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Ging-Jehli NR, Kuhn M, Blank JM, Chanthrakumar P, Steinberger DC, Yu Z, Herrington TM, Dillon DG, Pizzagalli DA, Frank MJ. Cognitive Signatures of Depressive and Anhedonic Symptoms and Affective States Using Computational Modeling and Neurocognitive Testing. Biol Psychiatry Cogn Neurosci Neuroimaging 2024:S2451-9022(24)00056-9. [PMID: 38401881 DOI: 10.1016/j.bpsc.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/03/2024] [Accepted: 02/09/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Deeper phenotyping may improve our understanding of depression. Because depression is heterogeneous, extracting cognitive signatures associated with severity of depressive symptoms, anhedonia, and affective states is a promising approach. METHODS Sequential sampling models decomposed behavior from an adaptive approach-avoidance conflict task into computational parameters quantifying latent cognitive signatures. Fifty unselected participants completed clinical scales and the approach-avoidance conflict task by either approaching or avoiding trials offering monetary rewards and electric shocks. RESULTS Decision dynamics were best captured by a sequential sampling model with linear collapsing boundaries varying by net offer values, and with drift rates varying by trial-specific reward and aversion, reflecting net evidence accumulation toward approach or avoidance. Unlike conventional behavioral measures, these computational parameters revealed distinct associations with self-reported symptoms. Specifically, passive avoidance tendencies, indexed by starting point biases, were associated with greater severity of depressive symptoms (R = 0.34, p = .019) and anhedonia (R = 0.49, p = .001). Depressive symptoms were also associated with slower encoding and response execution, indexed by nondecision time (R = 0.37, p = .011). Higher reward sensitivity for offers with negative net values, indexed by drift rates, was linked to more sadness (R = 0.29, p = .042) and lower positive affect (R = -0.33, p = .022). Conversely, higher aversion sensitivity was associated with more tension (R = 0.33, p = .025). Finally, less cautious response patterns, indexed by boundary separation, were linked to more negative affect (R = -0.40, p = .005). CONCLUSIONS We demonstrated the utility of multidimensional computational phenotyping, which could be applied to clinical samples to improve characterization and treatment selection.
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Affiliation(s)
- Nadja R Ging-Jehli
- Carney Institute for Brain Science, Department of Cognitive, Linguistic, & Psychological Sciences, Brown University, Providence, Rhode Island.
| | - Manuel Kuhn
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jacob M Blank
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts
| | - Pranavan Chanthrakumar
- Carney Institute for Brain Science, Department of Cognitive, Linguistic, & Psychological Sciences, Brown University, Providence, Rhode Island; Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - David C Steinberger
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts
| | - Zeyang Yu
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Todd M Herrington
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel G Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Michael J Frank
- Carney Institute for Brain Science, Department of Cognitive, Linguistic, & Psychological Sciences, Brown University, Providence, Rhode Island
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Tranter MM, Faget L, Hnasko TS, Powell SB, Dillon DG, Barnes SA. Postnatal Phencyclidine-Induced Deficits in Decision Making Are Ameliorated by Optogenetic Inhibition of Ventromedial Orbitofrontal Cortical Glutamate Neurons. Biol Psychiatry Glob Open Sci 2024; 4:264-274. [PMID: 38298783 PMCID: PMC10829674 DOI: 10.1016/j.bpsgos.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/12/2023] [Accepted: 08/01/2023] [Indexed: 02/02/2024] Open
Abstract
Background The orbitofrontal cortex (OFC) is essential for decision making, and functional disruptions within the OFC are evident in schizophrenia. Postnatal phencyclidine (PCP) administration in rats is a neurodevelopmental manipulation that induces schizophrenia-relevant cognitive impairments. We aimed to determine whether manipulating OFC glutamate cell activity could ameliorate postnatal PCP-induced deficits in decision making. Methods Male and female Wistar rats (n = 110) were administered saline or PCP on postnatal days 7, 9, and 11. In adulthood, we expressed YFP (yellow fluorescent protein) (control), ChR2 (channelrhodopsin-2) (activation), or eNpHR 3.0 (enhanced halorhodopsin) (inhibition) in glutamate neurons within the ventromedial OFC (vmOFC). Rats were tested on the probabilistic reversal learning task once daily for 20 days while we manipulated the activity of vmOFC glutamate cells. Behavioral performance was analyzed using a Q-learning computational model of reinforcement learning. Results Compared with saline-treated rats expressing YFP, PCP-treated rats expressing YFP completed fewer reversals, made fewer win-stay responses, and had lower learning rates. We induced similar performance impairments in saline-treated rats by activating vmOFC glutamate cells (ChR2). Strikingly, PCP-induced performance deficits were ameliorated when the activity of vmOFC glutamate cells was inhibited (halorhodopsin). Conclusions Postnatal PCP-induced deficits in decision making are associated with hyperactivity of vmOFC glutamate cells. Thus, normalizing vmOFC activity may represent a potential therapeutic target for decision-making deficits in patients with schizophrenia.
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Affiliation(s)
- Michael M. Tranter
- Department of Psychiatry, University of California San Diego, La Jolla, California
- Research Service, VA San Diego Healthcare System, La Jolla, California
| | - Lauren Faget
- Department of Neurosciences, University of California San Diego, La Jolla, California
| | - Thomas S. Hnasko
- Research Service, VA San Diego Healthcare System, La Jolla, California
- Department of Neurosciences, University of California San Diego, La Jolla, California
| | - Susan B. Powell
- Department of Psychiatry, University of California San Diego, La Jolla, California
- Research Service, VA San Diego Healthcare System, La Jolla, California
| | - Daniel G. Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Samuel A. Barnes
- Department of Psychiatry, University of California San Diego, La Jolla, California
- Research Service, VA San Diego Healthcare System, La Jolla, California
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Biernacki K, Molokotos E, Han C, Dillon DG, Leventhal AM, Janes AC. Enhanced decision-making in nicotine dependent individuals who abstain: A computational analysis using Hierarchical Drift Diffusion Modeling. Drug Alcohol Depend 2023; 250:110890. [PMID: 37480798 PMCID: PMC10530296 DOI: 10.1016/j.drugalcdep.2023.110890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/26/2023] [Accepted: 07/04/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Variability in decision-making capacity and reward responsiveness may underlie differences in the ability to abstain from smoking. Computational modeling of choice behavior, as with the Hierarchical Drift Diffusion Model (HDDM), can help dissociate reward responsiveness from underlying components of decision-making. Here we used the HDDM to identify which decision-making or reward-related parameters, extracted from data acquired in a reward processing task, contributed to the ability of people who smoke that are not seeking treatment to abstain from cigarettes during a laboratory task. METHODS 80 adults who smoke cigarettes completed the Probabilistic Reward Task (PRT) - a signal detection task with a differential reinforcement schedule - following smoking as usual, and the Relapse Analogue Task (RAT) - a task in which participants could earn money for delaying smoking up to 50min - after a period of overnight abstinence. Two cohorts were defined by the RAT; those who waited either 0-min (n=36) or the full 50-min (n=44) before smoking. RESULTS PRT signal detection metrics indicated all subjects learned the task contingencies, with no differences in response bias or discriminability between the two groups. However, HDDM analyses indicated faster drift rates in 50-min vs. 0-min waiters. CONCLUSIONS Relative to those who did not abstain, computational modeling indicated that people who abstained from smoking for 50min showed faster evidence accumulation during reward-based decision-making. These results highlight the importance of decision-making mechanisms to smoking abstinence, and suggest that focusing on the evidence accumulation process may yield new targets for treatment.
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Affiliation(s)
- Kathryn Biernacki
- National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD21224, United States.
| | - Elena Molokotos
- Suffolk University, Boston, MA02116, United States; CBTeam, Lexington, MA02421, United States
| | - Chungmin Han
- National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD21224, United States
| | - Daniel G Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA02478, United States; Harvard Medical School, Boston, MA02115, United States
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, CA90033, United States
| | - Amy C Janes
- National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD21224, United States
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Phillips RD, Walsh EC, Zürcher NR, Lalush DS, Kinard JL, Tseng CE, Cernasov PM, Kan D, Cummings K, Kelley L, Campbell D, Dillon DG, Pizzagalli DA, Izquierdo-Garcia D, Hooker JM, Smoski MJ, Dichter GS. Striatal dopamine in anhedonia: A simultaneous [ 11C]raclopride positron emission tomography and functional magnetic resonance imaging investigation. Psychiatry Res Neuroimaging 2023; 333:111660. [PMID: 37301129 PMCID: PMC10594643 DOI: 10.1016/j.pscychresns.2023.111660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 04/21/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Anhedonia is hypothesized to be associated with blunted mesocorticolimbic dopamine (DA) functioning in samples with major depressive disorder. The purpose of this study was to examine linkages between striatal DA, reward circuitry functioning, anhedonia, and, in an exploratory fashion, self-reported stress, in a transdiagnostic anhedonic sample. METHODS Participants with (n = 25) and without (n = 12) clinically impairing anhedonia completed a reward-processing task during simultaneous positron emission tomography and magnetic resonance (PET-MR) imaging with [11C]raclopride, a DA D2/D3 receptor antagonist that selectively binds to striatal DA receptors. RESULTS Relative to controls, the anhedonia group exhibited decreased task-related DA release in the left putamen, caudate, and nucleus accumbens and right putamen and pallidum. There were no group differences in task-related brain activation (fMRI) during reward processing after correcting for multiple comparisons. General functional connectivity (GFC) findings revealed blunted fMRI connectivity between PET-derived striatal seeds and target regions in the anhedonia group. Associations were identified between anhedonia severity and the magnitude of task-related DA release to rewards in the left putamen, but not mesocorticolimbic GFC. CONCLUSIONS Results provide evidence for reduced striatal DA functioning during reward processing and blunted mesocorticolimbic network functional connectivity in a transdiagnostic sample with clinically significant anhedonia.
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Affiliation(s)
- Rachel D Phillips
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States.
| | - Erin C Walsh
- Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Nicole R Zürcher
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - David S Lalush
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh, NC, United States
| | - Jessica L Kinard
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, Chapel Hill, NC, United States
| | - Chieh-En Tseng
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Paul M Cernasov
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Delia Kan
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, Chapel Hill, NC, United States
| | - Kaitlin Cummings
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Lisalynn Kelley
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, United States
| | - David Campbell
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, United States
| | - Daniel G Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, United States
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, United States
| | - David Izquierdo-Garcia
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Jacob M Hooker
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Moria J Smoski
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, United States
| | - Gabriel S Dichter
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States; Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States; Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, Chapel Hill, NC, United States
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Barnes SA, Dillon DG, Young JW, Thomas ML, Faget L, Yoo JH, Der-Avakian A, Hnasko TS, Geyer MA, Ramanathan DS. Modulation of ventromedial orbitofrontal cortical glutamatergic activity affects the explore-exploit balance and influences value-based decision-making. Cereb Cortex 2023; 33:5783-5796. [PMID: 36472411 PMCID: PMC10183731 DOI: 10.1093/cercor/bhac459] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022] Open
Abstract
The balance between exploration and exploitation is essential for decision-making. The present study investigated the role of ventromedial orbitofrontal cortex (vmOFC) glutamate neurons in mediating value-based decision-making by first using optogenetics to manipulate vmOFC glutamate activity in rats during a probabilistic reversal learning (PRL) task. Rats that received vmOFC activation during informative feedback completed fewer reversals and exhibited reduced reward sensitivity relative to rats. Analysis with a Q-learning computational model revealed that increased vmOFC activity did not affect the learning rate but instead promoted maladaptive exploration. By contrast, vmOFC inhibition increased the number of completed reversals and increased exploitative behavior. In a separate group of animals, calcium activity of vmOFC glutamate neurons was recorded using fiber photometry. Complementing our results above, we found that suppression of vmOFC activity during the latter part of rewarded trials was associated with improved PRL performance, greater win-stay responding and selecting the correct choice on the next trial. These data demonstrate that excessive vmOFC activity during reward feedback disrupted value-based decision-making by increasing the maladaptive exploration of lower-valued options. Our findings support the premise that pharmacological interventions that normalize aberrant vmOFC glutamate activity during reward feedback processing may attenuate deficits in value-based decision-making.
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Affiliation(s)
- Samuel A Barnes
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States
- Department of Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr, La Jolla, CA 92093, United States
| | - Daniel G Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, 115 Mill St, Belmont, MA 02478, United States
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02115, United States
| | - Jared W Young
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States
- Department of Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr, La Jolla, CA 92093, United States
| | - Michael L Thomas
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States
- Department of Psychology, 1876 Campus Delivery, Colorado State University, Fort Collins, CO 80523, United States
| | - Lauren Faget
- Department of Neurosciences, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States
| | - Ji Hoon Yoo
- Department of Neurosciences, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States
| | - Andre Der-Avakian
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States
| | - Thomas S Hnasko
- Department of Neurosciences, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States
- Research Service, VA San Diego Healthcare System, San Diego, CA, 92161, United States
| | - Mark A Geyer
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States
- Department of Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr, La Jolla, CA 92093, United States
| | - Dhakshin S Ramanathan
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States
- Department of Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr, La Jolla, CA 92093, United States
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr, La Jolla, CA 92093, United States
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Zhu X, Lazarov A, Dolan S, Bar-Haim Y, Dillon DG, Pizzagalli DA, Schneier F. Resting state connectivity predictors of symptom change during gaze-contingent music reward therapy of social anxiety disorder. Psychol Med 2023; 53:3115-3123. [PMID: 35314008 PMCID: PMC9612546 DOI: 10.1017/s0033291721005171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 11/10/2021] [Accepted: 11/29/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Social anxiety disorder (SAD) is common, first-line treatments are often only partially effective, and reliable predictors of treatment response are lacking. Here, we assessed resting state functional connectivity (rsFC) at pre-treatment and during early treatment as a potential predictor of response to a novel attention bias modification procedure, gaze-contingent music reward therapy (GC-MRT). METHODS Thirty-two adults with SAD were treated with GC-MRT. rsFC was assessed with multi-voxel pattern analysis of fMRI at pre-treatment and after 2-3 weeks. For comparison, 20 healthy control (HC) participants without treatment were assessed twice for rsFC over the same time period. All SAD participants underwent clinical evaluation at pre-treatment, early-treatment (week 2-3), and post-treatment. RESULTS SAD and depressive symptoms improved significantly from pre-treatment to post-treatment. After 2-3 weeks of treatment, decreased connectivity between the executive control network (ECN) and salience network (SN), and increased connectivity within the ECN predicted improvement in SAD and depressive symptoms at week 8. Increased connectivity between the ECN and default mode network (DMN) predicted greater improvement in SAD but not depressive symptoms at week 8. Connectivity within the DMN decreased significantly after 2-3 weeks of treatment in the SAD group, while no changes were found in HC over the same time interval. CONCLUSION We identified early changes in rsFC during a course of GC-MRT for SAD that predicted symptom change. Connectivity changes within the ECN, ECN-DMN, and ECN-SN may be related to mechanisms underlying the clinical effects of GC-MRT and warrant further study in controlled trials.
