Increased prefrontal cortex activity during negative emotion regulation as a predictor of depression symptom severity trajectory over 6 months

Aaron Heller, Tom Johnstone, Michael J. Peterson, Gregory G. Kolden, Ned H. Kalin, Richard J. Davidson

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

IMPORTANCE: Emotion regulation is critically disrupted in depression, and the use of paradigms that tap into these processesmay uncover essential changes in neurobiology during treatment. In addition, because neuroimaging outcome studies of depression commonly use only baseline and end-point data - which are more prone to week-to-week noise in symptomatology - we sought to use all data points over the course of a 6-month trial. OBJECTIVE: To examine changes in neurobiology resulting from successful treatment. DESIGN, SETTING, AND PARTICIPANTS: Double-blind trial examining changes in the neural circuits involved in emotion regulation resulting from 1 of 2 antidepressant treatments during a 6-month trial. Twenty-one patients with major depressive disorder and without other Axis I or Axis II diagnoses were scanned before treatment and 2 and 6 months into treatment at the university's functional magnetic resonance imaging facility. INTERVENTIONS: Venlafaxine hydrochloride extended release (with doses of up to 300 mg) or fluoxetine hydrochloride (with doses of up to 80 mg). MAIN OUTCOMES AND MEASURES: Neural activity, as measured using functional magnetic resonance imaging during performance of an emotion regulation paradigm, as well as regular assessments of symptom severity using the Hamilton Depression Rating Scale. For use of all data points, slope trajectories were calculated for rate of change in depression severity and for rate of change in neural engagement. RESULTS: The depressed individuals who showed the steepest decrease in depression severity over the 6-month period were the same individuals who showed the most rapid increases in activity in Brodmann area 10 and the right dorsolateral prefrontal cortex activity when regulating negative affect over the same time frame. This relationship was more robust when using only the baseline and end-point data. CONCLUSIONS AND RELEVANCE: Changes in prefrontal cortex engagement when regulating negative affect correlate with changes in depression severity over 6 months. These results are buttressed by calculating these statistics, which are more reliable and robust to week-to-week variation than are difference scores.

Original languageEnglish (US)
Pages (from-to)1181-1189
Number of pages9
JournalJAMA Psychiatry
Volume70
Issue number11
DOIs
StatePublished - 2013
Externally publishedYes

Fingerprint

Prefrontal Cortex
Emotions
Depression
Neurobiology
Magnetic Resonance Imaging
Outcome Assessment (Health Care)
Therapeutics
Symptom Assessment
Fluoxetine
Major Depressive Disorder
Neuroimaging
Antidepressive Agents
Noise

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Increased prefrontal cortex activity during negative emotion regulation as a predictor of depression symptom severity trajectory over 6 months. / Heller, Aaron; Johnstone, Tom; Peterson, Michael J.; Kolden, Gregory G.; Kalin, Ned H.; Davidson, Richard J.

In: JAMA Psychiatry, Vol. 70, No. 11, 2013, p. 1181-1189.

Research output: Contribution to journalArticle

Heller, Aaron ; Johnstone, Tom ; Peterson, Michael J. ; Kolden, Gregory G. ; Kalin, Ned H. ; Davidson, Richard J. / Increased prefrontal cortex activity during negative emotion regulation as a predictor of depression symptom severity trajectory over 6 months. In: JAMA Psychiatry. 2013 ; Vol. 70, No. 11. pp. 1181-1189.
@article{61a4cb3a70c240fcbc336f58ec8b9d37,
title = "Increased prefrontal cortex activity during negative emotion regulation as a predictor of depression symptom severity trajectory over 6 months",
abstract = "IMPORTANCE: Emotion regulation is critically disrupted in depression, and the use of paradigms that tap into these processesmay uncover essential changes in neurobiology during treatment. In addition, because neuroimaging outcome studies of depression commonly use only baseline and end-point data - which are more prone to week-to-week noise in symptomatology - we sought to use all data points over the course of a 6-month trial. OBJECTIVE: To examine changes in neurobiology resulting from successful treatment. DESIGN, SETTING, AND PARTICIPANTS: Double-blind trial examining changes in the neural circuits involved in emotion regulation resulting from 1 of 2 antidepressant treatments during a 6-month trial. Twenty-one patients with major depressive disorder and without other Axis I or Axis II diagnoses were scanned before treatment and 2 and 6 months into treatment at the university's functional magnetic resonance imaging facility. INTERVENTIONS: Venlafaxine hydrochloride extended release (with doses of up to 300 mg) or fluoxetine hydrochloride (with doses of up to 80 mg). MAIN OUTCOMES AND MEASURES: Neural activity, as measured using functional magnetic resonance imaging during performance of an emotion regulation paradigm, as well as regular assessments of symptom severity using the Hamilton Depression Rating Scale. For use of all data points, slope trajectories were calculated for rate of change in depression severity and for rate of change in neural engagement. RESULTS: The depressed individuals who showed the steepest decrease in depression severity over the 6-month period were the same individuals who showed the most rapid increases in activity in Brodmann area 10 and the right dorsolateral prefrontal cortex activity when regulating negative affect over the same time frame. This relationship was more robust when using only the baseline and end-point data. CONCLUSIONS AND RELEVANCE: Changes in prefrontal cortex engagement when regulating negative affect correlate with changes in depression severity over 6 months. These results are buttressed by calculating these statistics, which are more reliable and robust to week-to-week variation than are difference scores.",
author = "Aaron Heller and Tom Johnstone and Peterson, {Michael J.} and Kolden, {Gregory G.} and Kalin, {Ned H.} and Davidson, {Richard J.}",
year = "2013",
doi = "10.1001/jamapsychiatry.2013.2430",
language = "English (US)",
volume = "70",
pages = "1181--1189",
journal = "JAMA Psychiatry",
issn = "2168-622X",
publisher = "American Medical Association",
number = "11",

