A common pattern of aberrant brain activation during emotional processing may contribute to the pathophysiology of psychiatric disorders, according to a meta-analysis published in the American Journal of Psychiatry. The results of the study point to the validity of the Research Domain Criteria initiative and suggest that neuroimaging findings may not be specific to certain psychiatric disorders.
Lisa M. McTeague, PhD, of the department of psychiatry and behavioral sciences at the Medical University of South Carolina, Charleston, and colleagues searched PubMed for whole-brain functional neuroimaging studies comparing activation during emotional processing tasks in patients with psychiatric disorders and healthy controls. The investigators conducted activation likelihood estimation (ALE) meta-analyses to identify areas of spatial convergence.
The study included populations with schizophrenia, mood disorders, anxiety, and substance use disorders; both patients with a first episode and patients with chronic disorders were included in the analysis. Tasks were grouped into 3 categories: reactivity, regulation, and compound. Overall, the researchers identified 298 experiments (n=5427 patients and n=5491 controls), with functional magnetic resonance imaging (fMRI) used in almost all experiments (N=283).
The aberrant pattern detected appeared in areas usually associated with emotional reactivity and regulation, including the amygdala extending to the hippocampal and parahippocampal gyri, the ventromedial prefrontal cortex extending to the subgenual cingulate, the right anterior insula extending to the ventrolateral prefrontal cortex, the dorsomedial and pulvinar thalamic nuclei, and the inferior occipital cortex. Most tasks involved passive reactivity, meaning these areas largely reflect activation patterns for passive viewing of unpleasant scenes and faces. Specifically, hyperactivation was identified in the amygdala and hippocampal and parahippocampal gyri, whereas hypoactivation was seen in medial and lateral prefrontal regions.
“We observed strong evidence of a transdiagnostic and domain-general emotional neurocircuit disruption, with limited diagnosis-specific effects,” the researchers noted. Overall, the abnormalities observed in the study correspond to the reward network, a lateral orbitofrontal nonreward network, and the salience network. However, limited studies for some disorders contributed to a lack of power and publication bias may favor positive findings, an enduring problem in the field of neuroimaging. In addition, the presence of comorbidities and the difficulty of establishing agreement on a principal disorder could hinder the detection of impairments unique to a particular disorder.
Nonetheless, the findings of the study point to coordinated network disruptions that affect adaptive emotional expression and regulation and these networks may prove to be effective targets for therapeutic interventions. The researchers concluded, “Taken together, these findings support the concept that psychiatric illness may be productively formulated as a dysfunction in transdiagnostic neurobehavioral phenotypes, such as neurocircuit activation, as opposed to discrete diagnoses.”
Disclosures: Multiple study authors reported conflicts of interest. Please see the original study for a full list of disclosures.
McTeague LM, Rosenberg BM, Lopez JW, et al. Identification of common neural circuit disruptions in emotional processing across psychiatric disorders. AJP in Advance. doi:10.1176/appi.ajp.2019.18111271