Motivational deficits in effort-based decision making in individuals with subsyndromal depression, first-episode and remitted depression patients

Cognitive and behavioral training interventions to promote self-control

This review article discusses various cognitive and behavioral interventions that have been developed with the goal of promoting self-controlled responding. Self-control can exert a significant impact on human health and impulsive behaviors are associated with a wide range of diseases and disorders, leading to the suggestion that impulsivity is a trans-disease process. The self-control interventions include effort exposure, reward discrimination, reward bundling, interval schedules of reinforcement, impulse control training, and mindfulness training. Most of the interventions have been consistently shown to increase self-control, except for mindfulness training. Some of the successful interventions are long-lasting, whereas others may be transient. Most interventions are domain-specific, targeting specific cognitive and behavioral processes that relate to self-control rather than targeting overall self-control. For example, effort exposure appears to primarily increase effort tolerance, which in turn can improve self-control. Similarly, interval schedules primarily target interval timing, which promotes self-controlled responses. A diagram outlining a proposed set of intervention effects on self-control is introduced to motivate further research in this area. The diagram suggests that the individual target processes of the interventions may potentially summate to produce general self-control, or perhaps even produce synergistic effects. In addition, it is suggested that developing a self-control profile may be advantageous for aligning specific interventions to mitigate specific deficits. Overall, the results indicate that interventions are a promising avenue for promoting self-control and may help to contribute to changing health outcomes associated with a wide variety of diseases and disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Novel Atypical Dopamine Uptake Inhibitor (S)-CE-123 Partially Reverses the Effort-Related Effects of the Dopamine Depleting Agent Tetrabenazine and Increases Progressive Ratio Responding

Animal studies of effort-based choice behavior are being used to model effort-related motivational dysfunctions in humans. With these procedures, animals are offered a choice between high-effort instrumental actions leading to highly valued reinforcers vs. low effort/low reward options. Several previous studies have shown that dopamine (DA) uptake inhibitors, including GBR12909, lisdexamfetamine, methylphenidate, and PRX-14040, can reverse the effort-related effects of the vesicular monoamine transport blocker tetrabenazine, which inhibits DA storage. Because many drugs that block DA transport act as major stimulants that also release DA, and produce a number of undesirable side effects, there is a need to develop and characterize novel atypical DA transport inhibitors. (S)-CE-123 ((S)-5-((benzhydrylsulfinyl) methyl)thiazole) is a recently developed analog of modafinil with the biochemical characteristics of an atypical DA transport blocker. The present paper describes the enantioselective synthesis and initial chemical characterization of (S)-CE-123, as well as behavioral experiments involving effort-based choice and microdialysis studies of extracellular DA. Rats were assessed using the fixed ratio 5/chow feeding choice test. Tetrabenazine (1.0 mg/kg) shifted choice behavior, decreasing lever pressing and increasing chow intake. (S)-CE-123 was coadministered at doses ranging from 6.0 to 24.0 mg/kg, and the highest dose partially but significantly reversed the effects of tetrabenazine, although this dose had no effect on fixed ratio responding when administered alone. Additional experiments showed that (S)-CE-123 significantly increased lever pressing on a progressive ratio/chow feeding choice task and that the effective dose (24.0 mg/kg) increased extracellular DA in nucleus accumbens core. In summary, (S)-CE-123 has the behavioral and neurochemical profile of a compound that can block DA transport, reverse the effort-related effects of tetrabenazine, and increase selection of high-effort progressive ratio responding. This suggests that (S)-CE-123 or a similar compound could be useful as a treatment for effort-related motivational dysfunction in humans.

Why not try harder? Computational approach to motivation deficits in neuro-psychiatric diseases

Motivation deficits, such as apathy, are pervasive in both neurological and psychiatric diseases. Even when they are not the core symptom, they reduce quality of life, compromise functional outcome and increase the burden for caregivers. They are currently assessed with clinical scales that do not give any mechanistic insight susceptible to guide therapeutic intervention. Here, we present another approach that consists of phenotyping the behaviour of patients in motivation tests, using computational models. These formal models impose a precise and operational definition of motivation that is embedded in decision theory. Motivation can be defined as the function that orients and activates the behaviour according to two attributes: a content (the goal) and a quantity (the goal value). Decision theory offers a way to quantify motivation, as the cost that patients would accept to endure in order to get the benefit of achieving their goal. We then review basic and clinical studies that have investigated the trade-off between the expected cost entailed by potential actions and the expected benefit associated with potential rewards. These studies have shown that the trade-off between effort and reward involves specific cortical, subcortical and neuromodulatory systems, such that it may be shifted in particular clinical conditions, and reinstated by appropriate treatments. Finally, we emphasize the promises of computational phenotyping for clinical purposes. Ideally, there would be a one-to-one mapping between specific neural components and distinct computational variables and processes of the decision model. Thus, fitting computational models to patients' behaviour would allow inferring of the dysfunctional mechanism in both cognitive terms (e.g. hyposensitivity to reward) and neural terms (e.g. lack of dopamine). This computational approach may therefore not only give insight into the motivation deficit but also help personalize treatment.

Methylphenidate increases willingness to perform effort in adults with ADHD

BACKGROUND

A reduced willingness to perform effort based on the magnitude and probability of potential rewards has been associated with diminished dopamine function and may be relevant to attention-deficit/hyperactivity disorder (ADHD). Here, we investigated the influence of ADHD status and methylphenidate on effort-based decisions. We hypothesized that ADHD participants would make fewer high-effort selections than non-ADHD subjects, and that methylphenidate would increase the number of high-effort selections. Furthermore, we hypothesized there would be associations among ADHD severity and methylphenidate-related changes in effort-based and attentional performance across all participants.

METHODS AND PARTICIPANTS

ADHD (n = 23) and non-ADHD (n = 23) adults completed the Effort Expenditure for Rewards Task in which participants select between low-effort and high-effort options to receive monetary rewards at varying levels of reward magnitude and probability. A test of attentional performance was also completed.

RESULTS

Overall, participants made more high-effort selections as potential reward magnitude and probability increased. ADHD participants did not make fewer high-effort selections than non-ADHD participants, but ADHD participants showed greater methylphenidate-related increases in high-effort selections. ADHD participants had worse attentional performance than non-ADHD participants. ADHD severity was associated with methylphenidate-related changes in high-effort selections, but not changes in attentional performance.

CONCLUSIONS

These results indicate that methylphenidate increases the willingness to perform effort in individuals with ADHD, possibly due to disorder-related motivational deficits. This provides support for theories of insufficient effort allocation among individuals with ADHD.

TRIAL REGISTRATION

Clinicaltrials.gov Identifier, NCT02630017.

Stress transforms lateral habenula reward responses into punishment signals

Neuronal activity in the lateral habenula (LHb), a brain region implicated in depression [C. D. Proulx, O. Hikosaka, R. Malinow, Nat. Neurosci. 17, 1146-1152 (2014)], decreases during reward and increases during punishment or reward omission [M. Matsumoto, O. Hikosaka, Nature 447, 1111-1115 (2007)]. While stress is a major risk factor for depression and strongly impacts the LHb, its effect on LHb reward signals is unknown. Here we image LHb neuronal activity in behaving mice and find that acute stress transforms LHb reward responses into punishment-like neural signals; punishment-like responses to reward omission also increase. These neural changes matched the onset of anhedonic behavior and were specific to LHb neurons that distinguished reward and its omission. Thus, stress distorts LHb responsivity to positive and negative feedback, which could bias individuals toward negative expectations, a key aspect of the proposed pathogenesis of depression [A. T. Beck, Depression: Clinical, Experimental, and Theoretical Aspects, sixth Ed (1967)].

