Emotion Processing In Patients Research Articles

The Role of Attention Modulation and Its Neurophysiological Mechanisms in Tinnitus Management: A Review

Background and Aim: Tinnitus, characterized by the perception of sound without the presence of an external auditory stimulus, can profoundly affect the quality of life. This review study aims to assess the role of attention modulation in tinnitus management and investigate the neurophysiological mechanism of attention and its interaction with emotional processing in patients with tinnitus. Recent Findings: The studies revealed differences in the function of attentional networks among individuals with tinnitus. The studies showed the positive impact of various techniques for attention modulation through direct attention training or indirect mechanisms influencing attention. These techniques could modify attentional biases, enhance attention control, and alleviate tinnitus-related distress. Conclusion: The results of studies suggest the potential role of attention modulation in tinnitus management. By targeting attentional processes, researchers and clinicians can provide more effective interventions for individuals with tinnitus. However, there is a need for further investigation to optimize the intervention protocols by collaboration between researchers, clinicians, and individuals with tinnitus to achieve success in tinnitus management. Background and Aim: Tinnitus, characterized by the perception of sound without the presence of an external auditory stimulus, can profoundly affect the quality of life. This review study aims to assess the role of attention modulation in tinnitus management and investigate the neurophysiological mechanism of attention and its interaction with emotional processing in patients with tinnitus. Recent Findings: The studies revealed differences in the function of attentional networks among individuals with tinnitus. The studies showed the positive impact of various techniques for attention modulation through direct attention training or indirect mechanisms influencing attention. These techniques could modify attentional biases, enhance attention control, and alleviate tinnitus-related distress. Conclusion: The results of studies suggest the potential role of attention modulation in tinnitus management. By targeting attentional processes, researchers and clinicians can provide more effective interventions for individuals with tinnitus. However, there is a need for further investigation to optimize the intervention protocols by collaboration between researchers, clinicians, and individuals with tinnitus to achieve success in tinnitus management. Keywords: Tinnitus; attention; tinnitus management; neurophysiological mechanism; attention training

Facial emotion processing in patients with borderline personality disorder as compared with healthy controls: an fMRI and ECG study

BackgroundMaladaptive behaviors and interpersonal difficulties in patients with borderline personality disorder (BPD) seem connected to biased facial emotion processing. This bias is often accompanied by heightened amygdala activity in patients with BPD as compared to healthy controls. However, functional magnetic resonance imaging (fMRI) studies exploring differences between patients and healthy controls in facial emotion processing have produced divergent results. The current study explored fMRI and heart rate variability (HRV) correlates of negative facial emotion processing in patients with BPD and healthy controls.MethodsThe study included 30 patients with BPD (29 females; age: M = 24.22, SD = 5.22) and 30 healthy controls (29 females; M = 24.66, SD = 5.28). All participants underwent the “faces” task, an emotional face perception task, in an fMRI session simultaneously with ECG. In this task, participants are presented with emotional expressions of disgust, sadness, and fear (as a negative condition) and with the same pictures in a scrambled version (as a neutral condition).ResultsWe found no differences in brain activity between patients with BPD and healthy controls when processing negative facial expressions as compared to neutral condition. We observed activation in large-scale brain areas in both groups when presented with negative facial expressions as compared to neutral condition. Patients with BPD displayed lower HRV than healthy controls in both conditions. However, there were no significant associations between HRV and amygdala activity and BPD symptoms.ConclusionThe results of this study indicate no abnormal brain activity during emotional facial processing in patients with BPD. This result contrasts with previous studies and more studies are needed to clarify the relationship between facial emotion processing and brain activity in patients with BPD. Possible reasons for the absence of brain activity differences are discussed in the study. Consistent with previous findings, patients showed lower HRV than healthy controls. However, HRV was not associated with amygdala activity and BPD symptoms.

