Title: Functional Neuroimaging of Depression: A Role for Medial Prefrontal Cortex
Abstract:Abstract Functional imaging has proved an important tool in the study of depression with studies consistently reporting abnormalities. In this chapter we consider the converging findings from a number...Abstract Functional imaging has proved an important tool in the study of depression with studies consistently reporting abnormalities. In this chapter we consider the converging findings from a number of positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) studies that critically implicate regions of the medial prefrontal cortex in depression. The medial region of prefrontal cortex is extensively interconnected with other cortical and subcortical structures. More specifically, many of the connections of this region are to structures within the classically defined limbic system, a set of structures with a fundamental role in emotional aspects of processing. The medial prefrontal cortex also projects extensively to more lateral areas of cortex involved in the control of willed action and behavior. It thus provides a plausible substrate for mediating emotional determinants of cognition and behavior that may be dysfunctional in depression. Results from lesion studies, in both animals and humans, are consistent with this proposition. Damage to the medial portion of prefrontal cortex produces a spectrum of deficits, many of which have an emotional component. Specifically, the deficits associated with medial prefrontal damage suggest that this region performs an interpretative role in response to emotional stimuli. Thus it is involved less in the experience of emotion per se and more in the incorporation of emotional factors in decision making and behavioral response. Functional imaging of normal emotional processing, including transiently induced mood changes, would also suggest that medial prefrontal regions are involved in a number of aspects of mood and emotional processing. In this chapter we will briefly review this literature before considering data from recent neuroimaging studies of depression supporting a theory that medial prefrontal cortex dysfunction is the fundamental cortical manifestation of clinical depression. The evidence suggests that medial prefrontal function is abnormal in the resting state and that this abnormality can be related to clinical features of the disorder. Further, cognitive activation studies have demonstrated that depressed patients fail to show normal activation of this region in response to cognitive challenges. Finally, we discuss evidence suggesting that medial prefrontal abnormality can be related to response to various treatments in depressed patients and, indeed, that this region may be important in predicting treatment outcomes.Read More
Publication Year: 2002
Publication Date: 2002-12-19
Language: en
Type: book-chapter
Indexed In: ['crossref']
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Cited By Count: 7
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