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J Affect Disord. 2018 Nov;240:155-164. doi: 10.1016/j.jad.2018.07.020. Epub 2018 Jul 19.

An exploratory examination of reappraisal success in depressed adolescents: Preliminary evidence of functional differences in cognitive control brain regions.

Author information

1
Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA. Electronic address: kaja.lewinn@ucsf.edu.
2
Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; San Francisco VAHS, San Francisco, CA, USA.
3
Department of Biomedical Sciences, Florida State University, Tallahassee, FL, USA.
4
Department Psychiatry and the Behavioral Sciences, Stanford University, CA, USA; Department of Psychology, Stanford University, CA, USA.
5
Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
6
Department Psychiatry and the Behavioral Sciences, Stanford University, CA, USA.
7
Osher Center for Integrative Medicine, University of California, San Francisco, CA, USA.
8
Umea University, Sweden.
9
San Diego VA HCS and University of California, San Diego, CA, USA.
10
Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.

Abstract

BACKGROUND:

Most neuroimaging studies of adolescent depression employ tasks not designed to engage brain regions necessary for the cognitive control of emotion, which is central to many behavioral therapies for depression. Depressed adults demonstrate less effective activation of these regions and greater amygdala activation during cognitive reappraisal; we examined whether depressed adolescents show similar patterns of brain activation.

METHODS:

We collected functional magnetic resonance imaging (fMRI) data during cognitive reappraisal in 41 adolescents with major depressive disorder (MDD) and 34 matched controls (ages 13-17). We examined group differences in (1) activations associated with reappraisal and reappraisal success (i.e., negative affect reduction during reappraisal) using whole brain and amygdala region-of-interest analyses, and (2) functional connectivity of regions from the group-by-reappraisal success interaction.

RESULTS:

We found no significant group differences in whole brain or amygdala analyses during reappraisal. In the group-by-reappraisal success interaction, activations in the left dorsomedial prefrontal cortex (dmPFC) and left dorsolateral PFC (dlPFC) were associated with reappraisal success in healthy controls but not depressed adolescents. Depressed adolescents demonstrated reduced connectivity between the left dmPFC and the anterior insula/inferior frontal gyri bilaterally (AI/IFG) and between left dlPFC and left AI/IFG.

LIMITATIONS:

Our results should be considered exploratory given our less conservative statistical threshold in the group-by-reappraisal interaction.

CONCLUSIONS:

We find preliminary evidence that depressed adolescents engage cognitive control regions less efficiently than healthy controls, suggesting delayed maturation of regulatory prefrontal cortex regions; more research is needed to determine whether cognitive therapies improve functioning of these regions in depressed youth.

KEYWORDS:

Adolescence; Cognitive reappraisal; Depression; Emotion regulation; FMRI

PMID:
30071419
DOI:
10.1016/j.jad.2018.07.020

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