Objective
This study investigated neural substrate changes in affective processing among late-life
depression (LLD) patients undergoing antidepressant treatment and determined if these
changes correlated with remission status.
Methods
Thirty-three LLD patients were enrolled in a 12-week venlafaxine treatment course.
During treatment functional magnetic resonance imaging (fMRI) scans, paired with an
affective task that assessed emotional reactivity and regulation, were performed on
days 1, 2, 3, and 7 and at week 12. Following treatment patients were classified as
remitters or non-remitters. A voxel-wise two-way repeated-measures ANOVA was performed
to assess the fMRI data at a significance level of α = 0.05, corrected.
Results
The emotional reactivity contrast demonstrated a significant interaction between remission
status and scan time in the right middle temporal gyrus (MTG) (F = 24.1, df = 1,112,
k = 102). Further analysis showed increased emotional reactivity–induced activity
among non-remitters, and decreased activity among remitters, which significantly differed
from baseline at day 7 (95% CI: 0.027, 0.540; Cohen's d = −1.35) and week 12 (95%
CI: −0.171, −0.052; Cohen's d = 0.68), respectively. No significant interaction was
observed with the emotional regulation contrast, but multiple regions had significant
main effects of scan time, including the cuneus, occipital lobe, insula, lingual gyrus,
posterior cingulate cortex, and MTG.
Conclusions
During treatment of LLD patients, affective processing–induced activity in the right MTG shows changes based on remission
status. This alteration becomes evident early during the course of treatment, suggesting
that antidepressant pharmacotherapy may acutely affect the neural basis of emotional
reactivity in a differential manner that is relevant to illness remission.
Key Words
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References
- Review of community prevalence of depression in later life.Br J Psychiatry. 1999; 174: 307-311
- Depression as a risk factor for Alzheimer disease: the MIRAGE Study.Arch Neurol. 2003; 60: 753-759
- Depression and bipolar support alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in late life.Arch Gen Psychiatry. 2003; 60: 664-672
- Efficacy of antidepressants for late-life depression: a meta-analysis and meta-regression of placebo-controlled randomized trials.J Clin Psychiatry. 2011; 72: 1660-1668
- Serotonin-selective reuptake inhibitors in the treatment of geriatric depression and related disorders.Int J Neuropsychopharmacol. 1999; 2: 121-127
- Depression in the elderly.Lancet. 2005; 365: 1961-1970
- Magnetic resonance imaging predictors of treatment response in late-life depression.J Geriatr Psychiatry Neurol. 2014; 27: 24-32
- Frontostriatal and limbic dysfunction in late-life depression.Am J Geriatr Psychiatry. 2002; 10: 687-695
- Neural correlates of treatment outcome in major depression.Int J Neuropsychopharmacol. 2011; 14: 521-534
- Self-referential processing and the prefrontal cortex over the course of depression: a pilot study.J Affect Disord. 2010; 124: 196-201
- Frontal and limbic activation during inhibitory control predicts treatment response in major depressive disorder.Biol Psychiatry. 2007; 62: 1272-1280
- Neural responses to happy facial expressions in major depression following antidepressant treatment.Am J Psychiatry. 2007; 164: 599-607
- Brain imaging correlates of depressive symptom severity and predictors of symptom improvement after antidepressant treatment.Biol Psychiatry. 2007; 62: 407-414
- Emotional experience in everyday life across the adult life span.J Pers Soc Psychol. 2000; 79: 644-655
- Age-related differences and change in positive and negative affect over 23 years.J Pers Soc Psychol. 2001; 80: 136-151
- Is age-related stability of subjective well-being a paradox? Cross-sectional and longitudinal evidence from the Berlin Aging Study.Psychol Aging. 2000; 15: 511-526