Motivation and cognitive control in depression

Depression is linked to deficits in cognitive control and a host of other cognitive impairments arise as a consequence of these deficits. Despite of their important role in depression, there are no mechanistic models of cognitive control deficits in depression. In this paper we propose how these deficits can emerge from the interaction between motivational and cognitive processes. We review depression-related impairments in key components of motivation along with new cognitive neuroscience models that focus on the role of motivation in the decision-making about cognitive control allocation. Based on this review we propose a unifying framework which connects motivational and cognitive control deficits in depression. This framework is rooted in computational models of cognitive control and offers a mechanistic understanding of cognitive control deficits in depression.

What Role Does the Prefrontal Cortex Play in the Processing of Negative and Positive Stimuli in Adolescent Depression?

This perspective describes the contribution of the prefrontal cortex to the symptoms of depression in adolescents and specifically the processing of positive and negative information. We also discuss how the prefrontal cortex (PFC) activity and connectivity during tasks and at rest might be a biomarker for risk for depression onset in adolescents. We include some of our recent work examining not only the anticipation and consummation of positive and negative stimuli, but also effort to gain positive and avoid negative stimuli in adolescents with depression. We find, using region of interest analyses, that the PFC is blunted in those with depression compared to controls across the different phases but in a larger sample the PFC is blunted in the anticipatory phase of the study only. Taken together, in adolescents with depression there is evidence for dysfunctional PFC activity across different studies and tasks. However, the data are limited with small sample sizes and inconsistent findings. Larger longitudinal studies with more detailed assessments of symptoms across the spectrum are needed to further evaluate the role of the PFC in adolescent depression.

Psychotic like experiences as part of a continuum of psychosis: Associations with effort-based decision-making and reward responsivity

Research examining psychotic disorders typically involves comparison between individuals with a clinical disorder and healthy controls. However, research suggests that psychotic symptoms, such as delusions and hallucinations, may exist on a continuum ranging from variation in healthy individuals to diagnosable psychotic disorders. On this continuum, some individuals endorse occasional psychotic like experiences (PLEs) that do not cause sufficient impairment or distress to warrant a clinical diagnosis. Given this continuum model, one might expect to observe impairments in those with PLEs in the same behavioral domains impaired in schizophrenia. Thus, we examined two domains typically impaired in schizophrenia, effort allocation and reward responsivity, in a large university sample (n = 126). Participants completed tasks assessing effort-based decision-making, reward responsivity, and questionnaires assessing PLEs. Greater PLEs were associated with greater effort expenditure regardless of probability of receiving a reward or reward value. Higher PLEs were related to greater positive feelings when receiving rewards. Importantly, these relationships remained the same when controlling for other symptoms such as depression, anhedonia, and anxiety. These findings suggest that PLEs may be associated with hypersensitivity to reward at the less severe end of the psychotic continuum, with effort to attain a reward expended in a potentially inefficient manner. This pattern is consistent with models of hyperdopaminergic states in psychotic individuals not taking antipsychotic medications, given the role of dopamine in modulating effort allocation and reward anticipation.

Anticipatory pleasure for future experiences in schizophrenia spectrum disorders and major depression: A systematic review and meta-analysis

OBJECTIVES

Deficits in anticipating pleasure may be an important dimension of anhedonia and functioning in psychiatric disorders, particularly schizophrenia and depression; however, inconsistent findings have limited the conclusions that can be drawn. We conducted the first systemic review and meta-analysis of the extant literature for research comparing psychiatric groups to healthy control groups on anticipatory pleasure.

METHODS

Academic Search Complete, Science Direct, and CINAHL databases were systematically searched up to 9 June 2018 for relevant peer-reviewed articles, book chapters, and dissertations. Reference lists were also hand searched. A total of 36 studies were included in the review.

RESULTS

A moderate-sized deficit was observed in schizophrenia spectrum disorders (k = 32, 1,851 patients and 1,449 controls, g = -0.42 [95% CI = -0.53 to -0.31], p < .001), and a large deficit in major depression (k = 415 patients and 506 controls, g = -0.87 [95% CI = -1.23 to -0.51], p < .001), with this effect being significantly larger for depression (p < .05). Meta-regression showed that heterogeneity was partially explained in schizophrenia spectrum by longer duration of illness and lower cognitive functioning predicting larger deficits. In depression, some evidence was found that ruling out a history of psychiatric illness in controls may be related to larger effects. There was evidence for small study bias inflating estimates in schizophrenia spectrum disorders.

CONCLUSIONS

Deficits in anticipatory pleasure are manifest in these disorders, and significantly more so in major depression. These findings indicate a possible therapeutic target to link cognitive, affective, and behavioural factors that precipitate and maintain disorder.

PRACTITIONER POINTS

Anticipatory pleasure is impaired in schizophrenia spectrum and major depression. A particular focus on enhancing anticipatory pleasure may improve motivation for rewarding behaviour and psychosocial functioning. The review contained only a small number of studies for major depression. Given the heterogeneity in effects, there are likely to be more moderators of anticipatory pleasure that require examination.

Reward systems and cognitions in Major Depressive Disorder

A lack of motivation and anhedonia represent frequent and pervasive symptoms in depression, although with poor specificity. Historically described as a response bias, reward-related impairments in depression may account for the important aspects of the cognitive impairments associated with diagnosis of major depressive disorder. Reward processing is a broad psychological construct that can be parsed into 3 distinct components known as "reinforcement learning" (learning), "reward responsiveness" (liking), and "motivation to obtain a reward" (wanting). Depressed patients respond hyposensitively to reward and maladaptively to punishment: this pattern is related to a dysfunction in the frontostriatal systems modulated by the monoamine systems; seems to be observed in medicated and unmedicated patients with depression and in healthy individuals with high levels of anhedonia; and could be observed in patients with a history of depression, even when in full remission. Considered to be cognitive impairments, reward-related-impairments may also constitute part of an underlying neurobiological vulnerability to major depressive disorder (MDD). For example, the reward-related impairment is state dependent and, more or less, correlated with symptom severity in some studies but has also been proposed as being trait like, with endophenotype characteristics, possibly contributing to the persistence of the disease or treatment resistance. The 3 core aspects of reward processing have specific neurobiological correlates that involve the ventral and dorsal striatum, lateral habenula, ventral tegmental area, orbitofrontal cortex, anterior cingulate cortex, and ventromedial and dorsolateral prefrontal cortex. These structures underline the important role of the dopaminergic mesolimbic pathway, but glutamate and serotonin could also have an important role, at least in some aspects of reward-related impairments.

