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Zhang B, Rolls ET, Wang X, Xie C, Cheng W, Feng J. Roles of the medial and lateral orbitofrontal cortex in major depression and its treatment. Mol Psychiatry 2024:10.1038/s41380-023-02380-w. [PMID: 38212376 DOI: 10.1038/s41380-023-02380-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 01/13/2024]
Abstract
We describe evidence for dissociable roles of the medial and lateral orbitofrontal cortex (OFC) in major depressive disorder (MDD) from structure, functional activation, functional connectivity, metabolism, and neurochemical systems. The reward-related medial orbitofrontal cortex has lower connectivity and less reward sensitivity in MDD associated with anhedonia symptoms; and the non-reward related lateral OFC has higher functional connectivity and more sensitivity to non-reward/aversive stimuli in MDD associated with negative bias symptoms. Importantly, we propose that conventional antidepressants act to normalize the hyperactive lateral (but not medial) OFC to reduce negative bias in MDD; while other treatments are needed to operate on the medial OFC to reduce anhedonia, with emerging evidence suggesting that ketamine may act in this way. The orbitofrontal cortex is the key cortical region in emotion and reward, and the current review presents much new evidence about the different ways that the medial and lateral OFC are involved in MDD.
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Affiliation(s)
- Bei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, PR China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, PR China
| | - Edmund T Rolls
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, PR China.
- Oxford Centre for Computational Neuroscience, Oxford, UK.
- Department of Computer Science, University of Warwick, Coventry, UK.
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, PR China
- Medical Psychological Institute, Central South University, Changsha, PR China
- China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, PR China
| | - Chao Xie
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, PR China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, PR China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, PR China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, PR China.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, PR China.
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, PR China.
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, PR China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, PR China.
- Department of Computer Science, University of Warwick, Coventry, UK.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, PR China.
- Zhangjiang Fudan International Innovation Center, Shanghai, PR China.
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