- Aging and emotional memory: the forgettable nature of negative images for older adults.J Exp Psychol Gen. 2003; 132: 310-324
- Are the memories of older adults positively biased?.Psychol Aging. 2008; 23: 297-306
- National Institutes of Health: Incomplete Response in Late Life Depression: Getting to Remission (IRL GREY).(Bethesda, MD)2009 ([Internet] Identifier NCT00892047)
- National Institutes of Health: ADAPT: Addressing Depression and Pain Together.(Bethesda, MD)2010 ([Internet] Identifier: NCT01124188)
- Sleep quality and neural circuit function supporting emotion regulation.Biol Mood Anxiety Disord. 2012; 2: 22
- Detecting and adjusting for artifacts in fMRI time series data.Neuroimage. 2005; 27: 624-634
- Influence of the COMT genotype on working memory and brain activity changes during development.Biol Psychiatry. 2011; 70: 222-229
- Differences in verbal memory retrieval in breast cancer chemotherapy patients compared to healthy controls: a prospective fMRI study.Brain Imaging Behav. 2013; 7: 460-477
- Improved assessment of significant activation in functional magnetic resonance imaging (fMRI): use of a cluster-size threshold.Magn Reson Med. 1995; 33: 636-647
- BrainNet Viewer: a network visualization tool for human brain connectomics.PLoS ONE. 2013; 8: e68910
- Acute 5-HT reuptake blockade potentiates human amygdala reactivity.Neuropsychopharmacology. 2008; 33: 3221-3225
- Serotonergic and noradrenergic modulation of emotion processing by single dose antidepressants.Neuropsychopharmacology. 2010; 35: 521-533
- Acute neural effects of selective serotonin reuptake inhibitors versus noradrenaline reuptake inhibitors on emotion processing: implications for differential treatment efficacy.Neurosci Biobehav Rev. 2013; 37: 1786-1800
- Effect of acute antidepressant administration on negative affective bias in depressed patients.Am J Psychiatry. 2009; 166: 1178-1184
- A meta-analytic study of changes in brain activation in depression.Hum Brain Mapp. 2008; 29: 683-695
- Brain effects of antidepressants in major depression: a meta-analysis of emotional processing studies.J Affect Disord. 2011; 130: 66-74
- Subgenual anterior cingulate activation to valenced emotional stimuli in major depression.Neuroreport. 2005; 16: 1731-1734
- A double dissociation of ventromedial prefrontal cortical responses to sad and happy stimuli in depressed and healthy individuals.Biol Psychiatry. 2005; 58: 495-503
- A differential pattern of neural response toward sad versus happy facial expressions in major depressive disorder.Biol Psychiatry. 2005; 57: 201-209
- Automatic mood-congruent amygdala responses to masked facial expressions in major depression.Biol Psychiatry. 2010; 67: 155-160
- fMRI activation in the amygdala and the orbitofrontal cortex in unmedicated subjects with major depressive disorder.Psychiatry Res. 2010; 183: 209-217
- Age-related differences in brain activation during emotional face processing.Neurobiol Aging. 2003; 24: 285-295
- Emotional processing deficits in late-life depression.Am J Geriatr Psychiatry. 2010; 18: 652-656
- A meta-analytic review of emotion recognition and aging: implications for neuropsychological models of aging.Neurosci Biobehav Rev. 2008; 32: 863-881
- Emotion recognition deficits in the elderly.J Neurosci. 2004; 114: 403-432
- Early processing of the six basic facial emotional expressions.Brain Res Cogn Brain Res. 2003; 17: 613-620
- An fMRI study investigating cognitive modulation of brain regions associated with emotional processing of visual stimuli.Neuropsychologia. 2003; 41: 585-596
- Posterior cingulate cortex activation by emotional words: fMRI evidence from a valence decision task.Hum Brain Mapp. 2003; 18: 30-41
- Escitalopram effects on insula and amygdala BOLD activation during emotional processing.Psychopharmacol. 2008; 196: 661-672
Article info
Publication history
Published online: April 07, 2016
Accepted:
March 30,
2016
Received in revised form:
March 25,
2016
Received:
June 24,
2015
Identification
Copyright
© 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
