Progress in Neuro-Psychopharmacology and Biological Psychiatry
ReviewThe peculiarity of the right-hemisphere function in depression: solving the paradoxes
Introduction
The present paper discusses a very complicated and contradictory topic: the relationship between functional activity and physiological activation of the right hemisphere in depression. In the first part of this paper the author presents a review of the literature related to this topic. In the second part of the paper a new concept of brain laterality is proposed. In the final part of the paper this new concept is applied to the right-hemisphere function in depression.
Section snippets
Functional brain asymmetry in depression: data and concepts
According to contemporary thinking, functional brain asymmetry substantially contributes to the psychophysiological mechanisms of affective disorders Davidson, 1992, Davidson, 1993, Flor-Henry, 1983, Heller, 1993. Schwartz et al. (1975) have shown that greater right- than left-hemisphere activation mediates the effect of negative affect. It is worth emphasizing that the relative hyperactivation of the frontal pole of the right hemisphere characterizes not only major depression Debener et al.,
The right frontal physiological activity in depression: experimental data
Most investigations show a relative increase of the electrical activity of the right frontal lobe and prefrontal cortex in depression Heller, 1990, Henriques and Davidson, 1990, Jacobs and Snyder, 1996, Schaffer et al., 1983. It was shown Davidson et al., 1990, Tucker et al., 1981 that depressed mood and the experience of disgust are accompanied in normal subjects by the right-sided frontal activation compared with euphoric mood and the experience of happiness. Subjects with higher right-sided
Affect and brain laterality: speculations and contradictions
The theoretical integration of all the abovementioned experimental data is far from being comprehensive and exhaustive. A very substantial analysis performed by Heller and Nitschke (1998) led them to the conclusion that the anterior regions of the brain consistently emerge as important in affective valence related to a person's affective style, whereas the right parietotemporal region is important in arousal.
Davidson (1998) presented a broader and very well known interpretation of the
A main contradiction: disturbed right-hemisphere functions in depression
Although the right frontal lobe is physiologically hyperactivated in depression, the right-hemisphere functions are disturbed in depressed patients. According to blood flow studies, depression is characterized by the reduced right anterior brain functions Baxter et al., 1989, Bench et al., 1992. The experience of sadness is characterized by the decreased blood flow in the right dorsolateral prefrontal and inferior parietal regions while recovery from depression is accompanied by the restoration
Electroencephalogram (EEG) and brain functional efficacy
According to Lindsley (1951), the relationship between physiological activity and functional efficacy of the brain, and especially of the right hemisphere, is in general (in healthy subjects) not so linear as it is expected to be.
In some particular conditions the right hemisphere displays an obvious discrepancy between bioelectrical activation and functional efficacy. It was shown that the process of imagination in subjects with the domination of the right hemisphere occurs without additional
Modern concepts of the brain laterality: a short critical review
Modern concepts of brain laterality cannot explain these data in a comprehensive way and are not free from contradictions.
The first theoretical conceptualizations of brain laterality suggested that the left and right hemispheres process qualitatively different information Goldberg and Costa, 1981, Sperry et al., 1969. In particular, the left hemisphere was thought to be involved in the processing of verbal material, signs, and symbols, whereas the right hemisphere was thought to be involved in
Concept of mono- and polysemantic contexts
In order to avoid the abovementioned contradictions, I have presented the following concept Rotenberg, 1979, Rotenberg, 1982, Rotenberg, 1985, Rotenberg, 1993, Rotenberg, 1994, Rotenberg and Weinberg, 1999. In the most general form, the difference between the two strategies of thinking related to the left- and right-hemisphere functions is reduced to opposite modes of organizing the contextual connection between elements of information. “Left-hemisphere” or formal logical thinking so organizes
The right frontal hyperactivity in depression: functional meaning
If the additional physiological activation of the frontal lobe of the right hemisphere does not help to restore its functional sufficiency and to create the polysemantic context, then it is possible to understand the co-occurence of the functional disability of the right hemisphere and its relative physiological overactivation. The latter displays the insufficient and irrelevant efforts of the brain to overcome restrictions produced by the weakness of the right-hemisphere thinking (Rotenberg
Conclusion
Hyperactivation of the right-hemisphere frontal part in depression reflects its functional insufficiency and inability to build a polysemantic context. In combination with the partial insufficiency of the left hemisphere frontal part, it displays a predisposition to the development of depression.
Acknowledgements
My sincerest thanks to Prof. R. Greenberg and Dr. J. Fisch for their help and valuable comments to the first version of this manuscript.
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