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Affiliation(s)
- Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
- New York State Psychiatric Institute, New York, USA
| | - Amit Lazarov
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Sarah Dolan
- New York State Psychiatric Institute, New York, USA
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Daniel G Dillon
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - Franklin Schneier
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
- New York State Psychiatric Institute, New York, USA
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Cataldo AM, Scheuer L, Maksimovskiy AL, Germine LT, Dillon DG. Abnormal evidence accumulation underlies the positive memory deficit in depression. J Exp Psychol Gen 2023; 152:139-156. [PMID: 35913879 PMCID: PMC9890271 DOI: 10.1037/xge0001268] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Healthy adults show better memory for low-arousal positive versus negative stimuli, but depression compromises this positive memory advantage. Existing studies are limited by small samples or analyses that provide limited insight into underlying mechanisms. Our study addresses these concerns by using a multistaged analysis, including diffusion modeling, to identify precise psychological processes underlying the positive memory advantage and its disruption by depression in a large sample. A total of 1,358 participants completed the BDI-II (Beck et al., 1996) and an emotional memory task. At encoding, participants judged whether positive and negative words were positive or self-descriptive. After a free recall test, participants viewed an equal mix of studied and unstudied words and judged whether each was "old" or "new"; if judged "old," they indicated whether the study source was a valence or self-reference judgment. We replicate the positive memory advantage and its decrease in depression in recall, recognition, and source accuracy. The hierarchical drift diffusion model (HDDM; Wiecki et al., 2013) revealed that higher BDI-II scores are associated with more efficient evidence accumulation for negative words in the recognition and source memory tasks. By contrast, evidence accumulation for positive words is unaffected by BDI-II during the recognition task but becomes less efficient with increased BDI-II during the source memory task. In conclusion, in a well-controlled design with a large sample, we find that depression reduces the positive memory advantage. HDDM analyses suggest that this reflects differential effects of depression on the speed of evidence accumulation during the retrieval of positive versus negative memories. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Andrea M. Cataldo
- Center for Depression, Anxiety and Stress Research, McLean
Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston,
MA
| | - Luke Scheuer
- Institute for Technology in Psychiatry, McLean Hospital,
Belmont, MA
| | - Arkadiy L. Maksimovskiy
- Center for Depression, Anxiety and Stress Research, McLean
Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston,
MA
- Brain Imaging Center, McLean Hospital, Belmont, MA
| | - Laura T. Germine
- Department of Psychiatry, Harvard Medical School, Boston,
MA
- Institute for Technology in Psychiatry, McLean Hospital,
Belmont, MA
- School of Engineering and Applied Sciences, Harvard
University, Cambridge, MA
| | - Daniel G. Dillon
- Center for Depression, Anxiety and Stress Research, McLean
Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston,
MA
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Chao ZC, Dillon DG, Liu YH, Barrick EM, Wu CT. Altered coordination between frontal delta and parietal alpha networks underlies anhedonia and depressive rumination in major depressive disorder. J Psychiatry Neurosci 2022; 47:E367-E378. [PMID: 36318983 PMCID: PMC9633055 DOI: 10.1503/jpn.220046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/03/2022] [Accepted: 08/27/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND A hyperactive default mode network (DMN) has been observed in people with major depressive disorder (MDD), and weak DMN suppression has been linked to depressive symptoms. However, whether dysregulation of the DMN contributes to blunted positive emotional experience in people with MDD is unclear. METHODS We recorded 128-channel electroencephalograms (EEGs) from 24 participants with MDD and 31 healthy controls in a resting state (RS) and an emotion-induction state (ES), in which participants engaged with emotionally positive pictures. We combined Granger causality analysis and data-driven decomposition to extract latent brain networks shared among states and groups, and we further evaluated their interactions across individuals. RESULTS We extracted 2 subnetworks. Subnetwork 1 represented a delta (δ)-band (1~4 Hz) frontal network that was activated more in the ES than the RS (i.e., task-positive). Subnetwork 2 represented an alpha (α)-band (8~13 Hz) parietal network that was suppressed more in the ES than the RS (i.e., task-negative). These subnetworks were anticorrelated in both the healthy control and MDD groups, but with different sensitivities: for participants with MDD to achieve the same level of task-positive (subnetwork 1) activation as healthy controls, more suppression of task-negative (subnetwork 2) activation was necessary. Furthermore, the anticorrelation strength in participants with MDD correlated with the severity of 2 core MDD symptoms: anhedonia and rumination. LIMITATIONS The sample size was small. CONCLUSION Our findings revealed altered coordination between 2 functional networks in MDD and suggest that weak suppression of the task-negative α-band parietal network contributes to blunted positive emotional responses in adults with depression. The subnetworks identified here could be used for diagnosis or targeted for treatment in the future.
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Affiliation(s)
| | | | | | | | - Chien-Te Wu
- From the International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan (Chao, Wu); the Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Mass. (Dillon, Barrick); Harvard Medical School, Boston, Mass. (Dillon); the Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taiwan (Liu); the Yuan-Rung Medical System, Changhua, Taiwan (Liu)
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Maksimovskiy AL, Okine C, Cataldo AM, Dillon DG. Sluggish retrieval of positive memories in depressed adults. Cogn Affect Behav Neurosci 2022; 22:1172-1182. [PMID: 35556232 PMCID: PMC9464714 DOI: 10.3758/s13415-022-01010-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
Although depression is associated with poor memory for positive material, the underlying mechanisms remain unclear. We used the Hierarchical Drift Diffusion Model (HDDM) to determine whether slow evidence accumulation at retrieval contributes to depressed individuals' difficulty remembering positive events. Participants completed the Beck Depression Inventory-II and were stratified into High BDI (HBDI; BDI-II > 20, n = 49) and Low BDI (LBDI; BDI-II < 6, n = 46) groups. Next, participants completed an oddball task in which neutral, negative, and positive pictures served as rare targets. One day later, recognition memory was tested by presenting the encoded ("old") pictures along with closely matched ("new") lures. Recognition accuracy was analyzed with a generalized linear model, and choice and response time data were analyzed with the HDDM. Recognition accuracy for old positive pictures was lower in HBDI versus LBDI participants, and the HDDM highlighted slow evidence accumulation during positive memory retrieval in the HBDI group. Impaired memory for positive material in depressed adults was related to slow evidence accumulation at retrieval. Because oddballs should elicit prediction errors that normally strengthen memory formation, these retrieval findings may reflect weak positive prediction errors, at encoding, in depressed adults.
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Affiliation(s)
- Arkadiy L Maksimovskiy
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | | | - Andrea M Cataldo
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Daniel G Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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10
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Trombello JM, Cooper CM, Fatt CC, Grannemann BD, Carmody TJ, Jha MK, Mayes TL, Greer TL, Yezhuvath U, Aslan S, Pizzagalli DA, Weissman MM, Webb CA, Dillon DG, McGrath PJ, Fava M, Parsey RV, McInnis MG, Etkin A, Trivedi MH. Neural substrates of emotional conflict with anxiety in major depressive disorder: Findings from the Establishing Moderators and biosignatures of Antidepressant Response in Clinical Care (EMBARC) randomized controlled trial. J Psychiatr Res 2022; 149:243-251. [PMID: 35290819 PMCID: PMC9746288 DOI: 10.1016/j.jpsychires.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/16/2022] [Accepted: 03/07/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND The brain circuitry of depression and anxiety/fear is well-established, involving regions such as the limbic system and prefrontal cortex. We expand prior literature by examining the extent to which four discrete factors of anxiety (immediate state anxiety, physiological/panic, neuroticism/worry, and agitation/restlessness) among depressed outpatients are associated with differential responses during reactivity to and regulation of emotional conflict. METHODS A total of 172 subjects diagnosed with major depressive disorder underwent functional magnetic resonance imaging while performing an Emotional Stroop Task. Two main contrasts were examined using whole brain voxel wise analyses: emotional reactivity and emotion regulation. We also evaluated the association of these contrasts with the four aforementioned anxiety factors. RESULTS During emotional reactivity, participants with higher immediate state anxiety showed potentiated activation in the rolandic operculum and insula, while individuals with higher levels of physiological/panic demonstrated decreased activation in the posterior cingulate. No significant results emerged for any of the four factors on emotion regulation. When re-analyzing these statistically-significant brain regions through analyses of a subsample with (n = 92) and without (n = 80) a current anxiety disorder, no significant associations occurred among those without an anxiety disorder. Among those with an anxiety disorder, results were similar to the full sample, except the posterior cingulate was associated with the neuroticism/worry factor. CONCLUSIONS Divergent patterns of task-related brain activation across four discrete anxiety factors could be used to inform treatment decisions and target specific aspects of anxiety that involve intrinsic processing to attenuate overactive responses to emotional stimuli.
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Affiliation(s)
- Joseph M. Trombello
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Crystal M. Cooper
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Neuroscience Research, Cook Children’s Medical Center, Fort Worth, TX, USA
| | - Cherise Chin Fatt
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bruce D. Grannemann
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas J. Carmody
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Manish K. Jha
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L. Mayes
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tracy L. Greer
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Department of Psychology, The University of Texas at Arlington, Arlington, TX, USA
| | | | - Sina Aslan
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Advance MRI LLC, Frisco, TX, USA
| | - Diego A. Pizzagalli
- Harvard Medical School, McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Myrna M. Weissman
- Columbia University, Department of Psychiatry, New York, NY, USA,New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Christian A. Webb
- Harvard Medical School, McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Daniel G. Dillon
- Harvard Medical School, McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Patrick J. McGrath
- Columbia University, Department of Psychiatry, New York, NY, USA,New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Maurizio Fava
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA
| | - Ramin V. Parsey
- Stony Brook University, Department of Psychiatry, Stony Brook, NY, USA
| | - Melvin G. McInnis
- University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA
| | - Amit Etkin
- Stanford University School of Medicine, Department of Psychiatry, Palo Alto, CA, USA
| | - Madhukar H. Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Corresponding author. Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, USA. (M.H. Trivedi)
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11
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Ang YS, Cusin C, Petibon Y, Dillon DG, Breiger M, Belleau EL, Normandin M, Schroder H, Boyden S, Hayden E, Levine MT, Jahan A, Meyer AK, Kang MS, Brunner D, Gelda SE, Hooker J, El Fakhri G, Fava M, Pizzagalli DA. A multi-pronged investigation of option generation using depression, PET and modafinil. Brain 2022; 145:1854-1865. [PMID: 35150243 PMCID: PMC9166534 DOI: 10.1093/brain/awab429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 09/17/2021] [Accepted: 10/23/2021] [Indexed: 11/14/2022] Open
Abstract
Option generation is a critical process in decision making, but previous studies have largely focused on choices between options given by a researcher. Consequently, how we self-generate options for behaviour remain poorly understood. Here, we investigated option generation in major depressive disorder and how dopamine might modulate this process, as well as the effects of modafinil (a putative cognitive enhancer) on option generation in healthy individuals. We first compared differences in self-generated options between healthy non-depressed adults [n = 44, age = 26.3 years (SD 5.9)] and patients with major depressive disorder [n = 54, age = 24.8 years (SD 7.4)]. In the second study, a subset of depressed individuals [n = 22, age = 25.6 years (SD 7.8)] underwent PET scans with 11C-raclopride to examine the relationships between dopamine D2/D3 receptor availability and individual differences in option generation. Finally, a randomized, double-blind, placebo-controlled, three-way crossover study of modafinil (100 mg and 200 mg), was conducted in an independent sample of healthy people [n = 19, age = 23.2 years (SD 4.8)] to compare option generation under different doses of this drug. The first study revealed that patients with major depressive disorder produced significantly fewer options [t(96) = 2.68, P = 0.009, Cohen's d = 0.54], albeit with greater uniqueness [t(96) = -2.54, P = 0.01, Cohen's d = 0.52], on the option generation task compared to healthy controls. In the second study, we found that 11C-raclopride binding potential in the putamen was negatively correlated with fluency (r = -0.69, P = 0.001) but positively associated with uniqueness (r = 0.59, P = 0.007). Hence, depressed individuals with higher densities of unoccupied putamen D2/D3 receptors in the putamen generated fewer but more unique options, whereas patients with lower D2/D3 receptor availability were likely to produce a larger number of similar options. Finally, healthy participants were less unique [F(2,36) = 3.32, P = 0.048, partial η2 = 0.16] and diverse [F(2,36) = 4.31, P = 0.021, partial η2 = 0.19] after taking 200 mg versus 100 mg and 0 mg of modafinil, while fluency increased linearly with dosage at a trend level [F(1,18) = 4.11, P = 0.058, partial η2 = 0.19]. Our results show, for the first time, that option generation is affected in clinical depression and that dopaminergic activity in the putamen of patients with major depressive disorder may play a key role in the self-generation of options. Modafinil was also found to influence option generation in healthy people by reducing the creativity of options produced.
