Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA.
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Neuropsychopharmacology. 2018 Jun;43(7):1581-1588. doi: 10.1038/s41386-018-0032-x. Epub 2018 Feb 26.
Anhedonia (hyposensitivity to rewards) and negative bias (hypersensitivity to punishments) are core features of major depressive disorder (MDD), which could stem from abnormal reinforcement learning. Emerging evidence highlights blunted reward learning and reward prediction error (RPE) signaling in the striatum in MDD, although inconsistencies exist. Preclinical studies have clarified that ventral tegmental area (VTA) neurons encode RPE and habenular neurons encode punishment prediction error (PPE), which are then transmitted to the striatum and cortex to guide goal-directed behavior. However, few studies have probed striatal activation, and functional connectivity between VTA-striatum and VTA-habenula during reward and punishment learning respectively, in unmedicated MDD. To fill this gap, we acquired fMRI data from 25 unmedicated MDD and 26 healthy individuals during a monetary instrumental learning task and utilized a computational modeling approach to characterize underlying neural correlates of RPE and PPE. Relative to controls, MDD individuals showed impaired reward learning, blunted RPE signal in the striatum and overall reduced VTA-striatal connectivity to feedback. Critically, striatal RPE signal was increasingly blunted with more major depressive episodes (MDEs). No group differences emerged in PPE signals in the habenula and VTA or in connectivity between these regions. However, PPE signals in the habenula correlated positively with number of MDEs. These results highlight impaired reward learning, disrupted RPE signaling in the striatum (particularly among individuals with more lifetime MDEs) as well as reduced VTA-striatal connectivity in MDD. Collectively, these findings highlight reward-related learning deficits in MDD and their underlying pathophysiology.
快感缺失(对奖励的低敏感性)和负性偏向(对惩罚的高敏感性)是重性抑郁障碍(MDD)的核心特征,可能源于异常的强化学习。新出现的证据强调了 MDD 患者纹状体中奖励学习和奖励预测误差(RPE)信号的迟钝,尽管存在不一致的情况。临床前研究已经阐明腹侧被盖区(VTA)神经元编码 RPE,而缰核神经元编码惩罚预测误差(PPE),然后将其传递到纹状体和皮质,以指导目标导向行为。然而,很少有研究探讨纹状体在奖励和惩罚学习过程中的激活以及 VTA-纹状体和 VTA-缰核之间的功能连接,而这些在未经治疗的 MDD 患者中尚未得到研究。为了填补这一空白,我们在一项货币工具学习任务中从 25 名未经治疗的 MDD 患者和 26 名健康个体中获取了 fMRI 数据,并利用计算建模方法来描述 RPE 和 PPE 的潜在神经相关性。与对照组相比,MDD 个体表现出奖励学习受损,纹状体中的 RPE 信号迟钝,以及反馈时 VTA-纹状体连接整体减少。重要的是,纹状体的 RPE 信号随着更多的重性抑郁发作(MDEs)而变得越来越迟钝。在缰核和 VTA 中的 PPE 信号或这些区域之间的连接中,没有出现组间差异。然而,缰核中的 PPE 信号与 MDE 数量呈正相关。这些结果强调了奖励学习受损、纹状体中 RPE 信号中断(尤其是在有更多终生 MDEs 的个体中)以及 MDD 中 VTA-纹状体连接减少。总的来说,这些发现强调了 MDD 中与奖励相关的学习缺陷及其潜在的病理生理学。