Right and left amygdalae activation in patients with major depression receiving antidepressant treatment, as revealed by fMRI

BACKGROUND: A differential contribution of the right and left amygdalae to affective information processing has been proposed. However, the direction of this lateralization has not been confirmed. In this study, we used a pre- and post-treatment (escitalopram) design to analyze the relative differences between neural activity in the right and left amygdalae during exposure to emotional stimuli in currently depressed patients. To the best of our knowledge, this study is to compare neural activity between the left and right amygdalae in people with depression. Our findings could lead to the development of parameters or biomarkers for depressive symptoms and treatment response. METHODS: We used a pre–post-test design without a control group. Twenty currently depressed participants underwent an emotion processing task during fMRI. These participants were then treated with an antidepressant for 6 weeks. We used amygdala region-of-interest analysis to evaluate the hemodynamic response during exposure to colored emotional pictures. RESULTS: In total, thirteen of the 20 participants were placed into a separate group based on degree of response to antidepressants. The partial response group had an averaged HDRS score of 10.75 ± 2.25 and an averaged DBOLD(LR) signal of 189.18 ± 140.23 (m(1) = 8), and the remitted group had an averaged HDRS score of 4.80 ± 1.64 and an averaged DBOLD(LR) signal of 421.26 ± 109.19 (m(2) = 5). Each individual had lateralized amygdala activity, and the direction of asymmetry persisted following treatment. Amygdala responses to four types of emotional stimuli did not significantly change (p > 0.05) with treatment in either the right or the left amygdala. However, the difference in neural activity between the right and left amygdalae was greater after treatment, and the variation in neural activity was larger in the left amygdala. CONCLUSIONS: We found that the response between the right and left amygdala did not differ in terms of time series, although activity increased after pharmaceutical treatment for each emotion tested. In the future, changes in BOLD signals as revealed by fMRI might be useful in evaluating the clinical manifestation of major depression.