Current Psychiatry Research and Reviews

Author(s): Chien-Han Lai*

DOI: 10.2174/1573400515666181213155225

Major Depressive Disorder in Neuroimaging: What is Beyond Fronto-limbic Model?

Page: [37 - 43] Pages: 7

  • * (Excluding Mailing and Handling)

Abstract

Background: The major depressive disorder (MDD) is a chronic illness with major manifestations in cognitive, social and occupational functions. The pathophysiological model is an intrigue issue for scientists to understand the origin of MDD.

Objective: In the beginning, the cortico-limbic-striato-pallidal-thalamic model has been proposed to link the clinical symptoms with the abnormalities in brain structure and function. However, the model is still evolving due to recent advances in the neuroimaging techniques, especially for functional magnetic resonance imaging (fMRI). The recent findings in the fMRI studies in MDD showed the importance of fronto-limbic model for the modulations between cognitive function and primitive and negative emotions.

Method: This review will focus on the literature of fMRI studies in MDD with findings not in the fronto-limbic structures.

Results: Additional regions beyond the fronto-limbic model have been observed in some literature of MDD. Some regions in the parietal, temporal and occipital lobes have been shown with the alterations in gray matter, white matter and brain function. The importance of sensory detection, visuospatial function, language reception, motor response and emotional memories in these regions might provide the clues to understand the cognitive misinterpretations related to altered reception of outside information, behavioral responses related to biased cognition and emotional memories and clinical symptoms related to the significant alterations of interactions between different brain regions.

Conclusion: Future studies to establish a more comprehensive model for MDD will be warranted, especially for the model beyond the fronto-limbic structures.

Keywords: Depressive disorder, neuroimaging, fronto-limbic, fMRI, theory of mind, temporal region.

