title: Systematic review of the neural basis of social cognition in patients with mood disorders.
abstract: BACKGROUND
  This review integrates neuroimaging studies of 2 domains of social cognition--emotion comprehension and theory of mind (ToM)--in patients with major depressive disorder and bipolar disorder. The influence of key clinical and method variables on patterns of neural activation during social cognitive processing is also examined.
  
  
  METHODS
  Studies were identified using PsycINFO and PubMed (January 1967 to May 2011). The search terms were "fMRI," "emotion comprehension," "emotion perception," "affect comprehension," "affect perception," "facial expression," "prosody," "theory of mind," "mentalizing" and "empathy" in combination with "major depressive disorder," "bipolar disorder," "major depression," "unipolar depression," "clinical depression" and "mania."
  
  
  RESULTS
  Taken together, neuroimaging studies of social cognition in patients with mood disorders reveal enhanced activation in limbic and emotion-related structures and attenuated activity within frontal regions associated with emotion regulation and higher cognitive functions. These results reveal an overall lack of inhibition by higher-order cognitive structures on limbic and emotion-related structures during social cognitive processing in patients with mood disorders. Critically, key variables, including illness burden, symptom severity, comorbidity, medication status and cognitive load may moderate this pattern of neural activation.
  
  
  CONCLUSIONS
  Studies that did not include control tasks or a comparator group were included in this review.
  
  
  CONCLUSIONS
  Further work is needed to examine the contribution of key moderator variables and to further elucidate the neural networks underlying altered social cognition in patients with mood disorders. The neural networks under lying higher-order social cognitive processes, including empathy, remain unexplored in patients with mood disorders.
authors.affiliation: Mood Disorders Program, St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON.
authors.forename: Andrée M
authors.initials: AM
authors.lastname: Cusi
authors.forename: Anthony
authors.initials: A
authors.lastname: Nazarov
authors.forename: Katherine
authors.initials: K
authors.lastname: Holshausen
authors.forename: Glenda M
authors.initials: GM
authors.lastname: Macqueen
authors.forename: Margaret C
authors.initials: MC
authors.lastname: McKinnon
mesh_terms: D000339:Affect / Q000502:physiology; D000367:Age Factors; D001714:Bipolar Disorder / Q000473:pathology / Q000523:psychology; D003071:Cognition / Q000502:physiology*; D015897:Comorbidity; D017281:Cost of Illness; D003865:Major Depressive Disorder / Q000473:pathology / Q000523:psychology; D005149:Facial Expression; D006801:Humans; D008279:Magnetic Resonance Imaging; D019964:Mood Disorders / Q000188:drug therapy / Q000473:pathology* / Q000523:psychology*; D011613:Psychotherapy; D012919:Social Behavior; D056345:Theory of Mind