Emotion Regulation in Depression of Physical Achievement Based on Machine Learning

Depression is a clinical disease, mainly accompanied by mood or emotional abnormalities, mainly depression, slow thinking, often accompanied by emotional abnormalities, cognitive behavior, psychophysiological and interpersonal changes or disorders. Here, using static and task-state MRI data, we present a comprehensive study of abnormal neural activity in patients with depression through spatiotemporal, static, and dynamic measures, demonstrating its validity as an underlying biological trait. In order to effectively study the role of emotion regulation in depression, a brain dynamic network synthesis method based on support vector machine model and community detection algorithm was established. We selected data on the mental state of 45 patients from a hospital’s psychiatric disease control center. They had no history of hearing impairment and normal (or corrected) vision. All procedures are agreed in writing by each participant. The results show that this method can effectively reduce the depression degree of the subjects, and the multi-level features of the integration of task activation and task regulation connection reach 81% ( < 0.0010, surrogate test) and 83% (<0.0016, surrogate test), respectively. The recovery of its depressive psychological state has a significant impact. Numerous studies have used various forms of emotional stimuli to reveal abnormal behaviors and neural responses in multi-channel emotional processing in patients with depression, providing valuable insights into the mechanism of multi-channel emotion regulation in depression.

Effects of psychotherapy on brain activation during negative emotional processing in patients with posttraumatic stress disorder: a systematic review and meta-analysis.

Post-traumatic stress disorder (PTSD) is a debilitating condition which has been related to problems in emotional regulation, memory and cognitive control. Psychotherapy has a non-response rate of around 50% and understanding the neurobiological working mechanisms might help improve treatment. To integrate findings from multiple smaller studies, we performed the first meta-analysis of changes in brain activation with a specific focus on emotional processing after psychotherapy in PTSD patients. We performed a meta-analysis of brain activation changes after treatment during emotional processing for PTSD with seed-based d mapping using a pre-registered protocol (PROSPERO CRD42020211039). We analyzed twelve studies with 191 PTSD patients after screening 3700 studies. We performed systematic quality assessment both for the therapeutic interventions and neuroimaging methods. Analyses were done in the full sample and in a subset of studies that reported whole-brain results. We found decreased activation after psychotherapy in the left amygdala, (para)hippocampus, medial temporal lobe, inferior frontal gyrus, ventrolateral prefrontal cortex, right pallidum, anterior cingulate cortex, bilateral putamen, and insula. Decreased activation in the left amygdala and left ventrolateral PFC was also found in eight studies that reported whole-brain findings. Results did not survive correction for multiple comparisons. There is tentative support for decreased activation in the fear and cognitive control networks during emotional processing after psychotherapy for PTSD. Future studies would benefit from adopting a larger sample size, using designs that control for confounding variables, and investigating heterogeneity in symptom profiles and treatment response.

Emotion Recognition in Multiple System Atrophy: An Exploratory Eye-Tracking Study.

Emotional processing is a core feature of social interactions and has been well studied in patients with idiopathic Parkinson's disease (PD), albeit with contradictory. . However, these studies excluded patients with atypical parkinsonism, such as multiple system atrophy (MSA). The objective of this exploratory study was to provide better insights into emotion processing in patients with MSA using eye tracking data. We included 21 MSA patients, 15 PD patients and 19 matched controls in this study. Participants performed a dynamic and a static emotion recognition task, and gaze fixations were analyzed in different areas of interest. Participants underwent neuropsychological testing and assessment of depression and alexithymia. MSA patients were less accurate in recognizing anger than controls (p = 0.02) and had overall fewer fixations than controls (p = 0.001). In the static task, MSA patients had fewer fixations (p < 0.001) and a longer time to first fixation (p = 0.026) on the eye region. Furthermore, MSA patients had a longer fixation duration overall than PD patients (p = 0.004) and longer fixations on the nose than controls (p = 0.005). Alexithymia scores were higher in MSA patients compared to controls (p = 0.038). This study demonstrated impaired recognition of anger in MSA patients compared to HCs. Fewer and later fixations on the eyes along with a center bias suggest avoidance of eye contact, which may be a characteristic gaze behavior in MSA patients.

Comparing the Effects of Psychodynamic Group Psychotherapy and Mindfulness-Based Stress Reduction on Body Image and Emotional Processing in Patients with Colorectal Cancer

