Reduced Right Ventrolateral Prefrontal Cortex Activity While Inhibiting Positive Affect Is Associated with Improvement in Hedonic Capacity After 8 Weeks of Antidepressant Treatment in Major Depressive Disorder

Light, Sharee N.; Heller, Aaron S.; Johnstone, Tom; Kolden, Gregory G.; Peterson, Michael J.; Kalin, Ned H.; Davidson, Richard J.

doi:10.1016/j.biopsych.2011.06.031

Cited by 77 publications

(56 citation statements)

References 20 publications

(29 reference statements)

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“…[33][34][35] Longitudinal studies utilizing structural neuroimaging techniques comparing drug-naïve patients before and after psychotropic treatment have observed positive effects 33,34,36 or no brain structure modification 35 after psychotropic treatment, while functional neuroimaging studies have observed enhancements in neuroplasticity and in brain connectivity. [37][38][39][40] The findings reported herein should be interpreted in the context of a number of limitations. The relatively small number of patients enrolled may preclude wider conclusions.…”

Section: Discussionmentioning

confidence: 85%

Cortical morphology changes in women with borderline personality disorder: a multimodal approach

Araujo

Filho

Sato

et al. 2014

Rev. Bras. Psiquiatr.

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Objective: Borderline personality disorder (BPD) is a devastating condition that causes intense disruption of patients' lives and relationships. Proper understanding of BPD neurobiology could help provide the basis for earlier and effective interventions. As neuroimaging studies of patients with BPD are still scarce, volumetric and geometric features of the cortical structure were assessed to ascertain whether structural cortical alterations are present in BPD patients. Methods: Twenty-five female outpatients with BPD underwent psychiatric evaluation (SCID-I and II) and a 1.5 T magnetic resonance imaging (MRI) brain scan. The control group comprised 25 healthy age-matched females. Images were processed with the FreeSurfer package, which allows analysis of cortical morphology with more detailed descriptions of volumetric and geometric features of cortical structure. Results: Compared with controls, BPD patients exhibited significant cortical abnormalities in the fronto-limbic and paralimbic regions of both hemispheres. Conclusion: Significant morphologic abnormalities were observed in patients with BPD on comparison with a healthy control group through a multimodal approach. This study highlights the involvement of regions associated with mood regulation, impulsivity, and social behavior in BPD patients and presents a new approach for further investigation through a method of structural analysis based on distinct and simultaneous volumetric and geometric parameters.

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Section: Discussionmentioning

confidence: 85%

Cortical morphology changes in women with borderline personality disorder: a multimodal approach

Araujo

Filho

Sato

et al. 2014

Rev. Bras. Psiquiatr.

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“…After treatment with fluoxetine or venlafaxine, depressed patients reported increases in positive affect; interestingly, those patients demonstrating the largest increases in positive affect also demonstrated the largest increases in frontal activity 88. Furthermore, depressed patients who did not exhibit positive emotions also showed decreased PFC activity, which changed with improvement in anhedonia in response to treatment with fluoxetine and venlafaxine 86. Thus, given the similarities between activation of these regions in response to positive experiences in healthy populations with anhedonia and in patients with MDD, it has been postulated that anhedonia, or hedonic tone, may be predictive of development of MDD.…”

Section: Neurobiology Of Hedonic Tonementioning

confidence: 99%

Neurobiology of hedonic tone: the relationship between treatment-resistant depression, attention-deficit hyperactivity disorder, and substance abuse

