Impaired reward-related learning signals in remitted unmedicated patients with recurrent depression

作者：Hanneke Geugies, Roel J. T. Mocking, Caroline Figueroa, P.F.C. Groot, Jan‐Bernard C. Marsman, Michelle N. Servaas, J. Douglas Steele, Aart H. Schene, Henricus G. Ruhé · 发表于：Brain · 年份：2019 · DOI：10.1093/brain/awz167 · 被引用次数：70 · 研究领域：Mental Health Research Topics、Treatment of Major Depression、Heart Rate Variability and Autonomic Control

One of the core symptoms of major depressive disorder is anhedonia, an inability to experience pleasure. In patients with major depressive disorder, a dysfunctional reward-system may exist, with blunted temporal difference reward-related learning signals in the ventral striatum and increased temporal difference-related (dopaminergic) activation in the ventral tegmental area. Anhedonia often remains as residual symptom during remission; however, it remains largely unknown whether the abovementioned reward systems are still dysfunctional when patients are in remission. We used a Pavlovian classical conditioning functional MRI task to explore the relationship between anhedonia and the temporal difference-related response of the ventral tegmental area and ventral striatum in medication-free remitted recurrent depression patients (n = 36) versus healthy control subjects (n = 27). Computational modelling was used to obtain the expected temporal difference errors during this task. Patients, compared to healthy controls, showed significantly increased temporal difference reward learning activation in the ventral tegmental area (PFWE,SVC = 0.028). No differences were observed between groups for ventral striatum activity. A group × anhedonia interaction [t(57) = -2.29, P = 0.026] indicated that in patients, higher anhedonia was associated with lower temporal difference activation in the ventral tegmental area, while in healthy controls higher anhedonia was associated with higher ventra...