The Psychopharmacology of Effort-Related Decision Making: Dopamine, Adenosine, and Insights into the Neurochemistry of Motivation

Effort-based decision making is studied using tasks that offer choices between high-effort options leading to more highly valued reinforcers versus low-effort/low-reward options. These tasks have been used to study the involvement of neural systems, including mesolimbic dopamine and related circuits, in effort-related aspects of motivation. Moreover, such tasks are useful as animal models of some of the motivational symptoms that are seen in people with depression, schizophrenia, Parkinson's disease, and other disorders. The present review will discuss the pharmacology of effort-related decision making and will focus on the use of these tasks for the development of drug treatments for motivational dysfunction. Research has identified pharmacological conditions that can alter effort-based choice and serve as models for depression-related symptoms (e.g., the vesicular monoamine transport-2 inhibitor tetrabenazine and proinflammatory cytokines). Furthermore, tests of effort-based choice have identified compounds that are particularly useful for stimulating high-effort work output and reversing the deficits induced by tetrabenazine and cytokines. These studies indicate that drugs that act by facilitating dopamine transmission, as well as adenosine A_2A antagonists, are relatively effective at reversing effort-related impairments. Studies of effort-based choice may lead to the identification of drug targets that could be useful for treating motivational treatments that are resistant to commonly used antidepressants such as serotonin transport inhibitors.

Decreased Response to Positive Facial Affect in a Depressed Cohort in the Dorsal Striatum During a Working Memory Task-A Preliminary fMRI Study

People with depression have shown alterations in processing emotional information and working memory functionality. There is some evidence that emotional content may interact with working memory update processes, however neurological correlates are current unknown. In this preliminary study we utilized a novel version of the emotional variant of the n-back working memory task in fMRI. We examined BOLD response of 14 healthy controls and 13 depressed participants in response to happy, sad, and neutral displays of facial affect. No accuracy or reaction time differences were found between the two groups. The depressed group showed significantly decreased BOLD response to happy faces compared to the control group areas of the dorsal striatum and anterior cingulate. Significant, moderate, positive associations were found between right caudate activation with anxiety score and anterior cingulate activation with depression score in those with depression. Our novel task was able to elicit group level differences in emotional processing during working memory update. These results suggest those with depression fail to differentiate between positive emotional stimuli and stimuli with no emotional content.

New Developments on the Adenosine Mechanisms of the Central Effects of Caffeine and Their Implications for Neuropsychiatric Disorders

Recent studies on interactions between striatal adenosine and dopamine and one of its main targets, the adenosine A_2A receptor–dopamine D₂ receptor (A2AR–D2R) heteromer, have provided a better understanding of the mechanisms involved in the psychostimulant effects of caffeine and have brought forward new data on the mechanisms of operation of classical orthosteric ligands within G protein-coupled receptor heteromers. The striatal A2AR–D2R heteromer has a tetrameric structure and forms part of a signaling complex that includes a Gs and a Gi protein and the effector adenyl cyclase (subtype AC5). Another target of caffeine, the adenosine A₁ receptor–dopamine D₁ receptor (A1R–D1R) heteromer, seems to have a very similar structure. Initially suggested to be localized in the striatum, the A1R–D1R heteromer has now been identified in the spinal motoneuron and shown to mediate the spinally generated caffeine-induced locomotion. In this study, we review the recently discovered properties of A2AR–D2R and A1R–D1R heteromers. Our studies demonstrate that these complexes are a necessary condition to sustain the canonical antagonistic interaction between a Gs-coupled receptor (A2AR or D1R) and a Gi-coupled receptor (D2R or A1R) at the adenylyl cyclase level, which constitutes a new concept in the field of G protein-coupled receptor physiology and pharmacology. A2AR antagonists targeting the striatal A2AR–D2R heteromer are already being considered as therapeutic agents in Parkinson's disease. In this study, we review the preclinical evidence that indicates that caffeine and A2AR antagonists could be used to treat the motivational symptoms of depression and attention-deficit/hyperactivity disorder, while A1R antagonists selectively targeting the spinal A1R–D1R heteromer could be used in the recovery of spinal cord injury.

Expression of dopamine signaling genes in the post-mortem brain of individuals with mental illnesses is moderated by body mass index and mediated by insulin signaling genes

Preclinical studies implicate insulin signaling as a modulator of dopamine transmission, but human data is currently limited. We hypothesize that changes in the expression of insulin receptor-related genes in the post-mortem brain tissue of patients with mood and psychotic disorders mediate the expression of dopamine regulation-related genes. From a database containing microarray data from the post-mortem dorsolateral prefrontal cortex (dlPFC) (healthy controls [HC]: n = 209; patients: n = 321) and hippocampus (HC: n = 180; patients: n = 196), we conducted a hypothesis-driven analysis through the a priori selection of 12 dopamine- and 3 insulin-related genes. Mediation and moderated mediation models, accounting for the role of body mass index (BMI), were used. In the dlPFC, expressions of insulin receptor- and dopamine regulation-related genes were moderated by BMI, with significantly lower expression in high BMI patients. In the hippocampus, there were significantly lower expressions of these genes, which were not moderated by BMI. Illnesses by BMI effects on expression of dopamine genes were fully mediated by expression of insulin receptor gene (INSR). Analysis of conditional indirect effects showed interactions between INSR and BMI, indicating significantly stronger indirect effects at higher BMI values. In the hippocampus we observed that expression of insulin receptor substrate 1 and 2 fully mediated the effects of illnesses on expression of dopamine genes. In conclusion, differential expression of dopamine-related genes was related to altered expression of insulin signaling genes. BMI had region-specific effects, supporting the hypothesis that metabolic systems are critical mediators of dopaminergic function.

Dopamine dysregulation hypothesis: the common basis for motivational anhedonia in major depressive disorder and schizophrenia?

Abnormalities in reward processing are crucial symptoms of major depressive disorder (MDD) and schizophrenia (SCH). Recent neuroscientific findings regarding MDD have led to conclusions about two different symptoms related to reward processing: motivational and consummatory anhedonia, corresponding, respectively, to impaired motivation to obtain rewards ('wanting'), and diminished satisfaction from consuming them ('liking'). One can ask: which of these is common for MDD and SCH. In our review of the latest neuroscientific studies, we show that MDD and SCH do not share consummatory anhedonia, as SCH patients usually have unaltered liking. Therefore, we investigated whether motivational anhedonia is the common symptom across MDD and SCH. With regard to the similarities and differences between the neural mechanisms of MDD and SCH, here we expand the current knowledge of motivation deficits and present the common underlying mechanism of motivational anhedonia - the dopamine dysregulation hypothesis - stating that any prolonged dysregulation in tonic dopamine signaling that exceeds the given equilibrium can lead to striatal dysfunction and motivational anhedonia. The implications for further research and treatment of MDD and SCH are also discussed.

The time course of incentive processing in anticipatory and consummatory anhedonia

BACKGROUND

Anhedonia, the reduced capacity to experience pleasure, has long been regarded as a cardinal symptom in depression and schizophrenia. Recent evidence highlights that anhedonia is not a single construct but consists of an anticipatory component and a consummatory component, which is captured by the Temporal Experience of Pleasure Scale (TEPS). The current event-related potential study examined the electrophysiological underpinnings of anticipatory and consummatory aspects of anhedonia as assessed by the TEPS in a non-clinical sample.

METHODS

EEG was recorded during both anticipatory and consummatory phases of incentive processing in an anticipatory-anhedonia (ANT) group, a consummatory-anhedonia (CON) group, and a control (CNT) group selected from a large sample based on their TEPS scores.

RESULTS

The ANT relative to the CON group exhibited a reduced cue-P3 during the anticipatory phase, a less positive feedback-related negativity (FRN) and a blunted feedback P3 (fb-P3) during the consummatory phase. Moreover, correlation results revealed a dissociation between anticipatory and consummatory anhedonia, which occurred in an unexpected way such that higher levels of anticipatory anhedonia were associated with reduced fb-P3 amplitudes whereas higher levels of consummatory anhedonia with enhanced cue-P3 and FRN amplitudes.

