Article

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: 3.38). 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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    • "The use of such reward paradigms permits a more precise examination of neural activations reflecting abnormalities in appetitive motivational processing during reward anticipation and reward experiencing during outcome processing (Berridge & Kringelbach, 2008; Dillon et al. 2008, 2011; Kohls et al. 2012). Dichter et al. (2012) reported hyperactivation in rMDD individuals during reward anticipation in the ACC, midfrontal gyrus (MFG) and anterior cerebellum. Hyperactivation in the ACC and MFG was suggested to reflect greater recruitment of neural resources to represent the forthcoming value of rewards and to monitor the incentivebased motor response, which is necessary for obtaining rewards. "
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    ABSTRACT: Dysfunctional behavioural and neural processing of reward has been found in currently depressed individuals. However, little is known about altered reward processing in remitted depressed individuals. A total of 23 medication-free individuals with remitted major depressive disorder (rMDD) and 23 matched healthy controls (HCs) performed a reward task during functional magnetic resonance imaging. We also investigated reward dependence, novelty seeking and harm avoidance using the Tridimensional Personality Questionnaire and their association with neural responses of reward processing. Compared to HCs, individuals with rMDD exhibited enhanced responses to reward-predicting cues in the hippocampus, amygdala and superior frontal gyrus. When reward was delivered, rMDD subjects did not significantly differ from HCs. In both groups neural activity during reward anticipation was negatively correlated with harm avoidance. Our results show that rMDD is characterized by hyperactivation in fronto-limbic regions during reward anticipation. Alterations in neural activation during reward processing might reflect an increased effort in remitted depressed individuals to allocate neural activity for executive and evaluative processes during anticipatory reward processing.
    No preview · Article · Aug 2015 · Psychological Medicine
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    • "Negative mood state could have also affected the range of BIS/BAS scores. These results contrast previous research that has found disrupted reward-processing in remitted MDD (Dichter et al., 2012; Pechtel et al., 2013), as compared to healthy controls. We may have failed to find similar results due to the titration procedure, which could have helped r-MDD participants perform similarly to the HCs. "
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    ABSTRACT: Anhedonia, the diminished anticipation and pursuit of reward, is a core symptom of major depressive disorder (MDD). Trait behavioral activation (BA), as a proxy for anhedonia, and behavioral inhibition (BI) may moderate the relationship between MDD and reward-seeking. The present studies probed for reward learning deficits, potentially due to aberrant BA and/or BI, in active or remitted MDD individuals compared to healthy controls (HC). Active MDD (Study 1) and remitted MDD (Study 2) participants completed the modified monetary incentive delay task (mMIDT), a behavioral reward-seeking task whose response window parameters were individually titrated to theoretically elicit equivalent accuracy between groups. Participants completed the BI Scale and BA Reward-Responsiveness and Drive Scales. Despite individual titration, active MDD participants won significantly less money than HCs. Higher Reward-Responsiveness scores predicted more won; Drive and BI were not predictive. Remitted MDD participants' performance did not differ from controls', and trait BA and BI measures did not predict r-MDD performance. These results suggest that diminished reward-responsiveness may contribute to decreased motivation and reward pursuit during active MDD, but that reward learning is intact in remission. Understanding individual reward processing deficits in MDD may inform personalized intervention addressing anhedonia and motivation deficits in select MDD patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Full-text · Article · Aug 2015
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    • "Negative mood state could have also affected the range of BIS/BAS scores. These results contrast previous research that has found disrupted reward-processing in remitted MDD (Dichter et al., 2012; Pechtel et al., 2013), as compared to healthy controls. We may have failed to find similar results due to the titration procedure, which could have helped r-MDD participants perform similarly to the HCs. "
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    ABSTRACT: Background / Purpose: Individuals with depression often experience anhedonia and impaired reward-seeking behavior. We sought to find personality moderators (positive and/or negative trait affect) in the relationship between depression and reward-seeking deficits. Main conclusion: Low trait reward-responsiveness and high trait behavioral inhibition predicted reduced reward-seeking behavior in individuals with depression.
    Full-text · Conference Paper · Jul 2014
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