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Unmasking Disease-Specific Cerebral Blood Flow Abnormalities: Mood Challenge in Patients With Remitted Unipolar Depression
Abstract
OBJECTIVE: Remitted major depressive disorder is a vulnerable clinical state, suggesting persistence of an underlying disease diathesis between episodes. To investigate neural correlates of such risk and to identify potential depression trait markers, euthymic unipolar patients in remission, acutely depressed patients, and never-depressed volunteers were studied before and after transient sad mood challenge. METHOD: Common and differential changes in regional blood flow among the groups relative to the baseline state were examined with [(15)O]H(2)O positron emission tomography after provocation of sadness with autobiographical memory scripts. RESULTS: Mood provocation in both depressed groups resulted in regional cerebral blood flow (rCBF) decreases in medial orbitofrontal cortex Brodmann's area 10/11, which were absent in the healthy group. In the remitted group, mood provocation produced a unique rCBF decrease in pregenual anterior cingulate 24a. The main effects in healthy subjects, an rCBF increase in subgenual cingulate Brodmann's area 25 and a decrease in right prefrontal cortex Brodmann's area 9, were not present in the depressed groups. CONCLUSIONS: Mood challenge in unipolar euthymic patients in full remission unmasks an apparent depression trait marker. The pattern of acute CBF changes is distinct from that seen in euthymic healthy volunteers and mirrors the untreated depressed state seen during a major depressive episode and the pattern of change seen in depressed patients. These findings suggest that disease-specific modifications of pathways mediating transient mood changes are present in unipolar depression independent of clinical illness status. These findings have implications for understanding the vulnerability of remitted patients for illness relapse.
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“Functional neuroimaging studies in MDD have consistently indicated hypoactivation in reward-processing regions, including the dorsal and ventral striatum [210-214] and a host of other reward structures, including the medial prefrontal cortex [215,216], the pregenual and subgenual anterior cingulate, and the medial frontal gyrus [217,218].”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [218]
In the citing paper
“Resting blood flow recordings reveal hypoperfusion across a network of frontoparietal regions and hyperperfusion in subgenual cingulate and anterior insular cortices both in mood disorder and also with induction of transient sadness in healthy subjects (Mayberg et al. 1999; Liotti et al. 2002).”
From Anatomical connectivity of the subgenual cingulate region targeted with deep brain stimulation for treatment-resistant depression (2008) · cites this paper as Liotti et al. 2002
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Metadata
- Authors
- Liotti, M., Mayberg, H. S., McGinnis, S., Brannan, S. L., & Jerabek, P.
- Affiliations
- University of Nottingham (GB)
- Venue
- American Journal of Psychiatry
- Published
- 2002-11-01
- Volume
- 159
- Issue
- 11
- Pages
- 1830-1840
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2002611894
- Cited by
- 331
- References
- 56
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 1 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 4 · 2018: 7 · 2017: 13 · 2016: 6 · 2015: 17 · 2014: 17 · 2013: 13 · 2012: 24
- FWCI
- 11.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- major depressive disorder, regional cerebral blood flow, medial orbitofrontal cortex, pregenual anterior cingulate cortex, subgenual anterior cingulate cortex, prefrontal cortex, relapse vulnerability, neural correlates of depression
- MeSH terms
- Adult, Affect, Antidepressive Agents, Brain, Brain Mapping, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Middle Aged, Neural Pathways, Oxygen Radioisotopes, Radionuclide Imaging, Recurrence, Reference Values, Regional Blood Flow, Risk
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