Critical to the development of deep brain stimulation (DBS) as a novel therapy for patients with treatment resistant depression has been the characterization of brain systems mediating normal and abnormal mood states as well as those mediating successful and unsuccessful response to various antidepressant interventions using functional neuroimaging. The theoretical and data-driven foundation for this new treatment strategy will be presented including ongoing efforts to further delineate critical pathways and mechanisms mediating antidepressant effects of DBS. 

 

 

 

 

 

A series of brain imaging experiments support the notion that higher-cortical areas, such as the ventromedial prefrontal cortex, control behaviour when the degree of threat is appraised as
non- life endangering and guides the organism to choose the most effective strategy for avoidance. At extreme levels of threat, the periaqueductal gray may in turn inhibit more complex processes when a fast response is required, preparing the organism for tissue damage and survival through active (e.g. flight) and passive (e.g. freezing) coping. Are these distal and proximal fear networks part of an intelligent system where the primary goal is threat avoidance and survival?

 

 

 

Depression is one of the most prevalent psychiatric disorders and a leading cause of disability worldwide. While the defining clinical features of depression relate to disordered mood, cognitive problems are also very common symptoms. In particular, people with depression experience problems in situations requiring the integration of “hot” emotional information with “cold” cognitive information.
Recent work on neurocognitive aspects of depression has focused on the interface between emotion and cognition, identifying deficits in aspects including emotion recognition, attention to and memory for emotional material and social and moral emotion processing. This talk will consider the evidence that these deficits are central to and selective for depression.
Functional imaging techniques allow us to explore the brain mechanisms underpinning these affective cognitive deficits. This talk will also discuss recent neuroimaging studies suggesting key roles for limbic and medial prefrontal structures in mediating affective cognitive abnormalities in depression. Finally, evidence will be reviewed suggesting that these neurocognitive markers may represent important targets for both pharmacological and psychological treatments.