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Affiliation(s)
- Yuen-Siang Ang
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA,Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA,Social and Cognitive Computing Department, Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), Singapore 138632, Singapore
| | - Cristina Cusin
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA,Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Yoann Petibon
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA,Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Daniel G Dillon
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA,Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Micah Breiger
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA
| | - Emily L Belleau
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA,Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Marc Normandin
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA,Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Hans Schroder
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA,Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Sean Boyden
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Emma Hayden
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - M Taylor Levine
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Aava Jahan
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Ashley K Meyer
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Min Su Kang
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA
| | - Devon Brunner
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA
| | - Steven E Gelda
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Jacob Hooker
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA,Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Georges El Fakhri
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA,Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Maurizio Fava
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA,Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA,Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA,Correspondence to: Diego A. Pizzagalli, PhD McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA E-mail:
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12
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Dillon DG, Lazarov A, Dolan S, Bar-Haim Y, Pizzagalli DA, Schneier FR. Fast evidence accumulation in social anxiety disorder enhances decision making in a probabilistic reward task. Emotion 2022; 22:1-18. [PMID: 34968142 PMCID: PMC9521281 DOI: 10.1037/emo0001053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Choices and response times in two-alternative decision-making tasks can be modeled by assuming that individuals steadily accrue evidence in favor of each alternative until a response boundary for one of them is crossed, at which point that alternative is chosen. Prior studies have reported that evidence accumulation during decision-making tasks takes longer in adults with psychopathology than in healthy controls, indicating that slow evidence accumulation may be transdiagnostic. However, few studies have examined perceptual decision making in anxiety disorders, where hypervigilance might enhance performance. Therefore, this study used the Hierarchical Drift Diffusion model to investigate evidence accumulation in adults with social anxiety disorder (SAD) and healthy controls as they performed a probabilistic reward task (PRT), in which social rewards were delivered for correct perceptual judgments. Adults with SAD completed the PRT before and after gaze-contingent music reward therapy (GCMRT), which trains attention allocation and has shown efficacy for SAD. Healthy controls also completed the PRT twice. Results revealed excellent performance in adults with SAD, especially after GCMRT: relative to controls, they showed faster evidence accumulation, better discriminability, and earned more rewards. These data highlight a positive effect of attention training on performance in anxious adults and show how a behavioral trait that is typically problematic-hypervigilance in SAD-can nevertheless confer advantages in certain contexts. The data also indicate that, in contrast to other forms of psychopathology, SAD is not characterized by slow evidence accumulation, at least in the context of the social PRT. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Daniel G. Dillon
- McLean Hospital, Belmont, MA, USA,Harvard Medical School, Boston, MA, USA
| | | | - Sarah Dolan
- New York State Psychiatric Institute, New York, NY, USA
| | | | | | - Franklin R. Schneier
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
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13
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Chang RS, Cerit H, Hye T, Durham EL, Aizley H, Boukezzi S, Haimovici F, Goldstein JM, Dillon DG, Pizzagalli DA, Holsen LM. Stress-induced alterations in HPA-axis reactivity and mesolimbic reward activation in individuals with emotional eating. Appetite 2022; 168:105707. [PMID: 34562531 PMCID: PMC8671188 DOI: 10.1016/j.appet.2021.105707] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Emotional eating has emerged as a contributing factor to overeating, potentially leading to obesity or disordered eating behaviors. However, the underlying biological mechanisms related to emotional eating remain unclear. The present study examined emotional, hormonal, and neural alterations elicited by an acute laboratory stressor in individuals with and without emotional eating. METHODS Emotional (n = 13) and non-emotional eaters (n = 15) completed two main study visits, one week apart: one visit included a Stress version and the other a No-stress version of the Maastricht Acute Stress Task (MAST). Immediately pre- and post-MAST, blood was drawn for serum cortisol and participants rated their anxiety level. After the MAST, participants completed a Food Incentive Delay (FID) task during functional magnetic resonance imaging (fMRI), followed by an ad libitum snack period. RESULTS Emotional eaters exhibited elevated anxiety (p = 0.037) and cortisol (p = 0.001) in response to the Stress MAST. There were no changes in anxiety or cortisol among non-emotional eaters in response to the Stress MAST or in either group in response to the No-stress MAST. In response to the Stress MAST, emotional eaters exhibited reduced activation during anticipation of food reward in mesolimbic reward regions (caudate: p = 0.014, nucleus accumbens: p = 0.022, putamen: p = 0.013), compared to non-emotional eaters. Groups did not differ in snack consumption. CONCLUSIONS These data indicate disrupted neuroendocrine and neural responsivity to psychosocial stress amongst otherwise-healthy emotional eaters, who demonstrated hyperactive HPA-axis response coupled with hypoactivation in reward circuitry. Differential responsivity to stress may represent a risk factor in the development of maladaptive eating behaviors.
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Affiliation(s)
- Rose Seoyoung Chang
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA
| | - Hilâl Cerit
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA,Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA
| | - Taryn Hye
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA
| | - E. Leighton Durham
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA
| | - Harlyn Aizley
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA
| | - Sarah Boukezzi
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA,Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA
| | - Florina Haimovici
- Department of Psychiatry, Brigham and Women’s Hospital, 75 Francis St., Boston, Massachusetts, 02115, USA,Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA
| | - Jill M. Goldstein
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA,Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA,Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA,Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA,Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA
| | - Daniel G. Dillon
- Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA,Center for Depression, Anxiety and Stress Research, McLean Hospital, 115 Mill St., Belmont, Massachusetts, 02478, USA
| | - Diego A. Pizzagalli
- Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA,Center for Depression, Anxiety and Stress Research, McLean Hospital, 115 Mill St., Belmont, Massachusetts, 02478, USA,McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, Massachusetts, 02478, USA
| | - Laura M. Holsen
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA,Department of Psychiatry, Brigham and Women’s Hospital, 75 Francis St., Boston, Massachusetts, 02115, USA,Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA,Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA,Corresponding author: Laura Holsen, Ph.D., Division of Women’s Health, 1620 Tremont St., BC-3, Brigham and Women’s Hospital, Boston, MA 02120,
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14
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McHugh RK, Nguyen MD, Fitzmaurice GM, Dillon DG. Behavioral strategies to reduce stress reactivity in opioid use disorder: Study design. Health Psychol 2020; 39:806-814. [PMID: 32833482 DOI: 10.1037/hea0000862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES More than 2 million people in the United States had an opioid use disorder in 2017. Treatment for opioid use disorder-particularly medication combined with psychosocial support-is effective for reducing opioid use and decreasing overdose risk. However, approximately 50% of people who receive treatment will relapse or drop out. Stress reactivity, defined as the subjective and physiological response to stress, is heightened in people with opioid use disorder and higher stress reactivity is associated with poorer outcomes. Preliminary studies suggest that stress reactivity may be a key mechanistic target for improving outcomes. This article describes the design of an ongoing study examining behavioral strategies for reducing stress reactivity in adults with opioid use disorder. Our objective is to test the efficacy of two behavioral strategies for reducing stress reactivity and enhancing behavioral persistence in the context of stress (distress tolerance). METHOD We will recruit 120 adults with opioid use disorder and randomly assign them to brief training in (a) cognitive reappraisal, (b) affect labeling, or (c) a psychoeducational control. Participants will receive the training intervention followed by a laboratory stressor during which they will be instructed to apply the trained skill. RESULTS Subjective and physiological responses to stress will be measured as indices of stress reactivity and the stressor task will include a behavioral persistence component as a measure of distress tolerance. CONCLUSIONS The ultimate goal of this study is to inform the development of behavioral interventions that can be used as an adjunct to medication-based treatment for opioid use disorder. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Daniel G Dillon
- Center for Depression Anxiety and Stress Research, McLean Hospital
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15
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Abstract
BACKGROUND Cognitive deficits in depressed adults may reflect impaired decision-making. To investigate this possibility, we analyzed data from unmedicated adults with Major Depressive Disorder (MDD) and healthy controls as they performed a probabilistic reward task. The Hierarchical Drift Diffusion Model (HDDM) was used to quantify decision-making mechanisms recruited by the task, to determine if any such mechanism was disrupted by depression. METHODS Data came from two samples (Study 1: 258 MDD, 36 controls; Study 2: 23 MDD, 25 controls). On each trial, participants indicated which of two similar stimuli was presented; correct identifications were rewarded. Quantile-probability plots and the HDDM quantified the impact of MDD on response times (RT), speed of evidence accumulation (drift rate), and the width of decision thresholds, among other parameters. RESULTS RTs were more positively skewed in depressed v. healthy adults, and the HDDM revealed that drift rates were reduced-and decision thresholds were wider-in the MDD groups. This pattern suggests that depressed adults accumulated the evidence needed to make decisions more slowly than controls did. CONCLUSIONS Depressed adults responded slower than controls in both studies, and poorer performance led the MDD group to receive fewer rewards than controls in Study 1. These results did not reflect a sensorimotor deficit but were instead due to sluggish evidence accumulation. Thus, slowed decision-making-not slowed perception or response execution-caused the performance deficit in MDD. If these results generalize to other tasks, they may help explain the broad cognitive deficits seen in depression.
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Affiliation(s)
- Victoria M. Lawlor
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School
- Emory University
| | - Christian A. Webb
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School
| | | | | | | | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School
| | - Daniel G. Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School
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16
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Sperl MFJ, Panitz C, Rosso IM, Dillon DG, Kumar P, Hermann A, Whitton AE, Hermann C, Pizzagalli DA, Mueller EM. Fear Extinction Recall Modulates Human Frontomedial Theta and Amygdala Activity. Cereb Cortex 2020; 29:701-715. [PMID: 29373635 DOI: 10.1093/cercor/bhx353] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 12/21/2017] [Indexed: 12/31/2022] Open
Abstract
Human functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) studies, as well as animal studies, indicate that the amygdala and frontomedial brain regions are critically involved in conditioned fear and that frontomedial oscillations in the theta range (4-8 Hz) may support communication between these brain regions. However, few studies have used a multimodal approach to probe interactions among these key regions in humans. Here, our goal was to bridge the gap between prior human fMRI, EEG, and animal findings. Using simultaneous EEG-fMRI recordings 24 h after fear conditioning and extinction, conditioned stimuli presented (CS+E, CS-E) and not presented during extinction (CS+N, CS-N) were compared to identify effects specific to extinction versus fear recall. Differential (CS+ vs. CS-) electrodermal, frontomedial theta (EEG) and amygdala responses (fMRI) were reduced for extinguished versus nonextinguished stimuli. Importantly, effects on theta power covaried with effects on amygdala activation. Fear and extinction recall as indicated by theta explained 60% of the variance for the analogous effect in the right amygdala. Our findings show for the first time the interplay of amygdala and frontomedial theta activity during fear and extinction recall in humans and provide insight into neural circuits consistently linked with top-down amygdala modulation in rodents.
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Affiliation(s)
- Matthias F J Sperl
- Department of Psychology, Personality Psychology and Assessment, University of Marburg, Marburg, Germany.,Department of Psychology, Clinical Psychology and Psychotherapy, University of Giessen, Giessen, Germany.,Department of Psychiatry, Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Christian Panitz
- Department of Psychology, Personality Psychology and Assessment, University of Marburg, Marburg, Germany.,Department of Psychology, Clinical Psychology and Psychotherapy, University of Giessen, Giessen, Germany
| | - Isabelle M Rosso
- Department of Psychiatry, Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Daniel G Dillon
- Department of Psychiatry, Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Poornima Kumar
- Department of Psychiatry, Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Andrea Hermann
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Giessen, Giessen, Germany
| | - Alexis E Whitton
- Department of Psychiatry, Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Christiane Hermann
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Giessen, Giessen, Germany
| | - Diego A Pizzagalli
- Department of Psychiatry, Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Erik M Mueller
- Department of Psychology, Personality Psychology and Assessment, University of Marburg, Marburg, Germany.,Department of Psychology, Clinical Psychology and Psychotherapy, University of Giessen, Giessen, Germany
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17
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Jang AI, Nassar MR, Dillon DG, Frank MJ. Positive reward prediction errors during decision-making strengthen memory encoding. Nat Hum Behav 2019; 3:719-732. [PMID: 31061490 PMCID: PMC6625913 DOI: 10.1038/s41562-019-0597-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 03/27/2019] [Indexed: 01/19/2023]
Abstract
Dopamine is thought to provide reward prediction error signals to temporal lobe memory systems, but the role of these signals in episodic memory has not been fully characterized. Here we developed an incidental memory paradigm to (i) estimate the influence of reward prediction errors on the formation of episodic memories, (ii) dissociate this influence from surprise and uncertainty, (iii) characterize the role of temporal correspondence between prediction error and memoranda presentation and (iv) determine the extent to which this influence is dependent on memory consolidation. We found that people encoded incidental memoranda more strongly when they gambled for potential rewards. Moreover, the degree to which gambling strengthened encoding scaled with the reward prediction error experienced when memoranda were presented (and not before or after). This encoding enhancement was detectable within minutes and did not differ substantially after 24 h, indicating that it is not dependent on memory consolidation. These results suggest a computationally and temporally specific role for reward prediction error signalling in memory formation.
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Affiliation(s)
- Anthony I Jang
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, USA
| | - Matthew R Nassar
- Department of Neuroscience, Brown University, Providence, RI, USA.
