A review of fMRI studies during visual emotive processing in major depressive disorder

OBJECTIVES: This review synthesized literature on brain activity, indexed by functional magnetic resonance imaging (fMRI), during visual affective information processing in major depressive disorder (MDD). Activation was examined in regions consistently implicated in emotive processing, including the anterior cingulate cortex (ACC), prefrontal cortex (PFC), amygdala, thalamus/basal ganglia and hippocampus. We also reviewed the effects of antidepressant interventions on brain activity during emotive processing. METHODS: Sixty-four fMRI studies investigating neural activity during visual emotive information processing in MDD were included. RESULTS: Evidence indicates increased ventro-rostral ACC activity to emotive stimuli and perhaps decreased dorsal ACC activity in MDD. Findings are inconsistent for the PFC, though medial PFC hyperactivity tends to emerge to emotive information processing in the disorder. Depressed patients display increased amygdala activation to negative and arousing stimuli. MDD may also be associated with increased activity to negative, and decreased activity to positive, stimuli in basal ganglia/thalamic structures. Finally, there may be increased hippocampus activation during negative information processing. Typically, antidepressant interventions normalize these activation patterns. CONCLUSION: In general, depressed patients have increased activation to emotive, especially negative, visual stimuli in regions involved in affective processing, with the exception of certain PFC regions; this pattern tends to normalize with treatment.