title: Hyporeactivity of ventral striatum towards incentive stimuli in unmedicated depressed patients normalizes after treatment with escitalopram.
abstract: Major Depressive Disorder (MDD) involves deficits in the reward system. While neuroimaging studies have focused on affective stimulus processing, few investigations have directly addressed deficits in the anticipation of incentives. We examined neural responses during gain and loss anticipation in patients with MDD before and after treatment with a selective serotonin reuptake inhibitor (SSRI). Fifteen adults with MDD and 15 healthy participants, matched for age, verbal IQ and smoking habits, were investigated in a functional magnetic resonance imaging (fMRI) study using a monetary incentive delay task. Patients were scanned drug-free and after 6 weeks of open-label treatment with escitalopram; controls were scanned twice at corresponding time points. We compared the blood oxygenation level dependent (BOLD) response during the anticipation of gain and loss with a neutral condition. A repeated measures ANOVA was calculated to identify effects of group (MDD vs. controls), time (first vs. second scan) and group-by-time interaction. Severity of depression was measured with the Hamilton Rating Scale of Depression and the Beck Depression Inventory. MDD patients showed significantly less ventral striatal activation during anticipation of gain and loss compared with controls before, but not after, treatment. There was a significant group-by-time interaction during anticipation of loss in the left ventral striatum due to a signal increase in patients after treatment. Ventral striatal hyporesponsiveness was associated with the severity of depression and in particular anhedonic symptoms. These findings suggest that MDD patients show ventral striatal hyporesponsiveness during incentive cue processing, which normalizes after successful treatment.
authors.affiliation: Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany. meline.stoy@charite.de
authors.forename: Meline
authors.initials: M
authors.lastname: Stoy
authors.forename: Florian
authors.initials: F
authors.lastname: Schlagenhauf
authors.forename: Philipp
authors.initials: P
authors.lastname: Sterzer
authors.forename: Felix
authors.initials: F
authors.lastname: Bermpohl
authors.forename: Claudia
authors.initials: C
authors.lastname: Hägele
authors.forename: Kristina
authors.initials: K
authors.lastname: Suchotzki
authors.forename: Katharina
authors.initials: K
authors.lastname: Schmack
authors.forename: Jana
authors.initials: J
authors.lastname: Wrase
authors.forename: Roland
authors.initials: R
authors.lastname: Ricken
authors.forename: Brian
authors.initials: B
authors.lastname: Knutson
authors.forename: Mazda
authors.initials: M
authors.lastname: Adli
authors.forename: Michael
authors.initials: M
authors.lastname: Bauer
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
authors.forename: Andreas
authors.initials: A
authors.lastname: Ströhle
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001479:Basal Ganglia / Q000187:drug effects* / Q000503:physiopathology*; D015283:Citalopram / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009042:Motivation; D059906:Neuroimaging / Q000379:methods; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors