The Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, China.
The Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
J Affect Disord. 2013 Nov;151(2):531-539. doi: 10.1016/j.jad.2013.06.039. Epub 2013 Jul 12.
A growing number of functional magnetic resonance imaging (fMRI) studies have been conducted in major depressive disorder (MDD) to elucidate reward-related brain functions. The aim of this meta-analysis was to examine the common reward network in the MDD brain and to further distinguish the brain activation patterns between positive stimuli and monetary rewards as well as reward anticipation and outcome.
A series of activation likelihood estimation (ALE) meta-analyses were performed across 22 fMRI studies that examined reward-related processing, with a total of 341 MDD patients and 367 healthy controls.
We observed several frontostriatal regions that participated in reward processing in MDD. The common reward network in MDD was characterized by decreased subcortical and limbic areas activity and an increased cortical response. In addition, the cerebellum, lingual gyrus, parahippocampal gyrus and fusiform gyrus preferentially responded to positive stimuli in MDD, while the insula, precuneus, cuneus, PFC and inferior parietal lobule selectively responded to monetary rewards. Our results indicated a reduced caudate response during both monetary anticipation and outcome stages as well as increased activation in the middle frontal gyrus and dorsal anterior cingulate during reward anticipation in MDD.
The reward-related tasks and mood states of patients included in our analysis were heterogeneous.
Our current findings suggest that there exist emotional or motivational pathway dysfunctions in MDD during reward-related processing. Future studies may be strengthened by paying careful attention to the types of reward used as well as the different components of reward processing examined.
越来越多的功能磁共振成像（fMRI）研究在重度抑郁症（MDD）中进行，以阐明与奖励相关的大脑功能。本荟萃分析的目的是检查 MDD 大脑中的常见奖励网络，并进一步区分正性刺激和金钱奖励以及奖励预期和结果的大脑激活模式。
对 22 项研究进行了一系列的激活似然估计（ALE）荟萃分析，这些研究检查了与奖励相关的处理，共包括 341 名 MDD 患者和 367 名健康对照者。
我们观察到 MDD 中参与奖励处理的几个额-纹状体区域。MDD 中的常见奖励网络的特点是皮质下和边缘区域的活动减少，皮质反应增加。此外，小脑、舌回、海马旁回和梭状回在 MDD 中优先对正性刺激做出反应，而岛叶、顶下小叶、楔前叶、PFC 和下顶叶小叶则选择性地对金钱奖励做出反应。我们的结果表明，MDD 患者在金钱预期和结果阶段的尾状核反应减少，在奖励预期阶段的中额前回和背侧前扣带皮层的激活增加。
我们分析中包含的与奖励相关的任务和患者的情绪状态存在异质性。
我们目前的研究结果表明，在与奖励相关的处理过程中，MDD 存在情感或动机通路功能障碍。未来的研究可能会通过仔细关注所使用的奖励类型以及所检查的奖励处理的不同成分来得到加强。
