Functional magnetic resonance imaging correlates of emotional word encoding and recognition in depression and anxiety disorders.
BACKGROUND
Major depressive disorder (MDD), panic disorder, and social anxiety disorder are among the most prevalent and frequently co-occurring psychiatric disorders in adults and may be characterized by a common deficiency in processing of emotional information.


METHODS
We used functional magnetic resonance imaging during the performance of an emotional word encoding and recognition paradigm in patients with MDD (n = 51), comorbid MDD and anxiety (n = 59), panic disorder and/or social anxiety disorder without comorbid MDD (n = 56), and control subjects (n = 49). In addition, we studied effects of illness severity, regional brain volume, and antidepressant use.


RESULTS
Patients with MDD, prevalent anxiety disorders, or both showed a common hyporesponse in the right hippocampus during positive (>neutral) word encoding compared with control subjects. During negative encoding, increased insular activation was observed in both depressed groups (MDD and MDD + anxiety), whereas increased amygdala and anterior cingulate cortex activation during positive word encoding were observed as depressive state-dependent effects in MDD only. During recognition, anxiety patients showed increased inferior frontal gyrus activation. Overall, effects were unaffected by medication use and regional brain volume.


CONCLUSIONS
Hippocampal blunting during positive word encoding is a generic effect in depression and anxiety disorders, which may constitute a common vulnerability factor. Increased insular and amygdalar involvement during negative word encoding may underlie heightened experience of, and an inability to disengage from, negative emotions in depressive disorders. Our results emphasize a common neurobiological deficiency in both MDD and anxiety disorders, which may mark a general insensitiveness to positive information.
Neuroimaging Center, University Medical Center Groningen, University of Groningen, The Netherlands. M.J.van.Tol@umcg.nl
Marie-José
MJ
van Tol
Liliana R
LR
Demenescu
Nic J A
NJ
van der Wee
Rudie
R
Kortekaas
Nielen
N
Marjan M A
J A Den
JA
Boer
Remco J
RJ
Renken
Mark A
MA
van Buchem
Frans G
FG
Zitman
André
A
Aleman
Dick J
DJ
Veltman
D000328:Adult; D001007:Anxiety / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D059907:Functional Neuroimaging / Q000379:methods / Q000523:psychology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000523:psychology*; D008297:Male; D008568:Memory / Q000502:physiology*; D016584:Panic Disorder / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011597:Psychomotor Performance / Q000502:physiology; D021641:Recognition, Psychology / Q000502:physiology*; D012720:Severity of Illness Index