Neuropsychological mechanism underlying antidepressant effect: a systematic meta-analysis

Antidepressants are widely used in clinical practice for the treatment of depression and other mood disorders. Numerous neuroimaging studies have recently examined how antidepressants influence emotional processes. However, both clinical trials and neuroimaging studies have reported inconsistent res...

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Bibliographic Details
Published in:Molecular psychiatry 2015-03, Vol.20 (3), p.311-319
Main Author: Ma, Y
Format: Article
Language:English
Subjects:
631/378/340
631/92/436/2388
692/699/476
Amygdala
Animals
Antidepressants
Antidepressive Agents - therapeutic use
Attentional bias
Behavioral Sciences
Biological Psychology
Brain
Brain mapping
Clinical trials
Cognition Disorders - etiology
Depression (Mood disorder)
Diagnosis
Drug therapy
Emotions
Functional magnetic resonance imaging
Genetic aspects
Health aspects
Humans
Image processing
Medical imaging
Medicine
Medicine & Public Health
Mental depression
Mesencephalon
Meta-analysis
Mood
Mood Disorders - complications
Mood Disorders - drug therapy
Neuroimaging
Neuropsychological Tests
Neurosciences
Nucleus accumbens
original-article
Patients
Pharmacotherapy
Physiological aspects
Prefrontal Cortex - pathology
Psychiatry
Putamen
Risk factors
Systematic review
Thalamus
Tricyclic antidepressants
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Summary:Antidepressants are widely used in clinical practice for the treatment of depression and other mood disorders. Numerous neuroimaging studies have recently examined how antidepressants influence emotional processes. However, both clinical trials and neuroimaging studies have reported inconsistent responses to antidepressants. Moreover, the neuropsychological mechanisms by which antidepressants act to improve depressive features remain underspecified. This systematic meta-analysis summarizes pharmacological neuroimaging studies (before February 2013) and the antidepressant effects on human brain activity underlying emotional processes. Sixty fMRI studies (involving 1569 subjects) applying antidepressants vs control were included in the current quantitative Activation Likelihood Estimation (ALE) meta-analysis. Pooling of results by ALE meta-analyses was stratified for population (mood disorder patients/healthy volunteers), emotional valence (positive/negative emotions) and treatment effects (increased/decreased brain activity). For both patients and healthy volunteers, the medial prefrontal and core limbic parts of the emotional network (for example, anterior cingulate, amygdala and thalamus) were increased in response to positive emotions but decreased to negative emotions by repeated antidepressant administration. Moreover, selective antidepressant effects were uncovered in patients and healthy volunteers, respectively. Antidepressants increased activity in the dorsolateral prefrontal (dlPFC), a key region mediating emotion regulation, during both negative and positive emotions in patients. Repeated antidepressant administration decreased brain responses to positive emotions in the nucleus accumbens, putamen, medial prefrontal and midbrain in healthy volunteers. Antidepressants act to normalize abnormal neural responses in depressed patients by increasing brain activity to positive stimuli and decreasing activity to negative stimuli in the emotional network, and increasing engagement of the regulatory mechanism in dlPFC.
ISSN:1359-4184
1476-5578
DOI:10.1038/mp.2014.24