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Why are cortical GABA neurons relevant to internal focus in depression? A cross-level model linking cellular, biochemical and neural network findings

Molecular Psychiatry volume 19, pages 966–977 (2014)Cite this article

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Abstract

Major depression is a complex and severe psychiatric disorder whose symptomatology encompasses a critical shift in awareness, especially in the balance from external to internal mental focus. This is reflected by unspecific somatic symptoms and the predominance of the own cognitions manifested in increased self-focus and rumination. We posit here that sufficient empirical data has accumulated to build a coherent biologic model that links these psychologic concepts and symptom dimensions to observed biochemical, cellular, regional and neural network deficits. Specifically, deficits in inhibitory γ-aminobutyric acid regulating excitatory cell input/output and local cell circuit processing of information in key brain regions may underlie the shift that is observed in depressed subjects in resting-state activities between the perigenual anterior cingulate cortex and the dorsolateral prefrontal cortex. This regional dysbalance translates at the network level in a dysbalance between default-mode and executive networks, which psychopathologically surfaces as a shift in focus from external to internal mental content and associated symptoms. We focus here on primary evidence at each of those levels and on putative mechanistic links between those levels. Apart from its implications for neuropsychiatric disorders, our model provides for the first time a set of hypotheses for cross-level mechanisms of how internal and external mental contents may be constituted and balanced in healthy subjects, and thus also contributes to the neuroscientific debate on the neural correlates of consciousness.

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Acknowledgements

This work was supported by National Institute of Mental Health MH084060 and MH077159 (to ES), as well as CIHR, HDRF and EJLB-CIHR and Michael Smith Foundation (to GN). We thank both Sibille and Northoff lab members, H Aizenstein and K Erickson for feedback on the content of this manuscript, and B French for careful feedback and help with the manuscript.

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Author notes

  1. G Northoff and E Sibille: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Psychiatry, University of Ottawa Institute of Mental Health Research, Royal Ottawa Hospital, Ottawa, ON, Canada

    G Northoff

  2. Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada

    G Northoff

  3. Taipei Medical University, Graduate Institute of Humanities in Medicine, Taipei, Taiwan

    G Northoff

  4. Taipei Medical University-Shuang Ho Hospital, Brain and Consciousness Research Center, New Taipei City, Taiwan

    G Northoff

  5. National Chengchi University, Research Center for Mind, Brain and Learning, Taipei, Taiwan

    G Northoff

  6. Department of Psychology, National Chengchi University, Taipei, Taiwan

    G Northoff

  7. Centre for Cognition and Brain Disorders (CBBD), Normal University Hangzhou, Hangzhou, China

    G Northoff

  8. Department of Psychiatry, Center For Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA

    E Sibille

  9. Departments of Psychiatry and Pharmacology, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, ON, Canada

    E Sibille

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  1. G Northoff
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Correspondence to G Northoff or E Sibille.

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Northoff, G., Sibille, E. Why are cortical GABA neurons relevant to internal focus in depression? A cross-level model linking cellular, biochemical and neural network findings. Mol Psychiatry 19, 966–977 (2014). https://doi.org/10.1038/mp.2014.68

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