
Am J Psychiatry 156:675-682, May 1999
© 1999 American Psychiatric Association
Reciprocal Limbic-Cortical Function and Negative Mood: Converging PET Findings in Depression and Normal Sadness
Helen S. Mayberg, M.D.,
Mario Liotti, M.D., Ph.D.,
Stephen K. Brannan, M.D.,
Scott McGinnis, B.S.,
Roderick K. Mahurin, Ph.D.,
Paul A. Jerabek, Ph.D.,
J. Arturo Silva, M.D.,
Janet L. Tekell, M.D.,
Charles C. Martin, Ph.D.,
Jack L. Lancaster, Ph.D., and
Peter T. Fox, M.D.
OBJECTIVE: Theories of human behavior from Plato to Freud have repeatedly emphasized links between emotion and reason, a relationship now commonly attributed to pathways connecting phylogenetically "old" and "new" brain regions. Expanding on this theory, this study examined functional interactions between specific limbic and neocortical regions accompanying normal and disease-associated shifts in negative mood state. METHOD: Regions of concordant functional change accompanying provocation of transient sadness in healthy volunteers and resolution of chronic dysphoric symptoms in depressed patients were examined with two positron emission tomography techniques: [15O]water and [18F]fluorodeoxyglucose, respectively. RESULTS: With sadness, increases in limbic-paralimbic blood flow (subgenual cingulate, anterior insula) and decreases in neocortical regions (right dorsolateral prefrontal, inferior parietal) were identified. With recovery from depression, the reverse pattern, involving the same regions, was seenlimbic metabolic decreases and neocortical increases. A significant inverse correlation between subgenual cingulate and right dorsolateral prefrontal activity was also demonstrated in both conditions. CONCLUSIONS: Reciprocal changes involving subgenual cingulate and right prefrontal cortex occur with both transient and chronic changes in negative mood. The presence and maintenance of functional reciprocity between these regions with shifts in mood in either direction suggests that these regional interactions are obligatory and probably mediate the well-recognized relationships between mood and attention seen in both normal and pathological conditions. The bidirectional nature of this limbic-cortical reciprocity provides additional evidence of potential mechanisms mediating cognitive ("top-down"), pharmacological (mixed), and surgical ("bottom-up") treatments of mood disorders such as depression.
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Measurement of Brain Regional {alpha}-[11C]Methyl-L-Tryptophan Trapping as a Measure of Serotonin Synthesis in Medication-Free Patients With Major Depression
Arch Gen Psychiatry,
June 1, 2004;
61(6):
556 - 563.
[Abstract]
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[PDF]
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D. Mataix-Cols, S. Wooderson, N. Lawrence, M. J. Brammer, A. Speckens, and M. L. Phillips
Distinct Neural Correlates of Washing, Checking, and Hoarding Symptom Dimensions in Obsessive-compulsive Disorder
Arch Gen Psychiatry,
June 1, 2004;
61(6):
564 - 576.
[Abstract]
[Full Text]
[PDF]
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M. Carbon, S. Su, V. Dhawan, D. Raymond, S. Bressman, and D. Eidelberg
Regional metabolism in primary torsion dystonia: Effects of penetrance and genotype
Neurology,
April 27, 2004;
62(8):
1384 - 1390.
[Abstract]
[Full Text]
[PDF]
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S. Heckers, A. P. Weiss, T. Deckersbach, D. C. Goff, R. J. Morecraft, and G. Bush
Anterior Cingulate Cortex Activation During Cognitive Interference in Schizophrenia
Am J Psychiatry,
April 1, 2004;
161(4):
707 - 715.
[Abstract]
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[PDF]
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R. A. Richell and M. Anderson
Reproducibility of Negative Mood Induction: a Self-Referent Plus Musical Mood Induction Procedure and a Controllable/Uncontrollable Stress Paradigm
J Psychopharmacol,
March 1, 2004;
18(1):
94 - 101.
[Abstract]
[PDF]
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C. D. Kilts, R. E. Gross, T. D. Ely, and K. P.G. Drexler
The Neural Correlates of Cue-Induced Craving in Cocaine-Dependent Women
Am J Psychiatry,
February 1, 2004;
161(2):
233 - 241.
[Abstract]
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[PDF]
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R. E. Jorge, R. G. Robinson, D. Moser, A. Tateno, B. Crespo-Facorro, and S. Arndt
Major Depression Following Traumatic Brain Injury
Arch Gen Psychiatry,
January 1, 2004;
61(1):
42 - 50.
[Abstract]
[Full Text]
[PDF]
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P. Fossati, S. J. Hevenor, S. J. Graham, C. Grady, M. L. Keightley, F. Craik, and H. Mayberg
In Search of the Emotional Self: An fMRI Study Using Positive and Negative Emotional Words
Am J Psychiatry,
November 1, 2003;
160(11):
1938 - 1945.
