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Blunted amygdala activity is associated with depression severity in treatment-resistant depression.

Jamie M Ferri, Stuart J. Eisendrath, Susanna L Fryer, Erin P Gillung, Brian J Roach, Daniel H. Mathalon

Cognitive, Affective, & Behavioral Neuroscience December 2017 DOI: 10.3758/s13415-017-0544-6 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Longitudinal Peer reviewed
Sample size 117
Population Adults with treatment-resistant major depressive disorder (n = 80) and healthy controls (n = 37)
Interventions Mindfulness-based cognitive therapy (MBCT) Health enhancement program (HEP)
Duration 8-week intervention with 52-week follow-up
Topics Depression
Keywords Affect labeling Amygdala Emotion Faces Mindfulness-based cognitive therapy
Key findings TRD patients showed blunted amygdala activation during affect labeling compared with healthy controls, and this blunting was associated with greater depression severity. MBCT produced greater short-term depression reductions than HEP, but the advantage was not significant at 52 weeks; baseline amygdala reactivity predicted long-term depression severity in both groups.

Abstract

Up to 50% of individuals with major depressive disorder (MDD) do not recover after two antidepressant medication trials, and therefore meet the criteria for treatment-resistant depression (TRD). Mindfulness-based cognitive therapy (MBCT) is one promising treatment; however, the extent to which MBCT influences clinical outcomes relative to baseline neural activation remains unknown. In the present study we investigated baseline differences in amygdala activation between TRD patients and healthy controls (HCs), related amygdala activation to depression symptoms, and examined the impacts of MBCT and amygdala activation on longitudinal depression outcomes. At baseline, TRD patients (n = 80) and HCs (n = 37) participated in a functional magnetic resonance imaging task in which they identified either the emotion (affect labeling) or the gender (gender labeling) of faces, or passively viewed faces (observing). The TRD participants then completed eight weeks of MBCT or a health enhancement program (HEP). Relative to HCs, the TRD patients demonstrated less amygdala activation during affect labeling, and marginally less during gender labeling. Blunted amygdala activation in TRD patients during affect labeling was associated with greater depression severity. MBCT was associated with greater depression reductions than was HEP directly following treatment; however, at 52 weeks the treatment effect was not significant, and baseline amygdala activation across the task conditions predicted depression severity in both groups. TRD patients have blunted amygdala responses during affect labeling that are associated with greater concurrent depression. Furthermore, although MBCT produced greater short-term improvements in depression than did HEP, overall baseline amygdala reactivity was predictive of long-term clinical outcomes in both groups.

Comparable studies

Other randomized controlled trials on depression, most cited first.

Study Year Design Participants
A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Subjects with DSM-IV major depression (treatment resistant) 2006 Randomized, placebo-controlled, double-blind crossover study n = 18
Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients 2000 Randomized controlled trial n = 145
Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety 2016 Randomized controlled trial n = 51
Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Patients with cancer-related anxiety and depression 2016 Double-blind, placebo-controlled, crossover trial n = 29
Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients 2004 Randomized controlled trial n = 73

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