title: CHANGES IN REGIONAL BRAIN ACTIVATION RELATED TO DEPRESSIVE STATE: A 2-YEAR LONGITUDINAL FUNCTIONAL MRI STUDY.
abstract: BACKGROUND
  Abnormal brain activations during processing of emotional facial expressions in depressed patients have been demonstrated. We investigated the natural course of brain activation in response to emotional faces in depression, indexed by functional magnetic resonance imaging (fMRI) scans preceding and following change in depressive state. We hypothesized a decrease in activation in the amygdala, anterior cingulate cortex (ACC), and insula with a decrease in depressive pathology.
  
  
  METHODS
  A 2-year longitudinal fMRI study was conducted as part of the Netherlands Study of Depression and Anxiety. We included 32 healthy controls and 49 depressed patients. During the second scan, 27 patients were in remission (remitters), the other 22 were not (nonremitters). All participants viewed faces with emotional expressions during scanning.
  
  
  RESULTS
  Rostral ACC activation during processing of happy faces was predictive of a decrease in depressive state (PFWE = .003). In addition, remitters showed decreased activation of the insula over time (PFWE = .016), specifically during happy faces. Nonremitters displayed increased abnormalities in emotion recognition circuitry during the second scan compared to the first. No effect of selective serotonin reuptake inhibitor use was observed.
  
  
  CONCLUSIONS
  Our results demonstrate that rostral ACC activation may predict changes in depressive state even at 2-year outcome. The association between change in depressed state and change in insula activation provides further evidence for the role of the insula in a network maintaining emotional and motivational states.
authors.affiliation: BCN Neuroimaging Center, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Esther M
authors.initials: EM
authors.lastname: Opmeer
authors.affiliation: BCN Neuroimaging Center, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Rudie
authors.initials: R
authors.lastname: Kortekaas
authors.affiliation: BCN Neuroimaging Center, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: van Tol
authors.affiliation: BCN Neuroimaging Center, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Remco J
authors.initials: RJ
authors.lastname: Renken
authors.affiliation: Clinical Affective Neuroimaging Laboratory, Department of Neurology, Otto von Guericke University of Magdeburg, Magdeburg, Germany.
authors.forename: Liliana R
authors.initials: LR
authors.lastname: Demenescu
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, The Netherlands.|Department of Psychiatry, VU University Medical Center Amsterdam, The Netherlands.|Department of Medical Genomics, VU University Medical Center, Amsterdam, The Netherlands.|Neuroscience Campus Amsterdam, VU University, The Netherlands.|Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: Woudstra
authors.affiliation: BCN Neuroimaging Center, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Gert J
authors.initials: GJ
authors.lastname: Ter Horst
authors.affiliation: Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.|Department of Radiology, Leiden University Medical Center, The Netherlands.
authors.forename: Mark A
authors.initials: MA
authors.lastname: van Buchem
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, The Netherlands.|Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
authors.forename: Nic J A
authors.initials: NJ
authors.lastname: van der Wee
authors.affiliation: Department of Psychiatry, VU University Medical Center Amsterdam, The Netherlands.|Neuroscience Campus Amsterdam, VU University, The Netherlands.
authors.forename: Dick J
authors.initials: DJ
authors.lastname: Veltman
authors.affiliation: BCN Neuroimaging Center, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.|Department of Psychology, University of Groningen, The Netherlands.
authors.forename: André
authors.initials: A
authors.lastname: Aleman
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D003866:Depressive Disorder / Q000503:physiopathology* / Q000523:psychology; D004644:Emotions; D005149:Facial Expression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009426:Netherlands
keywords: ACC; depression; fMRI; insula; remission