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Hogeveen J, Campbell EM, Mullins TS, Robertson-Benta CR, Quinn DK, Mayer AR, Cavanagh JF. Neural response to monetary incentives in acquired adolescent depression after mild traumatic brain injury: Stage 2 Registered Report. Brain Commun 2024; 6:fcae250. [PMID: 39234169 PMCID: PMC11371397 DOI: 10.1093/braincomms/fcae250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/03/2024] [Accepted: 08/02/2024] [Indexed: 09/06/2024] Open
Abstract
Depression is a common consequence of traumatic brain injury. Separately, spontaneous depression-arising without brain injury-has been linked to abnormal responses in motivational neural circuitry to the anticipation or receipt of rewards. It is unknown if post-injury and spontaneously occurring depression share similar phenotypic profiles. This issue is compounded by the fact that nearly all examinations of these psychiatric sequelae are post hoc: there are rarely any prospective assessments of mood and neural functioning before and after a brain injury. In this Stage 2 Registered Report, we used the Adolescent Brain Cognitive Development Consortium dataset to examine if a disruption in functional neural responses to rewards is present in patients with depression after a mild traumatic brain injury. Notably, this study provides an unparalleled opportunity to examine the trajectory of neuropsychiatric symptoms longitudinally within-subjects. This allowed us to isolate mild traumatic brain injury-specific variance independent from pre-existing functioning. Here, we focus on a case-control comparison between 43 youth who experienced a mild traumatic brain injury between MRI visits, and 43 well-matched controls. Contrary to pre-registered predictions (https://osf.io/h5uba/), there was no statistically credible increase in depression in mild traumatic brain injury cases relative to controls. Mild traumatic brain injury was associated with subtle changes in motivational neural circuit recruitment during the anticipation of incentives on the Monetary Incentive Delay paradigm. Specifically, changes in neural recruitment appeared to reflect a failure to deactivate 'task-negative' brain regions (ventromedial prefrontal cortex), alongside blunted recruitment of 'task-positive' regions (anterior cingulate, anterior insula and caudate), during the anticipation of reward and loss in adolescents following mild brain injuries. Critically, these changes in brain activity were not correlated with depressive symptoms at either visit or depression change scores before and after the brain injury. Increased time since injury was associated with a recovery of cognitive functioning-driven primarily by processing speed differences-but depression did not scale with time since injury. These cognitive changes were also uncorrelated with neural changes after mild traumatic brain injury. This report provides evidence that acquired depression may not be observed as commonly after a mild traumatic brain injury in late childhood and early adolescence, relative to findings in adult cases. Several reasons for these differing findings are considered, including sampling enrichment in retrospective cohort studies, under-reporting of depressive symptoms in parent-report data, and neuroprotective factors in childhood and adolescence.
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Affiliation(s)
- Jeremy Hogeveen
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
- Psychology Clinical Neuroscience Center, University of New Mexico, Albuquerque, NM 87131, USA
| | - Ethan M Campbell
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
- Psychology Clinical Neuroscience Center, University of New Mexico, Albuquerque, NM 87131, USA
| | - Teagan S Mullins
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
- Psychology Clinical Neuroscience Center, University of New Mexico, Albuquerque, NM 87131, USA
| | - Cidney R Robertson-Benta
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
- Psychology Clinical Neuroscience Center, University of New Mexico, Albuquerque, NM 87131, USA
| | - Davin K Quinn
- Department of Psychiatry & Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - Andrew R Mayer
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
- Department of Psychiatry & Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
- Department of Neurology, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
- The Mind Research Network/Lovelace Biomedical Research Institute, Albuquerque, NM 87106, USA
| | - James F Cavanagh
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
- Psychology Clinical Neuroscience Center, University of New Mexico, Albuquerque, NM 87131, USA
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2
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Jung M, Han KM. Behavioral Activation and Brain Network Changes in Depression. J Clin Neurol 2024; 20:362-377. [PMID: 38951971 PMCID: PMC11220350 DOI: 10.3988/jcn.2024.0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 07/03/2024] Open
Abstract
Behavioral activation (BA) is a well-established method of evidence-based treatment for depression. There are clear links between the neural mechanisms underlying reward processing and BA treatment for depressive symptoms, including anhedonia; however, integrated interpretations of these two domains are lacking. Here we examine brain imaging studies involving BA treatments to investigate how changes in brain networks, including the reward networks, mediate the therapeutic effects of BA, and whether brain circuits are predictors of BA treatment responses. Increased activation of the prefrontal and subcortical regions associated with reward processing has been reported after BA treatment. Activation of these regions improves anhedonia. Conversely, some studies have found decreased activation of prefrontal regions after BA treatment in response to cognitive control stimuli in sad contexts, which indicates that the therapeutic mechanism of BA may involve disengagement from negative or sad contexts. Furthermore, the decrease in resting-state functional connectivity of the default-mode network after BA treatment appears to facilitate the ability to counteract depressive rumination, thereby promoting enjoyable and valuable activities. Conflicting results suggest that an intact neural response to rewards or defective reward functioning is predictive of the efficacy of BA treatments. Increasing the benefits of BA treatments requires identification of the unique individual characteristics determining which of these conflicting findings are relevant for the personalized treatment of each individual with depression.
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Affiliation(s)
- Minjee Jung
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Korea
| | - Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
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3
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Sellers KK, Cohen JL, Khambhati AN, Fan JM, Lee AM, Chang EF, Krystal AD. Closed-loop neurostimulation for the treatment of psychiatric disorders. Neuropsychopharmacology 2024; 49:163-178. [PMID: 37369777 PMCID: PMC10700557 DOI: 10.1038/s41386-023-01631-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Despite increasing prevalence and huge personal and societal burden, psychiatric diseases still lack treatments which can control symptoms for a large fraction of patients. Increasing insight into the neurobiology underlying these diseases has demonstrated wide-ranging aberrant activity and functioning in multiple brain circuits and networks. Together with varied presentation and symptoms, this makes one-size-fits-all treatment a challenge. There has been a resurgence of interest in the use of neurostimulation as a treatment for psychiatric diseases. Initial studies using continuous open-loop stimulation, in which clinicians adjusted stimulation parameters during patient visits, showed promise but also mixed results. Given the periodic nature and fluctuations of symptoms often observed in psychiatric illnesses, the use of device-driven closed-loop stimulation may provide more effective therapy. The use of a biomarker, which is correlated with specific symptoms, to deliver stimulation only during symptomatic periods allows for the personalized therapy needed for such heterogeneous disorders. Here, we provide the reader with background motivating the use of closed-loop neurostimulation for the treatment of psychiatric disorders. We review foundational studies of open- and closed-loop neurostimulation for neuropsychiatric indications, focusing on deep brain stimulation, and discuss key considerations when designing and implementing closed-loop neurostimulation.
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Affiliation(s)
- Kristin K Sellers
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Joshua L Cohen
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Ankit N Khambhati
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Joline M Fan
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Neurology, University of California, San Francisco, CA, USA
| | - A Moses Lee
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Edward F Chang
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Andrew D Krystal
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.
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4
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Ding Y, Ou Y, Yan H, Liu F, Li H, Li P, Xie G, Cui X, Guo W. Uncovering the Neural Correlates of Anhedonia Subtypes in Major Depressive Disorder: Implications for Intervention Strategies. Biomedicines 2023; 11:3138. [PMID: 38137360 PMCID: PMC10740577 DOI: 10.3390/biomedicines11123138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/10/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Major depressive disorder (MDD) represents a serious public health concern, negatively affecting individuals' quality of life and making a substantial contribution to the global burden of disease. Anhedonia is a core symptom of MDD and is associated with poor treatment outcomes. Variability in anhedonia components within MDD has been observed, suggesting heterogeneity in psychopathology across subgroups. However, little is known about anhedonia subgroups in MDD and their underlying neural correlates across subgroups. To address this question, we employed a hierarchical cluster analysis based on Temporal Experience of Pleasure Scale subscales in 60 first-episode, drug-naive MDD patients and 32 healthy controls. Then we conducted a connectome-wide association study and whole-brain voxel-wise functional analyses for identified subgroups. There were three main findings: (1) three subgroups with different anhedonia profiles were identified using a data mining approach; (2) several parts of the reward network (especially pallidum and dorsal striatum) were associated with anticipatory and consummatory pleasure; (3) different patterns of within- and between-network connectivity contributed to the disparities of anhedonia profiles across three MDD subgroups. Here, we show that anhedonia in MDD is not uniform and can be categorized into distinct subgroups, and our research contributes to the understanding of neural underpinnings, offering potential treatment directions. This work emphasizes the need for tailored approaches in the complex landscape of MDD. The identification of homogeneous, stable, and neurobiologically valid MDD subtypes could significantly enhance our comprehension and management of this multifaceted condition.
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Affiliation(s)
- Yudan Ding
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.D.); (H.Y.); (G.X.)
| | - Yangpan Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.D.); (H.Y.); (G.X.)
| | - Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.D.); (H.Y.); (G.X.)
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China;
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, China;
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar 161006, China;
| | - Guangrong Xie
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.D.); (H.Y.); (G.X.)
| | - Xilong Cui
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.D.); (H.Y.); (G.X.)
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.D.); (H.Y.); (G.X.)
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Darrow SM, Pizzagalli DA, Smoski M, Mathew SJ, Nurnberger J, Lisanby SH, Iosifescu D, Murrough JW, Yang H, Weiner RD, Sanacora G, Keefe RSE, Song A, Goodman W, Whitton AE, Potter WZ, Krystal AD. Using latent profile analyses to classify subjects with anhedonia based on reward-related measures obtained in the FAST-MAS study. J Affect Disord 2023; 339:584-592. [PMID: 37467805 DOI: 10.1016/j.jad.2023.07.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Growing evidence indicates that anhedonia is a multifaceted construct. This study examined the possibility of identifying subgroups of people with anhedonia using multiple reward-related measures to provide greater understanding the Research Domain Criteria's Positive Valence Systems Domain and pathways for developing treatments. METHODS Latent profile analysis of baseline data from a study that examined the effects of a novel kappa opioid receptor (KOR) antagonist drug on measures and biomarkers associated with anhedonia was used to identify subgroups. Measures included ventral striatal activation during the Monetary Incentive Delay task, response bias in the Probabilistic Reward Task, reward valuation scores from the Effort-Expenditure for Rewards Task, and scores from reward-related self-report measures. RESULTS Two subgroups were identified, which differed on self-report measures of reward. Participants in the subgroup reporting more anhedonia also reported more depression and had greater illness severity and functional impairments. Graphs of change with treatment showed a trend for the less severe subgroup to demonstrate higher response to KOR antagonist treatment on the neuroimaging measure, probabilistic reward task, and ratings of functioning; the subgroup with greater severity showed a trend for higher treatment response on reward-related self-report measures. LIMITATIONS The main limitations include the small sample size and exploratory nature of analyses. CONCLUSIONS Evidence of possible dissociation between self-reported measures of anhedonia and other measures with respect to treatment response emerged. These results highlight the importance for future research to consider severity of self-reported reward-related deficits and how the relationship across measurement methods may vary with severity.
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Affiliation(s)
- Sabrina M Darrow
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, United States of America.
| | | | - Moria Smoski
- Department of Psychiatry and Behavioral Sciences, Duke University, United States of America
| | | | - John Nurnberger
- Institute of Psychiatric Research, Indiana University Medical Center, United States of America
| | - Sarah H Lisanby
- National Institute of Mental Health, United States of America
| | | | - James W Murrough
- Department of Psychiatry, Mount Sinai School of Medicine, United States of America
| | | | | | - Gerard Sanacora
- Department of Psychiatry, Yale University, United States of America
| | - Richard S E Keefe
- Department of Psychiatry, Duke University Medical Center, United States of America
| | - Allen Song
- Duke University, United States of America
| | - Wayne Goodman
- Department of Psychiatry, Baylor College of Medicine, United States of America
| | | | | | - Andrew D Krystal
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, United States of America
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Ogura Y, Wakatsuki Y, Hashimoto N, Miyamoto T, Nakai Y, Toyomaki A, Tsuchida Y, Nakagawa S, Inoue T, Kusumi I. Hyperthymic temperament predicts neural responsiveness for nonmonetary reward. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e140. [PMID: 38867834 PMCID: PMC11114308 DOI: 10.1002/pcn5.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 06/14/2024]
Abstract
Aim Hyperthymic temperament is a cheerful action orientation that is suggested to have a protective effect on depressive symptoms. We recently reported that hyperthymic temperament can positively predict activation of reward-related brain areas in anticipation of monetary rewards, which could serve as a biomarker of hyperthymic temperament. However, the relationship between hyperthymic temperament and neural responsiveness to nonmonetary rewards (i.e., feedback indicating success in a task) remains unclear. Methods Healthy participants performed a modified monetary incentive delay task inside a functional magnetic resonance imaging scanner. To examine the effect of nonmonetary positive feedback, the participants performed feedback and no-feedback trials. We explored brain regions whose neural responsiveness to nonmonetary rewards was predicted by hyperthymic temperament. Results There was premotor area activation in anticipation of a nonmonetary reward, which was negatively predicted by hyperthymic temperament. Moreover, brain areas located mainly in the primary somatosensory area and somatosensory association area were activated by performance feedback, which was positively predicted by hyperthymic temperament. Conclusion We found that hyperthymic temperament is related to neural responsiveness to both monetary and nonmonetary rewards. This may be related to the process of affective regulation in the somatosensory area.