Background: Emotional processing plays an important role in dealing with stress related to chronic diseases. Objectives: The present study aimed to investigate the effects of psychodynamic group psychotherapy (PGP) and mindfulness-based stress reduction (MBSR) on body image and emotional processing in patients with colorectal cancer. Methods: This quasi-experimental research adopted a pre-test/post-test control group design with follow-up. The statistical population included all patients with colorectal cancer visiting Poursina Hakim Health Centers of Isfahan in 2022. The convenience sampling method was employed to select 42 participants who were then assigned to a mindfulness-based stress reduction group (eight 150-minute sessions), a psychodynamic group psychotherapy group (fourteen 120-minute sessions), and a control group as simple random sampling. The control group did not receive psychotherapy intervention during the treatment sessions for the experimental groups and was placed on the waiting list. There were 14 participants in each group. The Multidimensional Body-Self-Relations Questionnaire and Emotional Processing Questionnaire were used for data collection in the pre-test, post-test, and follow-up stages. The repeated measures ANOVA were then used for data analysis in SPSS 26. Results: According to the results, both MBSR and PGP improved body image and emotional processing equally and effectively in patients with colorectal cancer (P &lt; 0.001). The effects of both interventions on body image remained constant among patients over time (P &lt; 0.001). However, only the effect of MBSR on emotional processing remained constant and stable over time. Conclusions: PGP and MBSR are therapeutic methods that may positively affect body image and emotional processing in patients with colorectal cancer. Improving body image and emotional processing may lead to improved mental health and adaptability.

How do bipolar disease states affect positive and negative emotion processing? Insights from a meta-analysis on the neural fingerprints of emotional processing.

Functional magnetic resonance imaging studies on emotion processing in patients with bipolar disorder (BD) show hyperactivity of limbic-striatal brain areas and hypoactivity in inferior frontal areas compared to healthy participants. However, heterogeneous results in patients with different disease states and different valences of emotional stimuli have been identified. To integrate previous results and elucidate the impact of disease state and stimulus valence, we conducted a systematic literature search for journal articles in the Web of Science Core Collection including MEDLINE databases and employed a coordinate-based-meta-analysis of functional-MRI studies comparing emotion processing in BD-patients with healthy participantsusing seed-based d mapping (SDM) to test for between-subjects-effects. We included 31 studies published before 11/2022 with a total of N = 766 BD-patients and N = 836 controls. Patients with BD showed hyperactivated regions involved in salience processing of emotional stimuli (e.g., the bilateral insula) and hypoactivation of regions associated with emotion regulation (e.g., inferior frontal gyrus) during emotion processing, compared to healthy participants. A more detailed descriptive analysis revealed a hypoactive (anterior) insula in manic BD-patients specifically for negative in comparison to positive emotion processing. This meta-analysis corroborates the overall tenor of existing literature that patients with BD show an increased emotional reactivity (hyperactivity of salience-processing regions) together with a lower (cognitive) control (hypoactivity of brain areas associated with emotion regulation) over emotional states. Our analysis suggests reduced interoceptive processing of negative stimuli in mania, pointing out the need for longitudinal within-subject analyses of emotion processing.

Abnormal focal segments in left uncinate fasciculus in adults with obsessive-compulsive disorder.

Although the specific role of the uncinate fasciculus (UF) in emotional processing in patients with obsessive-compulsive disorder (OCD) has been investigated, the exact focal abnormalities in the UF have not been identified. The aim of the current study was to identify focal abnormalities in the white matter (WM) microstructure of the UF and to determine the associations between clinical features and structural neural substrates. In total, 71 drug-naïve patients with OCD and 81 age- and sex-matched healthy controls (HCs) were included. Automated fiber quantification (AFQ), a tract-based quantitative approach, was adopted to measure alterations in diffusion parameters, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD), along the trajectory of the UF. Additionally, we utilized partial correlation analyses to explore the relationship between the altered diffusion parameters and clinical characteristics. OCD patients showed significantly higher FA and lower RD at the level of the temporal and insular portions in the left UF than HCs. In the insular segments of the left UF, increased FA was positively correlated with the Hamilton Anxiety Scale (HAMA) score, while decreased RD was negatively correlated with the duration of illness. We observed specific focal abnormalities in the left UF in adult patients with OCD. Correlations with measures of anxiety and duration of illness underscore the functional importance of the insular portion of left UF disturbance in OCD patients.

