Depression and Affective Neuroscience

Transcription

1 Depression and Affective Neuroscience Margaret R. Zellner, Ph.D., L.P. copies of presentations available at mzellner.com The National Psychological Association for Psychoanalysis (NPAP) The Neuropsychoanalysis Foundation

2 early life stress genetic vulnerability SES intrapsychic factors loss depression psychotherapy medication brain stimulation social support exercise nutrition

3 action perception emotion

4 adapted from Berton and Nestler 2006 Nat Rev Neurosci motivation PAG activation of emotion generation of emotion

5 FRONTAL planning - WHAT and HOW to do PARIETAL the body and objects in space - WHERE things are TEMPORAL recognition of objects and people - WHO things are VMPFC, ANTERIOR TEMPORAL memory, emotion, reward - meaning, or, WHY to do or not to do Marcel Mesulam, 2000 Principles of Behaviora and Cognitive Neurology

6 Guevara et al 2012, NeuroImage

7 van den Heuvel & Sporns 2011 J Neurosci

8 and of course it s all connected... Kelley et al 2005 Kelley et al 2005

9 Frontoparietal Somatomotor Dorsal attention Default resting state networks areas presumed to be connected continuously active dynamically interactive correspond to functional studies Salience Default Visual Limbic Dorsal attention Somatomotor Frontoparietal Default Salience Default Visual Yeo et al 2011 J Neurophysiol Limbic

10 default mode network mind-wandering daydreaming stimulus-independent thought simulation episodic/autobiographical memory Buckner et al 2008

11 DMN correlated with spontaneous cognition Andrews-Hanna et al 2010 J Neurophysiology

12 attention network switching attention executive control/ frontoparietal network working memory staying on task maintaining focus salience network encoding value monitoring errors subjective experience ( aha moments, craving, and more)

13 salience sensory, auditory, motor working memory (frontoparietal and dorsal attention) visual DMN Doucet et al 2011 J Neurophysio

14 Uddin 2015 NATURE REVIEWS NEUROSCIENCE Craig 2009 NATURE REVIEWS NEUROSCIENCE

15 Eisenberger 2012 Nat Rev Neurosci Uddin 2015 NATURE REVIEWS NEUROSCIENCE

16 Salience network implicated across many psychiatric disorders gray matter loss across 6 diagnoses (schizophrenia, bipolar disorder, depression, addiction, obsessive-compulsive disorder, and anxiety) - the dorsal anterior cingulate, right insula, left insula Goodkind et al 2015 JAMA Psychiatry

17 Emotion, instinct, drive Attention, perception, regulation Panksepp and Solms 2012 Trends Cog Sci

18 Panksepp 2006 Prog Neuro-Psychopharm and Bio Psych

19 SEEKING RAGE FEAR (â PLAY) (á RAGE) â PLAY á FEAR â PLAY, LUST, SEEKING á RAGE LUST CARE â GRIEF PANIC/GRIEF â PLAY á â SEEKING á FEAR PLAY ACC NAcc fundamentally dynamic system BNST POA M M Hyp POA POA/ L VTA M M Amy L D PAG D C/L

20 PANIC/GRIEF System Panksepp 2003

21 PANIC/GRIEF System SEEKING System Coenen et al 2012 J Neuropsychiatry Clin Neurosci

22 PANIC/GRIEF System SEEKING System Coenen et al 2012 J Neuropsychiatry Clin Neurosci

23 Affect Regulation Arnsten and Rubia J Am Acad Child Adolesc Psychiatry 2012

24 Kupfer, D. J., Frank, E., & Phillips, M. L. (2012). Major depressive disorder: new clinical, neurobiological, and treatment perspectives. Lancet, 379(9820), doi: /s (11)

25 Disner, S. G., Beevers, C. G., Haigh, E. A. P., & Beck, A. T. (2011). Neural mechanisms of the cognitive model of depression. Nature Reviews Neuroscience, 12(8), doi: /nrn3027

26 Disner, S. G., Beevers, C. G., Haigh, E. A. P., & Beck, A. T. (2011). Neural mechanisms of the cognitive model of depression. Nature Reviews Neuroscience, 12(8), doi: /nrn3027

27 euthymia or depressive vulnerability PANIC-shutdown model of depression (Panksepp & Watt 2009) baseline opioid and oxytocin tone (social contact, good internal objects) responsive DA system appropriate levels of other global neuromodulators (NE, ACh, 5-HT) impaired infrastructure due to history impaired infrastructure due to genes depressive intrapsychic factors: intrapsychic conflict/defenses around grieving ( the shadow of the object / relating to negative internal objects) loss: separation distress á HPA activation á DA release, NE, ACh â opioids á dynorphin Bowlby: protest reunion á opioids, oxytocin â HPA activation á DA tone termination of separation distress: sadness â opioids, oxytocin â HPA activation â DA tone á PNS activation decathexis shut down + depression } despair Berton and Nestler, 2006 CREB and Dynorphin in NAC in Depression: Activation of CREB (camp( camp- responsive element binding protein) by stress-mediated upregulation of dynorphin. CREB activated by D1 receptors (or TrkB-regulated regulated signal transduction - BDNF), leading to increased expression of dynorphin. Dynorphin creates inhibitory feedback to VTA projection system (shuts down separation distress/longing and d create anhedonia). circadian disruption immune system - sickness behavior continued dynorphin activation? chronic HPA activation, leading to cognitive and immune problems, hypersensitive amygdala, other

28 Questions and discussion?

29 Additional slides

30 basic emotion systems hypothalamus protoself SC PBN NTS Antonio Damasio Self Comes to Mind (2012) Jaak Panksepp Affective Neuroscience (1998) Archeology of Mind (2012)

31 Neural interactions characteristics of brain emotional systems: 1) Various sensory stimuli can unconditionally access emotional systems; 2) Emotional systems generate instinctual motor outputs & 3) Modulate sensory inputs. 4) Emotional systems have positive feedback components which can sustain emotional arousal after precipitating events have passed. 5) These systems can be modulated by cognitive inputs, & 6) These systems can modify/channel cognitive activities. Panksepp 2011 PLoS One