Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
Psychol Med. 2024 Mar;54(4):639-651. doi: 10.1017/S0033291723003410. Epub 2023 Nov 24.
Reward processing dysfunctions are considered a candidate mechanism underlying anhedonia and apathy in depression. Neuroimaging studies have documented that neurofunctional alterations in mesocorticolimbic circuits may neurally mediate these dysfunctions. However, common and distinct neurofunctional alterations during motivational and hedonic evaluation of monetary and natural rewards in depression have not been systematically examined. Here, we capitalized on pre-registered neuroimaging meta-analyses to (1) establish general reward-related neural alterations in depression, (2) determine common and distinct alterations during the receipt and anticipation of monetary v. natural rewards, and, (3) characterize the differences on the behavioral, network, and molecular level. The pre-registered meta-analysis (https://osf.io/ay3r9) included 633 depressed patients and 644 healthy controls and revealed generally decreased subgenual anterior cingulate cortex and striatal reactivity toward rewards in depression. Subsequent comparative analyses indicated that monetary rewards led to decreased hedonic reactivity in the right ventral caudate while natural rewards led to decreased reactivity in the bilateral putamen in depressed individuals. These regions exhibited distinguishable profiles on the behavioral, network, and molecular level. Further analyses demonstrated that the right thalamus and left putamen showed decreased activation during the anticipation of monetary reward. The present results indicate that distinguishable neurofunctional alterations may neurally mediate reward-processing alterations in depression, in particular, with respect to monetary and natural rewards. Given that natural rewards prevail in everyday life, our findings suggest that reward-type specific interventions are warranted and challenge the generalizability of experimental tasks employing monetary incentives to capture reward dysregulations in everyday life.
奖赏处理功能障碍被认为是导致抑郁症快感缺失和淡漠的候选机制。神经影像学研究表明，中脑边缘皮质回路的神经功能改变可能在神经上介导这些功能障碍。然而，抑郁症患者在对金钱和自然奖赏进行动机和享乐评估时，共同和独特的神经功能改变尚未得到系统研究。在这里，我们利用预先注册的神经影像学元分析来：(1)确定抑郁症中一般的奖赏相关神经改变，(2)确定在接受和预期金钱与自然奖赏时的共同和独特改变，以及 (3)描述行为、网络和分子水平上的差异。预先注册的元分析（https://osf.io/ay3r9）包括 633 名抑郁症患者和 644 名健康对照者，结果表明抑郁症患者的扣带回前侧亚区和纹状体对奖赏的反应普遍降低。随后的比较分析表明，金钱奖励导致右侧腹侧尾状核的愉悦反应降低，而自然奖励导致双侧壳核的反应降低。这些区域在行为、网络和分子水平上表现出可区分的特征。进一步的分析表明，右侧丘脑和左侧壳核在预期金钱奖励时的激活降低。目前的结果表明，可区分的神经功能改变可能在神经上介导抑郁症中的奖赏处理改变，特别是在金钱和自然奖赏方面。鉴于自然奖赏在日常生活中占主导地位，我们的研究结果表明，针对特定奖赏类型的干预措施是必要的，并挑战了使用金钱奖励来捕捉日常生活中奖赏失调的实验任务的普遍性。
