BACKGROUND: So far findings on emotional face processing among depressed individuals reveal an inconsistent image, with only some studies supporting a mood-congruent bias in salience processing. Thereby, many results are based on the processing of sad emotions and mostly focused on resting-state connectivity analysis. The present study aimed to target this misbalance by implementing a social oddball paradigm, with a special focus on the amygdala, the ACC, the insula and subdivisions of insula and ACC.

METHODS: Twenty-seven depressed patients and twenty-seven non-depressed controls took part in a fMRI event-related social oddball paradigm based on smiling facial expressions as target stimuli embedded in a stream of neutral facial expressions. FMRI activation and functional connectivity analysis were calculated for the pre-defined ROIs of the salience network (SN), with a special focus on twelve insular subdivisions and six ACC subdivisions.

RESULTS: For both groups the social oddball paradigm triggered similar BOLD responses within the pre-defined ROIs, while the quality of functional connectivity showed pronounced alterations from the salience network to the ventral attention- and default mode network (DMN).

CONCLUSION: On a first level of target detection, smiling faces are equally processed and trigger similar bold responses in structures of the salience network. On a second level of inter-network communication the brain of depressed participants tends to be pre-formed for self-referential processing and rumination instead of fast goal directed behavior and socio-emotional cognitive processing.