Neural correlates of emotional processing in depression: changes with cognitive behavioral therapy and predictors of treatment response.
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2011-05
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Abstract
Major depressive disorder (MDD) is characterized by the presence of disturbances in emotional processing. However, the neural correlates of these alterations, and how they may be affected by therapeutic interventions, remain unclear. The present study addressed these issues in a preliminary investigation using functional magnetic resonance imaging (fMRI) to examine neural responses to positive, negative, and neutral pictures in unmedicated MDD patients (N = 22) versus controls (N = 14). After this initial scan, MDD patients were treated with cognitive behavioral therapy (CBT) and scanned again after treatment. Within regions that showed pre-treatment differences between patients and controls, we tested the association between pre-treatment activity and subsequent treatment response as well as activity changes from pre- to post-treatment. This study yielded three main findings. First, prior to treatment and relative to controls, patients exhibited overall reduced activity in the ventromedial prefrontal cortex (PFC), diminished discrimination between emotional and neutral items in the amygdala, caudate, and hippocampus, and enhanced responses to negative versus positive stimuli in the left anterior temporal lobe (ATL) and right dorsolateral PFC. Second, CBT-related symptom improvement in MDD patients was predicted by increased activity at baseline in ventromedial PFC as well as the valence effects in the ATL and dorsolateral PFC. Third, from pre- to post-treatment, MDD patients exhibited overall increases in ventromedial PFC activation, enhanced arousal responses in the amygdala, caudate, and hippocampus, and a reversal of valence effects in the ATL. The study was limited by the relatively small sample that was able to complete both scan sessions, as well as an inability to determine the influence of comorbid disorders within the current sample. Nevertheless, components of the neural networks corresponding to emotion processing disturbances in MDD appear to resolve following treatment and are predictive of treatment response, possibly reflecting improvements in emotion regulation processes in response to CBT.
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Ritchey, Maureen, Florin Dolcos, Kari M Eddington, Timothy J Strauman and Roberto Cabeza (2011). Neural correlates of emotional processing in depression: changes with cognitive behavioral therapy and predictors of treatment response. J Psychiatr Res, 45(5). pp. 577–587. 10.1016/j.jpsychires.2010.09.007 Retrieved from https://hdl.handle.net/10161/13854.
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Timothy J. Strauman
Professor Strauman’s work is grounded in the premise that mental health and well-being are fundamentally shaped by self-regulation—how individuals pursue goals, respond to challenges, and adapt over time. His research integrates clinical psychology, affective neuroscience, and behavioral science to characterize the psychological and neurobiological systems that support self-regulation, and to understand how disruptions in these systems contribute to vulnerability to depression and related conditions.
Across a program of experimental, clinical, and neuroimaging research, his work has examined self-regulation as a multi-level system, including its cognitive and motivational mechanisms, its development through socialization, and its links to affective and immunological processes. This work has also informed the development and evaluation of novel interventions targeting self-regulatory dysfunction.
More recently, his work has focused on translating this science of self-regulation into scalable approaches to intervention and prevention. This includes the development of new models of treatment that target regulatory processes across disorders, as well as efforts to extend effective self-regulation skills beyond traditional clinical settings and into everyday contexts. This translational focus reflects a broader aim of building integrated, system-level approaches to mental health that can improve outcomes at population scale.
Roberto Cabeza
My laboratory investigates the neural correlates of memory and cognition in young and older adults using fMRI. We have three main lines of research: First, we distinguish the neural correlates of various episodic memory processes. For example, we have compared encoding vs. retrieval, item vs. source memory, recall vs. recognition, true vs. false memory, and emotional vs. nonemotional memory. We are particularly interested in the contribution of prefrontal cortex (PFC) and medial temporal lobe (MTL) subregions and their interactions. Second, we investigate similarities and differences between the neural correlates of episodic memory and other memory and cognitive functions (working, semantic, implicit, and procedural memory; attention; perception, etc.). The main goal of this cross-functional approach is to understand the contributions of brain regions shared by different cognitive functions. Finally, in both episodic memory and cross-function studies, we also examine the effects of healthy and pathological aging. Regarding episodic memory, we have linked processes differentially affected by aging (e.g., item vs. source memory, recall vs. recognition) to the effects of aging on specific PFC and MTL subregions. Regarding cross-function comparisons, we identify age-related changes in activity that are common to various functions. For example, we have found an age-related increase in bilaterality that occurs for many functions (memory, attention, language, perception, and motor) and is associated with functional compensation.
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