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Facial emotion processing in major depression a systematic review of neuroimaging findings.doc

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Facial emotion processing in major depression a systematic review of neuroimaging findings

Stuhrmannetal.BiologyofMoodAnxietyDisorders2011,1:10 /content/1/1/10 Biology of Mood Anxiety Disorders RESEARCH OpenAccess Facialemotionprocessinginmajordepression:a systematicreviewofneuroimagingfindings AnjaStuhrmann1,ThomasSuslow1,2 andUdoDannlowski1* Abstract Background:Cognitivemodelsofdepressionsuggestthatmajordepressionischaracterizedbybiasedfacial emotionprocessing,makingfacialstimuliparticularlyvaluableforneuroimagingresearchontheneurobiological correlatesofdepression.Thepresentreviewprovidesanoverviewoffunctionalneuroimagingstudiesonabnormal facialemotionprocessinginmajordepression.Ourmainobjectivewastodescribeneurobiologicaldifferences betweendepressedpatientswithmajordepressivedisorder(MDD)andhealthycontrols(HCs)regardingbrain responsivenesstofacialexpressionsand,furthermore,todelineatealteredneuralactivationpatternsassociated withmood-congruentprocessingbiasandtointegratethesedatawithrecentfunctionalconnectivityresults.We furtherdiscussmethodologicalaspectspotentiallyexplainingtheheterogeneityofresults. Methods:AMedlinesearchwasperformeduptoAugust2011inordertoidentifystudiesonemotionalface processinginacutelydepressedpatientscomparedwithHCs.Atotalof25studiesusingfunctionalmagnetic resonanceimagingwerereviewed. Results:TheanalysisofneuralactivationdatashowedabnormalitiesinMDDpatientsinacommonface processingnetwork,pointingtomood-congruentprocessingbias(hyperactivationtonegativeandhypoactivation topositivestimuli)particularlyintheamygdala,insula,parahippocampalgyrus,fusiformfacearea,andputamen. Furthermore,abnormalactivationpatternswererepeatedlyfoundinpartsofthecingulategyrusandthe orbitofrontalcortex,whichareextendedbyinvestigationsimplementingfunctionalconnectivityanalysis.However, despiteseveralconvergingfindings,someinconsistenciesareobserved,particularlyinprefrontalareas,probably causedbyheterogeneitiesinparadigmsandpatientsamples. Conclusions:Furtherstudiesinremittedpatientsandhigh-risksamplesarerequiredtodiscernwhetherthe describedabnormaliti