LIMITATION

The sample size for each group was relatively small.

CONCLUSIONS

Anticipatory and consummatory anhedonia as measured by the TEPS might be driven by abnormal motivational salience, which was represented by the cue-P3 during the anticipatory phase and the FRN and fb-P3 during the consummatory phase of incentive processing.

Making Sense of Rodent Models of Anhedonia

A markedly reduced interest or pleasure in activities previously considered pleasurable is a main symptom in mood disorder and psychosis and is often present in other psychiatric disorders and neurodegenerative diseases. This condition can be labeled as "anhedonia," although in its most rigorous connotation the term refers to the lost capacity to feel pleasure that is one aspect of the complex phenomenon of processing and responding to reward. The responses to rewarding stimuli are relatively easy to study in rodents, and the experimental conditions that consistently and persistently impair these responses are used to model anhedonia. To this end, long-term exposure to environmental aversive conditions is primarily used, and the resulting deficits in reward responses are often accompanied by other deficits that are mainly reminiscent of clinical depressive symptoms. The different components of impaired reward responses induced by environmental aversive events can be assessed by different tests or protocols that require different degrees of time allocation, technical resources, and equipment. Rodent models of anhedonia are valuable tools in the study of the neurobiological mechanisms underpinning impaired behavioral responses and in the screening and characterization of drugs that may reverse these behavioral deficits. In particular, the antianhedonic or promotivational effects are relevant features in the spectrum of activities of drugs used in mood disorders or psychosis. Thus, more than the model, it is the choice of tests that is crucial since it influences which facets of anhedonia will be detected and should be tuned to the purpose of the study.

Enhanced motivation of cognitive control in Parkinson's disease

Motor and cognitive deficits in Parkinson's disease (PD) have been argued to reflect motivational deficits. In prior work, however, we have shown that motivation of cognitive control is paradoxically potentiated rather than impaired in Parkinson's disease. This is particularly surprising given the fact that Parkinson's disease is often accompanied by depression, a prototypical disorder of motivation. To replicate our previous finding and assess the effects of depression, we investigated performance of PD patients with (n = 22) and without depression (history) (n = 23) and age‐matched healthy controls (n = 23) on a task specifically designed to measure the effect of reward motivation on task‐switching. We replicated previous findings by showing contrasting effects of reward motivation on task‐switching in PD patients and age‐matched healthy controls. While the promise of high versus low reward improved task‐switching in PD, it tended to impair task‐switching in age‐matched healthy controls. There were no effects of a depression (history) diagnosis in PD patients. These findings reinforce prior observations that Parkinson's disease is accompanied by enhanced incentive motivation of cognitive control and highlight the potential of incentive motivational strategies for overcoming cognitive deficits in Parkinson's disease.

Left frontal anodal tDCS increases approach motivation depending on reward attributes

BACKGROUND

A growing body of literature indicates a correlation between asymmetrical activity of frontal brain sites and approach vs. withdrawal motivation. Yet the causal status of this relationship is presently unclear. Here we examined the effect of anodal tDCS applied over the left dorsolateral prefrontal cortex (dlPFC) on approach motivation, operationalized as effort allocation during the Effort-Expenditure for Reward Task (EEfRT).

HYPOTHESIS

We expected left frontal anodal transcranial direct current simulation (tDCS) to increase participants' willingness to allocate more effort during the EEfRT. Based on previous research, we expected this effect to be strongest on trials with low probability of reward attainment.

METHODS

60 right-handed neurologically and psychologically healthy participants (63% female) aged 18-35 were tested in a counterbalanced within-subject design. Participants were invited to our lab twice to complete two 15-min blocks of the EEfRT on each study day, randomly assigned to either an anodal tDCS or a SHAM condition.

RESULTS

No main effect of stimulation condition was found, however the interactions of stimulation condition and both probability of reward attainment and reward magnitude reached significance. These interactions indicated that left frontal anodal tDCS specifically increased the percentage of hard task choices (HTC) in trials with low probability of reward attainment and in trials with high reward magnitude.

DISCUSSION

The observation of an increasing effect of left frontal anodal tDCS on effort expenditure for reward as indicated by HTC supports the idea of a causal relationship between asymmetric activity of frontal brain sites and approach motivation and hints at moderating effects of task-features on the effects of tDCS.

Anhedonia in depression: biological mechanisms and computational models

Anhedonia is a severe condition that describes a near-complete absence of enjoyment, motivation, and interest. A core feature of depression, clinical manifestations of anhedonia can include deficits in experiencing pleasure, approach-related motivated behavior, and learning how to match expectations to the environment. To date, the precise neurobiological mechanisms of anhedonia in major depression are still poorly understood. We have previously argued that contradictory findings and the inability to identify specific neurobiological substrates for anhedonic symptoms may result from sample heterogeneity, suboptimal methods of assessment, and the challenge of dissociating between different components of anhedonia. Recently, however, computational advances to the operationalization of psychiatric symptoms have enhanced the ability to evaluate the neurobiology of constituent elements of this symptom domain. In this paper, we review (1) advances in behavioral and computational methods of assessing reward processing and motivation and (2) the development of new self-report, neurological, and biological methods of subtyping that may be useful in future pursuits to expand our understanding of the neurobiology of anhedonia in depression.

Effort-Based Decision-Making in Schizophrenia

Motivational impairment has long been associated with schizophrenia but the underlying mechanisms are not clearly understood. Recently, a small but growing literature has suggested that aberrant effort-based decision-making may be a potential contributory mechanism for motivational impairments in psychosis. Specifically, multiple reports have consistently demonstrated that individuals with schizophrenia are less willing than healthy controls to expend effort to obtain rewards. Further, this effort-based decision-making deficit has been shown to correlate with severity of negative symptoms and level of functioning, in many but not all studies. In the current review, we summarize this literature and discuss several factors that may underlie aberrant effort-based decision-making in schizophrenia.

Inflammation-induced motivational changes: Perspective gained by evaluating positive and negative valence systems

Inflammation can profoundly impact motivated behavior, as is the case with inflammation-induced depression. By evaluating objectively measurable basic neurobehavioral processes involved in motivation, recent research indicates that inflammation generally reduces approach motivation and enhances avoidance motivation. Increased effort valuation largely mediates the effects of inflammation on approach motivation. Changes in reward valuation are not uniformly observed in approach motivation. However, inflammation increases the averseness of negative stimuli. Within the context of both approach and avoidance motivation, inflammation appears to enhance the contrast between concurrently presented stimuli. While changes in both approach and avoidance motivation appear to be mediated by midbrain dopaminergic neurotransmission to the ventral striatum, it is unclear if the enhanced contrast is mediated by the same system.

Caffeine and Selective Adenosine Receptor Antagonists as New Therapeutic Tools for the Motivational Symptoms of Depression

Major depressive disorder is one of the most common and debilitating psychiatric disorders. Some of the motivational symptoms of depression, such anergia (lack of self-reported energy) and fatigue are relatively resistant to traditional treatments such as serotonin uptake inhibitors. Thus, new pharmacological targets are being investigated. Epidemiological data suggest that caffeine consumption can have an impact on aspects of depressive symptomatology. Caffeine is a non-selective adenosine antagonist for A1/A2A receptors, and has been demonstrated to modulate behavior in classical animal models of depression. Moreover, selective adenosine receptor antagonists are being assessed for their antidepressant effects in animal studies. This review focuses on how caffeine and selective adenosine antagonists can improve different aspects of depression in humans, as well as in animal models. The effects on motivational symptoms of depression such as anergia, fatigue, and psychomotor slowing receive particular attention. Thus, the ability of adenosine receptor antagonists to reverse the anergia induced by dopamine antagonism or depletion is of special interest. In conclusion, although further studies are needed, it appears that caffeine and selective adenosine receptor antagonists could be therapeutic agents for the treatment of motivational dysfunction in depression.

