title: Increased amygdala responses to sad but not fearful faces in major depression: relation to mood state and pharmacological treatment.
abstract: OBJECTIVE
  Increased amygdala response to negative emotions seen in functional MRI (fMRI) has been proposed as a biomarker for negative emotion processing bias underlying depressive symptoms and vulnerability to depressive relapse that are normalized by antidepressant drug treatment. The purpose of this study was to determine whether abnormal amygdala responses to face emotions in depression are related to specific emotions or change in response to antidepressant treatment and whether they are present as a stable trait in medication-free patients in remission.
  
  
  METHODS
  Sixty-two medication-free unipolar depressed patients (38 were currently depressed, and 24 were in remission) and 54 healthy comparison subjects underwent an indirect face-emotion processing task during fMRI. Thirty-two currently depressed patients were treated with the antidepressant citalopram for 8 weeks. Adherence to treatment was evaluated by measuring citalopram plasma concentrations.
  
  
  RESULTS
  Patients with current depression had increased bilateral amygdala responses specific to sad faces relative to healthy comparison subjects and nonmedicated patients in stable remission. Treatment with citalopram abolished the abnormal amygdala responses to sad faces in currently depressed patients but did not alter responses to fearful faces.
  
  
  CONCLUSIONS
  Aberrant amygdala activation in response to sad facial emotions is specific to the depressed state and is a potential biomarker for a negative affective bias during a depressive episode.
authors.affiliation: Neuroscience and Psychiatry Unit and Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester,United Kingdom. danilo.arnone@kcl.ac.uk
authors.forename: Danilo
authors.initials: D
authors.lastname: Arnone
authors.forename: Shane
authors.initials: S
authors.lastname: McKie
authors.forename: Rebecca
authors.initials: R
authors.lastname: Elliott
authors.forename: Emma J
authors.initials: EJ
authors.lastname: Thomas
authors.forename: Darragh
authors.initials: D
authors.lastname: Downey
authors.forename: Gabriella
authors.initials: G
authors.lastname: Juhasz
authors.forename: Steve R
authors.initials: SR
authors.lastname: Williams
authors.forename: J F William
authors.initials: JF
authors.lastname: Deakin
authors.forename: Ian M
authors.initials: IM
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects / Q000502:physiology*; D000679:Amygdala / Q000187:drug effects / Q000503:physiopathology*; D018687:Antidepressive Agents, Second-Generation / Q000097:blood / Q000627:therapeutic use*; D015415:Biomarkers; D016022:Case-Control Studies; D015283:Citalopram / Q000097:blood / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000503:physiopathology*; D005149:Facial Expression; D005239:Fear / Q000502:physiology; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015415:Biomarkers; D015283:Citalopram