Cited by 217Neural and Behavioral Psychology StudiesTreatment of Major DepressionNeurotransmitter Receptor Influence on Behavior

The DOI matches its Crossref record; 136 of the 139 references it cites were found in a registry or an index; 5 of the 185 sources its claims cite were checked for support.

Localization of Dysfunction in Major Depressive Disorder: Prefrontal Cortex and Amygdala

Open access

Abstract

Despite considerable effort, the localization of dysfunction in major depressive disorder (MDD) remains poorly understood. We present a hypothesis about its localization that builds on recent findings from primate neuropsychology. The hypothesis has four key components: a deficit in the valuation of "self" underlies the core disorder in MDD; the medial frontal cortex represents "self"; interactions between the amygdala and cortical representations update their valuation; and inefficiency in using positive feedback by orbital prefrontal cortex contributes to MDD.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

The paper proposes that major depressive disorder involves dysfunction in medial and orbital frontal cortex and their interactions with the amygdala, especially in valuing the self, objects, rules, and actions. It argues that inefficient use of positive feedback by orbital prefrontal cortex, together with altered amygdala updating, can produce negative bias and low self-esteem.

Key findings

  • The authors advance a four-part hypothesis: impaired valuation of the self is central to MDD; medial frontal cortex carries a self representation; amygdala–cortical interactions update valuations; and orbital prefrontal cortex contributes through inefficient use of positive feedback.
  • Human evidence cited implicates medial and orbital frontal cortex plus amygdala: altered activation during emotional and reward tasks, frontal lesions in depression after cerebrovascular disease, altered metabolism in depressed Parkinson’s patients, and volume/thickness reductions in PFo area 11, sulcal area 47, and subgenual cortex (areas 24, 32, 25). Subgenual volume reduction is reported before symptom onset in high familial risk, early in illness, persistent across episodes, and most consistent in severe cases.
  • In macaque devaluation tasks, bilateral amygdala lesions, bilateral PFo lesions, or crossed amygdala–PFo disconnection attenuate the devaluation effect, while lesions of ventral/dorsolateral prefrontal cortex, entorhinal cortex, perirhinal cortex, or hippocampus do not. In serial object reversal, PFo lesions slow learning, amygdala lesions do not; trial-by-trial analysis shows PFo lesions impair use of positive feedback, whereas amygdala lesions improve performance one trial after an error followed by a correct response. Buckley et al. reported EC+1 accuracy falling from 77% preoperatively to 50% after PFo lesions.
  • Treatment-related findings include increased activation in medial/orbital frontal and temporal/amygdala regions during depression versus remission; sertraline restored a normal happy-face bias and PFo activation to happy faces in a 26 ms masked-face paradigm. Deep brain stimulation is noted to improve about one-half of cases and produce remission in about one-third.

Methods

  • This is a theoretical review and hypothesis paper, not a primary empirical study; it synthesizes human clinical and neuroimaging findings with nonhuman primate neuropsychology, lesion, and physiology research.
  • The main analysis is a narrative integration of evidence from devaluation tasks, serial object-reversal learning, probabilistic learning, Pavlovian conditioning, and self-representation studies.
  • Cited data include MDD patients, healthy controls, remitted patients, patients with Parkinson’s or cerebrovascular disease, and nonhuman primates including macaques and marmosets, with some rodent findings.

Limitations

  • The paper states that animal conditioning tasks are blunt tools for human conscious emotion; that rodent frontal cortex is not homologous to primate granular prefrontal cortex; that cause versus effect in MDD remains unclear; that some arguments, such as the aversive analogue prediction, are indirect; and that gray matter reductions can produce partial volume effects that complicate activation–severity relationships.
  • Evident from the text: as a review/hypothesis, it does not directly test the proposed mechanism, relies heavily on cross-species inference, and draws on separate studies with varied methods rather than a systematic meta-analysis.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.biopsych.2010.09.041

Cites

136 of 136 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

110 Not checked yet · 46 Own interpretation · 2 Supported so far · 2 Own result · 2 No basis given · 1 Supported · 1 Mixed support · accuracy not yet measured

Verify all 180 references — free account

Show all 115 claims

  • It may state two separate claims as one. 45
  • Probably not a substantial claim. 7
49 of 49
  • The paper relies on this without support.

    The neural mechanisms revealed by macaque devaluation and reversal tasks are relevant to the pathophysiology of major depressive disorder in humans.

    “Despite this limitation, recent advances in primate neuropsychology can contribute to understanding MDD, and the largest part of this article considers some of these findings.”
    “In the next two sections, we explore recent neuropsychological results from nonhuman primates in order to gain insight into this problem.”
  • The paper relies on this without support.

    PFo receives relatively direct inputs from olfactory, gustatory, and visceral receptors via OFa.

    “PFo also receives relatively direct inputs from olfactory, gustatory and visceral receptors via the OFa (which includes the agranular insular cortex).”
  • The authors state this as an assumption.

    Negative affective responses would be affected by PFo and amygdala lesions in the same way as positive affective responses.

    “We will assume, however, that negative affective responses would be similarly affected by PFo and amygdala lesions.”
  • The paper relies on this without support.

    Findings from nonhuman primates about frontal-amygdala function can be extended to humans and to MDD.

    “using insights gained mainly from the study of nonhuman primates, we suggest how dysfunction in amygdala–frontal interactions could produce certain key symptoms of MDD.”
  • The paper relies on this without support.

    The same valuation mechanisms that operate on object, rule, and action representations in nonhuman primates also operate on the representation of self in humans.

    “Understanding how the frontal lobe functions in the valuation of object-, rule-, and action representations in nonhuman primates will illuminate how homologous areas function in the valuation of self in humans.”
5 of 5

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Citations

Cites

Show all 139 references

Research works printed but not linked: 2

  1. Drevets, 1997, Subgenual prefrontal cortex abnormalities in mood disorders, Nature, 386, 824, 10.1038/386824a0 · DOI · Paper page
  2. Martin-Soelch, 2006, Dysfunctional learning and neurophysiological activation during appetitive and aversive conditioning in major depression: An fMRI study, Neuroimage

Cited by

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Metadata

Authors
Murray, E. A., Wise, S. P., & Drevets, W. C.
Affiliations
  • National Institutes of Health (US)
  • Laureate Institute for Brain Research (US)
Corresponding author
Murray, Elisabeth A.
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2011-06
Volume
69
Issue
12
Pages
e43-e54
ISSN
0006-3223 (ISSN-L)
OpenAlex
W2078617766
Cited by
208
References
139
Citations by year
2026: 7 · 2025: 6 · 2024: 11 · 2023: 10 · 2022: 13 · 2021: 13 · 2020: 15 · 2019: 16 · 2018: 12 · 2017: 12 · 2016: 21 · 2015: 16 · 2014: 13 · 2013: 22 · 2012: 15
FWCI
0.98
Type
journal article
Language
en
Open access
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Institute of Mental Health (ZIAMH002886, ZIAMH002887)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords
major depressive disorder, prefrontal cortex, amygdala, self-representation, self-valuation, medial frontal cortex, orbitofrontal cortex, positive feedback
MeSH terms
Amygdala, Animals, Choice Behavior, Major Depressive Disorder, Ego, Emotions, Frontal Lobe, Humans, Psychomotor Performance, Reversal Learning, Self Concept, Prefrontal Cortex

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