Sternat¹,

Katzman²

2016

NDT

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Anhedonia, defined as the state of reduced ability to experience feelings of pleasure, is one of the hallmarks of depression. Hedonic tone is the trait underlying one’s characteristic ability to feel pleasure. Low hedonic tone represents a reduced capacity to experience pleasure, thus increasing the likelihood of experiencing anhedonia. Low hedonic tone has been associated with several psychopathologies, including major depressive disorder (MDD), substance use, and attention-deficit hyperactivity disorder (ADHD). The main neural pathway that modulates emotional affect comprises the limbic–cortical–striatal–pallidal–thalamic circuits. The activity of various components of the limbic–cortical–striatal–pallidal–thalamic pathway is correlated with hedonic tone in healthy individuals and is altered in MDD. Dysfunction of these circuits has also been implicated in the relative ineffectiveness of selective serotonin reuptake inhibitors used to treat anxiety and depression in patients with low hedonic tone. Mood disorders such as MDD, ADHD, and substance abuse share low hedonic tone as well as altered activation of brain regions involved in reward processing and monoamine signaling as their features. Given the common features of these disorders, it is not surprising that they have high levels of comorbidities. The purpose of this article is to review the neurobiology of hedonic tone as it pertains to depression, ADHD, and the potential for substance abuse. We propose that, since low hedonic tone is a shared feature of MDD, ADHD, and substance abuse, evaluation of hedonic tone may become a diagnostic feature used to predict subtypes of MDD, such as treatment-resistant depression, as well as comorbidities of these disorders.

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“…Another study, however, showed that a lower response at baseline in the dorsal anterior cingulate cortex was associated with an improved clinical outcome with an 8-week treatment with fluoxetine (167). Another study reported that lower pretreatment activity in the ventrolateral prefrontal cortex, a region implicated in more effortful, “voluntary” emotion regulation (13), during attempts to down-regulate positive emotion was associated with better response to either fluoxetine or the SNRI venlafaxine in depressed adults (168). …”

Section: Neuroimaging Studies Of Predictors Of Antidepressant Responsementioning

confidence: 99%

“…Findings from neuroimaging studies examining predictors of antidepressant treatment response in depression (8, 159–168) allow us to hypothesize that greater pretreatment activity and resting blood flow in the medial prefrontal cortex and pregenual anterior cingulate cortex implicit emotion regulation circuitry (panel A) may moderate response to SRIs versus nonserotonergic antidepressants. Changes in these measures after commencing such treatments may mediate response to SRIs.…”

Section: Figurementioning

confidence: 99%

Identifying Predictors, Moderators, and Mediators of Antidepressant Response in Major Depressive Disorder: Neuroimaging Approaches

Phillips¹,

Chase²,

Sheline³

et al. 2015

AJP

208

165

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Objective Despite significant advances in neuroscience and treatment development, no widely accepted biomarkers are available to inform diagnostics or identify preferred treatments for individuals with major depressive disorder. Method In this critical review, the authors examine the extent to which multimodal neuroimaging techniques can identify biomarkers reflecting key pathophysiologic processes in depression and whether such biomarkers may act as predictors, moderators, and mediators of treatment response that might facilitate development of personalized treatments based on a better understanding of these processes. Results The authors first highlight the most consistent findings from neuroimaging studies using different techniques in depression, including structural and functional abnormalities in two parallel neural circuits: serotonergically modulated implicit emotion regulation circuitry, centered on the amygdala and different regions in the medial prefrontal cortex; and dopaminergically modulated reward neural circuitry, centered on the ventral striatum and medial prefrontal cortex. They then describe key findings from the relatively small number of studies indicating that specific measures of regional function and, to a lesser extent, structure in these neural circuits predict treatment response in depression. Conclusions Limitations of existing studies include small sample sizes, use of only one neuroimaging modality, and a focus on identifying predictors rather than moderators and mediators of differential treatment response. By addressing these limitations and, most importantly, capitalizing on the benefits of multimodal neuroimaging, future studies can yield moderators and mediators of treatment response in depression to facilitate significant improvements in shorter- and longer-term clinical and functional outcomes.

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Reduced Right Ventrolateral Prefrontal Cortex Activity While Inhibiting Positive Affect Is Associated with Improvement in Hedonic Capacity After 8 Weeks of Antidepressant Treatment in Major Depressive Disorder

Cited by 77 publications

References 20 publications

Cortical morphology changes in women with borderline personality disorder: a multimodal approach

Cortical morphology changes in women with borderline personality disorder: a multimodal approach

Neurobiology of hedonic tone: the relationship between treatment-resistant depression, attention-deficit hyperactivity disorder, and substance abuse

Identifying Predictors, Moderators, and Mediators of Antidepressant Response in Major Depressive Disorder: Neuroimaging Approaches

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