Generalized anxiety modulates frontal and limbic activation in major depression.
BACKGROUND
Anxiety is relatively common in depression and capable of modifying the severity and course of depression. Yet our understanding of how anxiety modulates frontal and limbic activation in depression is limited.


METHODS
We used functional magnetic resonance imaging and two emotional information processing tasks to examine frontal and limbic activation in ten patients with major depression and comorbid with preceding generalized anxiety (MDD/GAD) and ten non-depressed controls.


RESULTS
Consistent with prior studies on depression, MDD/GAD patients showed hypoactivation in medial and middle frontal regions, as well as in the anterior cingulate, cingulate and insula. However, heightened anxiety in MDD/GAD patients was associated with increased activation in middle frontal regions and the insula and the effects varied with the type of emotional information presented.


CONCLUSIONS
Our findings highlight frontal and limbic hypoactivation in patients with depression and comorbid anxiety and indicate that anxiety level may modulate frontal and limbic activation depending upon the emotional context. One implication of this finding is that divergent findings reported in the imaging literature on depression could reflect modulation of activation by anxiety level in response to different types of emotional information.
Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
Michael W
MW
Schlund
Guillermo
G
Verduzco
Michael F
MF
Cataldo
Rudolf
R
Hoehn-Saric
D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000503:physiopathology*; D003865:Major Depressive Disorder / Q000150:complications / Q000503:physiopathology*; D004644:Emotions; D005149:Facial Expression; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008032:Limbic System / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D061212:Memory, Episodic; D008875:Middle Aged; D059906:Neuroimaging; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales