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Steinmann LA, Dohm K, Goltermann J, Richter M, Enneking V, Lippitz M, Repple J, Mauritz M, Dannlowski U, Opel N. Understanding the neurobiological basis of anhedonia in major depressive disorder - evidence for reduced neural activation during reward and loss processing. J Psychiatry Neurosci 2022; 47:E284-E292. [PMID: 35948341 PMCID: PMC9377543 DOI: 10.1503/jpn.210180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 04/16/2021] [Accepted: 05/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Anhedonia is a key symptom of major depressive disorder (MDD). Anhedonia is associated with aberrant reward processing, but whether it might interfere similarly with the neural processing of aversive stimuli, such as monetary loss, remains unknown. We aimed to investigate potential associations between anhedonia and neural response during reward and loss processing in patients with MDD. METHODS We investigated blood-oxygen-level-dependent response in the orbitofrontal cortex, cingulate cortex, insula and basal ganglia during monetary reward and loss processing in 182 patients with MDD, using a card-guessing paradigm. We measured anhedonia with the Social and Physical Anhedonia Scale (SASPAS), and we tested for the main and interaction effects of SASPAS scores and the experimental condition (reward or loss) in a full factorial model. RESULTS We detected a negative main effect of anhedonia, as well as a significant interaction effect of anhedonia and the experimental condition, on orbitofrontal and insular neural response. Post hoc analyses revealed that the interaction was driven by a significant association between higher anhedonia scores and hypoactivation during loss processing. We observed no significant association between anhedonia and neural response during reward processing. LIMITATIONS This study had a cross-sectional design. CONCLUSION Our findings confirmed that altered neural processing in the orbitofrontal cortex and insula is a neurobiological feature of anhedonic symptomatology in people with MDD. The pronounced association between anhedonia and blunted neural response during loss processing supports a broader concept for the neurobiological basis of anhedonia. Hence, MDD with anhedonic features might be characterized by reduced neural response to external stimuli, potentially because of amotivation.
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Affiliation(s)
- Lavinia A Steinmann
- From the Institute for Translational Psychiatry, University of Münster, Münster, Germany (Steinmann, Dohm, Goltermann, Richter, Enneking, Lippitz, Repple, Mauritz, Dannlowski, Opel); the Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt/Goethe University, Frankfurt am Main, Germany (Repple); and the Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany (Opel).
| | - Katharina Dohm
- From the Institute for Translational Psychiatry, University of Münster, Münster, Germany (Steinmann, Dohm, Goltermann, Richter, Enneking, Lippitz, Repple, Mauritz, Dannlowski, Opel); the Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt/Goethe University, Frankfurt am Main, Germany (Repple); and the Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany (Opel)
| | - Janik Goltermann
- From the Institute for Translational Psychiatry, University of Münster, Münster, Germany (Steinmann, Dohm, Goltermann, Richter, Enneking, Lippitz, Repple, Mauritz, Dannlowski, Opel); the Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt/Goethe University, Frankfurt am Main, Germany (Repple); and the Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany (Opel)
| | - Maike Richter
- From the Institute for Translational Psychiatry, University of Münster, Münster, Germany (Steinmann, Dohm, Goltermann, Richter, Enneking, Lippitz, Repple, Mauritz, Dannlowski, Opel); the Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt/Goethe University, Frankfurt am Main, Germany (Repple); and the Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany (Opel)
| | - Verena Enneking
- From the Institute for Translational Psychiatry, University of Münster, Münster, Germany (Steinmann, Dohm, Goltermann, Richter, Enneking, Lippitz, Repple, Mauritz, Dannlowski, Opel); the Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt/Goethe University, Frankfurt am Main, Germany (Repple); and the Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany (Opel)
| | - Marcia Lippitz
- From the Institute for Translational Psychiatry, University of Münster, Münster, Germany (Steinmann, Dohm, Goltermann, Richter, Enneking, Lippitz, Repple, Mauritz, Dannlowski, Opel); the Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt/Goethe University, Frankfurt am Main, Germany (Repple); and the Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany (Opel)
| | - Jonathan Repple
- From the Institute for Translational Psychiatry, University of Münster, Münster, Germany (Steinmann, Dohm, Goltermann, Richter, Enneking, Lippitz, Repple, Mauritz, Dannlowski, Opel); the Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt/Goethe University, Frankfurt am Main, Germany (Repple); and the Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany (Opel)
| | - Marco Mauritz
- From the Institute for Translational Psychiatry, University of Münster, Münster, Germany (Steinmann, Dohm, Goltermann, Richter, Enneking, Lippitz, Repple, Mauritz, Dannlowski, Opel); the Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt/Goethe University, Frankfurt am Main, Germany (Repple); and the Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany (Opel)
| | - Udo Dannlowski
- From the Institute for Translational Psychiatry, University of Münster, Münster, Germany (Steinmann, Dohm, Goltermann, Richter, Enneking, Lippitz, Repple, Mauritz, Dannlowski, Opel); the Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt/Goethe University, Frankfurt am Main, Germany (Repple); and the Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany (Opel)
| | - Nils Opel
- From the Institute for Translational Psychiatry, University of Münster, Münster, Germany (Steinmann, Dohm, Goltermann, Richter, Enneking, Lippitz, Repple, Mauritz, Dannlowski, Opel); the Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Frankfurt/Goethe University, Frankfurt am Main, Germany (Repple); and the Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany (Opel)
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