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Affiliation(s)
- Yukiko Ogura
- Center for Experimental Research in Social SciencesHokkaido UniversitySapporoJapan
| | - Yumi Wakatsuki
- Department of PsychiatryThe Hokkaido Medical CenterSapporoJapan
| | - Naoki Hashimoto
- Department of PsychiatryHokkaido University Graduate School of MedicineSapporoJapan
| | - Tamaki Miyamoto
- Department of PsychiatryHokkaido University Graduate School of MedicineSapporoJapan
| | | | - Atsuhito Toyomaki
- Department of PsychiatryHokkaido University Graduate School of MedicineSapporoJapan
| | - Yukio Tsuchida
- School of EducationOsaka University of Health and Sport SciencesOsakaJapan
| | - Shin Nakagawa
- Division of Neuropsychiatry, Department of NeuroscienceYamaguchi University Graduate School of MedicineYamaguchiJapan
| | - Takeshi Inoue
- Department of PsychiatryTokyo Medical UniversityTokyoJapan
| | - Ichiro Kusumi
- Department of PsychiatryHokkaido University Graduate School of MedicineSapporoJapan
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Murray L, Israel ES, Balkind EG, Pastro B, Lovell-Smith N, Lukas SE, Forbes EE, Pizzagalli DA, Webb CA. Multi-modal assessment of reward functioning in adolescent anhedonia. Psychol Med 2023; 53:4424-4433. [PMID: 35711146 DOI: 10.1017/s0033291722001222] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Anhedonia is a core symptom of depression that predicts worse treatment outcomes. Dysfunction in neural reward circuits is thought to contribute to anhedonia. However, whether laboratory-based assessments of anhedonia and reward-related neural function translate to adolescents' subjective affective experiences in real-world contexts remains unclear. METHODS We recruited a sample of adolescents (n = 82; ages 12-18; mean = 15.83) who varied in anhedonia and measured the relationships among clinician-rated and self-reported anhedonia, behaviorally assessed reward learning ability, neural response to monetary reward and loss (as assessed with functional magnetic resonance imaging), and repeated ecological momentary assessment (EMA) of positive affect (PA) and negative affect (NA) in daily life. RESULTS Anhedonia was associated with lower mean PA and higher mean NA across the 5-day EMA period. Anhedonia was not related to impaired behavioral reward learning, but low PA was associated with reduced nucleus accumbens response during reward anticipation and reduced medial prefrontal cortex (mPFC) response during reward outcome. Greater mean NA was associated with increased mPFC response to loss outcome. CONCLUSIONS Traditional laboratory-based measures of anhedonia were associated with lower subjective PA and higher subjective NA in youths' daily lives. Lower subjective PA and higher subjective NA were associated with decreased reward-related striatal functioning. Higher NA was also related to increased mPFC activity to loss. Collectively, these findings demonstrate that laboratory-based measures of anhedonia translate to real-world contexts and that subjective ratings of PA and NA may be associated with neural response to reward and loss.
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Affiliation(s)
- Laura Murray
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Elana S Israel
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Emma G Balkind
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Brianna Pastro
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | | | - Scott E Lukas
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Christian A Webb
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
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8
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Kotoula V, Evans JW, Punturieri CE, Zarate CA. Review: The use of functional magnetic resonance imaging (fMRI) in clinical trials and experimental research studies for depression. FRONTIERS IN NEUROIMAGING 2023; 2:1110258. [PMID: 37554642 PMCID: PMC10406217 DOI: 10.3389/fnimg.2023.1110258] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 06/12/2023] [Indexed: 08/10/2023]
Abstract
Functional magnetic resonance imaging (fMRI) is a non-invasive technique that can be used to examine neural responses with and without the use of a functional task. Indeed, fMRI has been used in clinical trials and pharmacological research studies. In mental health, it has been used to identify brain areas linked to specific symptoms but also has the potential to help identify possible treatment targets. Despite fMRI's many advantages, such findings are rarely the primary outcome measure in clinical trials or research studies. This article reviews fMRI studies in depression that sought to assess the efficacy and mechanism of action of compounds with antidepressant effects. Our search results focused on selective serotonin reuptake inhibitors (SSRIs), the most commonly prescribed treatments for depression and ketamine, a fast-acting antidepressant treatment. Normalization of amygdala hyperactivity in response to negative emotional stimuli was found to underlie successful treatment response to SSRIs as well as ketamine, indicating a potential common pathway for both conventional and fast-acting antidepressants. Ketamine's rapid antidepressant effects make it a particularly useful compound for studying depression with fMRI; its effects on brain activity and connectivity trended toward normalizing the increases and decreases in brain activity and connectivity associated with depression. These findings highlight the considerable promise of fMRI as a tool for identifying treatment targets in depression. However, additional studies with improved methodology and study design are needed before fMRI findings can be translated into meaningful clinical trial outcomes.
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Wang YB, Song NN, Ding YQ, Zhang L. Neural plasticity and depression treatment. IBRO Neurosci Rep 2023; 14:160-184. [PMID: 37388497 PMCID: PMC10300479 DOI: 10.1016/j.ibneur.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/29/2022] [Accepted: 09/01/2022] [Indexed: 12/08/2022] Open
Abstract
Depression is one of the most common mental disorders, which can lead to a variety of emotional problems and even suicide at its worst. As this neuropsychiatric disorder causes the patients to suffer a lot and function poorly in everyday life, it is imposing a heavy burden on the affected families and the whole society. Several hypotheses have been proposed to elucidate the pathogenesis of depression, such as the genetic mutations, the monoamine hypothesis, the hypothalamic-pituitary-adrenal (HPA) axis hyperactivation, the inflammation and the neural plasticity changes. Among these models, neural plasticity can occur at multiple levels from brain regions, cells to synapses structurally and functionally during development and in adulthood. In this review, we summarize the recent progresses (especially in the last five years) on the neural plasticity changes in depression under different organizational levels and elaborate different treatments for depression by changing the neural plasticity. We hope that this review would shed light on the etiological studies for depression and on the development of novel treatments.
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Affiliation(s)
- Yu-Bing Wang
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) and Department of Anatomy, Histology and Embryology, Tongji University School of Medicine, Shanghai 200092, China
| | - Ning-Ning Song
- Department of Laboratory Animal Science, Fudan University, Shanghai 200032, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudfan University, Shanghai 200032, China
| | - Yu-Qiang Ding
- Department of Laboratory Animal Science, Fudan University, Shanghai 200032, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudfan University, Shanghai 200032, China
| | - Lei Zhang
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) and Department of Anatomy, Histology and Embryology, Tongji University School of Medicine, Shanghai 200092, China
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10
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Hu Y, Zhao C, Zhao H, Qiao J. Abnormal functional connectivity of the nucleus accumbens subregions mediates the association between anhedonia and major depressive disorder. BMC Psychiatry 2023; 23:282. [PMID: 37085792 PMCID: PMC10122393 DOI: 10.1186/s12888-023-04693-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/17/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND The nucleus accumbens (Nac) is a crucial brain region in the pathophysiology of major depressive disorder (MDD) patients with anhedonia. However, the relationship between the functional imaging characteristics of Nac subregions and anhedonia remains unclear. Thus, this study aimed to investigate the role of resting-state functional connectivity (rsFC) of the Nac subregions between MDD and anhedonia. METHODS We performed resting-state functional magnetic resonance imaging (fMRI) to measure the rsFC of Nac subregions in 55 MDD patients and 30 healthy controls (HCs). A two-sample t test was performed to determine the brain regions with varying rsFC among Nac subregions between groups. Then, correlation analyses were carried out to investigate the relationships between the aberrant rsFC of Nac subregions and the severity of anhedonia. Furthermore, we constructed a mediation model to explain the role of the aberrant rsFC of Nac subregions between MDD and the severity of anhedonia. RESULTS Compared with the HC group, decreased rsFC of Nac subregions with regions of the prefrontal cortex, insula, lingual gyrus, and visual association cortex was observed in MDD patients. In the MDD group, the rsFC of the right Nac shell-like subregions with the middle frontal gyrus (MFG)/superior frontal gyrus (SFG) was correlated with consummatory anhedonia, and the rsFC of the Nac core-like subdivisions with the inferior frontal gyrus (IFG)/insula and lingual gyrus/visual association cortex was correlated with anticipatory anhedonia. More importantly, the functional alterations in the Nac subregions mediated the association between anhedonia and depression. CONCLUSIONS The present findings suggest that the functional alteration of the Nac subregions mediates the association between MDD and anhedonia, which provides evidence for the hypothesis that MDD patients have neurobiological underpinnings of reward systems that differ from those of HCs.
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Affiliation(s)
- Yanqin Hu
- Department of Psychiatry, First Clinical College, Xuzhou Medical University, Xuzhou, 221000, China
| | - Chaoqi Zhao
- Department of Psychiatry, First Clinical College, Xuzhou Medical University, Xuzhou, 221000, China
| | - Houfeng Zhao
- Department of Psychiatry, the Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, 221000, China.
- Department of Medical Psychology, Second Clinical College, Xuzhou Medical University, Xuzhou, 221000, China.
| | - Juan Qiao
- Department of Psychiatry, the Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, 221000, China.
- Department of Medical Psychology, Second Clinical College, Xuzhou Medical University, Xuzhou, 221000, China.
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11
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Costello H, Roiser JP, Howard R. Antidepressant medications in dementia: evidence and potential mechanisms of treatment-resistance. Psychol Med 2023; 53:654-667. [PMID: 36621964 PMCID: PMC9976038 DOI: 10.1017/s003329172200397x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/13/2022] [Accepted: 12/20/2022] [Indexed: 01/10/2023]
Abstract
Depression in dementia is common, disabling and causes significant distress to patients and carers. Despite widespread use of antidepressants for depression in dementia, there is no evidence of therapeutic efficacy, and their use is potentially harmful in this patient group. Depression in dementia has poor outcomes and effective treatments are urgently needed. Understanding why antidepressants are ineffective in depression in dementia could provide insight into their mechanism of action and aid identification of new therapeutic targets. In this review we discuss why depression in dementia may be a distinct entity, current theories of how antidepressants work and how these mechanisms of action may be affected by disease processes in dementia. We also consider why clinicians continue to prescribe antidepressants in dementia, and novel approaches to understand and identify effective treatments for patients living with depression and dementia.
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Affiliation(s)
- Harry Costello
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Jonathan P. Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK
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12
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Zhang X, Wang X, Dong D, Sun X, Zhong X, Xiong G, Cheng C, Lei H, Chai Y, Yu M, Quan P, Gehrman PR, Detre JA, Yao S, Rao H. Persistent Ventral Anterior Cingulate Cortex and Resolved Amygdala Hyper-responses to Negative Outcomes After Depression Remission: A Combined Cross-sectional and Longitudinal Study. Biol Psychiatry 2023; 93:268-278. [PMID: 36567087 DOI: 10.1016/j.biopsych.2022.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a highly prevalent mood disorder affecting more than 300 million people worldwide. Biased processing of negative information and neural hyper-responses to negative events are hallmarks of depression. This study combined cross-sectional and longitudinal experiments to explore both persistent and resolved neural hyper-responses to negative outcomes from risky decision making in patients with current MDD (cMDD) and remitted MDD (rMDD). METHODS A total of 264 subjects participated in the cross-sectional study, including 117 patients with medication-naïve, first-episode current depression; 45 patients with rMDD with only 1 episode of depression; and 102 healthy control subjects. Participants completed a modified balloon analog risk task during functional magnetic resonance imaging. In the longitudinal arm of the study, 42 patients with cMDD were followed and 26 patients with rMDD were studied again after 8 weeks of antidepressant treatment. RESULTS Patients with cMDD showed hyper-responses to loss outcomes in multiple limbic regions including the amygdala and ventral anterior cingulate cortex (vACC). Amygdala but not vACC hyperactivity correlated with depression scores in patients with cMDD. Furthermore, amygdala hyperactivity resolved while vACC hyperactivity persisted in patients with rMDD in both cross-sectional and longitudinal studies. CONCLUSIONS These findings provide consistent evidence supporting differential patterns of amygdala and vACC hyper-responses to negative outcomes during depression remission. Amygdala hyperactivity may be a symptomatic and state-dependent marker of depressive neural responses, while vACC hyperactivity may reflect a persistent and state-independent effect of depression on brain function. These findings offer new insights into the neural underpinnings of depression remission and prevention of depression recurrence.
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Affiliation(s)
- Xiaocui Zhang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute of Central South University, Changsha, China; National Clinical Research Center for Mental Disorders, Changsha, China; Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania; School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China.