Comparison of Emotional Processing Between Patients with Substance Use Disorder and Those with Dual Diagnosis: Relationship with Severity of Dependence and Use During Treatment

ABSTRACT This study analyzed, in a Spanish sample, the differences in emotional processing in patients diagnosed with substance use disorder (SUD) and patients with a dual diagnosis (DD), and tested whether alterations in emotional regulation were related to the severity of dependence and consumption during treatment. A descriptive follow-up study was conducted with 88 adult outpatients (83% men) who were receiving treatment for alcohol and cocaine SUD. Of the sample, 43.2% presented dual diagnosis according to DSM-IV-TR criteria. Emotional processing was assessed with the IAPS, and dependence severity with the SDSS. Consumption was determined with self-reports and toxicological tests. Regression analyses revealed that the DD group had more difficulties in identifying the valence and arousal of the images than patients with SUD. Patients with DD presented more difficulty in identifying images in which valence was manipulated, but not in those in which arousal was manipulated. Cocaine use during treatment was associated with difficulties in identifying unpleasant (U = 734.0; p < .05) and arousing (U = 723.5; p < .05) images. Although these results are preliminary, findings suggest that impaired emotional processing is aggravated in dual patients, although it may be a common transdiagnostic factor in SUD and other comorbid mental disorders. Findings highlight the importance of evaluating emotional regulation to better understand its possible role in the maintenance of substance use.

Emotional processing in patients with single brain damage in the right hemisphere

BackgroundThe interest in the relationship between brain damage and social cognition has increased in recent years. The objectives of the present study were the following: (1) to evaluate and compare emotional facial recognition and subjective emotional experience in patients who have suffered a single ischemic stroke in the right hemisphere (RH) and in healthy people, (2) to analyze the relationship between both variables in both groups of subjects, and (3) to analyze the association between the cerebral location of the stroke and these two variables.MethodsEmotional facial recognition and the subjective emotional experience of 41 patients who had suffered a single ischemic stroke in the RH and 45 volunteers without previous cerebrovascular pathology were evaluated.ResultsBrain damaged patients performed lower in facial emotional recognition and had a less intense subjective emotional response to social content stimuli compared to healthy subjects. Likewise, among patients with RH ischemic stroke, we observed negative associations between facial recognition of surprise and reactivity to unpleasant images, and positive associations between recognition of disgust and reactivity to pleasant images. Finally, patients with damage in the caudate nucleus of the RH presented a deficit in the recognition of happiness and sadness, and those with damage in the frontal lobe exhibited a deficit in the recognition of surprise, compared to those injured in other brain areas.ConclusionsEmotional facial recognition and subjective emotional experience are affected in patients who have suffered a single ischemic stroke in the RH. Professionals caring for stroke patients should improve their understanding of the general condition of affected persons and their environment, assess for risk of depression, and facilitate their adaptation to work, family, and social environments.

Effects of clenbuterol, an oral, CNS–penetrant β2 adrenoceptor agonist, on cognition and emotional processing in patients with parkinson’s disease

Effects of clenbuterol, an oral, CNS–penetrant β2 adrenoceptor agonist, on cognition and emotional processing in patients with parkinson’s disease

Moral emotions in neuropsychiatry : testing FTD and Schizophrenia patients with the MEA scale.

AbstractBackgroundMoral emotions have a key role in human prosocial behaviors. Impaired moral emotion processing can lead to disrupted decision‐making and behavioral adaptation.Better knowledge about moral emotion processing in neuropsychiatric diseases is necessary to facilitate diagnosis and patient care.The aim of this study was to investigate and to compare moral emotion processing in patients with neurodegenerative diseases ‐behavioral fronto temporal dementia (FTD) and Alzheimer’s disease (AD)‐ and patients with schizophrenia.MethodWe investigated 22 FTD, 15 AD, 30 schizophrenia patients and a control group with validated task, the Moral Emotions Assessment (MEA). This tool consisted in 42 scenarios exploring positive and negative moral emotions such as admiration, gratitude, shame or anger. Subjects had to choose between several emotions the most appropriate to the context of the scenario. To control for moral specificity, we contrasted the 42 moral scenarios with 18 extra‐moral scenarios eliciting the emotions without involving any inter‐human moral context.ResultFTD patients and Schizophrenia patients were significantly impaired in moral emotion processing, when compared to healthy controls, whereas AD patients were not impaired. There was a specific impairment of moral emotions in FTD, (73.1% of correct answers VS 95.1% in control group p&lt;0,001) and the most impaired emotion was guilt. AD patients didn’t show impairment in moral emotion processing compared to healthy controls. In Schizophrenia patients, moral emotion processing was significantly impaired (85,8% of correct answers VS 95,9% in control group, p&lt;0,001), and the most impaired emotions were anger and shame.ConclusionMoral emotions processing seemed significantly impaired in FTD patients and schizophrenia patients, with different patterns of deficits, whereas AD patients seemed to have preserved moral cognition. These results provide a better understanding of the behavioral changes observed in FTD and schizophrenia patients.