Effort-cost decision-making in psychosis and depression: could a similar behavioral deficit arise from disparate psychological and neural mechanisms?

Motivational impairment is a common feature of both depression and psychosis; however, the psychological and neural mechanisms that give rise to motivational impairment in these disorders are poorly understood. Recent research has suggested that aberrant effort-cost decision-making (ECDM) may be a potential contributor to motivational impairment in both psychosis and depression. ECDM refers to choices that individuals make regarding the amount of 'work' they are willing to expend to obtain a certain outcome or reward. Recent experimental work has suggested that those with psychosis and depression may be less willing to expend effort to obtain rewards compared with controls, and that this effort deficit is related to motivational impairment in both disorders. In the current review, we aim to summarize the current literature on ECDM in psychosis and depression, providing evidence for transdiagnostic impairment. Next, we discuss evidence for the hypothesis that a seemingly similar behavioral ECDM deficit might arise from disparate psychological and neural mechanisms. Specifically, we argue that effort deficits in psychosis might be largely driven by deficits in cognitive control and the neural correlates of cognitive control processes, while effort deficits in depression might be largely driven by reduced reward responsivity and the associated neural correlates of reward responsivity. Finally, we will provide some discussion regarding future directions, as well as interpretative challenges to consider when examining ECDM transdiagnostically.

Dopamine, Effort-Based Choice, and Behavioral Economics: Basic and Translational Research

Operant behavior is not only regulated by factors related to the quality or quantity of reinforcement, but also by the work requirements inherent in performing instrumental actions. Moreover, organisms often make effort-related decisions involving economic choices such as cost/benefit analyses. Effort-based decision making is studied using behavioral procedures that offer choices between high-effort options leading to relatively preferred reinforcers vs. low effort/low reward choices. Several neural systems, including the mesolimbic dopamine (DA) system and other brain circuits, are involved in regulating effort-related aspects of motivation. Considerable evidence indicates that mesolimbic DA transmission exerts a bi-directional control over exertion of effort on instrumental behavior tasks. Interference with DA transmission produces a low-effort bias in animals tested on effort-based choice tasks, while increasing DA transmission with drugs such as DA transport blockers tends to enhance selection of high-effort options. The results from these pharmacology studies are corroborated by the findings from recent articles using optogenetic, chemogenetic and physiological techniques. In addition to providing important information about the neural regulation of motivated behavior, effort-based choice tasks are useful for developing animal models of some of the motivational symptoms that are seen in people with various psychiatric and neurological disorders (e.g., depression, schizophrenia, Parkinson’s disease). Studies of effort-based decision making may ultimately contribute to the development of novel drug treatments for motivational dysfunction.

Evaluating the efficacy of an integrated motivational interviewing and multi-modal exercise intervention for youth with major depression: Healthy Body, Healthy Mind randomised controlled trial protocol

BACKGROUND

Recent meta-analytic reviews suggest exercise can reduce depression severity among adults with major depressive disorder (MDD); however, efficacy studies with depressed youth are limited. Few studies have investigated the efficacy of multi-modal exercise interventions in this population, addressed treatment engagement, or explored the differential effects of exercise on depressive symptom profiles.

OBJECTIVES

This paper describes the study protocol and recruitment pattern for an assessor blinded, two-arm randomised controlled trial investigating the efficacy of an integrated motivational interviewing (MI) and multi-modal exercise intervention in youth diagnosed with MDD. Associations between depressive symptom profiles (cognitive, somatic and affective) and psychological, physiological (fitness), and biological (blood biomarker) outcomes will also be examined.

METHODS

Participants aged 15-25 years with current MDD were recruited. Eligible participants were randomised and stratified according to gender and depression severity to either an immediate or delayed (control) group. The immediate group received a brief MI intervention followed by a 12-week small group exercise intervention (3 times per week for 1 h), all delivered by personal trainers. The delayed control group received the same intervention 12-weeks later. Both groups were reassessed at mid-treatment or mid-control, post-treatment or post-control, and follow-up (12 weeks post-treatment).

RESULTS

68 participants were recruited and randomly allocated to an intervention group.

CONCLUSION

This trial will increase our understanding of the efficacy of multi-modal exercise interventions for depression and the specific effects of exercise on depressive symptom profiles. It also offers a novel contribution by addressing treatment engagement in exercise efficacy trials in youth with MDD.

La motivation dans tous ses K

La motivation peut être définie comme la fonction qui oriente et active le comportement. Nous résumons dans cette revue les acquis récents des neurosciences concernant les bases cérébrales des fonctions motivationnelles. En clinique neuropsychiatrique, les troubles de la motivation sont fréquents et actuellement évalués par des échelles qui ne renseignent pas sur les mécanismes sous-jacents. Nous présentons ici une nouvelle approche, dite computationnelle. Elle consiste à phénotyper le comportement des patients dans des tests de motivation, au moyen de modèles computationnels. Ces phénotypes computationnels caractérisent l’état du patient et pourraient aider au suivi et à la personnalisation du traitement.

Chronic social stress induces peripheral and central immune activation, blunted mesolimbic dopamine function, and reduced reward-directed behaviour in mice

Psychosocial stress is a major risk factor for depression, stress leads to peripheral and central immune activation, immune activation is associated with blunted dopamine (DA) neural function, DA function underlies reward interest, and reduced reward interest is a core symptom of depression. These states might be inter-independent in a complex causal pathway. Whilst animal-model evidence exists for some specific steps in the pathway, there is currently no animal model in which it has been demonstrated that social stress leads to each of these immune, neural and behavioural states. Such a model would provide important existential evidence for the complex pathway and would enable the study of causality and mediating mechanisms at specific steps in the pathway. Therefore, in the present mouse study we investigated for effects of 15-day resident-intruder chronic social stress (CSS) on each of these states. Relative to controls, CSS mice exhibited higher spleen levels of granulocytes, inflammatory monocytes and T helper 17 cells; plasma levels of inducible nitric oxide synthase; and liver expression of genes encoding kynurenine pathway enzymes. CSS led in the ventral tegmental area to higher levels of kynurenine and the microglia markers Iba1 and Cd11b and higher binding activity of DA D1 receptor; and in the nucleus accumbens (NAcc) to higher kynurenine, lower DA turnover and lower c-fos expression. Pharmacological challenge with DA reuptake inhibitor identified attenuation of DA stimulatory effects on locomotor activity and NAcc c-fos expression in CSS mice. In behavioural tests of operant responding for sucrose reward validated as sensitive assays for NAcc DA function, CSS mice exhibited less reward-directed behaviour. Therefore, this mouse study demonstrates that a chronic social stressor leads to changes in each of the immune, neural and behavioural states proposed to mediate between stress and disruption of DA-dependent reward processing. The model can now be applied to investigate causality and, if demonstrated, underlying mechanisms in specific steps of this immune-neural-behavioural pathway, and thereby to identify potential therapeutic targets.

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Mouse chronic social stress (CSS) leads to spleen and liver immune activation.

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Mouse CSS leads to mesolimbic immune activation and blunted dopamine function.

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Mouse CSS leads to reduced reward-directed behaviour in operant tests.

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This constitutes an important model for the study of pathophysiological mechanisms.

An Examination of the Multi-Faceted Motivation System in Healthy Young Adults

Background: Amotivation is a prevalent symptom in schizophrenia (SZ) and depression (MDD), and is linked to poor functional outcomes in affected individuals. Conceptualizations of motivation have outlined a multi-faceted construct comprised of reward responsiveness, reward expectancy, reward valuation, effort valuation, and action selection/preference-based decision making. To date, findings from studies utilizing variable-centered approaches to examining isolated facets of motivation in SZ and MDD have been inconsistent. Thus, the present study adopted a person-centered approach, and comprehensively examined the reward system in a non-clinical sample in an attempt to explore potential subtypes of motivation impairments, while minimizing the effects of illness-related confounds. Methods: Ninety-six healthy undergraduate students were evaluated for amotivation, schizotypal traits, depressive symptoms, and cognition, and administered objective computerized tasks to measure the different facets of motivation. Cluster analysis was performed to explore subgroups of individuals based on similar motivation task performance. Additionally, correlational analyses were conducted in order to examine inter-relationships between motivation facets, and relations between clinical measures and facets of motivation. Results: Cluster analysis identified two subgroups of individuals with differential motivation performance profiles. Correlational analyses revealed that reward responsiveness was associated with amotivation, depressive symptoms, and negative schizotypy. Further, significant inter-correlations were found between reward responsiveness and reward expectancy, as well as between reward valuation and effort valuation. Conclusions: Our results mark important steps forward in understanding motivation in a non-clinical sample, and guide future dimensional and comprehensive analyses of the multi-faceted reward system. It remains to be seen whether these patterns of results will be similar in clinical populations such as SZ and MDD.

Learning and Choice in Mood Disorders: Searching for the Computational Parameters of Anhedonia

Computational approaches are increasingly being used to model behavioral and neural processes in mood and anxiety disorders. Here we explore the extent to which the parameters of popular learning and decision-making models are implicated in anhedonic symptoms of major depression. We first highlight the parameters of reinforcement learning that have been implicated in anhedonia, focusing, in particular, on the role that choice variability (i.e., "temperature") may play in explaining heterogeneity across previous findings. We then turn to neuroimaging findings implicating attenuated ventral striatum response in anhedonic responses and discuss possible causes of the heterogeneity in the literature. Taken together, the reviewed findings highlight the potential of the computational approach in teasing apart the observed heterogeneity in both behavioral and functional imaging results. Nevertheless, considerable challenges remain, and we conclude with five unresolved questions that seek to address issues highlighted by the reviewed data.

Adaptation and validation of the Melbourne Decision Making Questionnaire to Brazilian Portuguese

Abstract Introduction: Decision making (DM) is among the most important abilities for everyday functioning. However, the most widely used measures of DM come from behavioral paradigms, whose ecological validity and standalone use has been criticized in the literature. Though these issues could be addressed by the use of DM questionnaires as a complementary assessment method, no such instruments have been validated for use in Brazilian Portuguese. Therefore, the aim of this study was to conduct the translation and validation of the Melbourne Decision Making Questionnaire (MDMQ) for use in a Brazilian population. Methods: The adaptation of the MDMQ involved the following steps: translation, back-translation, expert review and pilot study. These steps were followed by factor analysis and internal consistency measurements, which led to the exclusion of 4 items from the scale. The 18-item version of the MDMQ was then administered to a validation sample consisting of healthy adults, as well as patients with bipolar disorder (BD) and major depressive disorder (MDD). Results: The instrument displayed good internal consistency, with the hypervigilance subscale showing the lowest, though still acceptable, Cronbach's alpha value. Its factor structure was comparable to that of the original MDMQ according to confirmatory factor analysis. Nevertheless, the MDMQ was sensitive to both depression severity and the presence of MDD and BD, both of which are known to have an impact on DM ability. Conclusion: The version of the MDMQ produced in the present study may be an important addition to neuropsychological assessment batteries with a focus on DM and related abilities

Oral Ingestion and Intraventricular Injection of Curcumin Attenuates the Effort-Related Effects of the VMAT-2 Inhibitor Tetrabenazine: Implications for Motivational Symptoms of Depression

Effort-related choice tasks are used for studying depressive motivational symptoms such as anergia/fatigue. These studies investigated the ability of the dietary supplement curcumin to reverse the low-effort bias induced by the monoamine storage blocker tetrabenazine. Tetrabenazine shifted effort-related choice in rats, decreasing high-effort lever pressing but increasing chow intake. The effects of tetrabenazine were reversed by oral ingestion of curcumin (80.0-160.0 mg/kg) and infusions of curcumin into the cerebral ventricles (2.0-8.0 μg). Curcumin attenuates the effort-related effects of tetrabenazine in this model via actions on the brain, suggesting that curcumin may be useful for treating human motivational symptoms.

Mapping anhedonia-specific dysfunction in a transdiagnostic approach: an ALE meta-analysis

Anhedonia is a prominent symptom in neuropsychiatric disorders, most markedly in major depressive disorder (MDD) and schizophrenia (SZ). Emerging evidence indicates an overlap in the neural substrates of anhedonia between MDD and SZ, which supported a transdiagnostic approach. Therefore, we used activation likelihood estimation (ALE) meta-analysis of functional magnetic resonance imaging studies in MDD and SZ to examine the neural bases of three subdomains of anhedonia: consummatory anhedonia, anticipatory anhedonia and emotional processing. ALE analysis focused specifically on MDD or SZ was used later to dissociate specific anhedonia-related neurobiological impairments from potential disease general impairments. ALE results revealed that consummatory anhedonia was associated with decreased activation in ventral basal ganglia areas, while anticipatory anhedonia was associated with more substrates in frontal-striatal networks except the ventral striatum, which included the dorsal anterior cingulate, middle frontal gyrus and medial frontal gyrus. MDD and SZ patients showed similar neurobiological impairments in anticipatory and consummatory anhedonia, but differences in the emotional experience task, which may also involve affective/mood general processing. These results support that anhedonia is characterized by alterations in reward processing and relies on frontal-striatal brain circuitry. The transdiagnostic approach is a promising way to reveal the overall neurobiological framework that contributes to anhedonia and could help to improve targeted treatment strategies.

Mental Imagery Training Increases Wanting of Rewards and Reward Sensitivity and Reduces Depressive Symptoms

High reward sensitivity and wanting of rewarding stimuli help to identify and motivate repetition of pleasant activities. This behavioral activation is thought to increase positive emotions. Therefore, both mechanisms are highly relevant for resilience against depressive symptoms. Yet, these mechanisms have not been targeted by psychotherapeutic interventions. In the present study, we tested a mental imagery training comprising eight 10-minute sessions every second day and delivered via the Internet to healthy volunteers (N = 30, 21 female, mean age of 23.8 years, Caucasian) who were preselected for low reward sensitivity. Participants were paired according to age, sex, reward sensitivity, and mental imagery ability. Then, members of each pair were randomly assigned to either the intervention or wait condition. Ratings of wanting and response bias toward probabilistic reward cues (Probabilistic Reward Task) served as primary outcomes. We further tested whether training effects extended to approach behavior (Approach Avoidance Task) and depressive symptoms (Beck Depression Inventory). The intervention led to an increase in wanting (p < .001, η²_p= .45) and reward sensitivity (p = .004, η²_p= .27). Further, the training group displayed faster approach toward positive edibles and activities (p = .025, η²_p= .18) and reductions in depressive symptoms (p = .028, η²_p= .16). Results extend existing literature by showing that mental imagery training can increase wanting of rewarding stimuli and reward sensitivity. Further, the training appears to reduce depressive symptoms and thus may foster the successful implementation of exsiting treatments for depression such as behavioral activation and could also increase resilience against depressive symptoms.

