title: Emotional reactivity to valence-loaded stimuli are related to treatment response of neurocognitive therapy.
abstract: Emotional Context Insensitivity (ECI) is a psychological feature observed in depressed patients characterized by a decreased emotional reactivity when presented to positive- and negative valence-loaded stimuli. Given that fronto-cingulate-limbic circuits are implicated in abnormal reactivity to valence-loaded stimuli, neurocognitive treatments engaging the prefrontal cortex may be able to modulate this emotional blunting observed in MDD. Therefore, our goal was to evaluate emotional reactivity in depressed patients before and after a combination of neurocognitive interventions that engage the prefrontal cortex (cognitive control training and/or transcranial direct current stimulation). In line with the premises of the ECI framework, before the start of the antidepressant intervention, patients showed blunted emotional reactivity after exposure to negative valence-loaded stimuli. This emotional reactivity pattern changed after 9 sessions of the intervention: positive affect decreased and negative affect increased after watching a series of negative valence-loaded stimuli (i.e. images). Interestingly, higher emotional reactivity (as indexed by a larger increase in negative affect after watching the valence-loaded stimuli) at baseline predicted reductions in depression symptoms after the intervention. On the other hand, higher emotional reactivity (as indexed by a decrease in positive affect) after the intervention was marginally associated with reductions in depression symptoms. To conclude, emotional reactivity increased after the neurocognitive antidepressant intervention and it was directly associated to the degree of depression improvement.
authors.affiliation: Department of Psychiatry and Medical Psychology, Ghent University, Belgium; Faculty of Medicine and Pharmacy, Free University Brussels, Brussels, Belgium. Electronic address: MarieAnne.Vanderhasselt@Ugent.be.
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Vanderhasselt
authors.affiliation: Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium.
authors.forename: Rudi
authors.initials: R
authors.lastname: De Raedt
authors.affiliation: Cognitive Neuroscience Laboratory and Developmental Disorders Program, Centre for Health and Biological Sciences, Mackenzie Presbyterian University, Sao Paulo, Brazil.
authors.forename: Victoria
authors.initials: V
authors.lastname: Namur
authors.affiliation: Interdisciplinary Center for Applied Neuromodulation & Clinical and Epidemiologic Research Center, University Hospital, University of São Paulo, São Paulo, Brazil; Service of Interdisciplinary Neuromodulation & Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
authors.forename: Leandro C L
authors.initials: LCL
authors.lastname: Valiengo
authors.affiliation: Interdisciplinary Center for Applied Neuromodulation & Clinical and Epidemiologic Research Center, University Hospital, University of São Paulo, São Paulo, Brazil.
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
authors.affiliation: Interdisciplinary Center for Applied Neuromodulation & Clinical and Epidemiologic Research Center, University Hospital, University of São Paulo, São Paulo, Brazil.
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Bensenor
authors.affiliation: Department of Psychiatry and Medical Psychology, Ghent University, Belgium; University and Department of Psychiatry, University Hospital UZBrussel, Belgium.
authors.forename: Chris
authors.initials: C
authors.lastname: Baeken
authors.affiliation: Cognitive Neuroscience Laboratory and Developmental Disorders Program, Centre for Health and Biological Sciences, Mackenzie Presbyterian University, Sao Paulo, Brazil.
authors.forename: Paulo S
authors.initials: PS
authors.lastname: Boggio
authors.affiliation: Interdisciplinary Center for Applied Neuromodulation & Clinical and Epidemiologic Research Center, University Hospital, University of São Paulo, São Paulo, Brazil; Service of Interdisciplinary Neuromodulation & Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil. Electronic address: Brunoni@usp.br.
authors.forename: Andre R
authors.initials: AR
authors.lastname: Brunoni
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D010775:Photic Stimulation; D017397:Prefrontal Cortex / Q000502:physiology*; D065908:Transcranial Direct Current Stimulation; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents
keywords: Depressive symptoms; Emotional Context Insensitivity; Emotional reactivity; Neurocognitive intervention; Positive and negative affect