Changes in brain function during negative emotion processing in the long-term course of depression
Verena Enneking, Melissa Klug, Tiana Borgers, Katharina Dohm, Dominik Grotegerd, Lisa Marie Frankenberger, Carina Hülsmann, Hannah Lemke, Susanne Meinert, Elisabeth J. Leehr, Nils Opel, Janik Goltermann, Maike Richter, Lena Waltemate, Joscha Böhnlein, Lisa Sindermann, Jonathan Repple, Jochen Bauer, Mareike Thomas, Udo Dannlowski, Ronny Redlich
Abstract
Background Relapses in major depression are frequent and are associated with a high burden of disease. Although short-term studies suggest a normalisation of depression-associated brain functional alterations directly after treatment, long-term investigations are sparse. Aims To examine brain function during negative emotion processing in association with course of illness over a 2-year span. Method In this prospective case–control study, 72 in-patients with current depression and 42 healthy controls were investigated during a negative emotional face processing paradigm, at baseline and after 2 years. According to their course of illness during the study interval, patients were divided into subgroups ( n = 25 no-relapse, n = 47 relapse). The differential changes in brain activity were investigated by a group × time analysis of covariance for the amygdala, hippocampus, insula and at whole-brain level. Results A significant relapse × time interaction emerged within the amygdala ( P TFCE-FWE = 0.011), insula ( P TFCE-FWE = 0.001) and at the whole-brain level mainly in the temporal and prefrontal cortex ( P TFCE-FWE = 0.027), resulting from activity increases within the no-relapse group, whereas in the relapse group, activity decreased during the study interval. At baseline, the no-relapse group showed amygdala, hippocampus and insula hypoactivity compared with healthy controls and the relapse group. Conclusions This study reveals course of illness-associated activity changes in emotion processing areas. Patients in full remission show a normalisation of their baseline hypo-responsiveness to the activation level of healthy controls after 2 years. Brain function during emotion processing could further serve as a potential predictive marker for future relapse.