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Amygdala Response to Fearful Faces in Anxious and Depressed Children
Kathleen M. Thomas, PhD;
Wayne C. Drevets, MD;
Ronald E. Dahl, MD;
Neal D. Ryan, MD;
Boris Birmaher, MD;
Clayton H. Eccard;
David Axelson, MD;
Paul J. Whalen, PhD;
B. J. Casey, PhD
Arch Gen Psychiatry. 2001;58:1057-1063.
Background Alterations in amygdala function have been implicated in the pathophysiological
characteristics of adult anxiety and depressive disorders. Studies with healthy
adults and children, as well as with adults who have amygdala lesions, have
found facial expressions of emotion to be useful probes of amygdala activity.
Our study examined the amygdala response to fearful and neutral facial expressions
in healthy, anxious, and depressed children. We hypothesized that children
with anxiety and depression may show atypical amygdala responses to emotional
stimuli.
Methods Twelve children (8-16 years of age) with generalized anxiety or panic
disorder and 12 healthy comparison children underwent noninvasive functional
magnetic resonance imaging while viewing photographs of fearful and neutral
facial expressions. In a second comparison, 5 girls with major depressive
disorder were compared with 5 anxious and 5 healthy girls from the previous
sample.
Results Children with anxiety disorders showed an exaggerated amygdala response
to fearful faces compared with healthy children, whereas depressed children
showed a blunted amygdala response to these faces. In addition, the magnitude
of the amygdala's signal change between fearful and neutral faces was positively
correlated with the severity of everyday anxiety symptoms.
Conclusions Our results suggest that amygdala function is affected in both anxiety
and depression during childhood and adolescence. Moreover, this disruption
appears to be specific to the child's own rating of everyday anxiety.
From the Sackler Institute for Developmental Psychobiology, Department
of Psychiatry, Weill Medical College of Cornell University, New York, NY (Drs
Thomas and Casey and Mr Eccard); the Mood and Anxiety Disorders Neuroimaging
Section, National Institute of Mental Health, Bethesda, Md (Dr Drevets); the
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pa (Drs Drevets,
Dahl, Ryan, Birmaher, and Axelson); and the Departments of Psychiatry and
Psychology, University of Wisconsin, Madison (Dr Whalen).
Corresponding author and reprints: Kathleen M. Thomas, PhD, Sackler
Institute for Developmental Psychobiology, Weill Medical College of Cornell
University, 1300 York Ave, Box 140, Suite F-1332, New York, NY 10021 (e-mail: kmt2001{at}med.cornell.edu).
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