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The neural basis of the depressive self
Date:8/31/2010

Depression is actually defined by specific clinical symptoms such as sadness, difficulty to experience pleasure, sleep problems etc., present for at least two weeks, with impairment of psychosocial functioning. These symptoms guide the physician to make a diagnosis and to select antidepressant treatment such as drugs or psychotherapy.

At least 40% of depressed patients actually benefit from antidepressant treatment, whereas 20-30% of patients may suffer from chronic depression that negatively impacts their quality of life. In order to improve the efficiency of treatment and reduce the burden of depressive disorders, depression clearly needs to be defined at the neurobiological level.

Role of neurobiological markers in depression

Current research efforts are devoted to the study of the neural bases of depression and treatment induced changes using modern brain imaging techniques such as functional Magnetic Resonance Imaging (fMRI). Since many years it has become clear that depression is associated with dysfunction of specific brain regions involved in cognitive control and emotional response.

A recent fMRI-study showed that depressed patients had an abnormal activation of the medial prefrontal cortex (Figure 1; Lemogne et al. 2009). During this study, subjects had to judge whether personality traits described them or not (i.e. 'Am I selfish?'), or whether it described a generally desirable trait or not (i.e. 'Is it good or bad to be greedy?'). The dysfunction of the medial prefrontal region may explain specific complaints of depressed patients such as self-blame, rumination and feeling of guilt.

It was observed that this activation pattern was maintained over the course of depression after 8 weeks of antidepressant treatment. These results are difficult to interpret but suggest that, after remission of depression, some patients show persistent abnormalities of specific brain regions. Such abnormalities may in
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Contact: Sonja Mak
s.mak@update.europe.at
431-405-5734
European College of Neuropsychopharmacology
Source:Eurekalert

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