Depression, sadness
yield brain link
By B. Bower
Major depression includes not only feelings of intense sadness and
despair but also a wandering, indecisive train of thought. Distinct
brain areas involved in emotion and attention together foster both depression
and ordinary bouts of sadness, according to a new study.
Specific changes in these neural regions accompany recovery from major
depression, whether achieved with an antidepressant drug or placebo
pills, says a team of neuroscientists led by Helen S. Mayberg of the
Rotman Research Institute in Toronto.
"The negative influence of depressed mood on attention is probably
due to functional connections between these two brain regions," Mayberg
says. "Successful treatment, including placebo use, alters those connections."
Mayberg's group first took positron emission tomography (PET) scans
of eight women resting and after recalling a sad personal experience.
The PET scans measured blood-flow changes in their brains, an indirect
sign of boosts or drops in brain-cell activity. None of the women or
their family members had been diagnosed with mood disorders.
In a second trial, the researchers took PET scans of eight men before
and after successful treatment for major depression. Over 6 weeks, four
men had improved after taking the antidepressant drug fluoxetine (Prozac);
the rest had rallied in response to pills that they thought might be
antidepressants but that contained no active ingredients.
When the women recalled sad experiences, blood-flow surged in a pair
of the inner brain structures that regulate emotional responses and
declined in two parts of the brain's outer layer previously linked to
attention, the team reports in the May American Journal of Psychiatry.
The men who had recovered from depression showed unusually high activity
in the two attention areas and low activity in the emotion areas.
Before recovery, however, the depressed men had exhibited marked overactivity
in only one of the two emotion-related areas characteristic of brief
sadness in the women. Further research will examine more closely the
processes that occur during depression, Mayberg says.
The findings suggest that a brain circuit incorporating emotion and
attention "offers a plausible converging point" for antidepressant effects
of drugs and psychotherapy, remark psychiatrist Charles B. Nemeroff
of Emory University School of Medicine in Atlanta and his coworkers
in an accompanying editorial.
Researchers haven't yet explored brain function in the substantial
minority of depressed people who don't benefit from treatment, Mayberg
adds.