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Roles of the medial and lateral orbitofrontal cortex in major depression and its treatment
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Zhang, Bei, Rolls, Edmund T., Wang, Xiang, Xie, Chao, Cheng, Wei and Feng, Jianfeng (2024) Roles of the medial and lateral orbitofrontal cortex in major depression and its treatment. Molecular Psychiatry . doi:10.1038/s41380-023-02380-w ISSN 1359-4184. (In Press)
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Official URL: https://doi.org/10.1038/s41380-023-02380-w
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.
Item Type: | Journal Article | ||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Science > Computer Science | ||||||
SWORD Depositor: | Library Publications Router | ||||||
Journal or Publication Title: | Molecular Psychiatry | ||||||
Publisher: | Nature Publishing Group | ||||||
ISSN: | 1359-4184 | ||||||
Official Date: | 12 January 2024 | ||||||
Dates: |
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DOI: | 10.1038/s41380-023-02380-w | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | In Press | ||||||
Access rights to Published version: | Restricted or Subscription Access |
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