Neural correlates of perception of emotional facial expressions in out-patients with mild-to-moderate depression and anxiety. A multicenter fMRI study

• Published in: Psychological medicine 2011-11, Vol.41 (11), p.2253-2264
• Main Authors: Demenescu, L. R., Renken, R., Kortekaas, R., van Tol, M.-J., Marsman, J. B. C., van Buchem, M. A., van der Wee, N. J. A., Veltman, D. J., den Boer, J. A., Aleman, A.
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Amygdala - drug effects; Amygdala - physiopathology; Anger; Anxiety; Anxiety Disorders - drug therapy; Anxiety Disorders - epidemiology; Anxiety Disorders - physiopathology; Anxiety Disorders - psychology; Anxiety-Depression; Biological and medical sciences; Brain Mapping; Case-Control Studies; Comorbidity; Cortex; Depression; Depressive Disorder - drug therapy; Depressive Disorder - epidemiology; Depressive Disorder - physiopathology; Depressive Disorder - psychology; Emotion recognition; Emotions; Face; Facial Expression; Facial expressions; Fear; Female; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Mental depression; Mood disorders; Netherlands; Neural networks; NMR; Nonverbal communication; Nuclear magnetic resonance; Patients; Perceptions; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotropic Drugs - pharmacology; Social Perception
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291711000596

Depression has been associated with limbic hyperactivation and frontal hypoactivation in response to negative facial stimuli. Anxiety disorders have also been associated with increased activation of emotional structures such as the amygdala and insula. This study examined to what extent activation of brain regions involved in perception of emotional faces is specific to depression and anxiety disorders in a large community-based sample of out-patients. An event-related functional magnetic resonance imaging (fMRI) paradigm was used including angry, fearful, sad, happy and neutral facial expressions. One hundred and eighty-two out-patients (59 depressed, 57 anxiety and 66 co-morbid depression-anxiety) and 56 healthy controls selected from the Netherlands Study of Depression and Anxiety (NESDA) were included in the present study. Whole-brain analyses were conducted. The temporal profile of amygdala activation was also investigated. Facial expressions activated the amygdala and fusiform gyrus in depressed patients with or without anxiety and in healthy controls, relative to scrambled faces, but this was less evident in patients with anxiety disorders. The response shape of the amygdala did not differ between groups. Depressed patients showed dorsolateral prefrontal cortex (PFC) hyperactivation in response to happy faces compared to healthy controls. We suggest that stronger frontal activation to happy faces in depressed patients may reflect increased demands on effortful emotion regulation processes triggered by mood-incongruent stimuli. The lack of strong differences in neural activation to negative emotional faces, relative to healthy controls, may be characteristic of the mild-to-moderate severity of illness in this sample and may be indicative of a certain cognitive-emotional processing reserve.