}

TY - JOUR

T1 - Increased prefrontal cortex activity during negative emotion regulation as a predictor of depression symptom severity trajectory over 6 months

AU - Heller, Aaron

AU - Johnstone, Tom

AU - Peterson, Michael J.

AU - Kolden, Gregory G.

AU - Kalin, Ned H.

AU - Davidson, Richard J.

PY - 2013

Y1 - 2013

N2 - IMPORTANCE: Emotion regulation is critically disrupted in depression, and the use of paradigms that tap into these processesmay uncover essential changes in neurobiology during treatment. In addition, because neuroimaging outcome studies of depression commonly use only baseline and end-point data - which are more prone to week-to-week noise in symptomatology - we sought to use all data points over the course of a 6-month trial. OBJECTIVE: To examine changes in neurobiology resulting from successful treatment. DESIGN, SETTING, AND PARTICIPANTS: Double-blind trial examining changes in the neural circuits involved in emotion regulation resulting from 1 of 2 antidepressant treatments during a 6-month trial. Twenty-one patients with major depressive disorder and without other Axis I or Axis II diagnoses were scanned before treatment and 2 and 6 months into treatment at the university's functional magnetic resonance imaging facility. INTERVENTIONS: Venlafaxine hydrochloride extended release (with doses of up to 300 mg) or fluoxetine hydrochloride (with doses of up to 80 mg). MAIN OUTCOMES AND MEASURES: Neural activity, as measured using functional magnetic resonance imaging during performance of an emotion regulation paradigm, as well as regular assessments of symptom severity using the Hamilton Depression Rating Scale. For use of all data points, slope trajectories were calculated for rate of change in depression severity and for rate of change in neural engagement. RESULTS: The depressed individuals who showed the steepest decrease in depression severity over the 6-month period were the same individuals who showed the most rapid increases in activity in Brodmann area 10 and the right dorsolateral prefrontal cortex activity when regulating negative affect over the same time frame. This relationship was more robust when using only the baseline and end-point data. CONCLUSIONS AND RELEVANCE: Changes in prefrontal cortex engagement when regulating negative affect correlate with changes in depression severity over 6 months. These results are buttressed by calculating these statistics, which are more reliable and robust to week-to-week variation than are difference scores.

AB - IMPORTANCE: Emotion regulation is critically disrupted in depression, and the use of paradigms that tap into these processesmay uncover essential changes in neurobiology during treatment. In addition, because neuroimaging outcome studies of depression commonly use only baseline and end-point data - which are more prone to week-to-week noise in symptomatology - we sought to use all data points over the course of a 6-month trial. OBJECTIVE: To examine changes in neurobiology resulting from successful treatment. DESIGN, SETTING, AND PARTICIPANTS: Double-blind trial examining changes in the neural circuits involved in emotion regulation resulting from 1 of 2 antidepressant treatments during a 6-month trial. Twenty-one patients with major depressive disorder and without other Axis I or Axis II diagnoses were scanned before treatment and 2 and 6 months into treatment at the university's functional magnetic resonance imaging facility. INTERVENTIONS: Venlafaxine hydrochloride extended release (with doses of up to 300 mg) or fluoxetine hydrochloride (with doses of up to 80 mg). MAIN OUTCOMES AND MEASURES: Neural activity, as measured using functional magnetic resonance imaging during performance of an emotion regulation paradigm, as well as regular assessments of symptom severity using the Hamilton Depression Rating Scale. For use of all data points, slope trajectories were calculated for rate of change in depression severity and for rate of change in neural engagement. RESULTS: The depressed individuals who showed the steepest decrease in depression severity over the 6-month period were the same individuals who showed the most rapid increases in activity in Brodmann area 10 and the right dorsolateral prefrontal cortex activity when regulating negative affect over the same time frame. This relationship was more robust when using only the baseline and end-point data. CONCLUSIONS AND RELEVANCE: Changes in prefrontal cortex engagement when regulating negative affect correlate with changes in depression severity over 6 months. These results are buttressed by calculating these statistics, which are more reliable and robust to week-to-week variation than are difference scores.

UR - http://www.scopus.com/inward/record.url?scp=84888405660&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84888405660&partnerID=8YFLogxK

U2 - 10.1001/jamapsychiatry.2013.2430

DO - 10.1001/jamapsychiatry.2013.2430

M3 - Article

VL - 70

SP - 1181

EP - 1189

JO - JAMA Psychiatry

JF - JAMA Psychiatry

SN - 2168-622X

IS - 11

ER -