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. 2021 Aug;45(4):795-804.
doi: 10.1007/s10608-021-10205-9. Epub 2021 Jan 23.

What's in a Face? Amygdalar Sensitivity to an Emotional Threatening Faces Task and Transdiagnostic Internalizing Disorder Symptoms in Participants Receiving Attention Bias Modification Training

Manivel Rengasamy  1 , Mary Woody  1 , Tessa Kovats  1 , Greg Siegle  1   2 , Rebecca B Price  1   2
Affiliations

What's in a Face? Amygdalar Sensitivity to an Emotional Threatening Faces Task and Transdiagnostic Internalizing Disorder Symptoms in Participants Receiving Attention Bias Modification Training

Manivel Rengasamy et al. Cognit Ther Res. 2021 Aug.

Abstract

Background: Altered amygdala activation in response to the emotional matching faces (EMF) task, a task thought to reflect implicit emotion detection and reactivity, has been found in some patients with internalizing disorders; mixed findings from the EMF suggest individual differences (within and/or across diagnoses) that may be important to consider. Attention Bias Modification (ABM), a mechanistic attention-targeting intervention, has demonstrated efficacy in treatment of internalizing disorders. Individual differences in neural activation to a relatively attention-independent task, such as the EMF, could reveal novel neural substrates relevant in ABM's transdiagnostic effects, such as the brain's generalized threat reactivity capacity.

Methods: In a sample of clinically anxious patients randomized to ABM (n = 43) or sham training (n = 18), we measured fMRI activation patterns during the EMF and related them to measures of transdiagnostic internalizing symptoms (i.e., anxious arousal, general distress, anhedonic depression, and general depressive symptoms).

Results: Lower baseline right amygdala activation to negative (fearful/angry) faces, relative to shapes, predicted greater pre-to-post reduction in general depression symptoms in ABM-randomized patients. Greater increases in bilateral amygdalae activation from pre-to-post ABM were associated with greater reductions in general distress, anhedonic depression, and general depression symptoms.

Conclusions: ABM may lead to greater improvement in depressive symptoms in individuals exhibiting blunted baseline amygdalar responses to the EMF task, potentially by enhancing neural-level discrimination between negative and unambiguously neutral stimuli. Convergently, longitudinal increases in amygdala reactivity from pre-to-post-ABM may be associated with greater improvement in depression, possibly secondary to improved neural discrimination of threat and/or decreased neurophysiological threat avoidance in these specific patients.

Keywords: Amygdala; Anxiety; Attention bias modification; Depression; Emotional context insensitivity; Neuroimaging.

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Conflict of interest statement

Conflict of Interest Manivel Rengasamy, Mary Woody, Tessa Kovats, Greg Siegle and Rebecca B. Price declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Baseline right amygdala BOLD response by BDI score change. Scatterplot of baseline right amygdala BOLD response (arbitrary units, reflecting negative faces vs. shapes contrast) with change in BDI scores over time in participants receiving ABM and participants receiving sham. Lines of best fit included for descriptive purposes (solid line = ABM cohort, dashed line = Sham cohort)
Fig. 2
Fig. 2
Amygdala BOLD response change by BDI score change. Scatterplot of bilateral amygdala BOLD response change over time (arbitrary units) with BDI score change over time. Lines of best fit included for descriptive purposes (right amygdala = dashed, left amygdala = solid). BDI Beck Depression Inventory II
Fig. 3
Fig. 3
Amygdala BOLD response change by MASQ-AD score change. Scatterplot of bilateral amygdala BOLD response change over time (arbitrary units) with MASQ anhedonic depression score change over time. Lines of best fit included for descriptive purposes (right amygdala = dashed, left amygdala = solid). MASQ Mood and Anxiety Symptoms Questionnaire
Fig. 4
Fig. 4
Amygdala BOLD response change by MASQ-GD score change. Scatterplot of bilateral amygdala BOLD response change over time (arbitrary units) with MASQ general distress score change over time. Lines of best fit included for descriptive purposes (right amygdala = dashed, left amygdala = solid). MASQ Mood and Anxiety Symptoms Questionnaire
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