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, USA.
| | - Daniel G Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Michael J Frank
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, USA
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, USA
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Whitton AE, Webb CA, Dillon DG, Kayser J, Rutherford A, Goer F, Fava M, McGrath P, Weissman M, Parsey R, Adams P, Trombello JM, Cooper C, Deldin P, Oquendo MA, McInnis MG, Carmody T, Bruder G, Trivedi MH, Pizzagalli DA. Pretreatment Rostral Anterior Cingulate Cortex Connectivity With Salience Network Predicts Depression Recovery: Findings From the EMBARC Randomized Clinical Trial. Biol Psychiatry 2019; 85:872-880. [PMID: 30718038 PMCID: PMC6499696 DOI: 10.1016/j.biopsych.2018.12.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 12/06/2018] [Accepted: 12/07/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Baseline rostral anterior cingulate cortex (rACC) activity is a well-replicated nonspecific predictor of depression improvement. The rACC is a key hub of the default mode network, which prior studies indicate is hyperactive in major depressive disorder. Because default mode network downregulation is reliant on input from the salience network and frontoparietal network, an important question is whether rACC connectivity with these systems contributes to depression improvement. METHODS Our study evaluated this hypothesis in outpatients (N = 238; 151 female) enrolled in the Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC) 8-week randomized clinical trial of sertraline versus placebo for major depressive disorder. Depression severity was measured using the Hamilton Rating Scale for Depression, and electroencephalography was recorded at baseline and week 1. Exact low-resolution electromagnetic tomography was used to compute activity from the rACC, and key regions within the default mode network (posterior cingulate cortex), frontoparietal network (left dorsolateral prefrontal cortex), and salience network (right anterior insula [rAI]). Connectivity in the theta band (4.5-7 Hz) and beta band (12.5-21 Hz) was computed using lagged phase synchronization. RESULTS Stronger baseline theta-band rACC-rAI (salience network hub) connectivity predicted greater depression improvement across 8 weeks of treatment for both treatment arms (B = -0.57, 95% confidence interval = -1.07, -0.08, p = .03). Early increases in theta-band rACC-rAI connectivity predicted greater likelihood of achieving remission at week 8 (odds ratio = 2.90, p = .03). CONCLUSIONS Among patients undergoing treatment, theta-band rACC-rAI connectivity is a prognostic, albeit treatment-nonspecific, indicator of depression improvement, and early connectivity changes may predict clinically meaningful outcomes.
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Affiliation(s)
- Alexis E. Whitton
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115,Center for Depression, Anxiety & Stress Research, McLean Hospital, 115 Mill Street, Belmont, MA 02478
| | - Christian A. Webb
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115,Center for Depression, Anxiety & Stress Research, McLean Hospital, 115 Mill Street, Belmont, MA 02478
| | - Daniel G. Dillon
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115,Center for Depression, Anxiety & Stress Research, McLean Hospital, 115 Mill Street, Belmont, MA 02478
| | - Jürgen Kayser
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York, NY 10032
| | - Ashleigh Rutherford
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115
| | - Franziska Goer
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115
| | - Maurizio Fava
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115,Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114
| | - Patrick McGrath
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York, NY 10032
| | - Myrna Weissman
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York, NY 10032
| | - Ramin Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, 100 Nicolls Road, Stony Brook, NY 11794
| | - Phil Adams
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York, NY 10032
| | - Joseph M. Trombello
- Department of Psychiatry, University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Crystal Cooper
- Department of Psychiatry, University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Patricia Deldin
- Department of Psychiatry, University of Michigan, 500 S State Street, Ann Arbor, MI 48109
| | - Maria A. Oquendo
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104
| | - Melvin G. McInnis
- Department of Psychiatry, University of Michigan, 500 S State Street, Ann Arbor, MI 48109
| | - Thomas Carmody
- Department of Psychiatry, University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Gerard Bruder
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York, NY 10032
| | - Madhukar H. Trivedi
- Department of Psychiatry, University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Diego A. Pizzagalli
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115,Center for Depression, Anxiety & Stress Research, McLean Hospital, 115 Mill Street, Belmont, MA 02478
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Kane J, Cavanagh JF, Dillon DG. Reduced Theta Power During Memory Retrieval in Depressed Adults. Biol Psychiatry Cogn Neurosci Neuroimaging 2019; 4:636-643. [PMID: 31072759 DOI: 10.1016/j.bpsc.2019.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/15/2019] [Accepted: 03/11/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with poor recollection, but the neural mechanisms responsible for this deficit are unclear. Recollection is supported by interactions between the hippocampus and cortex that appear to be mediated by oscillatory activity in the theta band (4-7 Hz) and that are elicited during source memory retrieval. Therefore, we tested the hypothesis that evoked theta power during source memory retrieval would be reduced in MDD, as this would provide a physiological basis for deficient recollection in adults with depression. METHODS Morlet wavelets were applied to event-related potentials collected from 24 unmedicated adults with MDD and 24 healthy control adults during the retrieval of source and semantic memories. Whole-scalp analyses focused on group differences in evoked theta power. RESULTS There were no group differences in behavior. Nevertheless, from 400 to 799 ms, theta power was broadly reduced in adults with depression versus healthy adults. This reduction was observed during source and semantic retrieval. Parietal midline electrodes showed significantly reduced theta power during source-but not semantic-retrieval in adults with depression versus healthy adults in this interval. Furthermore, theta power over parietal midline sites from 400 to 799 ms was more strongly related to source memory accuracy in healthy adults versus adults with depression. CONCLUSIONS Relative to healthy control adults, adults with depression showed reduced theta power during memory retrieval and a weaker relationship between parietal midline theta power and source memory accuracy. These findings indicate that abnormal theta signals may contribute to memory deficits in adults with MDD.
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Affiliation(s)
- Jonathan Kane
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts
| | - James F Cavanagh
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Daniel G Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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20
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Webb CA, Trivedi MH, Cohen ZD, Dillon DG, Fournier JC, Goer F, Fava M, McGrath PJ, Weissman M, Parsey R, Adams P, Trombello JM, Cooper C, Deldin P, Oquendo MA, McInnis MG, Huys Q, Bruder G, Kurian BT, Jha M, DeRubeis RJ, Pizzagalli DA. Personalized prediction of antidepressant v. placebo response: evidence from the EMBARC study. Psychol Med 2019; 49:1118-1127. [PMID: 29962359 PMCID: PMC6314923 DOI: 10.1017/s0033291718001708] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a highly heterogeneous condition in terms of symptom presentation and, likely, underlying pathophysiology. Accordingly, it is possible that only certain individuals with MDD are well-suited to antidepressants. A potentially fruitful approach to parsing this heterogeneity is to focus on promising endophenotypes of depression, such as neuroticism, anhedonia, and cognitive control deficits. METHODS Within an 8-week multisite trial of sertraline v. placebo for depressed adults (n = 216), we examined whether the combination of machine learning with a Personalized Advantage Index (PAI) can generate individualized treatment recommendations on the basis of endophenotype profiles coupled with clinical and demographic characteristics. RESULTS Five pre-treatment variables moderated treatment response. Higher depression severity and neuroticism, older age, less impairment in cognitive control, and being employed were each associated with better outcomes to sertraline than placebo. Across 1000 iterations of a 10-fold cross-validation, the PAI model predicted that 31% of the sample would exhibit a clinically meaningful advantage [post-treatment Hamilton Rating Scale for Depression (HRSD) difference ⩾3] with sertraline relative to placebo. Although there were no overall outcome differences between treatment groups (d = 0.15), those identified as optimally suited to sertraline at pre-treatment had better week 8 HRSD scores if randomized to sertraline (10.7) than placebo (14.7) (d = 0.58). CONCLUSIONS A subset of MDD patients optimally suited to sertraline can be identified on the basis of pre-treatment characteristics. This model must be tested prospectively before it can be used to inform treatment selection. However, findings demonstrate the potential to improve individual outcomes through algorithm-guided treatment recommendations.
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Affiliation(s)
| | | | | | | | | | | | - Maurizio Fava
- Harvard Medical School – Massachusetts General Hospital, Boston, MA
| | - Patrick J. McGrath
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Myrna Weissman
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY
| | | | - Phil Adams
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY
| | | | - Crystal Cooper
- University of Texas, Southwestern Medical Center, Dallas, TX
| | | | | | | | | | - Gerard Bruder
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Benji T. Kurian
- University of Texas, Southwestern Medical Center, Dallas, TX
| | - Manish Jha
- University of Texas, Southwestern Medical Center, Dallas, TX
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21
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Liao A, Walker R, Carmody TJ, Cooper C, Shaw MA, Grannemann BD, Adams P, Bruder GE, McInnis MG, Webb CA, Dillon DG, Pizzagalli DA, Phillips ML, Kurian BT, Fava M, Parsey RV, McGrath PJ, Weissman MM, Trivedi MH. Anxiety and anhedonia in depression: Associations with neuroticism and cognitive control. J Affect Disord 2019; 245:1070-1078. [PMID: 30699849 PMCID: PMC9667857 DOI: 10.1016/j.jad.2018.11.072] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/10/2018] [Accepted: 11/10/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Despite the fact that higher levels of anxiety and anhedonia in Major Depressive Disorder (MDD) are linked to poorer treatment outcomes, mechanisms contributing to these clinical presentations remain unclear. Neuroticism, impaired cognitive control, and blunted reward learning may be critical processes involved in MDD and may help to explain symptoms of anxiety and anhedonia. METHODS Using baseline data from patients with early-onset MDD (N = 296) in the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) trial, we conducted a path analysis to model relationships between neuroticism, cognitive control, and reward learning to levels of anxiety and anhedonia. RESULTS Neuroticism was positively associated with both anhedonia (standardized coefficient = 0.26, p < .001) and anxiety (standardized coefficient = 0.40, p < .001). Cognitive control was negatively associated with anxiety (standardized coefficient = -0.18, p < .05). Reward learning was not significantly associated with either anxiety or anhedonia. LIMITATIONS Extraneous variables not included in the model may have even more influence in explaining symptoms of anxiety and anhedonia. Restricted range in these variables may have attenuated some of the hypothesized relationships. Most important, because this was a cross-sectional analysis in a currently depressed sample, we cannot draw any causal conclusions without experimental and longitudinal data. CONCLUSIONS These cross-sectional findings suggest that neuroticism may contribute to anxiety and anhedonia in patients with early onset and either chronic or recurrent MDD, while enhanced cognitive control may protect against anxiety.
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Affiliation(s)
- Allen Liao
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Robrina Walker
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Thomas J. Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Crystal Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | | | | | - Phil Adams
- Department of Psychiatry, Columbia University
| | | | | | | | | | | | | | - Benji T. Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | | | - Ramin V. Parsey
- Department of Psychiatry, Stonybrook University School of Medicine
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22
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Trombello JM, Pizzagalli DA, Weissman MM, Grannemann BD, Cooper CM, Greer TL, Malchow AL, Jha M, Carmody TJ, Kurian BT, Webb CA, Dillon DG, McGrath PJ, Bruder G, Fava M, Parsey RV, McInnis MG, Adams P, Trivedi MH. Characterizing anxiety subtypes and the relationship to behavioral phenotyping in major depression: Results from the EMBARC study. J Psychiatr Res 2018; 102:207-215. [PMID: 29689518 PMCID: PMC6097520 DOI: 10.1016/j.jpsychires.2018.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 03/29/2018] [Accepted: 04/05/2018] [Indexed: 01/05/2023]
Abstract
The current study aimed to characterize the multifaceted nature of anxiety in patients with major depression by evaluating distinct anxiety factors. We then related these derived anxiety factors to performance on a Flanker Task of cognitive control, in order to further validate these factors. Data were collected from 195 patients with nonpsychotic chronic or recurrent major depression or dysthymic disorder. At baseline, participants completed self-report measures of anxiety, depression, and other related symptoms (mania, suicidality) and clinicians administered a structured diagnostic interview and the Hamilton Rating Scale for Depression, including anxiety/somatization items. Four discrete factors (State Anxiety, Panic, Neuroticism/Worry, and Restlessness/Agitation) emerged, with high degrees of internal consistency. Discriminant and convergent validity analyses also yielded findings in the expected direction. Furthermore, the neuroticism/worry factor was associated with Flanker Task interference, such that individuals higher on neuroticism/worry responded more incorrectly (yet faster) to incongruent vs. congruent trials whereas individuals higher on the fear/panic factor responded more slowly, with no accuracy effect, to the Flanker Task stimuli. These results parse anxiety into four distinct factors that encompass physiological, psychological, and cognitive components of anxiety. While state anxiety, panic and neuroticism/worry are related to existing measures of anxiety, the Restlessness/Agitation factor appears to be a unique measure of general anxious arousal. Furthermore, two factors were independently validated through the Flanker Task. These results suggest that these anxiety domains have distinct behavioral profiles and could have differential responses to distinct treatments.
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Affiliation(s)
- Joseph M. Trombello
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Diego A. Pizzagalli
- Harvard Medical School – McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Myrna M. Weissman
- Columbia University, Department of Psychiatry, New York, NY, USA, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Bruce D. Grannemann
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Crystal M. Cooper
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Tracy L. Greer
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Ashley L. Malchow
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Manish Jha
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Thomas J. Carmody
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Benji T. Kurian
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
| | - Christian A. Webb
- Harvard Medical School – McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Daniel G. Dillon
- Harvard Medical School – McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Patrick J. McGrath
- Columbia University, Department of Psychiatry, New York, NY, USA, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Gerard Bruder
- Columbia University, Department of Psychiatry, New York, NY, USA, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Maurizio Fava
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA
| | - Ramin V. Parsey
- Stony Brook University, Department of Psychiatry, Stony Brook, NY, USA
| | - Melvin G. McInnis
- University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA
| | - Phil Adams
- New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Madhukar H. Trivedi
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Department of Psychiatry, Dallas, TX, USA
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Kumar P, Goer F, Murray L, Dillon DG, Beltzer ML, Cohen AL, Brooks NH, Pizzagalli DA. Impaired reward prediction error encoding and striatal-midbrain connectivity in depression. Neuropsychopharmacology 2018; 43. [PMID: 29540863 PMCID: PMC5983542 DOI: 10.1038/s41386-018-0032-x] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Anhedonia (hyposensitivity to rewards) and negative bias (hypersensitivity to punishments) are core features of major depressive disorder (MDD), which could stem from abnormal reinforcement learning. Emerging evidence highlights blunted reward learning and reward prediction error (RPE) signaling in the striatum in MDD, although inconsistencies exist. Preclinical studies have clarified that ventral tegmental area (VTA) neurons encode RPE and habenular neurons encode punishment prediction error (PPE), which are then transmitted to the striatum and cortex to guide goal-directed behavior. However, few studies have probed striatal activation, and functional connectivity between VTA-striatum and VTA-habenula during reward and punishment learning respectively, in unmedicated MDD. To fill this gap, we acquired fMRI data from 25 unmedicated MDD and 26 healthy individuals during a monetary instrumental learning task and utilized a computational modeling approach to characterize underlying neural correlates of RPE and PPE. Relative to controls, MDD individuals showed impaired reward learning, blunted RPE signal in the striatum and overall reduced VTA-striatal connectivity to feedback. Critically, striatal RPE signal was increasingly blunted with more major depressive episodes (MDEs). No group differences emerged in PPE signals in the habenula and VTA or in connectivity between these regions. However, PPE signals in the habenula correlated positively with number of MDEs. These results highlight impaired reward learning, disrupted RPE signaling in the striatum (particularly among individuals with more lifetime MDEs) as well as reduced VTA-striatal connectivity in MDD. Collectively, these findings highlight reward-related learning deficits in MDD and their underlying pathophysiology.