Graphical Abstract

[1]
Testa MA, Simonson DC. Assesment of quality-of-life outcomes. N Engl J Med 1996; 334: 835-40.
[2]
Naranjo CA, Tremblay LK, Busto UE. The role of the brain reward system in depression. Prog Neuropsychopharmacol Biol Psychiatry 2001; 25: 781-823.
[3]
Judd LL, Paulus MP, Wells KB, Rapaport MH. Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population. Am J Psychiatry 1996; 153: 1411-7.
[4]
Judd LL, Akiskal HS, Zeller PJ, et al. Psychosocial disability during the long-term course of unipolar major depressive disorder. Arch Gen Psychiatry 2000; 57: 375-80.
[5]
Lepine JP, Gastpar M, Mendlewicz J, Tylee A. Depression in the community: The first pan-European study DEPRES (Depression Research in European Society). Int Clin Psychopharmacol 1997; 12: 19-29.
[6]
Wittchen HU, Carter RM, Pfister H, Montgomery SA, Kessler RC. Disabilities and quality of life in pure and comorbid generalized anxiety disorder and major depression in a national survey. Int Clin Psychopharmacol 2000; 15: 319-28.
[7]
Chung L, Pan AW, Hsiung PC. Quality of life for patients with major depression in Taiwan: A model-based study of predictive factors. Psychiatry Res 2009; 168: 153-62.
[8]
Trivedi MH, Rush AJ, Wisniewski SR, et al. Factors associated with health-related quality of life among outpatients with major depressive disorder: A STAR*D report. J Clin Psychiatry 2006; 67: 185-95.
[9]
Beekman AT, Deeg DJ, Braam AW, Smit JH, Van Tilburg W. Consequences of major and minor depression in later life: A study of disability, well-being and service utilization. Psychol Med 1997; 27: 1397-409.
[10]
Hirschfeld RM, Dunner DL, Keitner G, et al. Does psychosocial functioning improve independent of depressive symptoms? A comparison of nefazodone, psychotherapy, and their combination. Biol Psychiatry 2002; 51: 123-33.
[11]
Alexopoulos GS, Hoptman MJ, Kanellopoulos D, Murphy CF, Lim KO, Gunning FM. Functional connectivity in the cognitive control network and the default mode network in late-life depression. J Affect Disord 2012; 139: 56-65.
[12]
van Tol MJ, van der Wee NJ, van den Heuvel OA, et al. Regional brain volume in depression and anxiety disorders. Arch Gen Psychiatry 2010; 67: 1002-11.
[13]
Lai CH, Hsu YY, Wu YT. First episode drug-naive major depressive disorder with panic disorder: gray matter deficits in limbic and default network structures. Eur Neuropsychopharmacol 2010; 20: 676-82.
[14]
de Kwaasteniet B, Ruhe E, Caan M, et al. Relation between structural and functional connectivity in major depressive disorder. Biol Psychiatry 2013; 74: 40-7.
[15]
Sheline YI. 3D MRI studies of neuroanatomic changes in unipolar major depression: The role of stress and medical comorbidity. Biol Psychiatry 2000; 48: 791-800.
[16]
Sheline YI, Barch DM, Price JL, et al. The default mode network and self-referential processes in depression. Proc Natl Acad Sci USA 2009; 106: 1942-7.
[17]
Brzezicka A. Integrative deficits in depression and in negative mood states as a result of fronto-parietal network dysfunctions. Acta Neurobiol Exp 2013; 73: 313-25.
[18]
Kosel M, Frick C, Lisanby SH, Fisch HU, Schlaepfer TE. Magnetic seizure therapy improves mood in refractory major depression. Neuropsychopharmacology 2003; 28: 2045-8.
[19]
Schlaffke L, Lissek S, Lenz M, et al. Shared and nonshared neural networks of cognitive and affective theory-of-mind: A neuroimaging study using cartoon picture stories. Hum Brain Mapp 2015; 36: 29-39.
[20]
Mason RA, Just MA. Differentiable cortical networks for inferences concerning people’s intentions versus physical causality. Hum Brain Mapp 2011; 32: 313-29.
[21]
Frith CD, Frith U. Mechanisms of social cognition. Annu Rev Psychol 2012; 63: 287-313.
[22]
Wang YG, Wang YQ, Chen SL, Zhu CY, Wang K. Theory of mind disability in major depression with or without psychotic symptoms: A componential view. Psychiatry Res 2008; 161: 153-61.
[23]
Zobel I, Werden D, Linster H, et al. Theory of mind deficits in chronically depressed patients. Depress Anxiety 2010; 27: 821-8.
[24]
