THROUGHOUT the past 20 years, findings from studies of functional brain imaging have coalesced in the identification of regions of abnormal functional activity during major depressive episodes (MDE).1- 5 In studies performed during the resting state (no physiological or cognitive challenge), patients with MDE typically show reduced activity in the dorsolateral prefrontal cortex. At least 15 studies have found covariation between the magnitude of this reduction (or that of larger prefrontal areas) and the magnitude of depression severity,6- 8 with the suggestion that reduced dorsolateral prefrontal cortex activity is tied to psychomotor retardation or cognitive disturbance.9,10 In contrast, the ventral prefrontal cortex has been found to show increased activity in some studies,4 with the exception that an area ventral to the genu of the corpus callosum may be subject to perfusion and metabolic reduction, which has been linked to neuronal loss.11 Abnormal functional activity has been observed in several studies of the anterior cingulate gyrus. This is an important observation since, paradoxically, responders to sleep deprivation almost invariably show increased cingulate activity, and reduced activity in the medial prefrontal cortex and the anterior cingulate gyrus is associated with clinical improvement following sleep deprivation.12 In addition, there are findings that during MDE, patients have reduced functional activity in the basal ganglia, particularly in the caudate nuclei1,13 and in some areas of the parietal and temporal lobes.14
Thank you for submitting a comment on this article. It will be reviewed by JAMA Psychiatry editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 22
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Users' Guides to the Medical Literature
Clarifying Your Question
Users' Guides to the Medical Literature
Three Examples of Question Clarification
All results at
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.