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Affiliation(s)
- Poornima Kumar
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA. .,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Franziska Goer
- 0000 0000 8795 072Xgrid.240206.2Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA USA
| | - Laura Murray
- 0000 0000 8795 072Xgrid.240206.2Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA USA
| | - Daniel G. Dillon
- 0000 0000 8795 072Xgrid.240206.2Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA USA ,000000041936754Xgrid.38142.3cDepartment of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Miranda L. Beltzer
- 0000 0000 8795 072Xgrid.240206.2Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA USA
| | - Andrew L. Cohen
- 0000 0000 8795 072Xgrid.240206.2Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA USA
| | - Nancy H. Brooks
- 0000 0000 8795 072Xgrid.240206.2Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA USA
| | - Diego A. Pizzagalli
- 0000 0000 8795 072Xgrid.240206.2Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA USA ,000000041936754Xgrid.38142.3cDepartment of Psychiatry, Harvard Medical School, Boston, MA USA ,0000 0000 8795 072Xgrid.240206.2McLean Imaging Center, McLean Hospital, Belmont, MA USA
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Pizzagalli DA, Webb CA, Dillon DG, Tenke CE, Kayser J, Goer F, Fava M, McGrath P, Weissman M, Parsey R, Adams P, Trombello J, Cooper C, Deldin P, Oquendo MA, McInnis MG, Carmody T, Bruder G, Trivedi MH. Pretreatment Rostral Anterior Cingulate Cortex Theta Activity in Relation to Symptom Improvement in Depression: A Randomized Clinical Trial. JAMA Psychiatry 2018; 75:547-554. [PMID: 29641834 PMCID: PMC6083825 DOI: 10.1001/jamapsychiatry.2018.0252] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
IMPORTANCE Major depressive disorder (MDD) remains challenging to treat. Although several clinical and demographic variables have been found to predict poor antidepressant response, these markers have not been robustly replicated to warrant implementation in clinical care. Increased pretreatment rostral anterior cingulate cortex (rACC) theta activity has been linked to better antidepressant outcomes. However, no prior study has evaluated whether this marker has incremental predictive validity over clinical and demographic measures. OBJECTIVE To determine whether increased pretreatment rACC theta activity would predict symptom improvement regardless of randomization arm. DESIGN, SETTING, AND PARTICIPANTS A multicenter randomized clinical trial enrolled outpatients without psychosis and with chronic or recurrent MDD between July 29, 2011, and December 15, 2015 (Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care [EMBARC]). Patients were consecutively recruited from 4 university hospitals: 634 patients were screened, 296 were randomized to receive sertraline hydrochloride or placebo, 266 had electroencephalographic (EEG) recordings, and 248 had usable EEG data. Resting EEG data were recorded at baseline and 1 week after trial onset, and rACC theta activity was extracted using source localization. Intent-to-treat analysis was conducted. Data analysis was performed from October 7, 2016, to January 19, 2018. INTERVENTIONS An 8-week course of sertraline or placebo. MAIN OUTCOMES AND MEASURES The 17-item Hamilton Rating Scale for Depression score (assessed at baseline and weeks 1, 2, 3, 4, 6, and 8). RESULTS The 248 participants (160 [64.5%] women, 88 [35.5%] men) with usable EEG data had a mean (SD) age of 36.75 (13.15) years. Higher rACC theta activity at both baseline (b = -1.05; 95% CI, -1.77 to -0.34; P = .004) and week 1 (b = -0.83; 95% CI, -1.60 to -0.06; P < .04) predicted greater depressive symptom improvement, even when controlling for clinical and demographic variables previously linked with treatment outcome. These effects were not moderated by treatment arm. The rACC theta marker, in combination with clinical and demographic variables, accounted for an estimated 39.6% of the variance in symptom change (with 8.5% of the variance uniquely attributable to the rACC theta marker). CONCLUSIONS AND RELEVANCE Increased pretreatment rACC theta activity represents a nonspecific prognostic marker of treatment outcome. This is the first study to date to demonstrate that rACC theta activity has incremental predictive validity. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01407094.
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Affiliation(s)
- Diego A. Pizzagalli
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, Massachusetts
| | - Christian A. Webb
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, Massachusetts
| | - Daniel G. Dillon
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, Massachusetts
| | - Craig E. Tenke
- Department of Psychiatry, New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York
| | - Jürgen Kayser
- Department of Psychiatry, New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York
| | - Franziska Goer
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, Massachusetts
| | - Maurizio Fava
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston
| | - Patrick McGrath
- Department of Psychiatry, New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York
| | - Myrna Weissman
- Department of Psychiatry, New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York
| | - Ramin Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, New York
| | - Phil Adams
- Department of Psychiatry, New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York
| | - Joseph Trombello
- Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas
| | - Crystal Cooper
- Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas
| | | | - Maria A. Oquendo
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia
| | | | - Thomas Carmody
- Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas
| | - Gerard Bruder
- Department of Psychiatry, New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York
| | - Madhukar H. Trivedi
- Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas
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Dillon DG, Gonenc A, Belleau E, Pizzagalli DA. Depression is associated with dimensional and categorical effects on white matter pathways. Depress Anxiety 2018; 35:440-447. [PMID: 29486093 PMCID: PMC5934303 DOI: 10.1002/da.22734] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/10/2018] [Accepted: 01/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diffusion tensor imaging (DTI) studies report reduced fractional anisotropy (FA) in major depressive disorder (MDD). However, whether FA covaries with key depressive symptoms, such as anhedonia, is unclear. METHODS Magnetic resonance imaging data were acquired from 38 unmedicated adults with MDD and 52 healthy controls. DTI metrics were extracted from regions of interest that have consistently shown reduced FA in MDD. Analyses focused first on identifying group differences, and then determining whether reduced FA in depressed adults was related to individual differences in anhedonia and depressive severity. To establish specificity to depression, these analyses controlled for symptoms of anxiety. RESULTS Relative to controls, depressed adults showed reduced FA in the genu of the corpus callosum, the anterior limb of the internal capsule (ALIC), the cingulum bundle near the anterior cingulate cortex, and the uncinate fasciculus (UF). In the depressed group, anhedonia negatively correlated with FA in the genu, cingulum, and UF, but positively correlated with radial diffusivity (RD)-a metric previously linked to demyelination-in the genu and ALIC. Depressive severity positively correlated with RD in the ALIC. These relationships remained significant after accounting for anxiety. CONCLUSION Anhedonia was positively correlated with reduced FA and increased RD in white matter pathways that connect regions critical for value coding, representing stimulus-reward associations, and guiding value-based action selection. Thus, a cardinal symptom of MDD-anhedonia-was lawfully related to abnormalities in reward network connectivity.
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Affiliation(s)
- Daniel G. Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School
| | - Atilla Gonenc
- McLean Imaging Center, McLean Hospital/Harvard Medical School
| | - Emily Belleau
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School
| | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School
- McLean Imaging Center, McLean Hospital/Harvard Medical School
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Abstract
Depressed individuals typically show poor memory for positive events, potentiated memory for negative events, and impaired recollection. These phenomena are clinically important but poorly understood. Compelling links between stress and depression suggest promising candidate mechanisms. Stress can suppress hippocampal neurogenesis, inhibit dopamine neurons, and sensitize the amygdala. We argue that these phenomena may impair pattern separation, disrupt the encoding of positive experiences, and bias retrieval toward negative events, respectively, thus recapitulating core aspects of memory disruption in depression. Encouragingly, optogenetic reactivation of cells engaged during the encoding of positive memories rapidly reduces depressive behavior in preclinical models. Thus, many memory deficits in depression appear to be downstream consequences of chronic stress, and addressing memory disruption can have therapeutic value.
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Affiliation(s)
- Daniel G Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA.
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA
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Barrick EM, Dillon DG. An ERP study of multidimensional source retrieval in depression. Biol Psychol 2018; 132:176-191. [PMID: 29305874 DOI: 10.1016/j.biopsycho.2018.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 10/02/2017] [Accepted: 01/03/2018] [Indexed: 11/16/2022]
Abstract
We collected event-related potentials (ERPs) from 24 unmedicated adults with Major Depressive Disorder (MDD) and 24 controls during source memory retrieval. Words were encoded on the left or right during animacy and mobility judgments. Mobility judgments were slower than animacy judgments, suggesting deeper encoding. Participants then recalled the encoding judgment (Question cue) and position (Side cue) for each word. Depressed adults, but not controls, showed better accuracy for words from the mobility task presented under the Question vs. Side Cue. Furthermore, depressed adults showed larger left parietal ERPs to words from the mobility task presented under the Question vs. the Side Cue from 400 to 800 ms and 800-1400 ms. This ERP effect was negatively correlated with sleep quality. Thus, deep encoding followed by retrieval of the encoding judgment supported memory in MDD and augmented left parietal ERPs that have been linked to recollection and that appear sensitive to sleep disturbance.
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Affiliation(s)
- Elyssa M Barrick
- Center for Depression, Anxiety and Stress Research, McLean Hospital, United States
| | - Daniel G Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, United States.
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28
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Trivedi MH, South C, Jha MK, Rush AJ, Cao J, Kurian B, Phillips M, Pizzagalli DA, Trombello JM, Oquendo MA, Cooper C, Dillon DG, Webb C, Grannemann BD, Bruder G, McGrath PJ, Parsey R, Weissman M, Fava M. A Novel Strategy to Identify Placebo Responders: Prediction Index of Clinical and Biological Markers in the EMBARC Trial. Psychother Psychosom 2018; 87:285-295. [PMID: 30110685 PMCID: PMC9764260 DOI: 10.1159/000491093] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/15/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND One in three clinical trial patients with major depressive disorder report symptomatic improvement with placebo. Strategies to mitigate the effect of placebo responses have focused on modifying study design with variable success. Identifying and excluding or controlling for individuals with a high likelihood of responding to placebo may improve clinical trial efficiency and avoid unnecessary medication trials. METHODS Participants included those assigned to the placebo arm (n = 141) of the Establishing Moderators and Biosignatures for Antidepressant Response in Clinical Care (EMBARC) trial. The elastic net was used to evaluate 283 baseline clinical, behavioral, imaging, and electrophysiological variables to identify the most robust yet parsimonious features that predicted depression severity at the end of the double-blind 8-week trial. Variables retained in at least 50% of the 100 imputed data sets were used in a Bayesian multiple linear regression model to simultaneously predict the probabilities of response and remission. RESULTS Lower baseline depression severity, younger age, absence of melancholic features or history of physical abuse, less anxious arousal, less anhedonia, less neuroticism, and higher average theta current density in the rostral anterior cingulate predicted a higher likelihood of improvement with placebo. The Bayesian model predicted remission and response with an actionable degree of accuracy (both AUC > 0.73). An interactive calculator was developed predicting the likelihood of placebo response at the individual level. CONCLUSION Easy-to-measure clinical, behavioral, and electrophysiological assessments can be used to identify placebo responders with a high degree of accuracy. Development of this calculator based on these findings can be used to identify potential placebo responders.
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Affiliation(s)
- Madhukar H. Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Charles South
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Manish K. Jha
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - A. John Rush
- Duke-National University of Singapore, Singapore, Singapore;,Duke Medical School, Durham, NC, USA;,Texas Tech University Health Sciences Center, Permian Basin, TX, USA
| | - Jing Cao
- Department of Statistical Science, Southern Methodist University, Dallas, TX, USA
| | - Benji Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mary Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;,Columbia University, New York, NY, USA
| | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, Mclean Hospital, Belmont, MA, USA
| | - Joseph M. Trombello
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Maria A. Oquendo
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Crystal Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Daniel G. Dillon
- Center for Depression, Anxiety and Stress Research, Mclean Hospital, Belmont, MA, USA
| | - Christian Webb
- Center for Depression, Anxiety and Stress Research, Mclean Hospital, Belmont, MA, USA
| | - Bruce D. Grannemann
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Gerard Bruder
- New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons, New York, NY, USA
| | - Patrick J. McGrath
- New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons, New York, NY, USA
| | - Ramin Parsey
- Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Myrna Weissman
- New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons, New York, NY, USA
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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29
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Tenke CE, Kayser J, Pechtel P, Webb CA, Dillon DG, Goer F, Murray L, Deldin P, Kurian BT, McGrath PJ, Parsey R, Trivedi M, Fava M, Weissman MM, McInnis M, Abraham K, E Alvarenga J, Alschuler DM, Cooper C, Pizzagalli DA, Bruder GE. Demonstrating test-retest reliability of electrophysiological measures for healthy adults in a multisite study of biomarkers of antidepressant treatment response. Psychophysiology 2017; 54:34-50. [PMID: 28000259 DOI: 10.1111/psyp.12758] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 08/16/2016] [Indexed: 01/13/2023]
Abstract
Growing evidence suggests that loudness dependency of auditory evoked potentials (LDAEP) and resting EEG alpha and theta may be biological markers for predicting response to antidepressants. In spite of this promise, little is known about the joint reliability of these markers, and thus their clinical applicability. New standardized procedures were developed to improve the compatibility of data acquired with different EEG platforms, and used to examine test-retest reliability for the three electrophysiological measures selected for a multisite project-Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC). Thirty-nine healthy controls across four clinical research sites were tested in two sessions separated by about 1 week. Resting EEG (eyes-open and eyes-closed conditions) was recorded and LDAEP measured using binaural tones (1000 Hz, 40 ms) at five intensities (60-100 dB SPL). Principal components analysis of current source density waveforms reduced volume conduction and provided reference-free measures of resting EEG alpha and N1 dipole activity to tones from auditory cortex. Low-resolution electromagnetic tomography (LORETA) extracted resting theta current density measures corresponding to rostral anterior cingulate (rACC), which has been implicated in treatment response. There were no significant differences in posterior alpha, N1 dipole, or rACC theta across sessions. Test-retest reliability was .84 for alpha, .87 for N1 dipole, and .70 for theta rACC current density. The demonstration of good-to-excellent reliability for these measures provides a template for future EEG/ERP studies from multiple testing sites, and an important step for evaluating them as biomarkers for predicting treatment response.
