title: Attenuation of Frontostriatal Connectivity During Reward Processing Predicts Response to Psychotherapy in Major Depressive Disorder.
abstract: There are few reliable predictors of response to antidepressant treatments. In the present investigation, we examined pretreatment functional brain connectivity during reward processing as a potential predictor of response to Behavioral Activation Treatment for Depression (BATD), a validated psychotherapy that promotes engagement with rewarding stimuli and reduces avoidance behaviors. Thirty-three outpatients with major depressive disorder (MDD) and 20 matched controls completed two runs of the monetary incentive delay task during functional magnetic resonance imaging after which participants with MDD received up to 15 sessions of BATD. Seed-based generalized psychophysiological interaction analyses focused on task-based connectivity across task runs, as well as the attenuation of connectivity from the first to the second run of the task. The average change in Beck Depression Inventory-II scores due to treatment was 10.54 points, a clinically meaningful response. Groups differed in seed-based functional connectivity among multiple frontostriatal regions. Hierarchical linear modeling revealed that improved treatment response to BATD was predicted by greater connectivity between the left putamen and paracingulate gyrus during reward anticipation. In addition, MDD participants with greater attenuation of connectivity between several frontostriatal seeds, and midline subcallosal cortex and left paracingulate gyrus demonstrated improved response to BATD. These findings indicate that pretreatment frontostriatal functional connectivity during reward processing is predictive of response to a psychotherapy modality that promotes improving approach-related behaviors in MDD. Furthermore, connectivity attenuation among reward-processing regions may be a particularly powerful endophenotypic predictor of response to BATD in MDD.
authors: Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
authors: Erin
authors: http://orcid.org/0000-0002-9573-7165
authors: E
authors: Walsh
authors: Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.
authors: Hannah
authors: H
authors: Carl
authors: Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
authors: Tory
authors: T
authors: Eisenlohr-Moul
authors: Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.|Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors: Jared
authors: J
authors: Minkel
authors: UNC Neurobiology Curriculum, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
authors: Andrew
authors: A
authors: Crowther
authors: Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
authors: Tyler
authors: T
authors: Moore
authors: Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
authors: Devin
authors: D
authors: Gibbs
authors: Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, USA.
authors: Chris
authors: C
authors: Petty
authors: Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, USA.|Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
authors: Josh
authors: J
authors: Bizzell
authors: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors: Moria J
authors: MJ
authors: Smoski
authors: Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.|Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.|UNC Neurobiology Curriculum, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.|Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, USA.|Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
authors: Gabriel S
authors: GS
authors: Dichter
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D063132:Connectome; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D012201:Reward