Positive affective functioning in anhedonic individuals' daily life: Anything but flat and blunted

BACKGROUND

Anhedonia, the decreased interest and pleasure, is often described as 'flat' or 'blunted' positive affect (PA). Yet, little is known about PA functioning in anhedonic individuals' daily lives. The current study investigates PA reactivity to pleasurable experiences in anhedonia together with its relevant temporal dynamics (i.e., variability, instability, and inertia), and expands current knowledge by exploring the role of arousal therein.

METHODS

Using the Experience Sampling Method (ESM), we collected 90 assessments of real-life PA experiences across 30 days in 18-24 year old individuals with anhedonia (N=69) and without anhedonia (N=69).

RESULTS

Multilevel analyses showed that anhedonia was associated with less intense pleasure experience, and lower levels of PA. Contrary to predictions from laboratory research and depression theory, individuals with anhedonia showed more variability and less stability in PA, and no signs of blunted PA reactivity. In fact, when exploring high and low arousal PA, individuals with anhedonia showed a slightly stronger reactivity to pleasurable experiences in high-arousal PA but not low-arousal PA.

LIMITATIONS

We did not control for previous pleasure experiences and, instead of the last positive event, accumulation of positive events may have determined the change in high-arousal PA.

CONCLUSIONS

Individuals with anhedonia are likely less 'flat' or 'blunted' than generally thought. Although replication is warranted, impairments in high-arousal positive emotions may be of particular interest in the clinical treatment of anhedonia.

Reward processing and mood-related symptoms: An RDoC and translational neuroscience perspective

BACKGROUND

Two objectives of the NIMH Research Domain Criteria (RDoC) initiative are to identify (a) mechanisms that are common to multiple psychiatric disorders, and (b) mechanisms that are unique to specific psychiatric symptoms, and that reflect markers of differential risk for these symptoms. With respect to these objectives, a brain-behavior dimension that has received considerable attention and that is directly relevant to the Positive Valence Systems domain of the RDoC initiative involves reward processing.

METHODS

The present review paper first examines the relationship between reward processing and mood-related symptoms from an RDoC perspective. We then place this work in a larger context by examining the relationship between reward processing abnormalities and psychiatric symptoms defined broadly, including mood-related symptoms, schizophrenia, and addiction.

RESULTS

Our review suggests that reward hyposensitivity relates to a subtype of anhedonia characterized by motivational deficits in unipolar depression, and reward hypersensitivity relates to a cluster of hypo/manic symptoms characterized by excessive approach motivation in the context of bipolar disorder. Integrating this perspective with research on reward processing abnormalities in schizophrenia and addiction, we further argue that the principles of equifinality and multifinality may be preferable to a transdiagnostic perspective for conceptualizing the relationship between reward processing and psychiatric symptoms defined broadly.

CONCLUSION

We propose that vulnerability to either motivational anhedonia or approach-related hypo/manic symptoms involve extreme and opposite profiles of reward processing. We further propose that an equifinality and multifinality perspective may serve as a useful framework for future research on reward processing abnormalities and psychiatric symptoms.

Predicting Motivation: Computational Models of PFC Can Explain Neural Coding of Motivation and Effort-based Decision-making in Health and Disease

Human behavior is strongly driven by the pursuit of rewards. In daily life, however, benefits mostly come at a cost, often requiring that effort be exerted to obtain potential benefits. Medial PFC (MPFC) and dorsolateral PFC (DLPFC) are frequently implicated in the expectation of effortful control, showing increased activity as a function of predicted task difficulty. Such activity partially overlaps with expectation of reward and has been observed both during decision-making and during task preparation. Recently, novel computational frameworks have been developed to explain activity in these regions during cognitive control, based on the principle of prediction and prediction error (predicted response-outcome [PRO] model [Alexander, W. H., & Brown, J. W. Medial prefrontal cortex as an action-outcome predictor. Nature Neuroscience, 14, 1338-1344, 2011], hierarchical error representation [HER] model [Alexander, W. H., & Brown, J. W. Hierarchical error representation: A computational model of anterior cingulate and dorsolateral prefrontal cortex. Neural Computation, 27, 2354-2410, 2015]). Despite the broad explanatory power of these models, it is not clear whether they can also accommodate effects related to the expectation of effort observed in MPFC and DLPFC. Here, we propose a translation of these computational frameworks to the domain of effort-based behavior. First, we discuss how the PRO model, based on prediction error, can explain effort-related activity in MPFC, by reframing effort-based behavior in a predictive context. We propose that MPFC activity reflects monitoring of motivationally relevant variables (such as effort and reward), by coding expectations and discrepancies from such expectations. Moreover, we derive behavioral and neural model-based predictions for healthy controls and clinical populations with impairments of motivation. Second, we illustrate the possible translation to effort-based behavior of the HER model, an extended version of PRO model based on hierarchical error prediction, developed to explain MPFC-DLPFC interactions. We derive behavioral predictions that describe how effort and reward information is coded in PFC and how changing the configuration of such environmental information might affect decision-making and task performance involving motivation.

Reward Processing, Neuroeconomics, and Psychopathology

Abnormal reward processing is a prominent transdiagnostic feature of psychopathology. The present review provides a framework for considering the different aspects of reward processing and their assessment, and highlights recent insights from the field of neuroeconomics that may aid in understanding these processes. Although altered reward processing in psychopathology has often been treated as a general hypo- or hyperresponsivity to reward, increasing data indicate that a comprehensive understanding of reward dysfunction requires characterization within more specific reward-processing domains, including subjective valuation, discounting, hedonics, reward anticipation and facilitation, and reinforcement learning. As such, more nuanced models of the nature of these abnormalities are needed. We describe several processing abnormalities capable of producing the types of selective alterations in reward-related behavior observed in different forms of psychopathology, including (mal)adaptive scaling and anchoring, dysfunctional weighting of reward and cost variables, competition between valuation systems, and reward prediction error signaling.

Assessment of a glycine uptake inhibitor in animal models of effort-related choice behavior: implications for motivational dysfunctions

RATIONALE

Motivated behavior can be characterized by a substantial exertion of effort, and organisms often make effort-related decisions based upon analyses of work-related response costs and reinforcement preference. Moreover, alterations in effort-based choice can be seen in people with major depression and schizophrenia. Effort-related decision making is studied using tasks offering choices between high effort options leading to highly valued reinforces vs low effort/low reward options. Interference with dopamine (DA) transmission by administration of the DA D2 family antagonist haloperidol biases behavior towards the lower effort option that can be obtained with minimal work, and previous research has shown that DA interacts with other transmitters, including adenosine and GABA, to regulate effort-based choice.

OBJECTIVES

The present studies focused upon the ability of the glycine transport inhibitor bitopertin to attenuate haloperidol-induced shifts in effort-related choice behavior.