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Affiliation(s)
- Craig E Tenke
- Department of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, New York, NY, USA
| | - Jürgen Kayser
- Department of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, New York, NY, USA
| | - Pia Pechtel
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, Massachusetts, USA
| | - Christian A Webb
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, Massachusetts, USA
| | - Daniel G Dillon
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, Massachusetts, USA
| | - Franziska Goer
- Center For Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts, USA
| | - Laura Murray
- Center For Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts, USA
| | - Patricia Deldin
- Departments of Psychology and Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Benji T Kurian
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Patrick J McGrath
- Department of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, New York, NY, USA
| | - Ramin Parsey
- Department of Psychiatry, SUNY Stony Brook, Stony Brook, New York, USA
| | - Madhukar Trivedi
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Maurizio Fava
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, Massachusetts, USA.,Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Myrna M Weissman
- Department of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, New York, NY, USA
| | - Melvin McInnis
- Departments of Psychology and Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Karen Abraham
- Department of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, New York, NY, USA
| | - Jorge E Alvarenga
- Department of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, New York, NY, USA
| | - Daniel M Alschuler
- Department of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, New York, NY, USA
| | - Crystal Cooper
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, Massachusetts, USA
| | - Gerard E Bruder
- Department of Psychiatry, Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, New York, NY, USA
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30
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Admon R, Kaiser RH, Dillon DG, Beltzer M, Goer F, Olson DP, Vitaliano G, Pizzagalli DA. Dopaminergic Enhancement of Striatal Response to Reward in Major Depression. Am J Psychiatry 2017; 174:378-386. [PMID: 27771973 PMCID: PMC5378658 DOI: 10.1176/appi.ajp.2016.16010111] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Major depressive disorder is characterized by reduced reward-related striatal activation and dysfunctional reward learning, putatively reflecting decreased dopaminergic signaling. The goal of this study was to test whether a pharmacological challenge designed to facilitate dopaminergic transmission can enhance striatal responses to reward and improve reward learning in depressed individuals. METHOD In a double-blind placebo-controlled design, 46 unmedicated depressed participants and 43 healthy control participants were randomly assigned to receive either placebo or a single low dose (50 mg) of the D2/D3 receptor antagonist amisulpride, which is believed to increase dopamine signaling through presynaptic autoreceptor blockade. To investigate the effects of increased dopaminergic transmission on reward-related striatal function and behavior, a monetary incentive delay task (in conjunction with functional MRI) and a probabilistic reward learning task were administered at absorption peaks of amisulpride. RESULTS Depressed participants selected previously rewarded stimuli less frequently than did control participants, indicating reduced reward learning, but this effect was not modulated by amisulpride. Relative to depressed participants receiving placebo (and control participants receiving amisulpride), depressed participants receiving amisulpride exhibited increased striatal activation and potentiated corticostriatal functional connectivity between the nucleus accumbens and the midcingulate cortex in response to monetary rewards. Stronger corticostriatal connectivity in response to rewards predicted better reward learning among depressed individuals receiving amisulpride as well as among control participants receiving placebo. CONCLUSIONS Acute enhancement of dopaminergic transmission potentiated reward-related striatal activation and corticostriatal functional connectivity in depressed individuals but had no behavioral effects. Taken together, the results suggest that targeted pharmacological treatments may normalize neural correlates of reward processing in depression; despite such acute effects on neural function, behavioral modification may require more chronic exposure. This is consistent with previous reports that antidepressant effects of amisulpride in depression emerged after sustained administration.
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Affiliation(s)
- Roee Admon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Roselinde H. Kaiser
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Daniel G. Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Miranda Beltzer
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Franziska Goer
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - David P. Olson
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Gordana Vitaliano
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA,McLean Imaging Center, McLean Hospital, Belmont, MA, USA
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31
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Whitton AE, Veer AV, Kakani P, Dillon DG, Ironside ML, Haile A, Crowley DJ, Pizzagalli DA. Acute stress impairs frontocingulate activation during error monitoring in remitted depression. Psychoneuroendocrinology 2017; 75:164-172. [PMID: 27835807 PMCID: PMC5135598 DOI: 10.1016/j.psyneuen.2016.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/04/2016] [Accepted: 10/11/2016] [Indexed: 12/14/2022]
Abstract
Deficits in cognitive control are a hallmark characteristic of depression, however less is known about the degree to which they persist beyond symptom remission and might contribute to symptom recurrence in remitted individuals (rMDD). Evidence indicates that stress interferes with cognitive control, highlighting a potential mechanism by which stress precipitates depression relapse. Therefore, this study examined whether stress exposure elicits deficits in error monitoring - a component of cognitive control thought to be particularly implicated in the ability to adaptively respond to negative feedback - in individuals with rMDD. Unmedicated individuals with rMDD (n=30) and healthy controls (n=34) performed an Eriksen Flanker task before and 45min after an acute stressor while 128-channel event-related potentials (ERPs) were recorded. Flanker interference effects and post-error adjustments were examined, and ERP analyses focused on the error-related negativity (ERN) and error positivity (Pe). Standardized low resolution electromagnetic tomography (sLORETA) was used to examine stress-induced changes in current source density. Individuals with rMDD showed blunted cortisol reactivity to the stressor, coupled with heightened self-reported stress reactivity. Although no significant effects of group or stress were observed in scalp-level ERPs, source-level analyses indicated that among the rMDD group only, stress caused a reduction in activation in frontocingulate regions critically implicated in error monitoring. The magnitude of stress-induced decreases in frontocingulate activation correlated with heightened self-reported stress reactivity, and also predicted heightened levels of stress and depression 18 months later in the entire sample. These findings suggest that individuals with rMDD show a stress-induced disruption in frontocingulate function that is linked to heightened stress reactivity, and this disruption prospectively predicts heightened levels of future stress and depressive symptomatology.
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32
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Webb CA, Dillon DG, Pechtel P, Goer FK, Murray L, Huys QJM, Fava M, McGrath PJ, Weissman M, Parsey R, Kurian BT, Adams P, Weyandt S, Trombello JM, Grannemann B, Cooper CM, Deldin P, Tenke C, Trivedi M, Bruder G, Pizzagalli DA. Neural Correlates of Three Promising Endophenotypes of Depression: Evidence from the EMBARC Study. Neuropsychopharmacology 2016; 41:454-63. [PMID: 26068725 PMCID: PMC5130121 DOI: 10.1038/npp.2015.165] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 04/24/2015] [Accepted: 05/27/2015] [Indexed: 11/09/2022]
Abstract
Major depressive disorder (MDD) is clinically, and likely pathophysiologically, heterogeneous. A potentially fruitful approach to parsing this heterogeneity is to focus on promising endophenotypes. Guided by the NIMH Research Domain Criteria initiative, we used source localization of scalp-recorded EEG resting data to examine the neural correlates of three emerging endophenotypes of depression: neuroticism, blunted reward learning, and cognitive control deficits. Data were drawn from the ongoing multi-site EMBARC study. We estimated intracranial current density for standard EEG frequency bands in 82 unmedicated adults with MDD, using Low-Resolution Brain Electromagnetic Tomography. Region-of-interest and whole-brain analyses tested associations between resting state EEG current density and endophenotypes of interest. Neuroticism was associated with increased resting gamma (36.5-44 Hz) current density in the ventral (subgenual) anterior cingulate cortex (ACC) and orbitofrontal cortex (OFC). In contrast, reduced cognitive control correlated with decreased gamma activity in the left dorsolateral prefrontal cortex (dlPFC), decreased theta (6.5-8 Hz) and alpha2 (10.5-12 Hz) activity in the dorsal ACC, and increased alpha2 activity in the right dlPFC. Finally, blunted reward learning correlated with lower OFC and left dlPFC gamma activity. Computational modeling of trial-by-trial reinforcement learning further indicated that lower OFC gamma activity was linked to reduced reward sensitivity. Three putative endophenotypes of depression were found to have partially dissociable resting intracranial EEG correlates, reflecting different underlying neural dysfunctions. Overall, these findings highlight the need to parse the heterogeneity of MDD by focusing on promising endophenotypes linked to specific pathophysiological abnormalities.
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Affiliation(s)
- Christian A Webb
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA
| | - Daniel G Dillon
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA
| | - Pia Pechtel
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA
| | - Franziska K Goer
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA
| | - Laura Murray
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA
| | - Quentin JM Huys
- Centre for Addiction Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Switzerland,Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and Swiss Federal Institute of Technology (ETH) Zurich, Switzerland
| | - Maurizio Fava
- Clinical Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Patrick J McGrath
- Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Myrna Weissman
- Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Ramin Parsey
- Department of Psychiatry and Behavioral Science, Stony Brook University, Stony Brook, NY, USA
| | - Benji T Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Phillip Adams
- Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Sarah Weyandt
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Joseph M Trombello
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bruce Grannemann
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Crystal M Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Patricia Deldin
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | - Craig Tenke
- Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Madhukar Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Gerard Bruder
- Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA,Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA, Tel: +1 617 855 4230, Fax: +1 617 855 4230, E-mail:
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Abstract
Adults with unipolar depression typically show poor episodic memory for positive material, but the neuroscientific mechanisms responsible for this deficit have not been characterized. I suggest a simple hypothesis: weak memory for positive material in depression reflects disrupted communication between the mesolimbic dopamine pathway and medial temporal lobe (MTL) memory systems during encoding. This proposal draws on basic research showing that dopamine release in the hippocampus is critical for the transition from early- to late-phase long-term potentiation (LTP) that marks the conversion of labile, short-term memories into stable, long-term memories. Neuroimaging and pharmacological data from healthy humans paint a similar picture: activation of the mesolimbic reward circuit enhances encoding and boosts retention. Unipolar depression is characterized by anhedonia-loss of pleasure-and reward circuit dysfunction, which is believed to reflect negative effects of stress on the mesolimbic dopamine pathway. Thus, I propose that the MTL is deprived of strengthening reward signals in depressed adults and memory for positive events suffers accordingly. Although other mechanisms are important, this hypothesis holds promise as an explanation for positive memory deficits in depression.
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Affiliation(s)
- Daniel G Dillon
- Motivated Learning and Memory Laboratory, Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School , Belmont, MA, USA
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34
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Dillon DG, Wiecki T, Pechtel P, Webb C, Goer F, Murray L, Trivedi M, Fava M, McGrath PJ, Weissman M, Parsey R, Kurian B, Adams P, Carmody T, Weyandt S, Shores-Wilson K, Toups M, McInnis M, Oquendo MA, Cusin C, Deldin P, Bruder G, Pizzagalli DA. A computational analysis of flanker interference in depression. Psychol Med 2015; 45:2333-2344. [PMID: 25727375 PMCID: PMC4499007 DOI: 10.1017/s0033291715000276] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Depression is characterized by poor executive function, but - counterintuitively - in some studies, it has been associated with highly accurate performance on certain cognitively demanding tasks. The psychological mechanisms responsible for this paradoxical finding are unclear. To address this issue, we applied a drift diffusion model (DDM) to flanker task data from depressed and healthy adults participating in the multi-site Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care for Depression (EMBARC) study. METHOD One hundred unmedicated, depressed adults and 40 healthy controls completed a flanker task. We investigated the effect of flanker interference on accuracy and response time, and used the DDM to examine group differences in three cognitive processes: prepotent response bias (tendency to respond to the distracting flankers), response inhibition (necessary to resist prepotency), and executive control (required for execution of correct response on incongruent trials). RESULTS Consistent with prior reports, depressed participants responded more slowly and accurately than controls on incongruent trials. The DDM indicated that although executive control was sluggish in depressed participants, this was more than offset by decreased prepotent response bias. Among the depressed participants, anhedonia was negatively correlated with a parameter indexing the speed of executive control (r = -0.28, p = 0.007). CONCLUSIONS Executive control was delayed in depression but this was counterbalanced by reduced prepotent response bias, demonstrating how participants with executive function deficits can nevertheless perform accurately in a cognitive control task. Drawing on data from neural network simulations, we speculate that these results may reflect tonically reduced striatal dopamine in depression.
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Affiliation(s)
- Daniel G. Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA USA
| | - Thomas Wiecki
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI USA
| | - Pia Pechtel
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA USA
| | - Christian Webb
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA USA
| | - Franziska Goer
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA USA
| | - Laura Murray
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA USA
| | - Madhukar Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Maurizio Fava
- Clinical Research Program, Massachusetts General Hospital, Boston, MA USA
| | - Patrick J. McGrath
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY USA
| | - Myrna Weissman
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY USA
| | - Ramin Parsey
- Department of Psychiatry and Behavioral Science, Stony Brook University, Stony Brook, NY USA
| | - Benji Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Phillip Adams
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY USA
| | - Thomas Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Sarah Weyandt
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Kathy Shores-Wilson
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Marisa Toups
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Melvin McInnis
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI USA
| | - Maria A. Oquendo
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY USA
| | - Cristina Cusin
- Clinical Research Program, Massachusetts General Hospital, Boston, MA USA
| | - Patricia Deldin
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI USA
| | - Gerard Bruder
- New York State Psychiatric Institute & Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY USA
| | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA USA
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Beard C, Donahue RJ, Dillon DG, Van't Veer A, Webber C, Lee J, Barrick E, Hsu KJ, Foti D, Carroll FI, Carlezon Jr WA, Björgvinsson T, Pizzagalli DA. Abnormal error processing in depressive states: a translational examination in humans and rats. Transl Psychiatry 2015; 5:e564. [PMID: 25966364 PMCID: PMC4471285 DOI: 10.1038/tp.2015.54] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/03/2015] [Accepted: 03/24/2015] [Indexed: 01/13/2023] Open
Abstract
Depression has been associated with poor performance following errors, but the clinical implications, response to treatment and neurobiological mechanisms of this post-error behavioral adjustment abnormality remain unclear. To fill this gap in knowledge, we tested depressed patients in a partial hospital setting before and after treatment (cognitive behavior therapy combined with medication) using a flanker task. To evaluate the translational relevance of this metric in rodents, we performed a secondary analysis on existing data from rats tested in the 5-choice serial reaction time task after treatment with corticotropin-releasing factor (CRF), a stress peptide that produces depressive-like signs in rodent models relevant to depression. In addition, to examine the effect of treatment on post-error behavior in rodents, we examined a second cohort of rodents treated with JDTic, a kappa-opioid receptor antagonist that produces antidepressant-like effects in laboratory animals. In depressed patients, baseline post-error accuracy was lower than post-correct accuracy, and, as expected, post-error accuracy improved with treatment. Moreover, baseline post-error accuracy predicted attentional control and rumination (but not depressive symptoms) after treatment. In rats, CRF significantly degraded post-error accuracy, but not post-correct accuracy, and this effect was attenuated by JDTic. Our findings demonstrate deficits in post-error accuracy in depressed patients, as well as a rodent model relevant to depression. These deficits respond to intervention in both species. Although post-error behavior predicted treatment-related changes in attentional control and rumination, a relationship to depressive symptoms remains to be demonstrated.
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Affiliation(s)
- C Beard
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | - R J Donahue
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | - D G Dillon
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | - A Van't Veer
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | - C Webber
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | - J Lee
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | - E Barrick
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | - K J Hsu
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | - D Foti
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | - F I Carroll
- Research Triangle Institute, Research Triangle Park, NC, USA
| | - W A Carlezon Jr
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | - T Björgvinsson
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | - D A Pizzagalli
- Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA, USA
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Treadway MT, Waskom ML, Dillon DG, Holmes AJ, Park MTM, Chakravarty MM, Dutra SJ, Polli FE, Iosifescu DV, Fava M, Gabrieli JD, Pizzagalli DA. Illness progression, recent stress, and morphometry of hippocampal subfields and medial prefrontal cortex in major depression. Biol Psychiatry 2015; 77:285-294. [PMID: 25109665 PMCID: PMC4277904 DOI: 10.1016/j.biopsych.2014.06.018] [Citation(s) in RCA: 237] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 05/29/2014] [Accepted: 06/01/2014] [Indexed: 01/30/2023]
Abstract
BACKGROUND Longitudinal studies of illness progression in patients with major depressive disorder (MDD) indicate that the onset of subsequent depressive episodes becomes increasingly decoupled from external stressors. A possible mechanism underlying this phenomenon is that multiple episodes induce long-lasting neurobiological changes that confer increased risk for recurrence. Prior morphometric studies have frequently reported volumetric reductions in patients with MDD--especially in medial prefrontal cortex (mPFC) and the hippocampus--but few studies have investigated whether these changes are exacerbated by prior episodes. METHODS In a sample of 103 medication-free patients with depression and control subjects with no history of depression, structural magnetic resonance imaging was performed to examine relationships between number of prior episodes, current stress, hippocampal subfield volume and cortical thickness. Volumetric analyses of the hippocampus were performed using a recently validated subfield segmentation approach, and cortical thickness estimates were obtained using vertex-based methods. Participants were grouped on the basis of the number of prior depressive episodes and current depressive diagnosis. RESULTS Number of prior episodes was associated with both lower reported stress levels and reduced volume in the dentate gyrus. Cortical thinning of the left mPFC was associated with a greater number of prior depressive episodes but not current depressive diagnosis. CONCLUSIONS Collectively, these findings are consistent with preclinical models suggesting that the dentate gyrus and mPFC are especially vulnerable to stress exposure and provide evidence for morphometric changes that are consistent with stress-sensitization models of recurrence in MDD.
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Affiliation(s)
- Michael T. Treadway
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School Belmont, MA
| | | | - Daniel G. Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School Belmont, MA
| | - Avram J. Holmes
- Department of Psychiatry, Harvard Medical School, Boston, MA
,Department of Psychology, Yale University, New Haven, CT
| | - Min Tae M. Park
- Kimel Family Imaging Genetics Laboratory, Center for Addiction and Mental Health, Toronto, Canada
| | - M. Mallar Chakravarty
- Kimel Family Imaging Genetics Laboratory, Center for Addiction and Mental Health, Toronto, Canada
,Department of Psychiatry and Institute of Biomaterials and Biomedical engineering, University of Toronto, Toronto, Canada
| | - Sunny J. Dutra
- Department of Psychology, Yale University, New Haven, CT
| | | | | | - Maurizio Fava
- Depression Clinical and Research Program, MGH/Harvard Medical School Boston, MA
| | | | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School Belmont, MA
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Admon R, Nickerson LD, Dillon DG, Holmes AJ, Bogdan R, Kumar P, Dougherty DD, Iosifescu DV, Mischoulon D, Fava M, Pizzagalli DA. Dissociable cortico-striatal connectivity abnormalities in major depression in response to monetary gains and penalties. Psychol Med 2015; 45:121-131. [PMID: 25055809 PMCID: PMC4233014 DOI: 10.1017/s0033291714001123] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Individuals with major depressive disorder (MDD) are characterized by maladaptive responses to both positive and negative outcomes, which have been linked to localized abnormal activations in cortical and striatal brain regions. However, the exact neural circuitry implicated in such abnormalities remains largely unexplored. METHOD In this study 26 unmedicated adults with MDD and 29 matched healthy controls (HCs) completed a monetary incentive delay task during functional magnetic resonance imaging (fMRI). Psychophysiological interaction (PPI) analyses probed group differences in connectivity separately in response to positive and negative outcomes (i.e. monetary gains and penalties). RESULTS Relative to HCs, MDD subjects displayed decreased connectivity between the caudate and dorsal anterior cingulate cortex (dACC) in response to monetary gains, yet increased connectivity between the caudate and a different, more rostral, dACC subregion in response to monetary penalties. Moreover, exploratory analyses of 14 MDD patients who completed a 12-week, double-blind, placebo-controlled clinical trial after the baseline fMRI scans indicated that a more normative pattern of cortico-striatal connectivity pre-treatment was associated with greater improvement in symptoms 12 weeks later. CONCLUSIONS These results identify the caudate as a region with dissociable incentive-dependent dACC connectivity abnormalities in MDD, and provide initial evidence that cortico-striatal circuitry may play a role in MDD treatment response. Given the role of cortico-striatal circuitry in encoding action-outcome contingencies, such dysregulated connectivity may relate to the prominent disruptions in goal-directed behavior that characterize MDD.
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Affiliation(s)
- Roee Admon
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School Belmont, MA
| | - Lisa D. Nickerson
- McLean Imaging Center, McLean Hospital/Harvard Medical School Belmont, MA
| | - Daniel G. Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School Belmont, MA
| | - Avram J. Holmes
- Department of Psychology, Harvard University, Cambridge, MA
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School Boston, MA
| | - Ryan Bogdan
- Department of Psychology, Washington University in St. Louis, St Louis, MO
| | - Poornima Kumar
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School Belmont, MA
| | - Darin D. Dougherty
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School Boston, MA
| | - Dan V. Iosifescu
- Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY
| | - David Mischoulon
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School Boston, MA
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School Boston, MA
| | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School Belmont, MA
- McLean Imaging Center, McLean Hospital/Harvard Medical School Belmont, MA
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Dillon DG, Rosso IM, Pechtel P, Killgore WDS, Rauch SL, Pizzagalli DA. Peril and pleasure: an rdoc-inspired examination of threat responses and reward processing in anxiety and depression. Depress Anxiety 2014; 31:233-49. [PMID: 24151118 PMCID: PMC3951656 DOI: 10.1002/da.22202] [Citation(s) in RCA: 134] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 09/10/2013] [Accepted: 09/17/2013] [Indexed: 12/18/2022] Open
Abstract
As a step toward addressing limitations in the current psychiatric diagnostic system, the National Institute of Mental Health recently developed the Research Domain Criteria (RDoC) to stimulate integrative research-spanning self-report, behavior, neural circuitry, and molecular/genetic mechanisms-on core psychological processes implicated in mental illness. Here, we use the RDoC conceptualization to review research on threat responses, reward processing, and their interaction. The first section of the manuscript highlights the pivotal role of exaggerated threat responses-mediated by circuits connecting the frontal cortex, amygdala, and midbrain-in anxiety, and reviews data indicating that genotypic variation in the serotonin system is associated with hyperactivity in this circuitry, which elevates the risk for anxiety and mood disorders. In the second section, we describe mounting evidence linking anhedonic behavior to deficits in psychological functions that rely heavily on dopamine signaling, especially cost/benefit decision making and reward learning. The third section covers recent studies that document negative effects of acute threats and chronic stress on reward responses in humans. The mechanisms underlying such effects are unclear, but the fourth section reviews new optogenetic data in rodents indicating that GABAergic inhibition of midbrain dopamine neurons, driven by activation of the habenula, may play a fundamental role in stress-induced anhedonia. In addition to its basic scientific value, a better understanding of interactions between the neural systems that mediate threat and reward responses may offer relief from the burdensome condition of anxious depression.
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Affiliation(s)
- Daniel G. Dillon
- Center for Depression; Anxiety and Stress Research; McLean Hospital; Harvard Medical School; Boston Massachusetts
| | - Isabelle M. Rosso
- Center for Depression; Anxiety and Stress Research; McLean Hospital; Harvard Medical School; Boston Massachusetts
| | - Pia Pechtel
- Center for Depression; Anxiety and Stress Research; McLean Hospital; Harvard Medical School; Boston Massachusetts
| | - William D. S. Killgore
- Center for Depression; Anxiety and Stress Research; McLean Hospital; Harvard Medical School; Boston Massachusetts
| | - Scott L. Rauch
- Center for Depression; Anxiety and Stress Research; McLean Hospital; Harvard Medical School; Boston Massachusetts
| | - Diego A. Pizzagalli
- Center for Depression; Anxiety and Stress Research; McLean Hospital; Harvard Medical School; Boston Massachusetts
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Dillon DG, Dobbins IG, Pizzagalli DA. Weak reward source memory in depression reflects blunted activation of VTA/SN and parahippocampus. Soc Cogn Affect Neurosci 2013; 9:1576-83. [PMID: 24078019 DOI: 10.1093/scan/nst155] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Reward responses in the medial temporal lobes and dopaminergic midbrain boost episodic memory formation in healthy adults, and weak memory for emotionally positive material in depression suggests this mechanism may be dysfunctional in major depressive disorder (MDD). To test this hypothesis, we performed a study in which unmedicated adults with MDD and healthy controls encoded drawings paired with reward or zero tokens during functional magnetic resonance imaging. In a recognition test, participants judged whether drawings were previously associated with the reward token ('reward source') or the zero token ('zero source'). Unlike controls, depressed participants failed to show better memory for drawings from the reward source vs the zero source. Consistent with predictions, controls also showed a stronger encoding response to reward tokens vs zero tokens in the right parahippocampus and dopaminergic midbrain, whereas the MDD group showed the opposite pattern-stronger responses to zero vs reward tokens-in these regions. Differential activation of the dopaminergic midbrain by reward vs zero tokens was positively correlated with the reward source memory advantage in controls, but not depressed participants. These data suggest that weaker memory for positive material in depression reflects blunted encoding responses in the dopaminergic midbrain and medial temporal lobes.
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Affiliation(s)
- Daniel G Dillon
- Center for Depression, Anxiety and Stress Research & McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA and Department of Psychology, Washington University in Saint Louis, Saint Louis, MO 63130, USA
| | - Ian G Dobbins
- Center for Depression, Anxiety and Stress Research & McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA and Department of Psychology, Washington University in Saint Louis, Saint Louis, MO 63130, USA
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research & McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA and Department of Psychology, Washington University in Saint Louis, Saint Louis, MO 63130, USA
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Vanderhasselt MA, De Raedt R, Dillon DG, Dutra SJ, Brooks N, Pizzagalli DA. Decreased cognitive control in response to negative information in patients with remitted depression: an event-related potential study. J Psychiatry Neurosci 2012; 37:250-8. [PMID: 22433449 PMCID: PMC3380096 DOI: 10.1503/jpn.110089] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with difficulty disengaging attention from emotionally negative information. Few studies have investigated whether euthymic individuals with a history of depression (remitted MDD [rMDD]) show similar deficits, and little is known about concomitant neurophysiological features of such deficits. To fill these gaps, we investigated cognitive control over emotional stimuli in participants with rMDD and controls without history of depression or psychopathology. METHODS We collected 128- channel event-related potentials (ERPs) while participants performed a cued emotional conflict task. During the task, a cue instructed the participant to respond to the actual or opposite valence of an upcoming happy or sad face. RESULTS We enrolled 15 individuals with rMDD and 18 controls in our study. Event-related potentials showed no group differences in response to the cues, highlighting preserved preparatory processes when anticipating an emotional conflict. However, relative to the control group, the rMDD group responded more slowly and showed reduced N450 amplitudes on trials that required disengaging from negative faces (pressing "happy" in response to a sad face). LIMITATIONS The sample size was small, and the null finding in the cue-locked N2 analyses may be owing to low power. CONCLUSION Our results suggest a selective deficit in cognitive control over sad stimuli in individuals with rMDD. Additional studies will be required to pinpoint whether the current findings stem from impairments in response conflict, conflict monitoring and/or attentional disengagement in response to sad stimuli. Moreover, future studies are warranted to evaluate whether decreased cognitive control in response to negative information might increase the risk for future depressive episodes.