O’Neill A, D’Souza A, Samson AC, Carballedo A, Kerskens C, Frodl T. Dysregulation between emotion and theory of mind networks in borderline personality disorder. Psychiatry Res 2015; 231: 25-32.
[25]
Lai CH, Wu YT. The alterations in regional homogeneity of parieto-cingulate and temporo-cerebellum regions of first-episode medication-naive depression patients. Brain Imaging Behav 2016; 10(1): 187-94.
[26]
Lai CH, Wu YT. Frontal regional homogeneity increased and temporal regional homogeneity decreased after remission of first-episode drug-naive major depressive disorder with panic disorder patients under duloxetine therapy for 6 weeks. J Affect Disord 2012; 136: 453-8.
[27]
Wang L, Dai W, Su Y, et al. Amplitude of low-frequency oscillations in first-episode, treatment-naive patients with major depressive disorder: A resting-state functional MRI study. PLoS One 2012; 7: e48658.
[28]
Liu F, Guo W, Liu L, et al. Abnormal amplitude low-frequency oscillations in medication-naive, first-episode patients with major depressive disorder: A resting-state fMRI study. J Affect Disord 2013; 146: 401-6.
[29]
Guo WB, Liu F, Xun GL, et al. Reversal alterations of amplitude of low-frequency fluctuations in early and late onset, first-episode, drug-naive depression. Prog Neuropsychopharmacol Biol Psychiatry 2013; 40: 153-9.
[30]
Guo WB, Liu F, Xue ZM, et al. Alterations of the amplitude of low-frequency fluctuations in treatment-resistant and treatment-response depression: A resting-state fMRI study. Prog Neuropsychopharmacol Biol Psychiatry 2012; 37: 153-60.
[31]
Zhu Z, Lu Q, Meng X, Jiang Q, Peng L, Wang Q. Spatial patterns of intrinsic neural activity in depressed patients with vascular risk factors as revealed by the amplitude of low-frequency fluctuation. Brain Res 2012; 1483: 82-8.
[32]
Li CT, Lin CP, Chou KH, et al. Structural and cognitive deficits in remitting and non-remitting recurrent depression: A voxel-based morphometric study. Neuroimage 2010; 50: 347-56.
[33]
Lin WC, Chou KH, Chen HL, et al. Structural deficits in the emotion circuit and cerebellum are associated with depression, anxiety and cognitive dysfunction in methadone maintenance patients: A voxel-based morphometric study. Psychiatry Res 2012; 201: 89-97.
[34]
Graff-Guerrero A, Pellicer F, Mendoza-Espinosa Y, Martinez-Medina P, Romero-Romo J, de la Fuente-Sandoval C. Cerebral blood flow changes associated with experimental pain stimulation in patients with major depression. J Affect Disord 2008; 107: 161-8.
[35]
Liu F, Hu M, Wang S, et al. Abnormal regional spontaneous neural activity in first-episode, treatment-naive patients with late-life depression: A resting-state fMRI study. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39: 326-31.
[36]
Ma Z, Li R, Yu J, He Y, Li J. Alterations in regional homogeneity of spontaneous brain activity in late-life subthreshold depression. PLoS One 2013; 8: e53148.
[37]
Lai CH, Wu YT. The patterns of fractional amplitude of low-frequency fluctuations in depression patients: The dissociation between temporal regions and fronto-parietal regions. J Affect Disord 2015; 175: 441-5.
[38]
Grachev ID, Kumar R, Swarnkar A, Chang JK, Ramachandran TS. Effect of posterior temporal-parietal hematoma on orbital frontal chemistry in relation to a cognitive and anxiety state: A combined 1H-MRS and neuropsychological study of an unusual case as compared with 16 healthy subjects. J Chem Neuroanat 2002; 23: 223-30.
[39]
Venkatraman TN, Krishnan RR, Steffens DC, Song AW, Taylor WD. Biochemical abnormalities of the medial temporal lobe and medial prefrontal cortex in late-life depression. Psychiatry Res 2009; 172: 49-54.
[40]
Kyomen HH, Hennen J, Whitfield TH, Renshaw PF, Gottlieb GL, Gorman JM. Greater depression severity in elderly patients with memory complaints is associated with decreased left temporal-parietal dominance indicated by dynamic susceptibility contrast magnetic resonance imaging cerebral blood volume measures. Am J Geriatr Psychiatry 2007; 15: 604-10.
[41]
Ende G, Demirakca T, Walter S, et al. Subcortical and medial temporal MR-detectable metabolite abnormalities in unipolar major depression. Eur Arch Psychiatry Clin Neurosci 2007; 257: 36-9.
[42]
