Connections in Anterior Cingulate Regions Contribute to Persistent Sadness in Major Depressive Disorder

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Participants with major depressive disorder had stronger connections with their overall emotional experiences vs controls, which is indicative of greater inflexibility in their emotions, including sadness and avoidance.

The functional connectivity of certain brain regions is associated with day-to-day negative emotions experienced by individuals with major depressive disorder, according to a study published in the Journal of Affective Disorders.

The investigators of this study sought to characterize the relationship between the functional connectivity of the anterior cingulate cortex and the inflexibility and maintenance of negative emotions in major depressive disorder.

The study sample included 33 adults with major depressive disorder and a control group of 31 never-depressed adults. The participants completed the Beck Depression Inventory-II and the Beck Anxiety Inventory and underwent a resting-state MRI scan. Following the MRI scan, participants were prompted 5 times a day for 21 days to complete a smartphone-based Experience Sampling Methodology (ESM) survey with 18 questions about positive and negative emotions. Hierarchical linear modeling was used to calculate overall emotional inflexibility by estimating the strength of temporal connections with emotional ESM items. Groups were analyzed for differences in functional connectivity defined in bilateral regions of the subgenual anterior cingulate cortex; associations between functional connectivity values and emotional experiences were further assessed for each group.

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Participants with major depressive disorder showed significantly stronger connections with their overall emotional experiences vs controls; this indicates that individuals with major depressive disorder exhibit greater inflexibility in their emotions, including sadness and avoidance (P <.001). Functional connectivity between the right-side subgenual anterior cingulate cortex and pregenual/dorsal anterior cingulate cortex was weaker in the group with major depressive disorder vs the control group. Notably, connectivity between the right-side subgenual anterior cingulate and pregenual/dorsal anterior cingulate regions was found to predict inflexibility of sadness in both individuals with depression (P =.046) and individuals without depression (P =.033), indicating that this region is associated with day-to-day negative emotions.

A limitation included other maladaptive behaviors not assessed by this study, such as poor sleep quality,that may have affected the flexibility and maintenance of negative emotions. Furthermore, the association between subgenual anterior cingulate cortex functional connectivity and inflexibility of sadness cannot be generalized to individuals who have recovered from depression.

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Individuals with major depressive disorder exhibited greater inflexibility in emotions, including sadness and avoidance, and the investigators suggest that connections between anterior cingulate regions contribute to the persistence of negative emotions in depression.

Reference

Schwartz J, Ordaz SJ, Kircanski K, et al. Resting-state functional connectivity and inflexibility of daily emotions in major depression [published online February 6, 2019]. J Affect Disord. doi: 10.1016/j.jad.2019.01.040