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Affiliation(s)
| | | | | | | | | | - Diego A. Pizzagalli
- Correspondence to: D.A. Pizzagalli, Department of Psychiatry, Harvard Medical School, Center for Depression, Anxiety and Stress Research, McLean Hospital, 115 Mill St., Belmont MA 02478;
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Dillon DG, Deveney CM, Pizzagalli DA. From Basic Processes to Real-World Problems: How Research on Emotion and Emotion Regulation Can Inform Understanding of Psychopathology, and Vice Versa. Emot Rev 2011; 3:74-82. [PMID: 21584224 DOI: 10.1177/1754073910380973] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Research on emotion and emotion regulation is expected to improve our understanding of psychopathology. However, achieving this understanding requires overcoming several obstacles, including the paucity of objective markers of specific emotions or psychiatric diagnoses, and the fact that emotion regulation is a concept that can be difficult to operationalize. We review affective neuroscience research that has addressed these issues by focusing on psychological and neural mechanisms implicated in approach and avoidance behaviors, as revealed by studies of fear, anxiety, and reward processing. Dysfunction in these mechanisms may serve as risk markers for psychopathology, while emotion regulation research demonstrates that some of them are susceptible to volitional control. The conclusion acknowledges limitations of affective neuroscience and highlights goals for future work.
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Dillon DG, Bogdan R, Fagerness J, Holmes AJ, Perlis RH, Pizzagalli DA. Variation in TREK1 gene linked to depression-resistant phenotype is associated with potentiated neural responses to rewards in humans. Hum Brain Mapp 2010; 31:210-21. [PMID: 19621370 DOI: 10.1002/hbm.20858] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The TREK1 gene has been linked to a depression-resistant phenotype in rodents and antidepressant response in humans, but the neural mechanisms underlying these links are unclear. Because TREK1 is expressed in reward-related basal ganglia regions, it has been hypothesized that TREK1 genetic variation may be associated with anhedonic symptoms of depression. To investigate whether TREK1 genetic variation influences reward processing, we genotyped healthy individuals (n = 31) who completed a monetary incentive delay task during functional magnetic resonance imaging (fMRI). Three genotypes previously linked to positive antidepressant response were associated with potentiated basal ganglia activity to gains, but did not influence responses to penalties or no change feedback. TREK1 genetic variations did not affect basal ganglia volume, and fMRI group differences were confirmed when accounting for self-report measures of anhedonia. In addition, the total number of "protective" TREK1 alleles was associated with stronger responses to gains in several other reward-related regions, including the dorsal anterior cingulate cortex, orbitofrontal cortex, and mesial prefrontal cortex. In control analyses, associations between basal ganglia responses to gains and functional polymorphisms in the dopamine transporter (DAT1) and catechol-O-methyltransferase (COMT) genes were also explored. Results revealed that TREK1 and DAT/COMT genotypes were independently related to basal ganglia responses to gains. These findings indicate that TREK1 genotypes are associated with individual differences in reward-related brain activity. Future studies in depressed samples should evaluate whether variation in neural responses to rewards may contribute to the association between TREK1 and antidepressant response in humans.
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Affiliation(s)
- Daniel G Dillon
- Department of Psychology, Harvard University, Cambridge, Massachusetts 02138, USA
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Pizzagalli DA, Holmes AJ, Dillon DG, Goetz EL, Birk JL, Bogdan R, Dougherty DD, Iosifescu DV, Rauch SL, Fava M. Reduced caudate and nucleus accumbens response to rewards in unmedicated individuals with major depressive disorder. Am J Psychiatry 2009; 166:702-10. [PMID: 19411368 PMCID: PMC2735451 DOI: 10.1176/appi.ajp.2008.08081201] [Citation(s) in RCA: 841] [Impact Index Per Article: 56.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Major depressive disorder is characterized by impaired reward processing, possibly due to dysfunction in the basal ganglia. However, few neuroimaging studies of depression have distinguished between anticipatory and consummatory phases of reward processing. Using functional MRI (fMRI) and a task that dissociates anticipatory and consummatory phases of reward processing, the authors tested the hypothesis that individuals with major depression would show reduced reward-related responses in basal ganglia structures. METHOD A monetary incentive delay task was presented to 30 unmedicated individuals with major depressive disorder and 31 healthy comparison subjects during fMRI scanning. Whole-brain analyses focused on neural responses to reward-predicting cues and rewarding outcomes (i.e., monetary gains). Secondary analyses focused on the relationship between anhedonic symptoms and basal ganglia volumes. RESULTS Relative to comparison subjects, participants with major depression showed significantly weaker responses to gains in the left nucleus accumbens and the caudate bilaterally. Group differences in these regions were specific to rewarding outcomes and did not generalize to neutral or negative outcomes, although relatively reduced responses to monetary penalties in the major depression group emerged in other caudate regions. By contrast, evidence for group differences during reward anticipation was weaker, although participants with major depression showed reduced activation to reward cues in a small sector of the left posterior putamen. In the major depression group, anhedonic symptoms and depression severity were associated with reduced caudate volume bilaterally. CONCLUSIONS These results suggest that basal ganglia dysfunction in major depression may affect the consummatory phase of reward processing. Additionally, morphometric results suggest that anhedonia in major depression is related to caudate volume.
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Affiliation(s)
| | - Avram J. Holmes
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Daniel G. Dillon
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Elena L. Goetz
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Jeffrey L. Birk
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Ryan Bogdan
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Darin D. Dougherty
- Psychiatric Neuroimaging Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Dan V. Iosifescu
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts
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Wacker J, Dillon DG, Pizzagalli DA. The role of the nucleus accumbens and rostral anterior cingulate cortex in anhedonia: integration of resting EEG, fMRI, and volumetric techniques. Neuroimage 2009; 46:327-37. [PMID: 19457367 DOI: 10.1016/j.neuroimage.2009.01.058] [Citation(s) in RCA: 283] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Revised: 12/30/2008] [Accepted: 01/27/2009] [Indexed: 12/13/2022] Open
Abstract
Anhedonia, the reduced propensity to experience pleasure, is a promising endophenotype and vulnerability factor for several psychiatric disorders, including depression and schizophrenia. In the present study, we used resting electroencephalography, functional magnetic resonance imaging, and volumetric analyses to probe putative associations between anhedonia and individual differences in key nodes of the brain's reward system in a non-clinical sample. We found that anhedonia, but not other symptoms of depression or anxiety, was correlated with reduced nucleus accumbens (NAcc) responses to rewards (gains in a monetary incentive delay task), reduced NAcc volume, and increased resting delta current density (i.e., decreased resting activity) in the rostral anterior cingulate cortex (rACC), an area previously implicated in positive subjective experience. In addition, NAcc reward responses were inversely associated with rACC resting delta activity, supporting the hypothesis that delta might be lawfully related to activity within the brain's reward circuit. Taken together, these results help elucidate the neural basis of anhedonia and strengthen the argument for anhedonia as an endophenotype for depression.
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Affiliation(s)
- Jan Wacker
- Department of Psychology, Philipps-Universitaet, Marburg, Germany
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Abstract
The neural bases of inhibitory function are reviewed, covering data from paradigms assessing inhibition of motor responses (antisaccade, go/nogo, stop-signal), cognitive sets (e.g., Wisconsin Card Sort Test), and emotion (fear extinction). The frontal cortex supports performance on these paradigms, but the specific neural circuitry varies: response inhibition depends upon fronto-basal ganglia networks, inhibition of cognitive sets is supported by orbitofrontal cortex, and retention of fear extinction reflects ventromedial prefrontal cortexamygdala interactions. Inhibition is thus neurobiologically heterogeneous, although right ventrolateral prefrontal cortex may support a general inhibitory process. Dysfunctions in these circuits may contribute to psychopathological conditions marked by inhibitory deficits.
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Dillon DG, Holmes AJ, Jahn AL, Bogdan R, Wald LL, Pizzagalli DA. Dissociation of neural regions associated with anticipatory versus consummatory phases of incentive processing. Psychophysiology 2007; 45:36-49. [PMID: 17850241 PMCID: PMC2156200 DOI: 10.1111/j.1469-8986.2007.00594.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Incentive delay tasks implicate the striatum and medial frontal cortex in reward processing. However, prior studies delivered more rewards than penalties, possibly leading to unwanted differences in signal-to-noise ratio. Also, whether particular brain regions are specifically involved in anticipation or consumption is unclear. We used a task featuring balanced incentive delivery and an analytic strategy designed to identify activity specific to anticipation or consumption. Reaction time data in two independent samples (n=13 and n=8) confirmed motivated responding. Functional magnetic resonance imaging revealed regions activated by anticipation (anterior cingulate) versus consumption (orbital and medial frontal cortex). Ventral striatum was active during reward anticipation but not significantly more so than during consumption. Although the study features several methodological improvements and helps clarify the neural basis of incentive processing, replications in larger samples are needed.
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Affiliation(s)
| | | | | | - Ryan Bogdan
- Harvard University, Department of Psychology
| | - Lawrence L. Wald
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital
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47
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Abstract
The authors manipulated emotion regulation strategies at encoding and administered explicit and implicit memory tests. In Experiment 1, participants used reappraisal to enhance and decrease the personal relevance of unpleasant and neutral pictures. In Experiment 2, decrease cues were replaced with suppress cues that directed participants to inhibit emotion-expressive behavior. Across experiments, using reappraisal to enhance the personal relevance of pictures improved free recall. By contrast, attempting to suppress emotional displays tended to impair recall, especially compared to the enhance condition. Using reappraisal to decrease the personal relevance of pictures had different effects depending on picture type. Paired with unpleasant pictures, the decrease cue tended to improve recall. Paired with neutral stimuli, the decrease cue tended to impair recall. Emotion regulation did not affect perceptual priming. Results highlight dissociable effects of emotion regulation on explicit and implicit memory, as well as dissociations between regulation strategies with respect to explicit memory.
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Affiliation(s)
- Daniel G Dillon
- Center for Cognitive Neuroscience, Duke University, Durham, NC 27708-0999, USA
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48
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Dillon DG, Cooper JJ, Grent-'t-Jong T, Woldorff MG, LaBar KS. Dissociation of event-related potentials indexing arousal and semantic cohesion during emotional word encoding. Brain Cogn 2006; 62:43-57. [PMID: 16678953 DOI: 10.1016/j.bandc.2006.03.008] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2005] [Revised: 03/21/2006] [Accepted: 03/23/2006] [Indexed: 10/24/2022]
Abstract
Event-related potential (ERP) studies have shown that emotional stimuli elicit greater amplitude late positive-polarity potentials (LPPs) than neutral stimuli. This effect has been attributed to arousal, but emotional stimuli are also more semantically coherent than uncategorized neutral stimuli. ERPs were recorded during encoding of positive, negative, uncategorized neutral, and categorized neutral words. Differences in LPP amplitude elicited by emotional versus uncategorized neutral stimuli were evident from 450 to 1000 ms. From 450 to 700 ms, LPP effects at midline and right hemisphere frontal electrodes indexed arousal, whereas LPP effects at left hemisphere centro-parietal electrodes indexed semantic cohesion. This dissociation helps specify the processes underlying emotional stimulus encoding, and suggests the need to control for semantic cohesion in emotional information processing studies.
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Affiliation(s)
- Daniel G Dillon
- Center for Cognitive Neuroscience, Duke University, Durham, NC 27708-0999, USA
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49
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Abstract
Conscious regulation of negative emotion has been shown to affect human eyeblink startle responses, but whether these results depend on modulation of arousal- or valence-based processes is unknown. The authors presented participants with negative, neutral, and positive pictures and directed them to enhance, maintain, and suppress emotional responses. On emotional picture trials, startle responses decreased as a function of cue in the following order: enhance > maintain > suppress. Analysis of negative and positive picture trials separately revealed similar patterns of startle modulation by emotion regulation. There were no effects of emotion regulation on neutral trials. Results indicate that arousal, not valence, may be critical to startle modulation via conscious emotion regulation.
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50
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Fichtenholtz HM, Dean HL, Dillon DG, Yamasaki H, McCarthy G, LaBar KS. Emotion–attention network interactions during a visual oddball task. ACTA ACUST UNITED AC 2004; 20:67-80. [PMID: 15130591 DOI: 10.1016/j.cogbrainres.2004.01.006] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2004] [Indexed: 11/23/2022]
Abstract
Emotional and attentional functions are known to be distributed along ventral and dorsal networks in the brain, respectively. However, the interactions between these systems remain to be specified. The present study used event-related functional magnetic resonance imaging (fMRI) to investigate how attentional focus can modulate the neural activity elicited by scenes that vary in emotional content. In a visual oddball task, aversive and neutral scenes were presented intermittently among circles and squares. The squares were frequent standard events, whereas the other novel stimulus categories occurred rarely. One experimental group [N=10] was instructed to count the circles, whereas another group [N=12] counted the emotional scenes. A main effect of emotion was found in the amygdala (AMG) and ventral frontotemporal cortices. In these regions, activation was significantly greater for emotional than neutral stimuli but was invariant to attentional focus. A main effect of attentional focus was found in dorsal frontoparietal cortices, whose activity signaled task-relevant target events irrespective of emotional content. The only brain region that was sensitive to both emotion and attentional focus was the anterior cingulate gyrus (ACG). When circles were task-relevant, the ACG responded equally to circle targets and distracting emotional scenes. The ACG response to emotional scenes increased when they were task-relevant, and the response to circles concomitantly decreased. These findings support and extend prominent network theories of emotion-attention interactions that highlight the integrative role played by the anterior cingulate.
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Affiliation(s)
- Harlan M Fichtenholtz
- Center for Cognitive Neuroscience, Duke University, Room B203, LSRC Building, Durham, NC 27708-0999, USA
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