[Abstract]
[Full Text]
[PDF]
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S. Surguladze, P. Keedwell, and M. Phillips
Neural systems underlying affective disorders
Advan. Psychiatr. Treat.,
November 1, 2003;
9(6):
446 - 455.
[Abstract]
[Full Text]
[PDF]
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J.-K. Zubieta, T. A. Ketter, J. A. Bueller, Y. Xu, M. R. Kilbourn, E. A. Young, and R. A. Koeppe
Regulation of Human Affective Responses by Anterior Cingulate and Limbic {micro}-Opioid Neurotransmission
Arch Gen Psychiatry,
November 1, 2003;
60(11):
1145 - 1153.
[Abstract]
[Full Text]
[PDF]
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S. Paradiso, N. C. Andreasen, B. Crespo-Facorro, D. S. O'Leary, G. L. Watkins, L. L. Boles Ponto, and R. D. Hichwa
Emotions in Unmedicated Patients With Schizophrenia During Evaluation With Positron Emission Tomography
Am J Psychiatry,
October 1, 2003;
160(10):
1775 - 1783.
[Abstract]
[Full Text]
[PDF]
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P. Luu and M. I. Posner
Anterior cingulate cortex regulation of sympathetic activity
Brain,
October 1, 2003;
126(10):
2119 - 2120.
[Full Text]
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J. Shumake and F. Gonzalez-Lima
Brain Systems Underlying Susceptibility to Helplessness and Depression
Behav Cogn Neurosci Rev,
September 1, 2003;
2(3):
198 - 221.
[Abstract]
[PDF]
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M. E. Beutel, E. Stern, and D. A. Silbersweig
The Emerging Dialogue Between Psychoanalysis and Neuroscience: Neuroimaging Perspectives
J Am Psychoanal Assoc,
September 1, 2003;
51(3):
773 - 801.
[Abstract]
[PDF]
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M. N. Potenza, M. A. Steinberg, P. Skudlarski, R. K. Fulbright, C. M. Lacadie, M. K. Wilber, B. J. Rounsaville, J. C. Gore, and B. E. Wexler
Gambling Urges in Pathological Gambling: A Functional Magnetic Resonance Imaging Study
Arch Gen Psychiatry,
August 1, 2003;
60(8):
828 - 836.
[Abstract]
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[PDF]
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J. D. Bremner, M. Vythilingam, C. K. Ng, E. Vermetten, A. Nazeer, D. A. Oren, R. M. Berman, and D. S. Charney
Regional Brain Metabolic Correlates of {alpha}-Methylparatyrosine-Induced Depressive Symptoms: Implications for the Neural Circuitry of Depression
JAMA,
June 18, 2003;
289(23):
3125 - 3134.
[Abstract]
[Full Text]
[PDF]
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M. Ernst, A. S. Kimes, E. D. London, J. A. Matochik, D. Eldreth, S. Tata, C. Contoreggi, M. Leff, and K. Bolla
Neural Substrates of Decision Making in Adults With Attention Deficit Hyperactivity Disorder
Am J Psychiatry,
June 1, 2003;
160(6):
1061 - 1070.
[Abstract]
[Full Text]
[PDF]
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H. S Mayberg
Modulating dysfunctional limbic-cortical circuits in depression: towards development of brain-based algorithms for diagnosis and optimised treatment
Br. Med. Bull.,
March 1, 2003;
65(1):
193 - 207.
[Abstract]
[Full Text]
[PDF]
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M. L. Phillips, L. J. Gregory, S. Cullen, S. Cohen, V. Ng, C. Andrew, V. Giampietro, E. Bullmore, F. Zelaya, E. Amaro, et al.
The effect of negative emotional context on neural and behavioural responses to oesophageal stimulation
Brain,
March 1, 2003;
126(3):
669 - 684.
[Abstract]
[Full Text]
[PDF]
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S. Paradiso, R. G. Robinson, L. L. Boles Ponto, G. L. Watkins, and R. D. Hichwa
Regional Cerebral Blood Flow Changes During Visually Induced Subjective Sadness in Healthy Elderly Persons
J Neuropsychiatry Clin Neurosci,
February 1, 2003;
15(1):
35 - 44.
[Abstract]
[Full Text]
[PDF]
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R. J. Davidson, W. Irwin, M. J. Anderle, and N. H. Kalin
The Neural Substrates of Affective Processing in Depressed Patients Treated With Venlafaxine
Am J Psychiatry,
January 1, 2003;
160(1):
64 - 75.
[Abstract]
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[PDF]
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L. S. Kegeles, K. M. Malone, M. Slifstein, S. P. Ellis, E. Xanthopoulos, J. G. Keilp, C. Campbell, M. Oquendo, R. L. Van Heertum, and J. J. Mann
Response of Cortical Metabolic Deficits to Serotonergic Challenge in Familial Mood Disorders
Am J Psychiatry,
January 1, 2003;
160(1):
76 - 82.
