Reduced caudate and nucleus accumbens response to rewards in unmedicated individuals with major depressive disorder.
Reduced caudate and nucleus accumbens response to rewards in unmedicated individuals with major depressive disorder.
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DOI：
10.1176/appi.ajp.2008.08081201
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发表时间：
2009-06
期刊：
影响因子：
--
通讯作者：
Fava M
中科院分区：
文献类型：
--
作者：
Pizzagalli DA;Holmes AJ;Dillon DG;Goetz EL;Birk JL;Bogdan R;Dougherty DD;Iosifescu DV;Rauch SL;Fava M
重度抑郁症 (MDD) 的特点是奖赏处理受损，可能是由于基底神经节功能障碍所致。然而，很少有抑郁症的神经影像学研究区分了奖励处理的预期阶段和完成阶段。作者使用功能性磁共振成像 (fMRI) 和一项分离奖励处理的预期阶段和完成阶段的任务，测试了 MDD 参与者在基底神经节结构中表现出奖励相关反应减少的假设。在功能磁共振成像扫描期间，向 30 名未接受药物治疗的 MDD 受试者和 31 名健康对照受试者提出了金钱激励延迟任务。全脑分析侧重于对奖励预测线索和奖励结果（即金钱收益）的神经反应。次要分析侧重于快感缺乏症状与基底神经节体积之间的关系。相对于对照组，MDD 参与者对左侧伏核和双侧尾状核的增益反应明显较弱。这些区域中的群体差异特定于奖励结果，并没有概括为中性或负面结果，尽管其他尾状区域出现了对 MDD 金钱处罚的反应相对减少。相比之下，尽管 MDD 受试者在左后壳核的一小部分中表现出对奖励线索的激活减少，但奖励预期期间群体差异的证据较弱。在 MDD 受试者中，快感缺乏症状和抑郁严重程度与双侧尾状核体积减少有关。这些结果表明 MDD 中的基底神经节功能障碍可能会影响奖励处理的完成阶段。此外，形态测量结果表明 MDD 的快感缺乏与尾状核体积有关。
Major depressive disorder (MDD) 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 magnetic resonance imaging (fMRI) and a task that dissociates anticipatory and consummatory phases of reward processing, the authors tested the hypothesis that MDD participants would show reduced reward-related responses in basal ganglia structures. A monetary incentive delay task was presented to 30 unmedicated MDD subjects 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. Relative to comparison subjects, MDD participants showed significantly weaker responses to gains in the left nucleus accumbens and bilateral caudate. 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 MDD emerged in other caudate regions. By contrast, evidence for group differences during reward anticipation was weaker, although MDD subjects showed reduced activation to reward cues in a small sector of the left posterior putamen. Among MDD subjects, anhedonic symptoms and depression severity were associated with reduced bilateral caudate volume. These results indicate that basal ganglia dysfunction in MDD may affect the consummatory phase of reward processing. Additionally, morphometric results suggest that anhedonia in MDD is related to caudate volume.
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