscience, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: L R
authors.initials: LR
authors.lastname: Demenescu
authors.forename: R
authors.initials: R
authors.lastname: Renken
authors.forename: R
authors.initials: R
authors.lastname: Kortekaas
authors.forename: M-J
authors.initials: MJ
authors.lastname: van Tol
authors.forename: J B C
authors.initials: JB
authors.lastname: Marsman
authors.forename: M A
authors.initials: MA
authors.lastname: van Buchem
authors.forename: N J A
authors.initials: NJ
authors.lastname: van der Wee
authors.forename: D J
authors.initials: DJ
authors.lastname: Veltman
authors.forename: J A
authors.initials: JA
authors.lastname: den Boer
authors.forename: A
authors.initials: A
authors.lastname: Aleman
mesh_terms: D000328:Adult; D000679:Amygdala / Q000187:drug effects / Q000503:physiopathology*; D000786:Anger; D001008:Anxiety Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D001931:Brain Mapping; D016022:Case-Control Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D004644:Emotions; D005149:Facial Expression; D005239:Fear; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009426:Netherlands; D011619:Psychotropic Drugs / Q000494:pharmacology; D012938:Social Perception
chemical_list: D011619:Psychotropic Drugs