Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-27T19:53:41.330Z Has data issue: false hasContentIssue false

6 - Structural and functional brain imaging in treatment-resistant depression

from Part II - Biological basis

Published online by Cambridge University Press:  25 March 2010

Jay D. Amsterdam
Affiliation:
University of Pennsylvania
Mady Hornig
Affiliation:
University of California, Irvine
Andrew A. Nierenberg
Affiliation:
Harvard Medical School
Get access

Summary

Introduction

Mood disorders are a heterogeneous group of illnesses which vary in clinical features such as symptoms, severity, and longitudinal course. Emerging research suggests that clinical diversity reflects biologic heterogeneity, and this notion is supported by the fact that the effectiveness of treatments can vary markedly across patients. Methods to more effectively target therapeutics in treatment-resistant mood disorder patients are sorely needed. In this chapter we consider the insights that structural and functional brain imaging methods have offered into the neural substrates of affective processes as well as the current and possible future utility of these methods in the evaluation and management of patients with treatmentresistant mood disorders.

The neuroanatomy of affective processes

Neuroanatomic models

Neuroanatomic models of the substrates of affective processes were originally derived from non-human animal studies in addition to postmortem and in vivo studies of humans with brain trauma, neurologic, and psychiatric disorders. More recently, brain imaging studies of healthy volunteers and mood disorder patients have helped refine models of healthy and pathologic affective processes.

Midline cerebral structures have long been considered possible mediators of affective experiences. Over a century ago, Broca defined the great limbic lobe as a midline cortical limbus (border or ring) around the brainstem in mammals (Broca, 1878). In 1937 Papez proposed a corticothalamic mechanism of emotion in which the hypothalamus was the origin of emotional impulses, that were sent to mamillary body, thence to anterior thalamus, and then on to cingulate, which through cortical projections could add affective valence to various cerebral processes (Papez, 1937).

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×