Emotion regulation in mood and anxiety disorders: A meta-analysis of fMRI cognitive reappraisal studies

Abstract

Emotion regulation by means of cognitive reappraisal has been widely studied with functional magnetic resonance imaging (fMRI). To date, several meta-analyses of studies using cognitive reappraisal tasks in healthy volunteers have been carried out, but no meta-analyses have yet been performed on the fMRI data of clinical populations with identified alterations in emotion regulation capacity. We provide a comprehensive meta-analysis of cognitive reappraisal fMRI studies in populations of patients with mood or anxiety disorders, yielding a pooled sample of 247 patients and 262 controls from thirteen independent studies. As a distinguishing feature of this meta-analysis, original statistical brain maps were obtained from six of these studies. Our primary results demonstrated that patients with mood and anxiety disorders recruited the regulatory fronto-parietal network involved in cognitive reappraisal to a lesser extent in comparison to healthy controls. Conversely, they presented increased activation in regions that may be associated with the emotional experience (i.e., insula, cerebellum, precentral and inferior occipital gyri) and in regions whose activation may be the consequence of compensatory mechanisms (i.e., supramarginal gyri and superior parietal lobule). Moreover, activations in the left ventrolateral prefrontal cortex and the left superior temporal gyrus were associated with reinterpretation emotion regulation strategies, whereas medial frontal and parietal activations were associated with the deployment of distancing strategies. The regions revealed by this meta-analysis conform to a pattern of dysfunctional brain activation during cognitive reappraisal common to mood and anxiety disorders. As such, this neural pattern may reflect a transdiagnostic feature of these disorders.

Transdiagnostic neural correlates of volitional emotion regulation in anxiety and depression

“…The failure to find group differences in the amygdala replicates prior work using a similarly crafted large, trans-diagnostic sample of GAD, SAD, and MDD participants during exposure to negative stimuli but outside the context of reappraisal . In addition, recent metaanalytical work found no elevated amygdala reactivity during reappraisal in individuals with anxiety and depressive disorders (Picó-Pérez et al, 2017). Lack of amygdala differentiation between patients and controls is also consistent with prior studies that did not find amygdala differences between HCs and those with GAD or HCs and those with MDD (Erk et al, 2010) during reappraisal specifically.…”

“…Lack of amygdala differentiation between patients and controls is also consistent with prior studies that did not find amygdala differences between HCs and those with GAD or HCs and those with MDD (Erk et al, 2010) during reappraisal specifically. In addition, recent metaanalytical work found no elevated amygdala reactivity during reappraisal in individuals with anxiety and depressive disorders (Picó-Pérez et al, 2017). As a result, amygdala response to these types of stimuli may not be strongly associated with anxiety and depression symptoms, suggesting that this neural trait may not best characterize these disorders (Hägele et al, 2016).…”

The Role of Motivation in Cognitive Reappraisal for Depressed Patients

“…Although stronger MTG and STG were activated during emotion regulation for the MDD group, MTG and STG were less modulated by BAS across ER conditions. The hypoactivation of MTG for clinical depression is consistently activated in fMRI cognitive reappraisal studies (Pico-Perez et al, 2017 ). Greater MTG activation of depressed patients may represent more resources devoted to lexical representation and retrieval (Huang et al, 2012 ), and processing emotionally laden negative stimuli (Paquette et al, 2003 ; Jessen and Kotz, 2015 ).…”

Resting state cortico-limbic functional connectivity and dispositional use of emotion regulation strategies: A replication and extension study

“…In line with this, studies including patients with psychological disorders with reduced ability to regulate emotions (e.g. depression and anxiety) have found deficits in functional and effective connectivity between the amygdala and frontal brain regions (Clauss et al, 2014;Cullen et al, 2011;Erk, Mikschl, et al, 2010;Mochcovitch, da Rocha Freire, Garcia, & Nardi, 2014;Niedtfeld et al, 2012;Pico-Perez, Radua, Steward, Menchon, & Soriano-Mas, 2017;Radaelli et al, 2015). Additionally, there is evidence that not only taskrelated connectivity but also alterations in resting-state functional connectivity of (among others) PFC, amygdala and insula are associated with depression and anxiety (Barch, 2017;Menon, 2011;Zhang et al, 2014).…”