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Targeting abnormal neural circuits in mood and anxiety disorders: from the laboratory to the clinic

Nature Neuroscience volume 10, pages 1116–1124 (2007)Cite this article

Abstract

Recent decades have witnessed tremendous advances in the neuroscience of emotion, learning and memory, and in animal models for understanding depression and anxiety. This review focuses on new rationally designed psychiatric treatments derived from preclinical human and animal studies. Nonpharmacological treatments that affect disrupted emotion circuits include vagal nerve stimulation, rapid transcranial magnetic stimulation and deep brain stimulation, all borrowed from neurological interventions that attempt to target known pathological foci. Other approaches include drugs that are given in relation to specific learning events to enhance or disrupt endogenous emotional learning processes. Imaging data suggest that common regions of brain activation are targeted with pharmacological and somatic treatments as well as with the emotional learning in psychotherapy. Although many of these approaches are experimental, the rapidly developing understanding of emotional circuit regulation is likely to provide exciting and powerful future treatments for debilitating mood and anxiety disorders.

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Figure 1: Subgenual cingulate cortex activation across studies.
Figure 2: Amygdala activation across studies.
Figure 3: Ascending projections from vagus–nucleus solitarius pathways with VNS.
Figure 4: Deep brain stimulation.
Figure 5: Emotional learning processes related to fear.

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Acknowledgements

This authors are supported by grants from the US National Institutes of Mental Health (K.J.R., MH071537 and MH069884; H.S.M., P50 MH58922, P50 MH077083 and 1R01MH073719), US National Institute on Drug Abuse (K.J.R., DA-019624), NARSAD, Burroughs Wellcome Fund, Stanley Medical Research Foundation, Woodruff Fund and The Dana Foundation.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 954 Gatewood Drive, Atlanta, 30329, Georgia, USA

    Kerry J Ressler & Helen S Mayberg

  2. Yerkes National Primate Research Center, Emory University School of Medicine, 954 Gatewood Drive, Atlanta, 30329, Georgia, USA

    Kerry J Ressler

  3. Department of Neurology, Emory University School of Medicine, 954 Gatewood Drive, Atlanta, 30329, Georgia, USA

    Helen S Mayberg

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Correspondence to Kerry J Ressler.

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Competing interests

K.J.R. has a consulting agreement with and is on the Scientific Advisory Board of Tikvah Therapeutics, LLC, which has licensed a use-patent for D-cycloserine for the specific enhancement of learning during psychotherapy. K.J.R. is also entitled to sales royalty from future sales of D-cycloserine for this purpose. H.S.M. has served on the Cyberonics Scientific Advisory Board for Mechanisms of Action and has a consulting agreement with Advanced Neuromodulation Systems, Inc, which has licensed her intellectual property to develop Deep Brain Stimulation for the treatment of severe depression. K.J.R. also receives unrelated research support from Lundbeck, Inc. The terms of these arrangements have been reviewed and approved by Emory University in accordance with their conflict of interest policies.

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Ressler, K., Mayberg, H. Targeting abnormal neural circuits in mood and anxiety disorders: from the laboratory to the clinic. Nat Neurosci 10, 1116–1124 (2007). https://doi.org/10.1038/nn1944

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