Towards a neuroimaging biomarker of depression vulnerability

Abstract

Major depressive disorder (MDD) is a pervasive and debilitating illness, with a recurrent course and chronic prognosis. Although effective treatments for MDD exist, there is a pressing need to characterize relapse vulnerability in order to design effective prophylactic care. To date, heterogeneity within depression neuroimaging research has made it difficult to establish a reliable biomarker of disorder susceptibility. In this paper, we review neuroimaging evidence for the assessment of MDD vulnerability, theorizing that current findings can be broadly distinguished between those indicating the presence of depressive episodes and those indicating MDD vulnerability during symptom remission. We argue that unlike the amygdala hyperactivity and prefrontal hypoactivity observed during MDD episodes, prefrontal hyperactivity may be a characteristic of dysphoric cognition during symptom remission that indicates MDD vulnerability and relapse risk. Drawing on current research of normative emotion regulation, we describe a potential test of MDD vulnerability, employing emotional challenge paradigms that induce cognitive reactivity -the increased endorsement of negative self-descriptions during a transient dysphoric mood. Relative to a normative model of prefrontal function, the neuroimaging assessment of cognitive reactivity may provide a reliable indicator of MDD vulnerability, advancing the field of biomarker research as well as the delivery of preventative treatment on an individual basis.

Perseverate or decenter? Differential effects of metacognition on the relationship between parasympathetic inflexibility and symptoms of depression in a multi-wave study

“…Consistent with these hypotheses, MBCT may reduce excessive connectivity within the default mode network (Farb et al, 2007, 2011; Taylor et al, 2013), possibly reflecting strengthened present-moment awareness (e.g., Fresco et al, 2007b). Similarly, Fresco et al (2017) examined the associations between pretreatment neural patterns of intrinsic functional connectivity in hubs within the DMN to treatment-related changes in worry and decentering in generalized anxiety disorder patients (with and without MDD) receiving emotion regulation therapy (e.g., Fresco, Mennin, Heimberg, & Ritter, 2013; Mennin, Fresco, Ritter, & Heimberg, 2015).…”

What, me worry and ruminate about DSM‐5 and RDoC? The importance of targeting negative self‐referential processing.

“…A series of studies have validated decentering as a construct important in the acute and enduring treatment of MDD and anxious depression (Fresco, Moore, et al, 2007; Fresco, Segal, et al, 2007; Mennin & Fresco, 2011) and in the prevention of MDD relapse following prophylactic treatment with MBCT (Bieling et al, 2012). fMRI assessment and neural correlates of treatment following MBCT revealed that normalization of mPFC activity coupled with an ability to approach emotion provocation with a nonjudgmental, nonreactive, awareness-predicted treatment durability (Farb, Segal, & Anderson, 2011).…”

A narrative review of yoga and mindfulness as complementary therapies for addiction

“…32 Neuroimaging research has recently shown that hypoactive prefrontal activation coupled with hyperactive limbic system activation represents altered DMN function that could serve as a brain-based biomarker for vulnerability to mental disorders, including depression and substance abuse. 33-36 Some of the latest clinical and mechanistic research on the DMN has demonstrated that DMN activity is modifiable through meditation practice. Specifically, yoga meditation has been associated with greater functional connectivity between the DMN and other distributed brain networks involved in attention, self-referential processing, and affective responses, and mindfulness meditation has been shown to increase somatosensory processing, decrease cognitive elaboration associated with the narrative self, and diminish emotional reactivity in the limbic system.…”