Kraus T, Hosl K, Kiess O, Schanze A, Kornhuber J, Forster C. bold fMRI deactivation of limbic and temporal brain structures and mood enhancing effect by transcutaneous vagus nerve stimulation. J Neural Transm 2007; 114: 1485-93.
[43]
Green S, Lambon Ralph MA, Moll J, Deakin JF, Zahn R. Guilt-selective functional disconnection of anterior temporal and subgenual cortices in major depressive disorder. Arch Gen Psychiatry 2012; 69: 1014-21.
[44]
Yang XH, Tian K, Wang DF, et al. Anhedonia correlates with abnormal functional connectivity of the superior temporal gyrus and the caudate nucleus in patients with first-episode drug-naive major depressive disorder. J Affect Disord 2017; 218: 284-90.
[45]
Li J, Duan X, Cui Q, Chen H, Liao W. More than just statics: Temporal dynamics of intrinsic brain activity predicts the suicidal ideation in depressed patients. Psychol Med 2018; 1-9.
[46]
Yang XH, Huang J, Lan Y, et al. Diminished caudate and superior temporal gyrus responses to effort-based decision making in patients with first-episode major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2016; 64: 52-9.
[47]
Brown EC, Clark DL, Hassel S, MacQueen G, Ramasubbu R. Thalamocortical connectivity in major depressive disorder. J Affect Disord 2017; 217: 125-31.
[48]
Martinez A, Finegersh A, Cannon DM, et al. The 5-HT1A receptor and 5-HT transporter in temporal lobe epilepsy. Neurology 2013; 80: 1465-71.
[49]
Boccardi M, Almici M, Bresciani L, et al. Clinical and medial temporal features in a family with mood disorders. Neurosci Lett 2010; 468: 93-7.
[50]
Takahashi T, Yucel M, Lorenzetti V, et al. An MRI study of the superior temporal subregions in patients with current and past major depression. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34: 98-103.
[51]
McLellan Q, Wilkes TC, Swansburg R, Jaworska N, Langevin LM, MacMaster FP. History of suicide attempt and right superior temporal gyrus volume in youth with treatment-resistant major depressive disorder. J Affect Disord 2018; 239: 291-4.
[52]
Ma C, Ding J, Li J, et al. Resting-state functional connectivity bias of middle temporal gyrus and caudate with altered gray matter volume in major depression. PLoS One 2012; 7: e45263.
[53]
Avila R, Ribeiz S, Duran FL, et al. Effect of temporal lobe structure volume on memory in elderly depressed patients. Neurobiol Aging 2011; 32: 1857-67.
[54]
Peng H, Wu K, Li J, et al. Increased suicide attempts in young depressed patients with abnormal temporal-parietal-limbic gray matter volume. J Affect Disord 2014; 165: 69-73.
[55]
Pan LA, Ramos L, Segreti A, Brent DA, Phillips ML. Right superior temporal gyrus volume in adolescents with a history of suicide attempt. Br J Psychiatry 2015; 206: 339-40.
[56]
Gosnell SN, Velasquez KM, Molfese DL, et al. Prefrontal cortex, temporal cortex, and hippocampus volume are affected in suicidal psychiatric patients. Psychiatry Res Neuroimaging 2016; 256: 50-6.
[57]
De Brito SA, Viding E, Sebastian CL, et al. Reduced orbitofrontal and temporal grey matter in a community sample of maltreated children. J Child Psychol Psychiatry 2013; 54: 105-12.
[58]
Oudega ML, van Exel E, Wattjes MP, et al. White matter hyperintensities, medial temporal lobe atrophy, cortical atrophy, and response to electroconvulsive therapy in severely depressed elderly patients. J Clin Psychiatry 2011; 72: 104-12.
[59]
Sartorius A, Demirakca T, Bohringer A, et al. Electroconvulsive therapy increases temporal gray matter volume and cortical thickness. Eur Neuropsychopharmacol 2016; 26: 506-17.
[60]
Furtado CP, Hoy KE, Maller JJ, Savage G, Daskalakis ZJ, Fitzgerald PB. An investigation of medial temporal lobe changes and cognition following antidepressant response: A prospective rTMS study. Brain Stimul 2013; 6: 346-54.
[61]
Donix M, Haussmann R, Helling F, et al. Cognitive impairment and medial temporal lobe structure in young adults with a depressive episode. J Affect Disord 2018; 237: 112-7.
[62]
Eckart C, Stoppel C, Kaufmann J, et al. Structural alterations in lateral prefrontal, parietal and posterior midline regions of men with chronic posttraumatic stress disorder. J Psychiatry Neurosci 2011; 36: 176-86.