[Abstract]
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J. A. Posener, L. Wang, J. L. Price, M. H. Gado, M. A. Province, M. I. Miller, C. M. Babb, and J. G. Csernansky
High-Dimensional Mapping of the Hippocampus in Depression
Am J Psychiatry,
January 1, 2003;
160(1):
83 - 89.
[Abstract]
[Full Text]
[PDF]
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K. J. Black, T. Hershey, J. M. Koller, T. O. Videen, M. A. Mintun, J. L. Price, and J. S. Perlmutter
A possible substrate for dopamine-related changes in mood and behavior: Prefrontal and limbic effects of a D3-preferring dopamine agonist
PNAS,
December 24, 2002;
99(26):
17113 - 17118.
[Abstract]
[Full Text]
[PDF]
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R. D. Powazki and D. Walsh
Family distress in palliative medicine: A pilot study of the Family APGAR Scale
American Journal of Hospice and Palliative Medicine,
November 1, 2002;
19(6):
392 - 396.
[Abstract]
[PDF]
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B. Saletu, P. Anderer, C. Di Padova, A. Assandri, and G. M. Saletu-Zyhlarz
Electrophysiological neuroimaging of the central effects of S-adenosyl-L-methionine by mapping of electroencephalograms and event-related potentials and low-resolution brain electromagnetic tomography
Am. J. Clinical Nutrition,
November 1, 2002;
76
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1162S - 1171S.
[Abstract]
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A. F. Schatzberg
Brain Imaging in Affective Disorders: More Questions About Causes Versus Effects
Am J Psychiatry,
November 1, 2002;
159(11):
1807 - 1808.
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M. Liotti, H. S. Mayberg, S. McGinnis, S. L. Brannan, and P. Jerabek
Unmasking Disease-Specific Cerebral Blood Flow Abnormalities: Mood Challenge in Patients With Remitted Unipolar Depression
Am J Psychiatry,
November 1, 2002;
159(11):
1830 - 1840.
[Abstract]
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[PDF]
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O. G. Cameron and S. Minoshima
Regional Brain Activation Due to Pharmacologically Induced Adrenergic Interoceptive Stimulation in Humans
Psychosom Med,
November 1, 2002;
64(6):
851 - 861.
[Abstract]
[Full Text]
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K. A. SMITH, A. PLOGHAUS, P. J. COWEN, J. M. McCLEERY, G. M. GOODWIN, S. SMITH, I. TRACEY, and P. M. MATTHEWS
Cerebellar responses during anticipation of noxious stimuli in subjects recovered from depression: Functional magnetic resonance imaging study
The British Journal of Psychiatry,
November 1, 2002;
181(5):
411 - 415.
[Abstract]
[Full Text]
[PDF]
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R. Z. Goldstein and N. D. Volkow
Drug Addiction and Its Underlying Neurobiological Basis: Neuroimaging Evidence for the Involvement of the Frontal Cortex
Am J Psychiatry,
October 1, 2002;
159(10):
1642 - 1652.
[Abstract]
[Full Text]
[PDF]
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K. C. Evans, R. B. Banzett, L. Adams, L. McKay, R. S. J. Frackowiak, and D. R. Corfield
BOLD fMRI Identifies Limbic, Paralimbic, and Cerebellar Activation During Air Hunger
J Neurophysiol,
September 1, 2002;
88(3):
1500 - 1511.
[Abstract]
[Full Text]
[PDF]
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K. A. Lockwood, G. S. Alexopoulos, and W. G. van Gorp
Executive Dysfunction in Geriatric Depression
Am J Psychiatry,
July 1, 2002;
159(7):
1119 - 1126.
[Abstract]
[Full Text]
[PDF]
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R. Elliott, J. S. Rubinsztein, B. J. Sahakian, and R. J. Dolan
The Neural Basis of Mood-Congruent Processing Biases in Depression
Arch Gen Psychiatry,
July 1, 2002;
59(7):
597 - 604.
[Abstract]
[Full Text]
[PDF]
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H. S. Mayberg, J. A. Silva, S. K. Brannan, J. L. Tekell, R. K. Mahurin, S. McGinnis, and P. A. Jerabek
The Functional Neuroanatomy of the Placebo Effect
Am J Psychiatry,
May 1, 2002;
159(5):
728 - 737.
[Abstract]
[Full Text]
[PDF]
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M. J. Mentis, A. R. McIntosh, K. Perrine, V. Dhawan, B. Berlin, A. Feigin, C. Edwards, P. Mattis, and D. Eidelberg
Relationships Among the Metabolic Patterns That Correlate With Mnemonic, Visuospatial, and Mood Symptoms in Parkinson's Disease
Am J Psychiatry,
May 1, 2002;
159(5):
746 - 754.
[Abstract]
[Full Text]
[PDF]
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