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Different neural and cognitive response to emotional faces in healthy monozygotic twins at risk of depression

  • K. W. Miskowiak (a1), L. Glerup (a1), C. Vestbo (a1), C. J. Harmer (a2), A. Reinecke (a2), J. Macoveanu (a3), H. R. Siebner (a3) (a4), L. V. Kessing (a1) and M. Vinberg (a1)...



Negative cognitive bias and aberrant neural processing of emotional faces are trait-marks of depression. Yet it is unclear whether these changes constitute an endophenotype for depression and are also present in healthy individuals with hereditary risk for depression.


Thirty healthy, never-depressed monozygotic (MZ) twins with a co-twin history of depression (high risk group: n = 13) or without co-twin history of depression (low-risk group: n = 17) were enrolled in a functional magnetic resonance imaging (fMRI) study. During fMRI, participants viewed fearful and happy faces while performing a gender discrimination task. After the scan, they were given a faces dot-probe task, a facial expression recognition task and questionnaires assessing mood, personality traits and coping strategies.


High-risk twins showed increased neural response to happy and fearful faces in dorsal anterior cingulate cortex (ACC), dorsomedial prefrontal cortex (dmPFC), pre-supplementary motor area and occipito-parietal regions compared to low-risk twins. They also displayed stronger negative coupling between amygdala and pregenual ACC, dmPFC and temporo-parietal regions during emotional face processing. These task-related changes in neural responses in high-risk twins were accompanied by impaired gender discrimination performance during face processing. They also displayed increased attention vigilance for fearful faces and were slower at recognizing facial expressions relative to low-risk controls. These effects occurred in the absence of differences between groups in mood, subjective state or coping.


Different neural response and functional connectivity within fronto-limbic and occipito-parietal regions during emotional face processing and enhanced fear vigilance may be key endophenotypes for depression.


Corresponding author

* Address for correspondence: K. W. Miskowiak, Department of Psychiatry, Psychiatric Centre Copenhagen, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej Copenhagen, Denmark. (Email:


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