Activation in dorsolateral prefrontal cortex in response to maternal criticism and praise in recovered depressed and healthy control participants

Background: High family levels of expressed emotion reliably predict relapse inpatients with schizophrenia and mood disorders; however, the neural mechanisms linking expressed emotion and relapse are unexplored. Dysfunctional activity in the dorsolateral prefrontal cortex (DLPFC) has been implicated in the pathophysiology of depression. Functional magnetic resonance imaging (fMRI) was used to assess focal activation changes in DLPFC in response to a novel psychosocial challenge stimulus developed from the expressed emotion construct. Methods: Healthy control subjects and fully remitted unipolar depressed participants completed blood oxygen level-dependent fMRI while they beard their own mothers making critical and praising comments about them. Results: Relative to control subjects, participants with a history of depression failed to activate DLPFC when they beard critical remarks. There were no differences between the two groups in their DLPFC responses to maternal praise. Conclusions: Even if fully well at the time of testing, participants with a known vulnerability to depression respond differently to the psychosocial challenge of being criticized. These findings might have implications for our understanding of vulnerability to depression and to depressive relapse.