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute of Central South University, Changsha, China; National Clinical Research Center for Mental Disorders, Changsha, China
| | - Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute of Central South University, Changsha, China
| | - Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute of Central South University, Changsha, China
| | - Xue Zhong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute of Central South University, Changsha, China
| | - Ge Xiong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute of Central South University, Changsha, China
| | - Chang Cheng
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute of Central South University, Changsha, China
| | - Hui Lei
- College of Education, Hunan Agricultural University, Changsha, Hunan, China; Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ya Chai
- Key Laboratory of Applied Brain and Cognitive Sciences, Shanghai International Studies University, Shanghai, China; Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Meichen Yu
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peng Quan
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania; Research Center for Quality of Life and Applied Psychology, Guangdong Medical University, Dongguan, China
| | - Philip R Gehrman
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute of Central South University, Changsha, China; National Clinical Research Center for Mental Disorders, Changsha, China
| | - Hengyi Rao
- Key Laboratory of Applied Brain and Cognitive Sciences, Shanghai International Studies University, Shanghai, China; Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
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13
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English BA, Ereshefsky L. Experimental Medicine Approaches in Early-Phase CNS Drug Development. ADVANCES IN NEUROBIOLOGY 2023; 30:417-455. [PMID: 36928860 DOI: 10.1007/978-3-031-21054-9_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Traditionally, Phase 1 clinical trials were largely conducted in healthy normal volunteers and focused on collection of safety, tolerability, and pharmacokinetic data. However, in the CNS therapeutic area, with more drugs failing in later phase development, Phase 1 trials have undergone an evolution that includes incorporation of novel approaches involving novel study designs, inclusion of biomarkers, and early inclusion of patients to improve the pharmacologic understanding of novel CNS-active compounds early in clinical development with the hope of improving success in later phase pivotal trials. In this chapter, the authors will discuss the changing landscape of Phase 1 clinical trials in CNS, including novel trial methodology, inclusion of pharmacodynamic biomarkers, and experimental medicine approaches to inform early decision-making in clinical development.
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14
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Ogura Y, Wakatsuki Y, Hashimoto N, Miyamoto T, Nakai Y, Toyomaki A, Tsuchida Y, Nakagawa S, Inoue T, Kusumi I. Hyperthymic temperament predicts neural responsiveness for monetary reward. J Affect Disord 2023; 320:674-681. [PMID: 36206884 DOI: 10.1016/j.jad.2022.09.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/29/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Hyperthymic temperament is cheerful action orientation, and is suggested to have a protective effect on depressive symptoms. Responsiveness for reward, which is diminished in depressive patients, is suggested to be related to hyperthymic temperament. Moreover, neural hypoactivation in the reward system in depressive patients is well known. However, only a few previous studies have investigated the neurobiological substrate of hyperthymic temperament. We investigated the relationship between hyperthymic temperament and responsiveness to monetary rewards at the neural level. METHODS Healthy participants performed a modified version of the monetary incentive delay task in a functional magnetic resonance imaging scanner. We explored the brain regions where neural responsiveness for monetary reward was predicted by hyperthymic temperament. RESULTS Brain areas in the reward system were widely activated for reward anticipation. Activation in the left thalamus and left putamen was positively predicted by hyperthymic temperament. Conversely, activation in the ventral striatum and right insula was not modulated by hyperthymic temperament. No region activated for reward outcome was not modulated by hyperthymic temperament. LIMITATIONS Behavioral responsiveness to reward was not predicted by hyperthymic temperament or neural activity. Moreover, we did not correct P values for multiple regression analysis, considering that this was an exploratory study. CONCLUSIONS We found a neurobiological foundation for the protective aspect of hyperthymic temperament against depression in the reward system. Our findings suggest that the hyperthymic temperament may modulate attentional or motor responses or optimal selection of behavior based on reward, rather than value representation.
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Affiliation(s)
- Yukiko Ogura
- Graduate School of Information Science and Technology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yumi Wakatsuki
- Department of Psychiatry, The Hokkaido Medical Center, 1-1, 5-7 Yamanote, Nishi-ku, Sapporo 063-0005, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan.
| | - Tamaki Miyamoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
| | - Yukiei Nakai
- New Drug Research Center Inc., 452-1 Toiso, Eniwa-shi, Hokkaido 061-1405, Japan
| | - Atsuhito Toyomaki
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
| | - Yukio Tsuchida
- School of Education, Osaka University of Health and Sport Sciences, 1-1 Asashirodai, Kumatori-cho, Sennan-gun, Osaka 590-0496, Japan
| | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
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15
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Siemsen BM, Franco D, Lobo MK. Corticostriatal contributions to dysregulated motivated behaviors in stress, depression, and substance use disorders. Neurosci Res 2022:S0168-0102(22)00304-2. [PMID: 36565858 DOI: 10.1016/j.neures.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
Coordinated network activity, particularly in circuits arising from the prefrontal cortex innervating the ventral striatum, is crucial for normal processing of reward-related information which is perturbed in several psychiatric disorders characterized by dysregulated reward-related behaviors. Stress-induced depression and substance use disorders (SUDs) both share this common underlying pathology, manifested as deficits in perceived reward in depression, and increased attribution of positive valence to drug-predictive stimuli and dysfunctional cognition in SUDs. Here we review preclinical and clinical data that support dysregulation of motivated and reward-related behaviors as a core phenotype shared between these two disorders. We posit that altered processing of reward-related stimuli arises from dysregulated control of subcortical circuits by upstream regions implicated in executive control. Although multiple circuits are directly involved in reward processing, here we focus specifically on the role of corticostriatal circuit dysregulation. Moreover, we highlight the growing body of evidence indicating that such abnormalities may be due to heightened neuroimmune signaling by microglia, and that targeting the neuroimmune system may be a viable approach to treating this shared symptom.
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Affiliation(s)
| | - Daniela Franco
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mary Kay Lobo
- University of Maryland School of Medicine, Baltimore, MD, USA.
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16
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Chen Y, Dhingra I, Le TM, Zhornitsky S, Zhang S, Li CSR. Win and Loss Responses in the Monetary Incentive Delay Task Mediate the Link between Depression and Problem Drinking. Brain Sci 2022; 12:brainsci12121689. [PMID: 36552149 PMCID: PMC9775947 DOI: 10.3390/brainsci12121689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
Depression and alcohol misuse, frequently comorbid, are associated with altered reward processing. However, no study has examined whether and how the neural markers of reward processing are shared between depression and alcohol misuse. We studied 43 otherwise-healthy drinking adults in a monetary incentive delay task (MIDT) during fMRI. All participants were evaluated with the Alcohol Use Disorders Identification Test (AUDIT) and Beck's Depression Inventory (BDI-II) to assess the severity of drinking and depression. We performed whole brain regressions against each AUDIT and BDI-II score to investigate the neural correlates and evaluated the findings at a corrected threshold. We performed mediation analyses to examine the inter-relationships between win/loss responses, alcohol misuse, and depression. AUDIT and BDI-II scores were positively correlated across subjects. Alcohol misuse and depression shared win-related activations in frontoparietal regions and parahippocampal gyri (PHG), and right superior temporal gyri (STG), as well as loss-related activations in the right PHG and STG, and midline cerebellum. These regional activities (β's) completely mediated the correlations between BDI-II and AUDIT scores. The findings suggest shared neural correlates interlinking depression and problem drinking both during win and loss processing and provide evidence for co-morbid etiological processes of depressive and alcohol use disorders.
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Affiliation(s)
- Yu Chen
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Isha Dhingra
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Thang M. Le
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06520, USA
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT 06520, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06520, USA
- Correspondence: ; Tel.: +1-203-974-7354
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17
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Tang A, Harrewijn A, Benson B, Haller SP, Guyer AE, Perez-Edgar KE, Stringaris A, Ernst M, Brotman MA, Pine DS, Fox NA. Striatal Activity to Reward Anticipation as a Moderator of the Association Between Early Behavioral Inhibition and Changes in Anxiety and Depressive Symptoms From Adolescence to Adulthood. JAMA Psychiatry 2022; 79:1199-1208. [PMID: 36287532 PMCID: PMC9607981 DOI: 10.1001/jamapsychiatry.2022.3483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/07/2022] [Indexed: 01/14/2023]
Abstract
Importance The early childhood temperament of behavioral inhibition (BI), characterized by inhibited and fearful behaviors, has been associated with heightened risk for anxiety and depression across the lifespan. Although several neurocognitive correlates underlying vulnerability to the development of anxiety among inhibited children have been identified, little is known about the neurocognitive correlates underlying vulnerability to the development of depression. Objective To examine whether blunted striatal activation to reward anticipation, a well-documented neurocognitive vulnerability marker of depression, moderates the association between early BI and the developmental changes in depression and anxiety from adolescence to adulthood. Design, Setting, and Participants Participants in this prospective longitudinal study were recruited at age 4 months between 1989 and 1993 in the US. Follow-up assessments extended into 2018 (age 26 years). Data were analyzed between September 2021 to March 2022. Main Outcomes and Measures BI was measured through an observation paradigm in infancy (ages 14 and 24 months). Neural activity to anticipated rewards during a monetary incentive delay task was measured using functional magnetic resonance imaging in adolescence (between ages 15-18 years; 83 individuals had usable data). Anxiety and depressive symptoms were self-reported across adolescence to young adulthood (ages 15 and 26 years; n = 108). A latent change score model, accounting for the interdependence between anxiety and depression, tested the moderating role of striatal activity to reward anticipation in the association between early BI and changes in anxiety and depressive symptoms. A region of interest approach limited statistical tests to regions within the striatum (ie, nucleus accumbens, caudate head, caudate body, putamen). Results Of 165 participants, 84 (50.1%) were female and 162 (98%) were White. Preliminary analyses revealed significant increases in anxiety and depressive symptoms across ages 15 to 26 years, as well as individual variation in the magnitude of changes. Main analyses showed that reduced activity in the nucleus accumbens to reward anticipation moderated the association between early BI and increases in depressive (β = -0.32; b = -4.23; 95% CI, -7.70 to -0.76; P = .02), and more depressive symptoms at age 26 years (β = -0.47; b = -5.09; 95% CI, -7.74 to -2.43; P < .001). However, there were no significant interactions associated with latent changes in anxiety across age nor anxiety at age 26 years. Activity in the caudate and putamen did not moderate these associations. Conclusions and Relevance Blunted reward sensitivity in the ventral striatum may be a developmental risk factor connecting an inhibited childhood temperament and depression over the transition to adulthood. Future studies should examine the efficacy of prevention programs, which target maladaptive reward processing and motivational deficits among anxious youths, in reducing risks for later depression.
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Affiliation(s)
- Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
- Department of Psychology, University of Texas at Dallas, Richardson
| | - Anita Harrewijn
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Brenda Benson
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Simone P. Haller
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Amanda E. Guyer
- Department of Human Ecology and Center for Mind and Brain, University of California, Davis, Davis
| | | | - Argyris Stringaris
- Department of Psychiatry, University College London, London, United Kingdom
| | - Monique Ernst
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Melissa A. Brotman
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Daniel. S. Pine
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
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18
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van den Heuvel LL, Ahmed-Leitao F, du Plessis S, Hoddinott G, Spies G, Seedat S. Hazardous or harmful alcohol use and reward processing in people with HIV. J Neurovirol 2022; 28:514-526. [PMID: 36214999 DOI: 10.1007/s13365-022-01097-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 08/11/2022] [Accepted: 09/12/2022] [Indexed: 01/13/2023]
Abstract
The intersecting epidemics of HIV and hazardous or harmful alcohol use (HAU) can have significant detrimental consequences. Both HIV and HAU have independent negative influences on executive function. Dysfunction in reward processing may play a role in these co-occurring epidemics. In this cross-sectional case-control study, we investigated the association of HAU with reward processing amongst people with HIV (PWH). We investigated the function of the ventral-striatal reward system using a functional MRI (fMRI) monetary incentive delay (MID) task in a sample of 60 South African adults (mean age 32.7 years): 42 living with HIV and on ART (21 with harmful alcohol use [HIV + HAU], 21 without [HIV-HAU]) and 18 healthy controls, matched for age, gender, and resident community. Education significantly influenced task performance, with those with a secondary level of education demonstrating a greater increase in reaction time (p = 0.048) and accuracy (p = 0.002) than those without. There were no significant differences in reward anticipation in the ventral striatum (VS) between HIV + HAU, HIV-HAU, and healthy controls when controlling for level of education. There were also no significant differences in reward outcome in the orbitofrontal cortex (OFC) between HIV + HAU, HIV-HAU, and healthy controls when controlling for level of education. In a sample of South African adults, we did not demonstrate significant differences in reward anticipation in the VS and reward outcome in the OFC in PWH, with and without HAU, and controls. Factors, such as task performance, education, and depression may have influenced our results. Further studies are needed to better delineate the potential links between HIV, HAU, and depression and reward system function.
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Affiliation(s)
- Leigh L van den Heuvel
- Department of Psychiatry, Clinical Building, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, PO Box 241, Cape Town, 8000, South Africa. .,Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
| | - Fatima Ahmed-Leitao
- Department of Psychiatry, Clinical Building, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, PO Box 241, Cape Town, 8000, South Africa.,DSI/NRF South African Research Chairs Initiative, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Stefan du Plessis
- Department of Psychiatry, Clinical Building, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, PO Box 241, Cape Town, 8000, South Africa.,Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Graeme Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Georgina Spies
- Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,DSI/NRF South African Research Chairs Initiative, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Clinical Building, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, PO Box 241, Cape Town, 8000, South Africa.,Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,DSI/NRF South African Research Chairs Initiative, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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19
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Liebenow B, Jones R, DiMarco E, Trattner JD, Humphries J, Sands LP, Spry KP, Johnson CK, Farkas EB, Jiang A, Kishida KT. Computational reinforcement learning, reward (and punishment), and dopamine in psychiatric disorders. Front Psychiatry 2022; 13:886297. [PMID: 36339844 PMCID: PMC9630918 DOI: 10.3389/fpsyt.2022.886297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Abstract
In the DSM-5, psychiatric diagnoses are made based on self-reported symptoms and clinician-identified signs. Though helpful in choosing potential interventions based on the available regimens, this conceptualization of psychiatric diseases can limit basic science investigation into their underlying causes. The reward prediction error (RPE) hypothesis of dopamine neuron function posits that phasic dopamine signals encode the difference between the rewards a person expects and experiences. The computational framework from which this hypothesis was derived, temporal difference reinforcement learning (TDRL), is largely focused on reward processing rather than punishment learning. Many psychiatric disorders are characterized by aberrant behaviors, expectations, reward processing, and hypothesized dopaminergic signaling, but also characterized by suffering and the inability to change one's behavior despite negative consequences. In this review, we provide an overview of the RPE theory of phasic dopamine neuron activity and review the gains that have been made through the use of computational reinforcement learning theory as a framework for understanding changes in reward processing. The relative dearth of explicit accounts of punishment learning in computational reinforcement learning theory and its application in neuroscience is highlighted as a significant gap in current computational psychiatric research. Four disorders comprise the main focus of this review: two disorders of traditionally hypothesized hyperdopaminergic function, addiction and schizophrenia, followed by two disorders of traditionally hypothesized hypodopaminergic function, depression and post-traumatic stress disorder (PTSD). Insights gained from a reward processing based reinforcement learning framework about underlying dopaminergic mechanisms and the role of punishment learning (when available) are explored in each disorder. Concluding remarks focus on the future directions required to characterize neuropsychiatric disorders with a hypothesized cause of underlying dopaminergic transmission.
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Affiliation(s)
- Brittany Liebenow
- Neuroscience Graduate Program, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Rachel Jones
- Neuroscience Graduate Program, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Emily DiMarco
- Neuroscience Graduate Program, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Jonathan D. Trattner
- Neuroscience Graduate Program, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Joseph Humphries
- Neuroscience Graduate Program, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - L. Paul Sands
- Neuroscience Graduate Program, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Kasey P. Spry
- Neuroscience Graduate Program, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Christina K. Johnson
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Evelyn B. Farkas
- Georgia State University Undergraduate Neuroscience Institute, Atlanta, GA, United States
| | - Angela Jiang
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Kenneth T. Kishida
- Neuroscience Graduate Program, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Department of Neurosurgery, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, NC, United States
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20
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Souther MK, Wolf DH, Kazinka R, Lee S, Ruparel K, Elliott MA, Xu A, Cieslak M, Prettyman G, Satterthwaite TD, Kable JW. Decision value signals in the ventromedial prefrontal cortex and motivational and hedonic symptoms across mood and psychotic disorders. Neuroimage Clin 2022; 36:103227. [PMID: 36242852 PMCID: PMC9668619 DOI: 10.1016/j.nicl.2022.103227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 11/11/2022]
Abstract
Deficits in motivation and pleasure are common across many psychiatric disorders, and manifest as symptoms of amotivation and anhedonia, which are prominent features of both mood and psychotic disorders. Here we provide evidence for an association between neural value signals and symptoms of amotivation and anhedonia across adults with major depression, bipolar disorder, schizophrenia, or no psychiatric diagnosis. We found that value signals in the ventromedial prefrontal cortex (vmPFC) during intertemporal decision-making were dampened in individuals with greater motivational and hedonic deficits, after accounting for primary diagnosis. This relationship remained significant while controlling for diagnosis-specific symptoms of mood and psychosis, such as depression as well as positive and negative symptoms. Our results demonstrate that dysfunction in the vmPFC during value-based decision-making is specifically linked to motivational and hedonic impairments. These findings provide a quantitative neural target for the potential development of novel treatments for amotivation and anhedonia.
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Affiliation(s)
- Min K Souther
- Department of Psychology, University of Pennsylvania, US.
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine, US
| | - Rebecca Kazinka
- Department of Psychology, University of Pennsylvania, US; Department of Psychiatry, University of Minnesota, US
| | - Sangil Lee
- Department of Psychology, University of Pennsylvania, US
| | - Kosha Ruparel
- Department of Psychiatry, Perelman School of Medicine, US
| | | | - Anna Xu
- Department of Psychiatry, Perelman School of Medicine, US
| | | | | | - Theodore D Satterthwaite
- Department of Psychiatry, Perelman School of Medicine, US; Penn-CHOP Lifespan Brain Institute, US
| | - Joseph W Kable
- Department of Psychology, University of Pennsylvania, US
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21
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Decreased reward circuit connectivity during reward anticipation in major depression. Neuroimage Clin 2022; 36:103226. [PMID: 36257119 PMCID: PMC9668633 DOI: 10.1016/j.nicl.2022.103226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 09/21/2022] [Accepted: 10/08/2022] [Indexed: 11/11/2022]
Abstract
An important symptom of major depressive disorder (MDD) is the inability to experience pleasure, possibly due to a dysfunction of the reward system. Despite promising insights regarding impaired reward-related processing in MDD, circuit-level abnormalities remain largely unexplored. Furthermore, whereas studies contrasting experimental conditions from incentive tasks have revealed important information about reward processing, temporal difference modeling of reward-related prediction error (PE) signals might give a more accurate representation of the reward system. We used a monetary incentive delay task during functional MRI scanning to explore PE-related striatal and ventral tegmental area (VTA) activation in response to anticipation and delivery of monetary rewards in 24 individuals with MDD versus 24 healthy controls (HCs). Furthermore, we investigated group differences in temporal difference related connectivity with a generalized psychophysiological interaction (gPPI) analysis with the VTA, ventral striatum (VS) and dorsal striatum (DS) as seeds during reward versus neutral, both in anticipation and delivery. Relative to HCs, MDD patients displayed a trend-level (p = 0.052) decrease in temporal difference-related activation in the VS during reward anticipation and delivery combined. Moreover, gPPI analyses revealed that during reward anticipation, MDD patients exhibited decreased functional connectivity between the VS and anterior cingulate cortex / medial prefrontal cortex, anterior cingulate gyrus, angular/middle orbital gyrus, left insula, superior/middle frontal gyrus (SFG/MFG) and precuneus/superior occipital gyrus/cerebellum compared to HC. Moreover, MDD patients showed decreased functional connectivity between the VTA and left insula compared to HC during reward anticipation. Exploratory analysis separating medication free patients from patients using antidepressant revealed that these decreased functional connectivity patterns were mainly apparent in the MDD group that used antidepressants. These results suggest that MDD is characterized by alterations in reward circuit connectivity rather than isolated activation impairments. These findings represent an important extension of the existing literature since improved understanding of neural pathways underlying depression-related reward dysfunctions, may help currently unmet diagnostic and therapeutic efforts.
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22
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Yang X, Su Y, Yang F, Song Y, Yan J, Luo Y, Zeng J. Neurofunctional mapping of reward anticipation and outcome for major depressive disorder: a voxel-based meta-analysis. Psychol Med 2022; 52:1-14. [PMID: 36047042 DOI: 10.1017/s0033291722002707] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Aberrations in how people form expectations about rewards and how they respond to receiving rewards are thought to underlie major depressive disorder (MDD). However, the underlying mechanism linking the appetitive reward system, specifically anticipation and outcome, is still not fully understood. To examine the neural correlates of monetary anticipation and outcome in currently depressed subjects with MDD, we performed two separate voxel-wise meta-analyses of functional neuroimaging studies using the monetary incentive delay task. During reward anticipation, the depressed patients exhibited an increased response in the bilateral middle cingulate cortex (MCC) extending to the anterior cingulate cortex, the medial prefrontal cortex, the left inferior frontal gyrus (IFG), and the postcentral gyrus, but a reduced response in the mesolimbic circuit, including the left striatum, insula, amygdala, right cerebellum, striatum, and IFG, compared to controls. During the outcome stage, MDD showed higher activity in the left inferior temporal gyrus, and lower activity in the mesocortical pathway, including the bilateral MCC, left caudate nucleus, precentral gyrus, thalamus, cerebellum, right striatum, insula, IFG, middle frontal gyrus, and temporal pole. Our findings suggest that cMDD may be characterised by state-dependent hyper-responsivity in cortical regions during the anticipation phase, and hypo-responsivity of the mesocortico-limbic circuit across the two phases of the reward response. Our study showed dissociable neural circuit responses to monetary stimuli during reward anticipation and outcome, which help to understand the dysfunction in different aspects of reward processing, particularly motivational v. hedonic deficits in depression.
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Affiliation(s)
- Xun Yang
- School of Public Policy and Administration, Chongqing University, Chongqing, 400044, China
| | - Yueyue Su
- School of Public Policy and Administration, Chongqing University, Chongqing, 400044, China
| | - Fan Yang
- Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
- Chengdu Chenghua District Maternal and Child Health Hospital, Sichuan University, Chengdu, 610041, China
| | - Yuan Song
- School of Public Policy and Administration, Chongqing University, Chongqing, 400044, China
| | - Jiangnan Yan
- School of Economics and Business Administration, Chongqing University, Chongqing, 400044, China
| | - Ya Luo
- Department of Psychiatry, State Key Lab of Biotherapy, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, Chongqing, 400044, China
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23
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Sun J, Guo C, Ma Y, Du Z, Wang Z, Luo Y, Chen L, Gao D, Li X, Xu K, Hong Y, Yu X, Xiao X, Fang J, Liu Y. A comparative study of amplitude of low-frequence fluctuation of resting-state fMRI between the younger and older treatment-resistant depression in adults. Front Neurosci 2022; 16:949698. [PMID: 36090288 PMCID: PMC9462398 DOI: 10.3389/fnins.2022.949698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/08/2022] [Indexed: 12/02/2022] Open
Abstract
Background Treatment-resistant depression (TRD) may have different physiopathological neuromechanism in different age groups. This study used the amplitude of low frequency fluctuations (ALFF) to initially compare abnormalities in local functional brain activity in younger and older patients with TRD. Materials and methods A total of 21 older TRD patients, 19 younger TRD, 19 older healthy controls (HCs), and 19 younger HCs underwent resting-state functional MRI scans, and the images were analyzed using the ALFF and further analyzed for correlation between abnormal brain regions and clinical symptoms in TRD patients of different age groups. Results Compared with the older TRD, the younger TRD group had increased ALFF in the left middle frontal gyrus and decreased ALFF in the left caudate nucleus. Compared with the matched HC group, ALFF was increased in the right middle temporal gyrus and left pallidum in the older TRD group, whereas no significant differences were found in the younger TRD group. In addition, ALFF values in the left middle frontal gyrus in the younger TRD group and in the right middle temporal gyrus in the older TRD were both positively correlated with the 17-item Hamilton Rating Scale for Depression score. Conclusion Different neuropathological mechanisms may exist in TRD patients of different ages, especially in the left middle frontal gyrus and left caudate nucleus. This study is beneficial in providing potential key targets for the clinical management of TRD patients of different ages.
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Affiliation(s)
- Jifei Sun
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunlei Guo
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Ma
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhongming Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi Wang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Luo
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Limei Chen
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Deqiang Gao
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaojiao Li
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ke Xu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Hong
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xue Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Jiliang Fang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Jiliang Fang,
| | - Yong Liu
- Affiliated Hospital of Traditional Chinese Medicine, Southwest Medical University, Luzhou, China
- Yong Liu,
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24
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Gerlach AR, Karim HT, Peciña M, Ajilore O, Taylor WD, Butters MA, Andreescu C. MRI predictors of pharmacotherapy response in major depressive disorder. Neuroimage Clin 2022; 36:103157. [PMID: 36027717 PMCID: PMC9420953 DOI: 10.1016/j.nicl.2022.103157] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/11/2022] [Accepted: 08/15/2022] [Indexed: 02/08/2023]
Abstract
Major depressive disorder is among the most prevalent psychiatric disorders, exacting a substantial personal, social, and economic toll. Antidepressant treatment typically involves an individualized trial and error approach with an inconsistent success rate. Despite a pressing need, no reliable biomarkers for predicting treatment outcome have yet been discovered. Brain MRI measures hold promise in this regard, though clinical translation remains elusive. In this review, we summarize structural MRI and functional MRI (fMRI) measures that have been investigated as predictors of treatment outcome. We broadly divide these into five categories including three structural measures: volumetric, white matter burden, and white matter integrity; and two functional measures: resting state fMRI and task fMRI. Currently, larger hippocampal volume is the most widely replicated predictor of successful treatment. Lower white matter hyperintensity burden has shown robustness in late life depression. However, both have modest discriminative power. Higher fractional anisotropy of the cingulum bundle and frontal white matter, amygdala hypoactivation and anterior cingulate cortex hyperactivation in response to negative emotional stimuli, and hyperconnectivity within the default mode network (DMN) and between the DMN and executive control network also show promise as predictors of successful treatment. Such network-focused measures may ultimately provide a higher-dimensional measure of treatment response with closer ties to the underlying neurobiology.