A Single Session of Bifrontal tDCS Can Improve Facial Emotion Recognition in Major Depressive Disorder: An Exploratory Pilot Study.

Emotional processing deficits are key features in major depressive disorder (MDD). Neuroimaging studies indicate that the dorsolateral prefrontal cortex (DLPFC) plays a pivotal role in both depressive symptoms and emotional processing. Recently, transcranial Direct Current Stimulations (tDCS) applied over the DLPFCs have held the promise to alleviate the symptoms in patients with MDD, but the effect on emotional processing in the patients is unclear. Here, we investigated the effect of a single session of tDCS over the DLPFCs on the emotional processing in patients with treatment-resistant MDD. In a randomized sham-controlled study, 35 patients received a single 30 min session of either active (2 mA, n = 18) or sham tDCS (n = 17). The anode was placed over the left and the cathode over the right DLPFC. Emotional processing accuracy was measured by a facial emotion recognition (FER) task. We observed an overall improvement in FER performance after the active tDCS, but not the sham tDCS. These exploratory results suggest that a single session of tDCS over the DLPFCs may improve FER in MDD, a crucial function of social cognition. Further studies are needed to investigate whether this acute improvement of FER in response to a single tDCS session could translate into clinical benefits or predict remission following repeated sessions of stimulation.

Anhedonia symptoms: The assessment of brain functional mechanism following music stimuli using functional magnetic resonance imaging

PurposeThis study aimed to investigate the effect of music stimulation on the brain functional mechanism of depressed patients with anhedonia symptoms using functional magnetic resonance imaging (fMRI). MethodsParticipants in this study included 20 healthy subjects as the control group, 25 subjects with depression and no anhedonia as the intervention group A, and 24 subjects with depression and anhedonia as the intervention group B. The safely emotional stimulation was done by Iranian music. To investigate the effect of music therapy on the brain, a task including 50 tracks of 12 s Iranian music (traditional and pop) was used. Finally, the data were analyzed using SPM Toolbox in MATLAB software. ResultsThe results showed that brain patterns in depressed patients with and without anhedonia could be distinguished based on positive and negative musical stimuli (p < 0.05). Important fMRI biomarker such as effective connectivity strength related to the fronto-limbic network, including the supragenual ACC, subgenual ACC, AMYG, and FFG were evaluated in depressed patients with anhedonia. ConclusionThis was the first study to investigate the neural circuits involved in music-related emotional processing in patients with anhedonia symptoms. These findings could help advance neurological understandings of anhedonia and suggest new treatments.

Emotional Word Processing in Patients With Juvenile Myoclonic Epilepsy.

ObjectiveAccording to Panksepp's hierarchical emotion model, emotion processing relies on three functionally and neuroanatomically distinct levels. These levels comprise subcortical networks (primary level), the limbic system (secondary level), and the neocortex (tertiary level) and are suggested to serve differential emotional processing. We aimed to validate and extend previous evidence of discrete and dimensional emotion processing in patient with juvenile myoclonic epilepsy (JME).MethodsWe recorded brain activity of patients with JME and healthy controls in response to lexical decisions to words reflecting the discrete emotion fear and the affective dimension negativity previously suggested to rely on different brain regions and to reflect different levels of processing. In all study participants, we tested verbal cognitive functions, as well as the relationship of psychiatric conditions, seizure types and duration of epilepsy and emotional word processing.ResultsIn support of the hierarchical emotion model, we found an interaction of discrete emotion and affective dimensional processing in the right amygdala likely to reflect secondary level processing. Brain activity related to affective dimensional processing was found in the right inferior frontal gyrus and is suggested to reflect tertiary level processing. Psychiatric conditions, type of seizure nor mono- vs. polytherapy and duration of epilepsy within patients did not have any effect on the processing of emotional words. In addition, no differences in brain activity or response times between patients and controls were observed, despite neuropsychological testing revealed slightly decreased verbal intelligence, verbal fluency and reading speed in patients with JME.SignificanceThese results were interpreted to be in line with the hierarchical emotion model and to highlight the amygdala's role in processing biologically relevant stimuli, as well as to suggest a semantic foundation of affective dimensional processing in prefrontal cortex. A lack of differences in brain activity of patients with JME and healthy controls in response to the emotional content of words could point to unaffected implicit emotion processing in patients with JME.

