Chapter 7

Neurobiology of cognitive dysfunction in major depressive disorder

Key Points

0 Cognitive deficits in MDD are subserved by disturbances in several integrated neural.

neurotransmitter. inflammatory, oxidative. and endocrine systems.

0 Disturbances in ‘hot' and ‘cold' cognition reflect abnormal structure, function. and reciprocity in
discrete and overlapping neural circuits and networks.

0 Both state and trait effects pertinent to the neurobiology of cognition have been documented.

M Introduction

Recent advances in neuroimaging have allowed for the study of complex neural networks that subserve
cognitive and affective processes. Neural connectivity refers to networks of structural and functional
connections between brain regions that are active under basal and task-related conditions.
Understanding the neural connectivity between and within brain regions may elucidate the underlying
pathophysiological basis of M00 and its associated cognitive deficits (Huivershorn et ai 2011). Cognitive
func. born in M00 is also subserved by multiple interacting neurobiologicai systems. including
nwrotransmitter. inflammatory. oxidative. and endocrine.

7.1.1 Connectivity

Progress in molecular and cellular biology as well as neuroimaging have advanced the understanding of
cognitive function/ dysfunction and has supported the hypothesis that P100 is subserved by
abnormalities in the structure. function. and chemical composiion of frontosubcortical circuitry
(Pizzagaiii 2011). The neural basis of cognitive and imotiomi processes is represented by overlapping
neural networks (Figure 7.1; Diener it sl 2012). For example. the ventromediai prefrontai cortex has
reciprocal conneciom to the amygdala and hippocampus. regions implicated in emotional processing
and mm as well as the dorsoiaterai prefrontai cortex, which has reciprocal connections a disparate brain
areas (ea. basal ganglia. cinguiate cortex. parietal cortex; Wood and