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Affiliation(s)
- Andrew R Gerlach
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Helmet T Karim
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marta Peciña
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Olusola Ajilore
- Department of Psychiatry, University of Illinois-Chicago, Chicago, IL, USA
| | - Warren D Taylor
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN, USA
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
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25
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Feng C, Huang W, Xu K, Stewart JL, Camilleri JA, Yang X, Wei P, Gu R, Luo W, Eickhoff SB. Neural substrates of motivational dysfunction across neuropsychiatric conditions: Evidence from meta-analysis and lesion network mapping. Clin Psychol Rev 2022; 96:102189. [PMID: 35908312 PMCID: PMC9720091 DOI: 10.1016/j.cpr.2022.102189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/13/2022] [Accepted: 07/18/2022] [Indexed: 02/03/2023]
Abstract
Motivational dysfunction constitutes one of the fundamental dimensions of psychopathology cutting across traditional diagnostic boundaries. However, it is unclear whether there is a common neural circuit responsible for motivational dysfunction across neuropsychiatric conditions. To address this issue, the current study combined a meta-analysis on psychiatric neuroimaging studies of reward/loss anticipation and consumption (4308 foci, 438 contrasts, 129 publications) with a lesion network mapping approach (105 lesion cases). Our meta-analysis identified transdiagnostic hypoactivation in the ventral striatum (VS) for clinical/at-risk conditions compared to controls during the anticipation of both reward and loss. Moreover, the VS subserves a key node in a distributed brain network which encompasses heterogeneous lesion locations causing motivation-related symptoms. These findings do not only provide the first meta-analytic evidence of shared neural alternations linked to anticipatory motivation-related deficits, but also shed novel light on the role of VS dysfunction in motivational impairments in terms of both network integration and psychological functions. Particularly, the current findings suggest that motivational dysfunction across neuropsychiatric conditions is rooted in disruptions of a common brain network anchored in the VS, which contributes to motivational salience processing rather than encoding positive incentive values.
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Affiliation(s)
- Chunliang Feng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education (South China Normal University), Guangzhou, China,Guangdong Provincial Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China,Corresponding authors at: Guangdong Provincial Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou 510631, China; Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China. (C. Feng), (R. Gu)
| | - Wenhao Huang
- Beijing Key Laboratory of Learning and Cognition, and School of Psychology, Capital Normal University, Beijing, China,Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Potsdam-Rehbrücke, Germany
| | - Kangli Xu
- The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | | | - Julia A. Camilleri
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany,Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Xiaofeng Yang
- The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ping Wei
- Beijing Key Laboratory of Learning and Cognition, and School of Psychology, Capital Normal University, Beijing, China
| | - Ruolei Gu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,Corresponding authors at: Guangdong Provincial Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou 510631, China; Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China. (C. Feng), (R. Gu)
| | - Wenbo Luo
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
| | - Simon B. Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany,Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
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26
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Wakatsuki Y, Ogura Y, Hashimoto N, Toyomaki A, Miyamoto T, Nakagawa S, Inoue T, Kusumi I. Subjects with bipolar disorder showed different reward system activation than subjects with major depressive disorder in the monetary incentive delay task. Psychiatry Clin Neurosci 2022; 76:393-400. [PMID: 35608194 DOI: 10.1111/pcn.13429] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Differentiating between bipolar disorder (BD) and major depressive disorder (MDD) during the depressive episode is an important clinical challenge. Reward system abnormalities have received much attention as one of the biological underpinnings of BD and MDD, but few studies have directly compared these abnormalities in remitted and depressed states. METHODS This was a functional MRI study using the Monetary Incentive Delay task in 65 patients (BD [n = 33], MDD [n = 32]) and 33 healthy controls (HC). Regions of interest (ROI) analysis with 21 ROIs related to reward anticipation and 17 ROIs related to gain outcome were implemented, as well as whole-brain analysis. The difference in the dimensional effect of depression on brain activation was also examined. RESULTS Relative to the HC group, BD patients showed significantly decreased activation during reward anticipation in the anterior cingulate cortex, anterior insula (AI), and putamen, and MDD patients showed significantly decreased activation in the AI and brainstem. The dimensional effect of depression severity showed a trend-level difference between BD and MDD in the right brainstem and left AI. CONCLUSIONS The current study showed a possible differential effect of depression on the reward system between MDD and BD. Further studies on reward systems might offer reliable markers to distinguish between MDD and BD patients in the depressive phase.
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Affiliation(s)
- Yumi Wakatsuki
- Department of Psychiatry, The Hokkaido medical center, Sapporo, Japan
| | - Yukiko Ogura
- Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Atsuhito Toyomaki
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tamaki Miyamoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shin Nakagawa
- Department of Neuropsychiatry, Yamaguchi University, Yamaguchi, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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27
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Zhang D, Shen J, Bi R, Zhang Y, Zhou F, Feng C, Gu R. Differentiating the abnormalities of social and monetary reward processing associated with depressive symptoms. Psychol Med 2022; 52:2080-2094. [PMID: 33143780 DOI: 10.1017/s0033291720003967] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Reward dysfunction is a major dimension of depressive symptomatology, but it remains obscure if that dysfunction varies across different reward types. In this study, we focus on the abnormalities in anticipatory/consummatory processing of monetary and social reward associated with depressive symptoms. METHODS Forty participants with depressive symptoms and forty normal controls completed the monetary incentive delay (MID) and social incentive delay (SID) tasks with event-related potential (ERP) recording. RESULTS In the SID but not the MID task, both the behavioral hit rate and the ERP component contingent negative variation (CNV; indicating reward anticipation) were sensitive to the interaction between the grouping factor and reward magnitude; that is, the depressive group showed a lower hit rate and a smaller CNV to large-magnitude (but not small-magnitude) social reward cues compared to the control group. Further, these two indexes were correlated with each other. Meanwhile, the ERP components feedback-related negativity and P3 (indicating reward consumption) were sensitive to the main effect of depression across the MID and SID tasks, though this effect was more prominent in the SID task. CONCLUSIONS Overall, we suggest that depressive symptoms are associated with deficits in both the reward anticipation and reward consumption stages, particularly for social rewards. These findings have a potential to characterize the profile of functional impairment that comprises and maintains depression.
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Affiliation(s)
- Dandan Zhang
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
- School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Junshi Shen
- School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Rong Bi
- School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Yueyao Zhang
- School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Fang Zhou
- School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Chunliang Feng
- Guangdong Provincial Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou 510631, China
- Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Ministry of Education, Guangzhou 510631, China
| | - Ruolei Gu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
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28
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Kong X, Zhang P, Xiao F, Fang S, Ji X, Wang X, Lin P, Li H, Yao S, Wang X. State-independent and -dependent behavioral and neuroelectrophysiological characteristics during dynamic decision-making in patients with current and remitted depression. J Affect Disord 2022; 309:85-94. [PMID: 35472481 DOI: 10.1016/j.jad.2022.04.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND It is unclear whether the altered decision-making (DM) observed in patients with major depressive disorder (MDD) is neurophysiological and whether it improves with remission of depressive symptoms. The aim of this study was to identify developmental patterns of DM behavior, related cognitive characteristics, and electrophysiological abnormalities in patients with MDD across clinical stages. METHODS A sample of 48 first-episode MDD patients (FD group), 41 remitted MDD patients (RD group), and 43 healthy controls (HCs) completed psychometric assessments and performed the balloon analogue risk task (BART) while event-related potentials (ERPs) were recorded. RESULTS The RD group had lower depressiveness, self-blame, rumination, and catastrophizing tendencies, and higher mental resilience scores than the FD group, but retained significant differences from HCs. MDD patients showed a more conservative DM strategy than HCs, with no significant difference between the FD and RD groups. Compared to the FD group, the RD group had a smaller FRN for negative feedback and a trend toward a smaller P3 for positive feedback. Compared with HCs, the RD group had a smaller P3 during the positive feedback phase. FRN amplitude correlated positively with depression level and negatively with mental resilience. LIMITATIONS Because a comparative cross-section design was employed, longitudinal studies are needed to make causal inferences. CONCLUSION MDD patients presented a stable risk-avoidance bias in actively depressed and remission periods, consistent with a state-independent impairment pattern. Significantly reduced FRN amplitudes during remission indicated a state-dependent impairment pattern, and FRN amplitudes correlated with depression level. An abnormal feedback P3 component may be a state-independent characteristic that may become more pronounced with MDD progression.
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Affiliation(s)
- Xinyuan Kong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, China
| | - Panwen Zhang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Shanghai Songjiang Jiuting Middle School, Shanghai, China
| | - Fan Xiao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, China
| | - Shulin Fang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, China
| | - Xinlei Ji
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, China
| | - Xiaosheng Wang
- Department of Human Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - Pan Lin
- Department of Psychology and Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, Hunan 410081, China
| | - Huanhuan Li
- Department of Psychology, Renmin University of China, Beijing 100872, China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, China
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, China.
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29
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Anhedonia reduction correlates with increased ventral caudate connectivity with superior frontal gyrus in depression. J Psychiatr Res 2022; 151:286-290. [PMID: 35525230 DOI: 10.1016/j.jpsychires.2022.04.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/11/2022] [Accepted: 04/25/2022] [Indexed: 11/23/2022]
Abstract
This study was to investigate the relationship between the ventral caudate connectivity and anhedonia. Nineteen depressed patients and 16 healthy controls participated in two identical functional magnetic resonance imaging scans during a 1-year period to determine the resting-state functional connectivity changes using a seed-based approach. Patients showed increased left ventral caudate functional connectivity with superior frontal gyrus over time and the increased connectivity was associated with anhedonia improvement. None of these associations were observed in healthy controls. The findings suggest that left ventral caudate may serve as a potential target to improve the severity of anhedonia.
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30
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Transcranial Photobiomodulation Therapy for Sexual Dysfunction Associated with Depression or Induced by Antidepressant Medications. PHOTONICS 2022. [DOI: 10.3390/photonics9050330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Sexual dysfunction (SD) is frequently encountered in patients suffering from depression. There is a bidirectional relationship between various types of SD and depression, so the presence or treatment of one condition may exacerbate or improve the other condition. The most frequent sexual problem in untreated depressed patients is declining sexual desire, while in treated depressed patients it is difficulties with erection/ejaculation and with orgasm. Numerous classes of neuropsychiatric medications, commonly used in depressed patients—such as antidepressant, antipsychotic, alpha sympathetic, and opioid drugs—may cause SD. Photobiomodulation (PBM) therapy, also called low-level light/laser therapy, is a novel neuromodulation technique for neuropsychiatric conditions, such as depression. Transcranial PBM (tPBM) targets the cellular metabolism—through the mitochondrial respiratory enzyme, cytochrome c oxidase—and has numerous cellular and physiological beneficial effects on the central nervous system. This paper represents a comprehensive review of the application of tPBM to SD, coexisting with depression or induced by antidepressant medications.
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Ventorp F, Lindahl J, van Westen D, Jensen J, Björkstrand J, Lindqvist D. Preliminary Evidence of Efficacy and Target Engagement of Pramipexole in Anhedonic Depression. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2022; 4:42-47. [PMID: 36225720 PMCID: PMC9534553 DOI: 10.1176/appi.prcp.20210042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/18/2022] [Accepted: 03/31/2022] [Indexed: 12/01/2022] Open
Abstract
Objective To investigate feasibility and target engagement of high‐dose, add‐on pramipexole treatment in anhedonic depression. Method In this open‐label pilot study, we included 12 patients with unipolar or bipolar, moderate‐to‐severe depression and with significant anhedonia symptoms. All patients were on a stable dose of one or a combination of antidepressants and/or mood stabilizers and received 10 weeks of adjunctive pramipexole titrated to a maximum dose of 4.5 mg salt/day. All patients were rated with the Dimensional Anhedonia Rating Scale (DARS), the Montgomery Åsberg Depression Rating (MADRS) and the Snaith Hamilton Pleasure Scale (SHAPS). Serum high‐sensitivity C‐reactive protein (hs‐CRP) was analyzed pre‐ and post‐treatment. Eight patients underwent fMRI pre‐ and post‐treatment and a simplified version of the monetary incentive delay task was used to investigate the effect of treatment on striatal activity during reward anticipation. Results DARS, MADRS and SHAPS scores all improved significantly over 10 weeks of pramipexole treatment (p<0.01). Mean levels of hs‐CRP decreased significantly over the course of treatment from mean 3.8 mg/L at baseline to 2.6 mg/L at endpoint (p<0.01). There were significant treatment‐associated increases in reward related activity in several brain areas including the right lateral putamen, anterior left caudate, left posterior putamen, right dorsal caudate, left anterior putamen, and the right nucleus accumbens. Conclusions This is the first study to suggest efficacy and target engagement of pramipexole in anhedonic depression. Larger randomized controlled trials are needed to confirm or refute these preliminary findings. In this open‐label pilot study, high dose, add‐on pramipexole was a feasible and well‐tolerated treatment for anhedonic depression Serum high sensitivity C‐reactive protein decreased over the treatment course Add‐on pramipexole was associated with increased activity in the ventral striatum
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Affiliation(s)
- Filip Ventorp
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden (F. Ventorp, J. Lindahl, D. Lindqvist); Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Lund, Sweden (F. Ventorp, J. Lindahl); Department of Clinical Sciences Lund, Diagnostic Radiology, Faculty of Medicine, Lund University, Lund, Sweden (D. van Westen); Image and Function, Skåne University Hospital, Lund, Sweden (D. van Westen); Centre for Psychology, Kristianstad University,
| | - Jesper Lindahl
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden (F. Ventorp, J. Lindahl, D. Lindqvist); Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Lund, Sweden (F. Ventorp, J. Lindahl); Department of Clinical Sciences Lund, Diagnostic Radiology, Faculty of Medicine, Lund University, Lund, Sweden (D. van Westen); Image and Function, Skåne University Hospital, Lund, Sweden (D. van Westen); Centre for Psychology, Kristianstad University,
| | - Danielle van Westen
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden (F. Ventorp, J. Lindahl, D. Lindqvist); Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Lund, Sweden (F. Ventorp, J. Lindahl); Department of Clinical Sciences Lund, Diagnostic Radiology, Faculty of Medicine, Lund University, Lund, Sweden (D. van Westen); Image and Function, Skåne University Hospital, Lund, Sweden (D. van Westen); Centre for Psychology, Kristianstad University,
| | - Jimmy Jensen
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden (F. Ventorp, J. Lindahl, D. Lindqvist); Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Lund, Sweden (F. Ventorp, J. Lindahl); Department of Clinical Sciences Lund, Diagnostic Radiology, Faculty of Medicine, Lund University, Lund, Sweden (D. van Westen); Image and Function, Skåne University Hospital, Lund, Sweden (D. van Westen); Centre for Psychology, Kristianstad University,
| | - Johannes Björkstrand
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden (F. Ventorp, J. Lindahl, D. Lindqvist); Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Lund, Sweden (F. Ventorp, J. Lindahl); Department of Clinical Sciences Lund, Diagnostic Radiology, Faculty of Medicine, Lund University, Lund, Sweden (D. van Westen); Image and Function, Skåne University Hospital, Lund, Sweden (D. van Westen); Centre for Psychology, Kristianstad University,
| | - Daniel Lindqvist
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden (F. Ventorp, J. Lindahl, D. Lindqvist); Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Lund, Sweden (F. Ventorp, J. Lindahl); Department of Clinical Sciences Lund, Diagnostic Radiology, Faculty of Medicine, Lund University, Lund, Sweden (D. van Westen); Image and Function, Skåne University Hospital, Lund, Sweden (D. van Westen); Centre for Psychology, Kristianstad University,
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Moran EK, Gold JM, Carter CS, MacDonald AW, Ragland JD, Silverstein SM, Luck SJ, Barch DM. Both unmedicated and medicated individuals with schizophrenia show impairments across a wide array of cognitive and reinforcement learning tasks. Psychol Med 2022; 52:1115-1125. [PMID: 32799938 PMCID: PMC8095353 DOI: 10.1017/s003329172000286x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Schizophrenia is a disorder characterized by pervasive deficits in cognitive functioning. However, few well-powered studies have examined the degree to which cognitive performance is impaired even among individuals with schizophrenia not currently on antipsychotic medications using a wide range of cognitive and reinforcement learning measures derived from cognitive neuroscience. Such research is particularly needed in the domain of reinforcement learning, given the central role of dopamine in reinforcement learning, and the potential impact of antipsychotic medications on dopamine function. METHODS The present study sought to fill this gap by examining healthy controls (N = 75), unmedicated (N = 48) and medicated (N = 148) individuals with schizophrenia. Participants were recruited across five sites as part of the CNTRaCS Consortium to complete tasks assessing processing speed, cognitive control, working memory, verbal learning, relational encoding and retrieval, visual integration and reinforcement learning. RESULTS Individuals with schizophrenia who were not taking antipsychotic medications, as well as those taking antipsychotic medications, showed pervasive deficits across cognitive domains including reinforcement learning, processing speed, cognitive control, working memory, verbal learning and relational encoding and retrieval. Further, we found that chlorpromazine equivalency rates were significantly related to processing speed and working memory, while there were no significant relationships between anticholinergic load and performance on other tasks. CONCLUSIONS These findings add to a body of literature suggesting that cognitive deficits are an enduring aspect of schizophrenia, present in those off antipsychotic medications as well as those taking antipsychotic medications.
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Affiliation(s)
- Erin K. Moran
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - James M. Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | | | | | | | - Steven M. Silverstein
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School Hospital, Piscataway, NJ
| | - Steven J. Luck
- Department of Psychology, University of California, Davis, CA
| | - Deanna M. Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
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Costi S, Han MH, Murrough JW. The Potential of KCNQ Potassium Channel Openers as Novel Antidepressants. CNS Drugs 2022; 36:207-216. [PMID: 35258812 DOI: 10.1007/s40263-021-00885-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 12/12/2022]
Abstract
Major depressive disorder (MDD) is a leading cause of disability worldwide and less than one-third of patients with MDD achieve stable remission of symptoms, despite currently available treatments. Although MDD represents a serious health problem, a complete understanding of the neurobiological mechanisms underlying this condition continues to be elusive. Accumulating evidence from preclinical and animal studies provides support for the antidepressant potential of modulators of KCNQ voltage-gated potassium (K+) channels. KCNQ K+ channels, through regulation of neuronal excitability and activity, contribute to neurophysiological mechanisms underlying stress resilience, and represent potential targets of drug discovery for depression. The present article focuses on the pharmacology and efficacy of KCNQ2/3 K+ channel openers as novel therapeutic agents for depressive disorders from initial studies conducted on animal models showing depressive-like behaviors to recent work in humans that examines the potential for KCNQ2/3 channel modulators as novel antidepressants. Data from preclinical work suggest that KCNQ-type K+ channels are an active mediator of stress resilience and KCNQ2/3 K+ channel openers show antidepressant efficacy. Similarly, evidence from clinical trials conducted in patients with MDD using the KCNQ2/3 channel opener ezogabine (retigabine) showed significant improvements in depressive symptoms and anhedonia. Overall, KCNQ channel openers appear a promising target for the development of novel therapeutics for the treatment of psychiatric disorders and specifically for MDD.
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Affiliation(s)
- Sara Costi
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Ming-Hu Han
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Center for Affective Neuroscience, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Mental Health and Public Health, Faculty of Life and Health Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - James W Murrough
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA. .,Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Ventral Striatal-Hippocampus Coupling During Reward Processing as a Stratification Biomarker for Psychotic Disorders. Biol Psychiatry 2022; 91:216-225. [PMID: 34607654 DOI: 10.1016/j.biopsych.2021.07.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/15/2021] [Accepted: 07/15/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Altered ventral striatal (vST) activation to reward expectancy is a well-established intermediate phenotype for psychiatric disorders, specifically schizophrenia (SZ). Preclinical research suggests that striatal alterations are related to a reduced inhibition by the hippocampal formation, but its role in human transdiagnostic reward-network dysfunctions is not well understood. METHODS We performed functional magnetic resonance imaging during reward processing in 728 individuals including healthy control subjects (n = 396), patients (SZ: n = 46; bipolar disorder: n = 45; major depressive disorder: n = 60), and unaffected first-degree relatives (SZ: n = 46; bipolar disorder: n = 50; major depressive disorder: n = 85). We assessed disorder-specific differences in functional vST-hippocampus coupling and transdiagnostic associations with dimensional measures of positive, negative, and cognitive symptoms. We also probed the genetic underpinning using polygenic risk scores for SZ in a subset of healthy participants (n = 295). RESULTS Functional vST-hippocampus coupling was 1) reduced in patients with SZ and bipolar disorder (pFWE < .05, small-volume corrected [SVC]); 2) associated transdiagnostically to dimensional measures of positive (pFWE = .01, SVC) and cognitive (pFWE = .02, SVC), but not negative, (pFWE > .05, SVC) symptoms; and 3) reduced in first-degree relatives of patients with SZ (pFWE = .017, SVC) and linked to the genetic risk for SZ in healthy participants (p = .035). CONCLUSIONS We provide evidence that reduced vST-hippocampus coupling during reward processing is an endophenotype for SZ linked to positive and cognitive symptoms, supporting current preclinical models of the emergence of psychosis. Moreover, our data indicate that vST-hippocampus coupling is familial and linked to polygenic scores for SZ, supporting the use of this measure as an intermediate phenotype for psychotic disorders.
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McLauchlan DJ, Lancaster T, Craufurd D, Linden DEJ, Rosser AE. Different depression: motivational anhedonia governs antidepressant efficacy in Huntington's disease. Brain Commun 2022; 4:fcac278. [PMID: 36440100 PMCID: PMC9683390 DOI: 10.1093/braincomms/fcac278] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 04/13/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
Depression is more common in neurodegenerative diseases such as Huntington's disease than the general population. Antidepressant efficacy is well-established for depression within the general population: a recent meta-analysis showed serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants and mirtazapine outperformed other antidepressants. Despite the severe morbidity, antidepressant choice in Huntington's disease is based on Class IV evidence. We used complementary approaches to determine treatment choice for depression in Huntington's disease: propensity score analyses of antidepressant treatment outcome using the ENROLL-HD data set, and a dissection of the cognitive mechanisms underlying depression in Huntington's disease using a cognitive battery based on the Research Domain Criteria for Depression. Study 1 included ENROLL-HD 5486 gene-positive adult patients started on an antidepressant medication for depression. Our outcome measures were depression (Hospital Anxiety and Depression Scale or Problem Behaviours Assessment 'Depressed Mood' item) at first follow-up (primary outcome) and all follow-ups (secondary outcome). The intervention was antidepressant class. We used Svyglm&Twang in R to perform propensity scoring, using known variables (disease progression, medical comorbidity, psychiatric morbidity, sedatives, number of antidepressants, demographics and antidepressant contraindications) to determine the probability of receiving different antidepressants (propensity score) and then included the propensity score in a model of treatment efficacy. Study 2 recruited 51 gene-positive adult patients and 26 controls from the South Wales Huntington's Disease Management Service. Participants completed a motor assessment, in addition to measures of depression and apathy, followed by tasks measuring consummatory anhedonia, motivational anhedonia, learning from reward and punishment and reaction to negative outcome. We used generalised linear models to determine the association between task performance and depression scores. Study 1 showed selective serotonin reuptake inhibitors outperformed serotonin norepinephrine reuptake inhibitors on the primary outcome (P = 0.048), whilst both selective serotonin reuptake inhibitors (P = 0.00069) and bupropion (P = 0.0045) were superior to serotonin norepinephrine reuptake inhibitors on the secondary outcome. Study 2 demonstrated an association between depression score and effort for reward that was not explained by apathy. No other mechanisms were associated with depression score. We found that selective serotonin reuptake inhibitors and bupropion outperform serotonin norepinephrine reuptake inhibitors at alleviating depression in Huntington's disease. Moreover, motivational anhedonia appears the most significant mechanism underlying depression in Huntington's disease. Bupropion is improves motivational anhedonia and has a synergistic effect with selective serotonin reuptake inhibitors. This work provides the first large-scale, objective evidence to determine treatment choice for depression in Huntington's disease, and provides a model for determining antidepressant efficacy in other neurodegenerative diseases.
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Affiliation(s)
- Duncan James McLauchlan
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff CF24 4HQ, UK.,Department of Neurology, Morriston Hospital, Swansea Bay University Health Board, Swansea SA6 6NL, UK
| | - Thomas Lancaster
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff CF24 4HQ, UK.,Cardiff University Brain Research Imaging Center, Cardiff University, Cardiff CF24 4HQ, UK.,Department of Psychology, University of Bath, Bath BA2 7AY, UK
| | - David Craufurd
- Manchester Center for Genomic Medicine, Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Center, Manchester M13 9PL, UK.,St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Center, Manchester M13 9WL, UK
| | - David E J Linden
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff CF24 4HQ, UK.,Cardiff University Brain Research Imaging Center, Cardiff University, Cardiff CF24 4HQ, UK.,Department of Psychology, University of Bath, Bath BA2 7AY, UK.,School for Mental Health and Neuroscience, Fac. Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Anne E Rosser
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff CF24 4HQ, UK.,Department of Neurology, Morriston Hospital, Swansea Bay University Health Board, Swansea SA6 6NL, UK.,School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK
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Srirangarajan T, Mortazavi L, Bortolini T, Moll J, Knutson B. Multi-band FMRI compromises detection of mesolimbic reward responses. Neuroimage 2021; 244:118617. [PMID: 34600102 PMCID: PMC8626533 DOI: 10.1016/j.neuroimage.2021.118617] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/09/2022] Open
Abstract
Recent innovations in Functional Magnetic Resonance Imaging (FMRI) have sped data collection by enabling simultaneous scans of neural activity in multiple brain locations, but have these innovations come at a cost? In a meta-analysis and preregistered direct comparison of original data, we examined whether acquiring FMRI data with multi-band versus single-band scanning protocols might compromise detection of mesolimbic activity during reward processing. Meta-analytic results (n = 44 studies; cumulative n = 5005 subjects) indicated that relative to single-band scans, multi-band scans showed significantly decreased effect sizes for reward anticipation in the Nucleus Accumbens (NAcc) by more than half. Direct within-subject comparison of single-band versus multi-band scanning data (multi-band factors = 4 and 8; n = 12 subjects) acquired during repeated administration of the Monetary Incentive Delay task indicated that reductions in temporal signal-to-noise ratio could account for compromised detection of task-related responses in mesolimbic regions (i.e., the NAcc). Together, these findings imply that researchers should opt for single-band over multi-band scanning protocols when probing mesolimbic responses with FMRI. The findings also have implications for inferring mesolimbic activity during related tasks and rest, for summarizing historical results, and for using neuroimaging data to track individual differences in reward-related brain activity.
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Affiliation(s)
- Tara Srirangarajan
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Leili Mortazavi
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Tiago Bortolini
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Jorge Moll
- Department of Psychology, Stanford University, Stanford, CA, United States; D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Brian Knutson
- Department of Psychology, Stanford University, Stanford, CA, United States.
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Pasquereau B, Drui G, Saga Y, Richard A, Millot M, Météreau E, Sgambato V, Tobler PN, Tremblay L. Selective serotonin reuptake inhibitor treatment retunes emotional valence in primate ventral striatum. Neuropsychopharmacology 2021; 46:2073-2082. [PMID: 33692476 PMCID: PMC8505611 DOI: 10.1038/s41386-021-00991-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/29/2021] [Accepted: 02/19/2021] [Indexed: 01/31/2023]
Abstract
Selective serotonin reuptake inhibitors (SSRIs) are widely used to treat psychiatric disorders with affective biases such as depression and anxiety. How SSRIs exert a beneficial action on emotions associated with life events is still unknown. Here we ask whether and how the effectiveness of the SSRI fluoxetine is underpinned by neural mechanisms in the ventral striatum. To address these issues, we studied the spiking activity of neurons in the ventral striatum of monkeys during an approach-avoidance task in which the valence assigned to sensory stimuli was manipulated. Neural responses to positive and negative events were measured before and during a 4-week treatment with fluoxetine. We conducted PET scans to confirm that fluoxetine binds within the ventral striatum at a therapeutic dose. In our monkeys, fluoxetine facilitated approach of rewards and avoidance of punishments. These beneficial effects were associated with changes in tonic and phasic activities of striatal neurons. Fluoxetine increased the spontaneous firing rate of striatal neurons and amplified the number of cells responding to rewards versus punishments, reflecting a drug-induced positive shift in the processing of emotionally valenced information. These findings reveal how SSRI treatment affects ventral striatum neurons encoding positive and negative valence and striatal signaling of emotional information. In addition to a key role in appetitive processing, our results shed light on the involvement of the ventral striatum in aversive processing. Together, the ventral striatum appears to play a central role in the action of SSRIs on emotion processing biases commonly observed in psychiatric disorders.
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Affiliation(s)
- Benjamin Pasquereau
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Centre National de la Recherche Scientifique, Bron Cedex, France. .,Université Claude Bernard Lyon 1, Villeurbanne, France.
| | - Guillaume Drui
- grid.465537.6Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Centre National de la Recherche Scientifique, Bron Cedex, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Yosuke Saga
- grid.465537.6Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Centre National de la Recherche Scientifique, Bron Cedex, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Augustin Richard
- grid.465537.6Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Centre National de la Recherche Scientifique, Bron Cedex, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Mathilde Millot
- grid.465537.6Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Centre National de la Recherche Scientifique, Bron Cedex, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Elise Météreau
- grid.465537.6Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Centre National de la Recherche Scientifique, Bron Cedex, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Véronique Sgambato
- grid.465537.6Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Centre National de la Recherche Scientifique, Bron Cedex, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Philippe N. Tobler
- grid.7400.30000 0004 1937 0650Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Léon Tremblay
- grid.465537.6Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Centre National de la Recherche Scientifique, Bron Cedex, France ,grid.7849.20000 0001 2150 7757Université Claude Bernard Lyon 1, Villeurbanne, France
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Ben-Zion Z, Shany O, Admon R, Keynan NJ, Avisdris N, Balter SR, Shalev AY, Liberzon I, Hendler T. Neural Responsivity to Reward versus Punishment Shortly after Trauma Predicts Long-term Development of Post-Traumatic Stress Symptoms. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 7:150-161. [PMID: 34534702 DOI: 10.1016/j.bpsc.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/11/2021] [Accepted: 09/01/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Processing negative and positive valenced stimuli involve multiple brain regions including the amygdala and ventral striatum (VS). Post-Traumatic Stress Disorder (PTSD) is often associated with hyper-responsivity to negatively valenced, yet recent evidence also points to deficient positive valence functioning. It is yet unclear what is the relative contribution of such opposing valence processing shortly after trauma to the development of chronic PTSD. METHODS Neurobehavioral indicators of motivational positive vs. negative valence sensitivities were longitudinally assessed in 171 adults (87 females, age=34.19±11.47 years) at 1-, 6-, and 14-months following trauma exposure (TP1, TP2, TP3). Using a gambling fMRI paradigm, amygdala and VS functionality (activity and functional connectivity with the prefrontal cortex) in response to rewards vs. punishments were assessed with relation to PTSD severity at different time-points. The effect of valence processing was depicted behaviorally by the amount of risk taken to maximize reward. RESULTS PTSD severity at TP1 was associated with greater neural functionality in the amygdala (but not the VS) towards punishments vs. rewards, and fewer risky choices. PTSD severity at TP3 was associated with decreased neural functionality in both the VS and amygdala towards rewards vs. punishments at TP1 (but not with risky behavior). Explainable machine learning revealed the primacy of VS biased processing, over the amygdala, in predicting PTSD severity at TP3. CONCLUSIONS These results highlight the importance of biased neural responsivity to positive relative to negative motivational outcomes in PTSD development. Novel therapeutic strategies early after trauma may thus target both valence fronts.
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Affiliation(s)
- Ziv Ben-Zion
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; Yale School of Medicine, Yale University, New Haven, Connecticut, United States; United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, United States
| | - Ofir Shany
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, Haifa, Israel; The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
| | - Nimrod Jackob Keynan
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Netanell Avisdris
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; School of Computer Science and Engineering, the Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shira Reznik Balter
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Arieh Y Shalev
- Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - Israel Liberzon
- Department of Psychiatry, Texas A&M Health Science Center, TX, USA
| | - Talma Hendler
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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39
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Foell J, Klawohn J, Bruchnak A, Brush CJ, Patrick CJ, Hajcak G. Ventral striatal activation during reward differs between major depression with and without impaired mood reactivity. Psychiatry Res Neuroimaging 2021; 313:111298. [PMID: 33979730 DOI: 10.1016/j.pscychresns.2021.111298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/08/2021] [Accepted: 04/26/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Recent efforts to classify subtypes of major depressive disorder marked by different psychophysiological indicators have identified blunted reward-related brain activation in gambling tasks as a characteristic linked specifically to depressed participants with impaired mood reactivity. METHODS The current study compared individuals diagnosed with current depressive disorder (n = 26) with healthy controls (n = 24) regarding brain responses to gain and loss trials in an fMRI version of the "Doors" choice-feedback task. Study aims were to examine reward-related brain activation in relation to depression, depressive subtypes, and course of depression. RESULTS Across the sample, participants showed a significant response to gain versus loss in left and right ventral striatum as well as medial and left lateral prefrontal cortex. Relative to controls, participants with current depression were characterized by blunted reactivity in left ventral striatum. Furthermore, activation in the left ventral striatum differentiated subgroups of depression with and without impaired mood reactivity. Finally, left striatal hypoactivation to reward predicted remission when controlling for current depressive symptomatology, albeit at a trend level. CONCLUSIONS Blunted reward-related activation in the left ventral striatum might be useful as a marker for depression subtype and may have the potential to predict future course of depression.
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Affiliation(s)
- Jens Foell
- Department of Psychology, Florida State University, 1107 West Call St, Tallahassee, FL 32304, United States.
| | - Julia Klawohn
- Department of Psychology, Florida State University, 1107 West Call St, Tallahassee, FL 32304, United States; Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
| | - Alec Bruchnak
- Department of Psychology, Florida State University, 1107 West Call St, Tallahassee, FL 32304, United States
| | - C J Brush
- Department of Psychology, Florida State University, 1107 West Call St, Tallahassee, FL 32304, United States
| | - Christopher J Patrick
- Department of Psychology, Florida State University, 1107 West Call St, Tallahassee, FL 32304, United States
| | - Greg Hajcak
- Department of Psychology, Florida State University, 1107 West Call St, Tallahassee, FL 32304, United States
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Horne SJ, Topp TE, Quigley L. Depression and the willingness to expend cognitive and physical effort for rewards: A systematic review. Clin Psychol Rev 2021; 88:102065. [PMID: 34274800 DOI: 10.1016/j.cpr.2021.102065] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/26/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
Depression is associated with reduced motivation to engage in previously enjoyed activities. In particular, anhedonia has been linked to reduced motivation, though other depressive symptoms may also play a role. The purposes of this systematic review were to 1) examine the relationship between depression and motivation, as operationalized by a willingness to expend effort for rewards, 2) examine the relationship between anhedonia and motivation, and 3) examine potential methodological moderators of these relationships. Forty-three articles met our inclusion criteria for the review. Our review found that individuals with depression and anhedonia demonstrate reduced willingness to expend cognitive and physical effort for rewards, though the effect has been more robustly demonstrated for physical effort expenditure. Task design impacted the strength of these relationships, with stronger effects for tasks that used indices of decision-making and accuracy rather than response time. These findings have clinical implications for behavioral activation, which seeks to improve depressive symptoms by encouraging individuals to increase their activity level. Future research should examine the determinants of motivation in individuals with depression and anhedonia, to ultimately help these individuals become more active and hopefully improve their quality of life as a result.
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Affiliation(s)
- Sarah J Horne
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States of America.
| | - Tzippora E Topp
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States of America
| | - Leanne Quigley
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States of America
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Ketamine Modulates the Neural Correlates of Reward Processing in Unmedicated Patients in Remission from Depression. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 7:285-292. [PMID: 34126264 DOI: 10.1016/j.bpsc.2021.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/26/2021] [Accepted: 05/23/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Ketamine as an antidepressant improves anhedonia as early as 2h post-infusion. These drug effects are thought to be exerted via actions on reward-related brain areas-yet, these actions remain largely unknown. Our study investigates ketamine's effects during the anticipation and receipt of an expected reward, after the psychotomimetic effects of ketamine have passed, when early antidepressant effects are reported. METHODS We examined ketamine's effects during the anticipation and receipt of expected rewards on pre-defined brain areas, namely the dorsal and ventral striatum, the ventral tegmental area, the amygdala and the insula. We have recruited 37 male and female participants who remitted from depression and were free from symptoms and antidepressant treatments at the time of the scan. Participants were scanned, 2h after drug administration, in a double-blind cross over design (ketamine:0.5mg/kg and placebo) while performing a monetary reward task. RESULTS A significant main effect of ketamine, across all ROIs, was observed during the anticipation and feedback phases of win and no-win trials. The drug effects were particularly prominent in the nucleus accumbens and putamen, which showed increased activation upon the receipt of smaller rewards compared to neutral. The levels of (2R,6R)-HNK, 2h post-infusion, significantly correlated with the activation observed in the ventral tegmental area for that contrast. CONCLUSIONS These findings demonstrate that ketamine can produce detectable changes in reward-related brain areas, 2h after infusion, which occur without symptom changes and support the idea that ketamine might improve reward-related symptoms via modulation of response to feedback.
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Janouschek H, Chase HW, Sharkey RJ, Peterson ZJ, Camilleri JA, Abel T, Eickhoff SB, Nickl-Jockschat T. The functional neural architecture of dysfunctional reward processing in autism. Neuroimage Clin 2021; 31:102700. [PMID: 34161918 PMCID: PMC8239466 DOI: 10.1016/j.nicl.2021.102700] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/30/2022]
Abstract
Functional imaging studies have found differential neural activation patterns during reward-paradigms in patients with autism spectrum disorder (ASD) compared to neurotypical controls. However, publications report conflicting results on the directionality and location of these aberrant activations. We here quantitatively summarized relevant fMRI papers in the field using the anatomical likelihood estimation (ALE) algorithm. Patients with ASD consistently showed hypoactivations in the striatum across studies, mainly in the right putamen and accumbens. These regions are functionally involved in the processing of rewards and are enrolled in extensive neural networks involving limbic, cortical, thalamic and mesencephalic regions. The striatal hypo-activations found in our ALE meta-analysis, which pooled over contrasts derived from the included studies on reward-processing in ASD, highlight the role of the striatum as a key neural correlate of impaired reward processing in autism. These changes were present for studies using social and non-social stimuli alike. The involvement of these regions in extensive networks associated with the processing of both positive and negative emotion alike might hint at broader impairments of emotion processing in the disorder.
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Affiliation(s)
- Hildegard Janouschek
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Rachel J Sharkey
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Zeru J Peterson
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Julia A Camilleri
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Ted Abel
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Neuroscience and Pharmacology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Thomas Nickl-Jockschat
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Psychiatry, University of Iowa, Iowa City, IA, USA; Department of Neuroscience and Pharmacology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
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Rizvi SJ, Gandhi W, Salomons T. Reward processing as a common diathesis for chronic pain and depression. Neurosci Biobehav Rev 2021; 127:749-760. [PMID: 33951413 DOI: 10.1016/j.neubiorev.2021.04.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/14/2020] [Accepted: 04/27/2021] [Indexed: 12/25/2022]
Abstract
Pain disorders and psychiatric illness are strongly comorbid, particularly in the context of Major Depressive Disorder (MDD). While these disorders account for a significant amount of global disability, the mechanisms of their overlap remain unclear. Understanding these mechanisms is of vital importance to developing prevention strategies and interventions that target both disorders. Of note, brain reward processing may be relevant to explaining how the comorbidity arises, given pain disorders and MDD can result in maladaptive reward responsivity that limits reward learning, appetitive approach behaviours and consummatory response. In this review, we discuss this research and explore the possibility of reward processing deficits as a common diathesis to explain the manifestation of pain disorders and MDD. Specifically, we hypothesize that contextual physical or psychological events (e.g. surgery, divorce) in the presence of a reward impairment diathesis worsens symptoms and results in a negative feedback loop that increases the chronicity and probability of developing the other disorder. We also highlight the implications for treatment and provide a framework for future research.