Is It a Gut Feeling? Bodily Sensations Associated With the Experience of Valence and Arousal in Patients With Inflammatory Bowel Disease.

BackgroundPrevious studies have shown dysfunctional emotion processing in patients with inflammatory bowel diseases (IBD), characterized by a hypersensitivity to negative emotions and a hyposensitivity to positive emotions. Models of emotion processing emphasize the importance of bodily sensations to the experience of emotions. Since there have been no studies on whether emotion-associated bodily sensations are changed in IBD, we investigated the experience of bodily sensations related to valence and arousal, together with their links to emotional awareness, as one domain of interoceptive sensibility relevant to emotion processing.MethodsUsing a topographical self-report measure, 41 IBD patients in clinical remission and 44 healthy control (HC) participants were asked to indicate where and how intensely in their body they perceive changes when experiencing emotions of positive and negative valence, as well as relaxation and tension. Additionally, we used self-report questionnaires to assess emotional awareness as one domain of an individual’s interoceptive sensibility, gastrointestinal-specific anxiety (GSA), and psychological distress.ResultsPatients with IBD reported higher emotional awareness but lower intensities of perceived changes in their bodily sensations related to valence and arousal of emotional processing. IBD patients reported less intense bodily activation during positive emotions and less intense bodily deactivation during negative emotional states in comparison to HC participants. Higher emotional awareness and psychological distress were linked to stronger experiences of emotion-related bodily sensations in IBD patients.ConclusionInflammatory bowel diseases patients exhibited alterations in how they link bodily sensations to their emotional experience. Such persistent changes can affect a patient’s wellbeing and are related to higher levels of anxiety and depression among IBD patients, even in remission.

Neuro-Cognitive Remediation of Emotion Processing in Patients with Borderline Personality Disorder through Psychotherapy

Neuro-Cognitive Remediation of Emotion Processing in Patients with Borderline Personality Disorder through Psychotherapy

The Prediction of Benefit Finding in Cancer Based on Demographic and Clinical Characteristics, Illness Cognition, and Emotional Processing in Patients Referred to Kosar Specialized Clinic in Semnan in 2020: A Descriptive Study

The Prediction of Benefit Finding in Cancer Based on Demographic and Clinical Characteristics, Illness Cognition, and Emotional Processing in Patients Referred to Kosar Specialized Clinic in Semnan in 2020: A Descriptive Study

P.0804 Effects of psychotherapy on brain activation during emotional processing in patients with posttraumatic stress disorder: a meta-analysis

P.0804 Effects of psychotherapy on brain activation during emotional processing in patients with posttraumatic stress disorder: a meta-analysis

Neuronal response to high negative affective stimuli in major depressive disorder: An fMRI study

BackgroundDisturbed emotion processing underlies depression. We examined the neuronal underpinnings of emotional processing in patients (PAT) with major depressive disorder (MDD) compared to healthy volunteers (HV) using functional magnetic resonance (fMRI) scan. MethodsThirty-six MDD patients and 30 HV underwent T2-weighted fMRI assessments during the presentation of an implicit affective processing task in three conditions. They differed regarding their affective quality (=valence, high negative, low negative and neutral stimuli) and regarding the arousal based on stimuli from the International Affective Picture System. ResultsGroup contrasts showed lower left-sided activation in dorsolateral prefrontal cortex (DLPFC), anterior PFC, precentral and premotor cortex in PAT compared with HV (Cluster-level threshold, 5000 iterations, p<0.01). We found a significant interaction effect of valence and group, a significant effect of emotional valence and a significant effect of group. All effects were shown in brain regions within the emotional network (Cluster-level threshold, 5000 iterations, p<0.01). Higher arousal (rho=-0.33, p<0.01) and higher valence (rho=-0.33, p<0.01) during high negative stimuli presentation as well as more severe depression (Beck Depression Inventory II [BDI II]; r = 0.39, p = 0.01) were significantly negatively associated with left DLFPC activity in patients. LimitationsPotential influence of psychopharmacological drugs on functional activation is one of the most discussed source of bias in studies with medicated psychiatric patients. ConclusionsThe results highlight the importance of left DLPFC during the processing of negative emotional stimuli in MDD. The integration of a neurophysiological model of emotional processing in MDD may help to clarify and improve therapeutic options.