Abstract
Disruptions in the cortico-limbic emotion regulation networks have been linked to depression, anxiety, impulsivity, and aggression. Altered transmission of the central nervous serotonin (5-HT) contributes to dysfunctions in the cognitive control of emotions. To date, studies relating to pharmaco-fMRI challenging of the 5-HT system have focused on emotion processing for facial expressions. We investigated effects of a single-dose selective 5-HT reuptake inhibitor (escitalopram) on emotion regulation during virtual violence. For this purpose, 38 male participants played a violent video game during fMRI scanning. The SSRI reduced neural responses to violent actions in right-hemispheric inferior frontal gyrus and medial prefrontal cortex encompassing the anterior cingulate cortex (ACC), but not to non-violent actions. Within the ACC, the drug effect differentiated areas with high inhibitory 5-HT1A receptor density (subgenual s25) from those with a lower density (pregenual p32, p24). This finding links functional responses during virtual violent actions with 5-HT neurotransmission in emotion regulation networks, underpinning the ecological validity of the 5-HT model in aggressive behavior. Available 5-HT receptor density data suggest that this SSRI effect is only observable when inhibitory and excitatory 5-HT receptors are balanced. The observed early functional changes may impact patient groups receiving SSRI treatment.
Highlights
Cognitive emotion regulationThe neural circuitry of cognitive emotion regulation includes the orbitofrontal cortex (OFC), and lateral and medial prefrontal cortex (PFC), such as anterior cingulate cortex (ACC), and amygdala (Elliott et al 2011; KohnAachen, Aachen, Germany 8 JARA-Translational Brain Medicine, Aachen, Germany1 3 Vol.:(0123456789)Brain Structure and Function (2018) 223:3327–3345 et al 2014; Morawetz et al 2017)
Bipolar disorder is generally defined by a hyperactivity in the ventrolateral PFC during up- and downregulation of negative effect (Morris et al 2012); this region is hypoactive in schizophrenia patients during reappraisal of emotions
In OCD, which is characterized by intrusive thoughts and ritualized repetitive behaviors aimed at reducing thoughtinduced distress and anxiety (Rauch and Carlezon 2013; Maia and Cano-Colino 2015), the OFC, ACC and caudate display hyperactivation at rest and during symptom provocation (Benzina et al 2016)
Summary
Cognitive emotion regulationThe neural circuitry of cognitive emotion regulation includes the orbitofrontal cortex (OFC), and lateral and medial prefrontal cortex (PFC), such as anterior cingulate cortex (ACC), and amygdala (Elliott et al 2011; KohnAachen, Aachen, Germany 8 JARA-Translational Brain Medicine, Aachen, Germany1 3 Vol.:(0123456789)Brain Structure and Function (2018) 223:3327–3345 et al 2014; Morawetz et al 2017). The medial prefrontal and cingulate cortices exert an inhibitory top–down control over the amygdala (Ochsner and Gross 2005; Motzkin et al 2015), reducing negative emotions and stress (Lederbogen et al 2011). Deficient emotion regulation is a symptom of many psychiatric disorders and have been linked to disruptions in cortico-limbic circuits (Millan et al 2012); among those are depression, anxiety (Mayberg 1997; Zilverstand et al 2017), bipolar disorder (Townsend and Altshuler 2012), schizophrenia (Morris et al 2012; van der Velde et al 2015) and obsessive–compulsive disorder (OCD, Benzina et al 2016). In OCD, which is characterized by intrusive thoughts and ritualized repetitive behaviors aimed at reducing thoughtinduced distress and anxiety (Rauch and Carlezon 2013; Maia and Cano-Colino 2015), the OFC, ACC and caudate display hyperactivation at rest and during symptom provocation (Benzina et al 2016)
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