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Affiliation(s)
- Sakina J Rizvi
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
| | - Wiebke Gandhi
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Tim Salomons
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
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Costi S, Morris LS, Kirkwood KA, Hoch M, Corniquel M, Vo-Le B, Iqbal T, Chadha N, Pizzagalli DA, Whitton A, Bevilacqua L, Jha MK, Ursu S, Swann AC, Collins KA, Salas R, Bagiella E, Parides MK, Stern ER, Iosifescu DV, Han MH, Mathew SJ, Murrough JW. Impact of the KCNQ2/3 Channel Opener Ezogabine on Reward Circuit Activity and Clinical Symptoms in Depression: Results From a Randomized Controlled Trial. Am J Psychiatry 2021; 178:437-446. [PMID: 33653118 PMCID: PMC8791195 DOI: 10.1176/appi.ajp.2020.20050653] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Preclinical studies point to the KCNQ2/3 potassium channel as a novel target for the treatment of depression and anhedonia, a reduced ability to experience pleasure. The authors conducted the first randomized placebo-controlled trial testing the effect of the KCNQ2/3 positive modulator ezogabine on reward circuit activity and clinical outcomes in patients with depression. METHODS Depressed individuals (N=45) with elevated levels of anhedonia were assigned to a 5-week treatment period with ezogabine (900 mg/day; N=21) or placebo (N=24). Participants underwent functional MRI during a reward flanker task at baseline and following treatment. Clinical measures of depression and anhedonia were collected at weekly visits. The primary endpoint was the change from baseline to week 5 in ventral striatum activation during reward anticipation. Secondary endpoints included depression and anhedonia severity as measured using the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Snaith-Hamilton Pleasure Scale (SHAPS), respectively. RESULTS The study did not meet its primary neuroimaging endpoint. Participants in the ezogabine group showed a numerical increase in ventral striatum response to reward anticipation following treatment compared with participants in the placebo group from baseline to week 5. Compared with placebo, ezogabine was associated with a significantly larger improvement in MADRS and SHAPS scores and other clinical endpoints. Ezogabine was well tolerated, and no serious adverse events occurred. CONCLUSIONS The study did not meet its primary neuroimaging endpoint, although the effect of treatment was significant on several secondary clinical endpoints. In aggregate, the findings may suggest that future studies of the KCNQ2/3 channel as a novel treatment target for depression and anhedonia are warranted.
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Affiliation(s)
- Sara Costi
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laurel S. Morris
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katherine A. Kirkwood
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Megan Hoch
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Morgan Corniquel
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brittany Vo-Le
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA; Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Tabish Iqbal
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA; Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Nisha Chadha
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Diego A. Pizzagalli
- Department of Psychiatry, Harvard Medical School & McLean Hospital, Belmont, MA, USA
| | - Alexis Whitton
- Department of Psychiatry, Harvard Medical School & McLean Hospital, Belmont, MA, USA,School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Laura Bevilacqua
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manish K. Jha
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefan Ursu
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA; Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Alan C Swann
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA; Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Katherine A. Collins
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Ramiro Salas
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA; Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Emilia Bagiella
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael K. Parides
- Montefiore Medical Center/Albert Einstein College of Medicine, New York, New York
| | - Emily R. Stern
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Dan V. Iosifescu
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Ming-Hu Han
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA,Center for Affective Neuroscience, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sanjay J. Mathew
- Mood and Anxiety Disorders Program, Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA; Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - James W. Murrough
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Kryza-Lacombe M, Pearson N, Lyubomirsky S, Stein MB, Wiggins JL, Taylor CT. Changes in neural reward processing following Amplification of Positivity treatment for depression and anxiety: Preliminary findings from a randomized waitlist controlled trial. Behav Res Ther 2021; 142:103860. [PMID: 33894554 DOI: 10.1016/j.brat.2021.103860] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/17/2021] [Accepted: 03/30/2021] [Indexed: 11/16/2022]
Abstract
Positive valence system (PVS) deficits are increasingly recognized as important treatment targets for depression and anxiety. Emerging behavioral treatments designed to upregulate the PVS show initial promise; however, neural mechanisms underlying these approaches remain unknown. This study investigated neural reward-processing-related changes following Amplification of Positivity (AMP)-a treatment designed to enhance positive thinking, emotions and behaviors through positive activity interventions (Clinicaltrials.gov: NCT02330627). Individuals with depression and/or anxiety (N = 29) were randomized to 10 sessions of AMP (n = 16) or waitlist (WL; n = 13). Participants completed a monetary incentive delay task during fMRI at baseline and post-assessment. Hypothesis-driven region of interest (ventral striatum, insula, anterior cingulate) and exploratory whole-brain activation and connectivity analyses evaluated pre-to-post changes for AMP vs. WL when anticipating potential monetary gain or loss. No between-group brain activation changes emerged in regions of interest or whole-brain analyses. Increased neural connectivity from pre-to-post-treatment was observed in AMP vs. WL, including ventral striatum, anterior insula, and anterior cingulate connectivity with prefrontal, limbic, occipital and parietal regions-predominantly during loss anticipation. This preliminary study is the first to examine neural mechanisms of positive activity interventions in depression and anxiety and suggests that AMP may strengthen brain connectivity in reward processing, attention, and emotion regulation networks.
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Affiliation(s)
- Maria Kryza-Lacombe
- San Diego State University, University of California, San Diego Joint Doctoral Program in Clinical Psychology, United States
| | - Nana Pearson
- Department of Psychiatry, University of California, San Diego, United States
| | - Sonja Lyubomirsky
- Department of Psychology, University of California, Riverside, United States
| | - Murray B Stein
- San Diego State University, University of California, San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychiatry, University of California, San Diego, United States
| | - Jillian Lee Wiggins
- San Diego State University, University of California, San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychology, San Diego State University, United States
| | - Charles T Taylor
- San Diego State University, University of California, San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychiatry, University of California, San Diego, United States.
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Gao F, Fan J, Xia J, Soondrum T, Liu W, Du H, Zhu J, Tan C, Zhu X. Decreased sensitivity to risk levels in ventral stratum in major depressive disorder during risky decision-making. J Affect Disord 2021; 282:187-193. [PMID: 33418366 DOI: 10.1016/j.jad.2020.12.131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 11/20/2020] [Accepted: 12/24/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Reduced decision-making ability in depressive people has been observed both in daily life and experimental behavioral studies. However, the neurobiology of dysfunction in decision-making among depressive people is still unclear. METHODS The study included 63 patients with major depressive disorder (MDD) and 49 healthy controls (HCs). The balloon analog risk task (BART), a risky decision-making paradigm, was used in a functional magnetic resonance imaging experiment to evaluate how brain activation was modulated by different levels of risk. RESULTS No significant difference in behavioral performance was found. In prespecified brain regions, the activation of the left ventral stratum (VS) in MDD patients showed reduced modulation by risk levels compared with HCs. No significant group difference was found in prespecified dorsal anterior cingulate cortex (dACC) and right dorsal lateral prefrontal cortex (DLPFC). LIMITATIONS BART did not isolate stages of making a choice and experiencing the outcome of the choice. CONCLUSION The left VS was less sensitive to risk levels in MDD patients compared with HCs, indicating inefficient reward processing in risky decision-making in MDD.
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Affiliation(s)
- Feng Gao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha, Hunan, China
| | - Jie Fan
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China
| | - Jie Xia
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Tamini Soondrum
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wanting Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hongyu Du
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiang Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Changlian Tan
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Xiongzhao Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China.
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Brandt IM, Köhler-Forsberg K, Ganz M, Ozenne B, Jorgensen MB, Poulsen A, Knudsen GM, Frokjaer VG, Fisher PM. Reward processing in major depressive disorder and prediction of treatment response - Neuropharm study. Eur Neuropsychopharmacol 2021; 44:23-33. [PMID: 33455816 DOI: 10.1016/j.euroneuro.2020.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/04/2020] [Accepted: 12/28/2020] [Indexed: 11/18/2022]
Abstract
Major depressive disorder (MDD) is a prevalent brain disorder for which anhedonia is a core symptom, indicating aberrations in the neural processing of reward. The striatum, medial prefrontal cortex (mPFC) and anterior insula (AI) are core reward processing regions. Here we used a reward-related, card-guessing functional magnetic resonance imaging (fMRI) paradigm to assay brain responses to reward in 90 MDD individuals and 58 healthy controls. We evaluated group differences in task-responsive, reward-related striatal, mPFC, and AI reactivity and whether baseline reactivity predicted an eight-week escitalopram antidepressant treatment response in MDD individuals. Thirty-eight MDD individuals also completed the reward paradigm after treatment and we evaluated antidepressant effects on reward reactivity estimates. Multivariate statistical analysis of task-responsive striatum, mPFC and AI brain responses did not reveal statistically significant differences between MDD and HC individuals (puncorrected>0.23). Logistic regression models (five-fold cross-validation, statistical significance assessed with permutation testing) also did not support that baseline reward-related brain responses significantly predicted antidepressant treatment response (puncorrected>0.39). Finally, reward-related brain responses were not statistically significantly changed over the course of treatment (puncorrected>0.27). Our findings in a comparatively large MDD cohort do not support that these reward-related fMRI brain responses are informative biomarkers of MDD or antidepressant treatment response to escitalopram.
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Affiliation(s)
- Ida Marie Brandt
- Neurobiology Research Unit and NeuroPharm, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Faculty of Science, University of Copenhagen, Copenhagen, DK
| | - Kristin Köhler-Forsberg
- Neurobiology Research Unit and NeuroPharm, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Psychiatric Center Copenhagen, Rigshospitalet, 2100 Copenhagen O, Denmark
| | - Melanie Ganz
- Neurobiology Research Unit and NeuroPharm, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark; Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit and NeuroPharm, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark; Department of Public Health, Section of Biostatistics, University of Copenhagen, 1014 Copenhagen K, Denmark
| | - Martin B Jorgensen
- Neurobiology Research Unit and NeuroPharm, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Psychiatric Center Copenhagen, Rigshospitalet, 2100 Copenhagen O, Denmark
| | - Asbjorn Poulsen
- Neurobiology Research Unit and NeuroPharm, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit and NeuroPharm, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit and NeuroPharm, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Psychiatric Center Copenhagen, Rigshospitalet, 2100 Copenhagen O, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit and NeuroPharm, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen O, Denmark.
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Mason TB, Smith KE, Anderson LM, Hazzard VM. Anhedonia, positive affect dysregulation, and risk and maintenance of binge-eating disorder. Int J Eat Disord 2021; 54:287-292. [PMID: 33295671 PMCID: PMC8673784 DOI: 10.1002/eat.23433] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/02/2020] [Accepted: 11/23/2020] [Indexed: 11/12/2022]
Abstract
Low positive affect has been identified as an antecedent of binge-eating episodes among individuals with binge-eating disorder (BED), yet positive affect has received far less attention in eating disorders research than its counterpart, negative affect. In this article, we argue that the low levels of positive affect which occur with anhedonia (i.e., loss of interest or pleasure in activities) may contribute to the onset and maintenance of BED. We introduce a theoretical model in which anhedonia increases the risk for BED through its interrelationships with dysregulated eating and weight gain, and we describe potential direct (e.g., reward-related processes) as well as indirect (e.g., influences on depressive symptoms and physical activity) pathways by which anhedonia may lead to adverse eating- and weight-related outcomes. We also propose a momentary maintenance model in which low positive affect and positive affect dysregulation occurring with anhedonia maintain binge eating directly and indirectly through maladaptive health behaviors, such as decreased physical activity, less healthy eating, and fewer social interactions, which in turn maintain anhedonia. We draw upon outside literature to present evidence that aligns with the proposed risk and maintenance models and conclude by outlining avenues for future research-including methodological/measurement, theoretical, and clinical research directions.
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Affiliation(s)
- Tyler B. Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Kathryn E. Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA
| | - Lisa M. Anderson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN
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Nielson DM, Keren H, O'Callaghan G, Jackson SM, Douka I, Vidal-Ribas P, Pornpattananangkul N, Camp CC, Gorham LS, Wei C, Kirwan S, Zheng CY, Stringaris A. Great Expectations: A Critical Review of and Suggestions for the Study of Reward Processing as a Cause and Predictor of Depression. Biol Psychiatry 2021; 89:134-143. [PMID: 32797941 PMCID: PMC10726343 DOI: 10.1016/j.biopsych.2020.06.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/20/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
Both human and animal studies support the relationship between depression and reward processing abnormalities, giving rise to the expectation that neural signals of these processes may serve as biomarkers or mechanistic treatment targets. Given the great promise of this research line, we scrutinized those findings and the theoretical claims that underlie them. To achieve this, we applied the framework provided by classical work on causality as well as contemporary approaches to prediction. We identified a number of conceptual, practical, and analytical challenges to this line of research and used a preregistered meta-analysis to quantify the longitudinal associations between reward processing abnormalities and depression. We also investigated the impact of measurement error on reported data. We found that reward processing abnormalities do not reach levels that would be useful for clinical prediction, yet the available evidence does not preclude a possible causal role in depression.
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Affiliation(s)
- Dylan M Nielson
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Hanna Keren
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Georgia O'Callaghan
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Sarah M Jackson
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ioanna Douka
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Pablo Vidal-Ribas
- Social and Behavioral Science Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | | | - Christopher C Camp
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Lisa S Gorham
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Christine Wei
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Stuart Kirwan
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Charles Y Zheng
- Machine Learning Team, Functional Magnetic Resonance Imaging Facility, National Institutes of Health, Bethesda, Maryland
| | - Argyris Stringaris
- Section on Clinical and Computational Psychiatry (CompΨ), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
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