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Dichter GS, Kozink RV, McClernon FJ, Smoski MJ. Remitted major depression is characterized by reward network hyperactivation during reward anticipation and hypoactivation during reward outcomes. J Affect Disord 136: 1126-1134

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, United States.
Journal of Affective Disorders (Impact Factor: 3.71). 02/2012; 136(3):1126-34. DOI: 10.1016/j.jad.2011.09.048
Source: PubMed

ABSTRACT Although functional brain imaging has established that individuals with unipolar major depressive disorder (MDD) are characterized by frontostriatal dysfunction during reward processing, no research to date has examined the chronometry of neural responses to rewards in euthymic individuals with a history of MDD.
A monetary incentive delay task was used during fMRI scanning to assess neural responses in frontostriatal reward regions during reward anticipation and outcomes in 19 participants with remitted major depressive disorder (rMDD) and in 19 matched control participants.
During the anticipation phase of the task, the rMDD group was characterized by relatively greater activation in bilateral anterior cingulate gyrus, in right midfrontal gyrus, and in the right cerebellum. During the outcome phase of the task, the rMDD group was characterized by relatively decreased activation in bilateral orbital frontal cortex, right frontal pole, left insular cortex, and left thalamus. Exploratory analyses indicated that activation within a right frontal pole cluster that differentiated groups during reward anticipation predicted the number of lifetime depressive episodes within the rMDD group.
Replication with larger samples is needed.
Results suggest a double dissociation between reward network reactivity and temporal phase of the reward response in rMDD, such that rMDD is generally characterized by reward network hyperactivation during reward anticipation and reward network hypoactivation during reward outcomes. More broadly, these data suggest that aberrant frontostriatal response to rewards may potentially represent a trait marker for MDD, though future research is needed to evaluate the prospective utility of this functional neural endophenotype as a marker of MDD risk.

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Available from: Francis Joseph McClernon, Aug 21, 2015
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    • "For example, it is not known whether decreased positive mood symptoms are generally more persistent than increased negative mood symptoms and whether low levels of decreased positive mood symptoms are more likely to be present between episodes of recurrent MDD. Interestingly, altered reward-network responsivity is found in individuals with a history of MDD but without significant current symptoms (Dichter et al., 2012b; McCabe et al., 2009). "
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    • "A growing number of studies suggest that using functional neuroimaging in rMDD is a valid approach to investigating biological trait markers for future major depressive episodes ( Bhagwagar and Cowen, 2008 ; Dichter et al., 2012 ; Elliott et al., 2012 ; Nixon et al., 2014 ; Schiller et al., 2013 ; Pulcu et al., 2014 ). Studying remitted MDD has additional advantages such as mitigating the effects of current mood state and antidepressant medications ( Dichter et al., 2012 ; Schiller et al., 2013 ). Here, we investigated the following hypotheses, based on previous literature reviewed above: compared with controls, people with rMDD would exhibit 1) enhanced sgACC response to donation decisions relative to simple monetary rewards and 2) reduced responses to rewards in striatal regions (e.g. "
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    • "However , these studies have yielded inconsistent results probably due to the differences in the tasks employed in the studies. Compared to healthy subjects, remitted patients with MDD showed decreased activity in the right frontal pole, left insula, left thalamus, and the OFC bilaterally during the outcome phase of the monetary incentive delay task (Dichter et al., 2012). When compared to healthy subjects, patients with MDD also showed increased activity in the left inferior frontal gyrus and thalamus bilaterally during the positive reward in outcome phase of the Wheel of Fortune task, but showed decreased activity in the medial frontal cortex, the right caudate, and auditory cortex combined with increased activity in the OFC, inferior frontal cortex, and middle frontal cortex during the negative reward in outcome phase (Smoski et al., 2009). "
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