Multi-unit relations among neural, self-report, and behavioral correlates of emotion regulation in comorbid depression and obesity

Adam R Pines,Matthew D Sacchet,Monica Kullar,Leanne M Williams,Jun Ma

doi:10.1038/s41598-018-32394-2

Abstract

Depression is a leading cause of disability and is commonly comorbid with obesity. Emotion regulation is impaired in both depression and obesity. In this study, we aimed to explicate multi-unit relations among brain connectivity, behavior, and self-reported trait measures related to emotion regulation in a comorbid depressed and obese sample (N = 77). Brain connectivity was quantified as fractional anisotropy (FA) of the uncinate fasciculi, a white matter tract implicated in emotion regulation and in depression. Use of emotion regulation strategies was assessed using the Emotion Regulation Questionnaire (ERQ). We additionally measured reaction times to identifying negative emotions, a behavioral index of depression-related emotion processing biases. We found that greater right uncinate fasciculus FA was related to greater usage of suppression (r = 0.27, p = 0.022), and to faster reaction times to identifying negative emotions, particularly sadness (r = −0.30, p = 0.010) and fear (r = −0.35, p = 0.003). These findings suggest that FA of the right uncinate fasciculus corresponds to maladaptive emotion regulation strategies and emotion processing biases that are relevant to co-occurring depression and obesity. Interventions that consider these multi-unit associations may prove to be useful for subtyping and improving clinical outcomes for comorbid depression and obesity.

Highlights

Of all the manifestations of depression, one of the most debilitating is that which occurs with comorbid obesity
We focus the current study in diffusion-weighted imaging (DWI) of the uncinate fasciculi, a major white matter tract implicated in emotion regulation, depression, and obesity[11,12,13]
Functional neuroimaging studies have linked negative information processing biases in depression to brain areas connected by the uncinate fasciculus, including the amygdala and anterior cingulate cortex[31], and altered reactivity to negative emotion facial expressions has been demonstrated to be a predictor of treatment response[33]

Summary

Introduction

Of all the manifestations of depression, one of the most debilitating is that which occurs with comorbid obesity. From a precision medicine perspective[7], one step toward developing more targeted interventions is to first understand the brain behavior disruptions that characterize these conditions Toward this objective, the goal of the current study was to explicate multi-unit relations among neural, behavioral, and trait measures related to emotion regulation, an important component in successful treatment of both conditions[8,9,10], in a patient cohort of comorbid depressed-obese individuals. Functional neuroimaging studies have linked negative information processing biases in depression to brain areas connected by the uncinate fasciculus, including the amygdala and anterior cingulate cortex[31], and altered reactivity to negative emotion facial expressions has been demonstrated to be a predictor of treatment response[33]

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