METHODS

Effort-based choice in rats was assessed using the concurrent fixed ratio (FR) 5/chow feeding choice task and the T-maze barrier choice procedure.

RESULTS

Haloperidol shifted effort-based choice, biasing animals towards the low effort option in each task. Co-administration of bitopertin (1.0-10.0 mg/kg) significantly attenuated haloperidol-induced shifts in choice behavior, but the same doses of bitopertin had no effect when administered alone.

CONCLUSIONS

These results indicated that elevation of extracellular glycine via inhibition of glycine uptake was able to reverse the effects of D2 antagonism. Increases in extracellular glycine, possibly through actions on the glycine allosteric site on the NMDA receptor, may be a useful strategy for treating motivational dysfunctions in humans.

Longitudinal evaluation of anhedonia as a mediator of fear of positive evaluation and other depressive symptoms

Fear of positive evaluation (FPE) is experiencing dread during real or potential praise. FPE is associated with social anxiety, but its relation to depressive symptoms is unclear. Anhedonia is a core symptom of depression related to symptoms of anxiety in cross-sectional research. The current study investigated the indirect effect of FPE on depressive symptoms via anhedonia over time. One-hundred ninety-six participants completed three waves of questionnaires over a total timespan of approximately four months via Amazon's Mechanical Turk, including measures of FPE, depressive symptoms, and anticipatory and consummatory anhedonia. Findings indicated that anticipatory anhedonia at Time 2 mediated the relationship between FPE at Time 1 and depressive symptoms at Time 3. Consummatory anhedonia, however, did not. Each model was contextualised by accounting for prospective covarying relationships, such as depressive symptoms predicting the same symptoms at later waves. The constellation of findings is considered within a reward devaluation framework.

Blunted neural response to anticipation, effort and consummation of reward and aversion in adolescents with depression symptomatology

Neural reward function has been proposed as a possible biomarker for depression. However, how the neural response to reward and aversion might differ in young adolescents with current symptoms of depression is as yet unclear. Thirty-three adolescents were recruited, 17 scoring low on the Mood and Feelings Questionnaire (low risk group) and 16 scoring high (high risk group). Our functional magnetic resonance imaging task measured; anticipation (pleasant/unpleasant cue), effort (achieve a pleasant taste or avoid an unpleasant taste) and consummation (pleasant/unpleasant tastes) in regions of interest; ventral medial prefrontal cortex, pregenual cingulate cortex, the insula and ventral striatum. We also examined whole brain group differences. In the regions of interest analysis we found reduced activity in the high risk group in the pregenual cingulate cortex during anticipation and reduced pregenual cingulate cortex and ventral medial prefrontal cortex during effort and consummation. In the whole brain analysis we also found reduced activity in the high risk group in the prefrontal cortex and the precuneus during anticipation. We found reduced activity in the hippocampus during the effort phase and in the anterior cingulate/frontal pole during consummation in the high risk group. Increased anhedonia measures correlated with decreased pregenual cingulate cortex activity during consummation in the high risk group only. Our results are the first to show that adolescents with depression symptoms have blunted neural responses during the anticipation, effort and consummation of rewarding and aversive stimuli. This study suggests that interventions in young people at risk of depression, that can reverse blunted responses, might be beneficial as preventative strategies.

Inflammation Effects on Motivation and Motor Activity: Role of Dopamine

Motivational and motor deficits are common in patients with depression and other psychiatric disorders, and are related to symptoms of anhedonia and motor retardation. These deficits in motivation and motor function are associated with alterations in corticostriatal neurocircuitry, which may reflect abnormalities in mesolimbic and mesostriatal dopamine (DA). One pathophysiologic pathway that may drive changes in DAergic corticostriatal circuitry is inflammation. Biomarkers of inflammation such as inflammatory cytokines and acute-phase proteins are reliably elevated in a significant proportion of psychiatric patients. A variety of inflammatory stimuli have been found to preferentially target basal ganglia function to lead to impaired motivation and motor activity. Findings have included inflammation-associated reductions in ventral striatal neural responses to reward anticipation, decreased DA and DA metabolites in cerebrospinal fluid, and decreased availability, and release of striatal DA, all of which correlated with symptoms of reduced motivation and/or motor retardation. Importantly, inflammation-associated symptoms are often difficult to treat, and evidence suggests that inflammation may decrease DA synthesis and availability, thus circumventing the efficacy of standard pharmacotherapies. This review will highlight the impact of administration of inflammatory stimuli on the brain in relation to motivation and motor function. Recent data demonstrating similar relationships between increased inflammation and altered DAergic corticostriatal circuitry and behavior in patients with major depressive disorder will also be presented. Finally, we will discuss the mechanisms by which inflammation affects DA neurotransmission and relevance to novel therapeutic strategies to treat reduced motivation and motor symptoms in patients with high inflammation.

Altered task-specific deactivation in the default mode network depends on valence in patients with major depressive disorder

BACKGROUND

Major depressive disorder (MDD) is a highly prevalent psychiatric condition in which patients often have difficulties regulating their emotions. Prior studies have shown that attention bias towards negative emotion is linked to activation in regions of the default mode network (DMN) in MDD individuals. Furthermore, MDD patients showed increased resting-state functional connectivity (FC) between the medial prefrontal cortex and other DMN structures.

METHODS

Twenty-one MDD patients that currently experiencing depressive episodes and twenty-five healthy control participants performed the current emotional expectancy paradigm in a gradient-echo SENSE-SPIRAL fMRI. Whole brain and psycho-physiological interaction (PPI) analysis were applied to explore the task-related brain activity and FCs.

RESULTS

Relative to healthy participants, we found MDD patients had greater activity in dorsal medial prefrontal cortex as a function of positive vs. neutral expectancy conditions. PPI results revealed a significant group difference of MDD patients having relatively decreased task-dependent decoupling from dorsal medial prefrontal cortex (DMPFC) towards posterior cingulate cortex (PCC) and parieto-occipital cortex during positive vs. neutral expectancy conditions, and patients exhibited a positive correlation between PPI (DMPFC and PCC) and anhedonia as measured via SHAPS during the same conditions.

LIMITATIONS

Modest sample size and lack of concurrent depressive episodes limit the generalizability of our findings.

CONCLUSIONS

In MDD patients, insufficient DMN decoupling might occur in response to positive expectancy conditions. Our findings are consistent with the hypothesis that high intrinsic DMN connectivity in MDD patients interfere with the down-regulation of intrinsic focus in order to incorporate information derived from external positive events.

Emotional and cognitive dysregulation in schizophrenia and depression: understanding common and distinct behavioral and neural mechanisms

Emerging behavioral and neuroimaging studies in schizophrenia (SCZ) and major depressive disorder (MD) are mapping mechanisms of co-occurring and distinct affective disturbances across these disorders. This constitutes a critical goal towards developing rationally guided therapies for upstream neural pathways that contribute to comorbid symptoms across disorders. We highlight the current state of the art in our understanding of emotional dysregulation in SCZ versus MD by focusing on broad domains of behavioral function that can map onto underlying neural systems, namely deficits in hedonics, anticipatory behaviors, computations underlying value and effort, and effortful goal-directed behaviors needed to pursue rewarding outcomes. We highlight unique disturbances in each disorder that may involve dissociable neural systems, but also possible interactions between affect and cognition in MD versus SCZ. Finally, we review computational and translational approaches that offer mechanistic insight into how cellular-level disruptions can lead to complex affective disturbances, informing development of therapies across MD and SCZ.