The Course of Disease in Major Depressive Disorder Is Associated With Altered Activity of the Limbic System During Negative Emotion Processing

Hannah Lemke; Stefanie Probst; Antonia Warneke; Lena Waltemate; Alexandra Winter; Katharina Thiel; Susanne Meinert; Verena Enneking; Fabian Breuer; Melissa Klug; Janik Goltermann; Carina Hülsmann; Dominik Grotegerd; Ronny Redlich; Katharina Dohm; Elisabeth J Leehr; Jonathan Repple; Nils Opel; Katharina Brosch; Tina Meller; Julia-Katharina Pfarr; Kai Ringwald; Simon Schmitt; Frederike Stein; Axel Krug; Andreas Jansen; Igor Nenadic; Tilo Kircher; Tim Hahn; Udo Dannlowski

doi:10.1016/j.bpsc.2021.05.008

The Course of Disease in Major Depressive Disorder Is Associated With Altered Activity of the Limbic System During Negative Emotion Processing

Biol Psychiatry Cogn Neurosci Neuroimaging. 2022 Mar;7(3):323-332. doi: 10.1016/j.bpsc.2021.05.008. Epub 2021 Jun 5.

Authors

Hannah Lemke¹, Stefanie Probst¹, Antonia Warneke¹, Lena Waltemate¹, Alexandra Winter¹, Katharina Thiel¹, Susanne Meinert¹, Verena Enneking¹, Fabian Breuer¹, Melissa Klug¹, Janik Goltermann¹, Carina Hülsmann¹, Dominik Grotegerd¹, Ronny Redlich², Katharina Dohm¹, Elisabeth J Leehr¹, Jonathan Repple¹, Nils Opel³, Katharina Brosch⁴, Tina Meller⁴, Julia-Katharina Pfarr⁴, Kai Ringwald⁴, Simon Schmitt⁴, Frederike Stein⁴, Axel Krug⁵, Andreas Jansen⁴, Igor Nenadic⁴, Tilo Kircher⁴, Tim Hahn¹, Udo Dannlowski⁶

Affiliations

¹ Institute for Translational Psychiatry, University of Münster, Münster, Germany.
² Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychology, University of Halle, Halle, Germany.
³ Institute for Translational Psychiatry, University of Münster, Münster, Germany; Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Münster, Germany.
⁴ Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany.
⁵ Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
⁶ Institute for Translational Psychiatry, University of Münster, Münster, Germany. Electronic address: udo.dannlowski@uni-muenster.de.

PMID: 34102346
DOI: 10.1016/j.bpsc.2021.05.008

Abstract

Background: Brain functional alterations during emotion processing in patients with major depressive disorder (MDD) compared with healthy control subjects (HCs) are frequently reported. However, evidence for functional correlates of emotion processing with regard to MDD trajectories is scarce. This study investigates the role of lifetime disease course for limbic brain activation during negative emotional face processing in patients with MDD.

Methods: In a large sample of patients with MDD (n = 333; 58.55% female) and HCs (n = 333; 60.06% female), brain activation was investigated during a negative emotional face-processing task within a cross-sectional design. Differences between HC and MDD groups were analyzed. Previous disease course, characterized by 2 components, namely hospitalization and duration of illness, was regressed on brain activation of the amygdala, (para-)hippocampus, and insula in patients with MDD.

Results: Patients with MDD showed increased activation in the amygdala, insula, and hippocampus compared with HCs (all p values corrected for familywise error [p_FWE] < .045). The hospitalization component showed negative associations with brain activation in the bilateral insula (right: p_FWE = .026, left: p_FWE = .019) and (para-)hippocampus (right: p_FWE = .038, left: p_FWE = .031). No significant association was found for the duration of illness component (all p_FWE > .057).

Conclusions: This study investigated negative emotion processing in a large sample of patients with MDD and HCs. Our results confirm limbic hyperactivation in patients with MDD during negative emotion processing; however, this hyperactivation may resolve with a more severe lifetime disease course in the insula and (para-)hippocampus-brain regions involved in emotion processing and regulation. These findings need further replication in longitudinal studies.

Keywords: (Para-)hippocampus; Amygdala; Depression; Disease course; Functional magnetic resonance imaging; Insula.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Depressive Disorder, Major*
Emotions / physiology
Female
Humans
Limbic System
Magnetic Resonance Imaging
Male