[63]
Teixeira S, Machado S, Velasques B, et al. Integrative parietal cortex processes: Neurological and psychiatric aspects. J Neurol Sci 2014; 338: 12-22.
[64]
Biver F, Goldman S, Delvenne V, et al. Frontal and parietal metabolic disturbances in unipolar depression. Biol Psychiatry 1994; 36: 381-8.
[65]
van Heeringen K, Wu GR, Vervaet M, Vanderhasselt MA, Baeken C. Decreased resting state metabolic activity in frontopolar and parietal brain regions is associated with suicide plans in depressed individuals. J Psychiatr Res 2017; 84: 243-8.
[66]
Stewart JL, Towers DN, Coan JA, Allen JJ. The oft-neglected role of parietal EEG asymmetry and risk for major depressive disorder. Psychophysiology 2011; 48: 82-95.
[67]
van Honk J, Schutter DJ, Putman P, de Haan EH, d’Alfonso AA. Reductions in phenomenological, physiological and attentional indices of depressive mood after 2 Hz rTMS over the right parietal cortex in healthy human subjects. Psychiatry Res 2003; 120: 95-101.
[68]
Schutter DJ, Laman DM, van Honk J, Vergouwen AC, Koerselman GF. Partial clinical response to 2 weeks of 2 Hz repetitive transcranial magnetic stimulation to the right parietal cortex in depression. Int J Neuropsychopharmacol 2009; 12: 643-50.
[69]
Schutter DJ, van Honk J, Laman M, Vergouwen AC, Koerselman F. Increased sensitivity for angry faces in depressive disorder following 2 weeks of 2-Hz repetitive transcranial magnetic stimulation to the right parietal cortex. Int J Neuropsychopharmacol 2010; 13: 1155-61.
[70]
Metzger LJ, Paige SR, Carson MA, et al. PTSD arousal and depression symptoms associated with increased right-sided parietal EEG asymmetry. J Abnorm Psychol 2004; 113: 324-9.
[71]
Nelson BD, Shankman SA. Visuospatial and mathematical dysfunction in major depressive disorder and/or panic disorder: A study of parietal functioning. Cogn Emotion 2016; 30: 417-29.
[72]
Peters AT, Van Meter A, Pruitt PJ, et al. Acute cortisol reactivity attenuates engagement of fronto-parietal and striatal regions during emotion processing in negative mood disorders. Psychoneuroendocrinology 2016; 73: 67-78.
[73]
Lai CH, Wu YT, Hou YM. Functional network-based statistics in depression: Theory of mind subnetwork and importance of parietal region. J Affect Disord 2017; 217: 132-7.
[74]
Alarcon G, Pfeifer JH, Fair DA, Nagel BJ. Adolescent gender differences in cognitive control performance and functional connectivity between default mode and fronto-parietal networks within a self-referential context. Front Behav Neurosci 2018; 12: 73.
[75]
Sambataro F, Doerig N, Hanggi J, et al. Anterior cingulate volume predicts response to psychotherapy and functional connectivity with the inferior parietal cortex in major depressive disorder. Eur Neuropsychopharmacol 2018; 28: 138-48.
[76]
Hinton EC, Wise RG, Singh KD, von Hecker U. Reasoning with linear orders: Differential parietal cortex activation in sub-clinical depression. An FMRI investigation in sub-clinical depression and controls. Front Hum Neurosci 2014; 8: 1061.
[77]
Yang XH, Wang Y, Huang J, et al. Increased prefrontal and parietal cortical thickness does not correlate with anhedonia in patients with untreated first-episode major depressive disorders. Psychiatry Res 2015; 234: 144-51.
[78]
Lai CH, Wu YT, Chen CY, Hou YC. Gray matter increases in fronto-parietal regions of depression patients with aripiprazole monotherapy: An exploratory study. Medicine 2016; 95: e4654.
[79]
Bhagwagar Z, Wylezinska M, Jezzard P, et al. Low GABA concentrations in occipital cortex and anterior cingulate cortex in medication-free, recovered depressed patients. Int J Neuropsychopharmacol 2008; 11: 255-60.
[80]
Plante DT, Jensen JE, Schoerning L, Winkelman JW. Reduced gamma-aminobutyric acid in occipital and anterior cingulate cortices in primary insomnia: a link to major depressive disorder? Neuropsychopharmacology 2012; 37: 1548-57.
[81]
Carlson PJ, Diazgranados N, Nugent AC, et al. Neural correlates of rapid antidepressant response to ketamine in treatment-resistant unipolar depression: a preliminary positron emission tomography study. Biol Psychiatry 2013; 73: 1213-21.
[82]
Cheng Y, Xu J, Arnone D, et al. Resting-state brain alteration after a single dose of SSRI administration predicts 8-week remission of patients with major depressive disorder. Psychol Med 2017; 47: 438-50.
[83]
Miskowiak KW, Kessing LV, Ott CV, et al. Does a single session of electroconvulsive therapy alter the neural response to emotional faces in depression? A randomised sham-controlled functional magnetic resonance imaging study. J Psychopharmacol 2017; 31: 1215-24.
[84]
Miskowiak KW, Svendsen AMB, Harmer CJ, et al. Differences in neural and cognitive response to emotional faces in middle-aged dizygotic twins at familial risk of depression. Psychol Med 2017; 47: 2345-57.
[85]
Gong L, He C, Yin Y, et al. Nonlinear modulation of interacting between COMT and depression on brain function. Eur Psychiatry 2017; 45: 6-13.
[86]
Mannie ZN, Harmer CJ, Cowen PJ, Norbury R. A functional magnetic resonance imaging study of verbal working memory in young people at increased familial risk of depression. Biol Psychiatry 2010; 67: 471-7.
[87]
Wang L, Li K, Zhang Q, et al. Short-term effects of escitalopram on regional brain function in first-episode drug-naive patients with major depressive disorder assessed by resting-state functional magnetic resonance imaging. Psychol Med 2014; 44: 1417-26.
[88]
Liu Y, Zhao X, Cheng Z, et al. Regional homogeneity associated with overgeneral autobiographical memory of first-episode treatment-naive patients with major depressive disorder in the orbitofrontal cortex: A resting-state fMRI study. J Affect Disord 2017; 209: 163-8.
[89]
Zhang J, Wang J, Wu Q, et al. Disrupted brain connectivity networks in drug-naive, first-episode major depressive disorder. Biol Psychiatry 2011; 70: 334-42.
[90]
Zhang B, Li S, Zhuo C, et al. Altered task-specific deactivation in the default mode network depends on valence in patients with major depressive disorder. J Affect Disord 2017; 207: 377-83.
[91]
Young KD, Bellgowan PS, Bodurka J, Drevets WC. Behavioral and neurophysiological correlates of autobiographical memory deficits in patients with depression and individuals at high risk for depression. JAMA Psychiatry 2013; 70: 698-708.
[92]
Zhong X, Pu W, Yao S. Functional alterations of fronto-limbic circuit and default mode network systems in first-episode, drug-naive patients with major depressive disorder: A meta-analysis of resting-state fMRI data. J Affect Disord 2016; 206: 280-6.
[93]
Maller JJ, Thomson RH, Rosenfeld JV, Anderson R, Daskalakis ZJ, Fitzgerald PB. Occipital bending in depression. Brain 2014; 137: 1830-7.
[94]
Korgaonkar MS, Rekshan W, Gordon E, et al. Magnetic resonance imaging measures of brain structure to predict antidepressant treatment outcome in major depressive disorder. EBioMedicine 2015; 2: 37-45.
[95]
Bergamino M, Kuplicki R, Victor TA, Cha YH, Paulus MP. Comparison of two different analysis approaches for DTI free-water corrected and uncorrected maps in the study of white matter microstructural integrity in individuals with depression. Hum Brain Mapp 2017; 38: 4690-702.
[96]
Chen Z, Peng W, Sun H, et al. High-field magnetic resonance imaging of structural alterations in first-episode, drug-naive patients with major depressive disorder. Transl Psychiatry 2016; 6: e942.
[97]
Kostic M, Canu E, Agosta F, et al. The cumulative effect of genetic polymorphisms on depression and brain structural integrity. Hum Brain Mapp 2016; 37: 2173-84.
[98]
Zhao Y, Chen L, Zhang W, et al. Gray matter abnormalities in non-comorbid medication-naive patients with major depressive disorder or social anxiety disorder. EBioMedicine 2017; 21: 228-35.
[99]
Sankar A, Zhang T, Gaonkar B, et al. Diagnostic potential of structural neuroimaging for depression from a multi-ethnic community sample. BJP Open 2016; 2: 247-54.
[100]
Zalesky A, Fornito A, Bullmore ET. Network-based statistic: Identifying differences in brain networks. Neuroimage 2010; 53: 1197-207.
[101]
Rosa MJ, Portugal L, Hahn T, et al. Sparse network-based models for patient classification using fMRI. Neuroimage 2015; 105: 493-506.