title: Mapping Depression in Schizophrenia: A Functional Magnetic Resonance Imaging Study.
abstract: Depressive symptoms are common in schizophrenia, often left untreated, and associated with a high relapse rate, suicidal ideation, increased mortality, reduced social adjustment and poor quality of life. The neural mechanisms underlying depression in psychosis are poorly understood. Given reports of altered brain response to negative facial affect in depressive disorders, we examined brain response to emotive facial expressions in relation to levels of depression in people with psychosis. Seventy outpatients (final N= 63) and 20 healthy participants underwent functional magnetic resonance imaging during an implicit affect processing task involving presentation of facial expressions of fear, anger, happiness as well as neutral expressions and a (no face) control condition. All patients completed Beck Depression Inventory (BDI-II) and had their symptoms assessed on the Positive and Negative Syndrome Scale (PANSS). In patients, depression (BDI-II) scores associated positively with activation of the left thalamus, extending to the putamen-globus pallidus, insula, inferior-middle frontal and para-post-pre-central gyri during fearful expressions. Furthermore, patients with moderate-to-severe depression had significantly higher activity in these brain regions during fearful expressions relative to patients with no, minimal, or mild depression and healthy participants. The study provides first evidence of enhanced brain response to fearful facial expressions, which signal an uncertain source of threat in the environment, in patients with psychosis and a high level of self-reported depression.
authors.affiliation: Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK; veena.kumari@kcl.ac.uk.
authors.forename: Veena
authors.initials: V
authors.lastname: Kumari
authors.affiliation: Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK;
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Peters
authors.affiliation: Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK;
authors.forename: Ashley
authors.initials: A
authors.lastname: Guinn
authors.affiliation: Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK;
authors.forename: Dominic
authors.initials: D
authors.lastname: Fannon
authors.affiliation: Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK;
authors.forename: Tamara
authors.initials: T
authors.lastname: Russell
authors.affiliation: Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK;
authors.forename: Alexander
authors.initials: A
authors.lastname: Sumich
authors.affiliation: Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK;
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
authors.affiliation: Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
authors.forename: Steven C R
authors.initials: SC
authors.lastname: Williams
authors.affiliation: Department of Old Age Psychiatry and Department of Neuroimaging Sciences, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK;
authors.forename: Dominic H
authors.initials: DH
authors.lastname: Ffytche
mesh_terms: D000328:Adult; D001931:Brain Mapping / Q000379:methods*; D002540:Cerebral Cortex / Q000503:physiopathology*; D003342:Corpus Striatum / Q000503:physiopathology*; D003866:Depressive Disorder / Q000503:physiopathology*; D005149:Facial Expression; D005239:Fear / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000503:physiopathology*; D012559:Schizophrenia / Q000503:physiopathology*; D013788:Thalamus / Q000503:physiopathology*; D055815:Young Adult
keywords: depressive symptoms; fMRI; fear; psychosis; thalamus