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. 2022 Aug 10;47(4):E284-E292.
doi: 10.1503/jpn.210180. Print 2022 Jul-Aug.

Understanding the neurobiological basis of anhedonia in major depressive disorder - evidence for reduced neural activation during reward and loss processing

Lavinia A Steinmann  1 , Katharina Dohm  2 , Janik Goltermann  2 , Maike Richter  2 , Verena Enneking  2 , Marcia Lippitz  2 , Jonathan Repple  2 , Marco Mauritz  2 , Udo Dannlowski #  2 , Nils Opel #  2
Affiliations

Understanding the neurobiological basis of anhedonia in major depressive disorder - evidence for reduced neural activation during reward and loss processing

Lavinia A Steinmann et al. J Psychiatry Neurosci. .

Abstract

Background: Anhedonia is a key symptom of major depressive disorder (MDD). Anhedonia is associated with aberrant reward processing, but whether it might interfere similarly with the neural processing of aversive stimuli, such as monetary loss, remains unknown. We aimed to investigate potential associations between anhedonia and neural response during reward and loss processing in patients with MDD.

Methods: We investigated blood-oxygen-level-dependent response in the orbitofrontal cortex, cingulate cortex, insula and basal ganglia during monetary reward and loss processing in 182 patients with MDD, using a card-guessing paradigm. We measured anhedonia with the Social and Physical Anhedonia Scale (SASPAS), and we tested for the main and interaction effects of SASPAS scores and the experimental condition (reward or loss) in a full factorial model.

Results: We detected a negative main effect of anhedonia, as well as a significant interaction effect of anhedonia and the experimental condition, on orbitofrontal and insular neural response. Post hoc analyses revealed that the interaction was driven by a significant association between higher anhedonia scores and hypoactivation during loss processing. We observed no significant association between anhedonia and neural response during reward processing.

Limitations: This study had a cross-sectional design.

Conclusion: Our findings confirmed that altered neural processing in the orbitofrontal cortex and insula is a neurobiological feature of anhedonic symptomatology in people with MDD. The pronounced association between anhedonia and blunted neural response during loss processing supports a broader concept for the neurobiological basis of anhedonia. Hence, MDD with anhedonic features might be characterized by reduced neural response to external stimuli, potentially because of amotivation.

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Conflict of interest statement

Competing interests: J. Goltermann received a Society of Biological Psychiatry 2022 travel Award. No other competing interests declared.

Figures

Figure 1
Figure 1
Results from multiple regression analysis of the effect of anhedonia on BOLD response during a loss condition, displaying clusters in the bilateral insula and orbitofrontal cortex. Axial (z = 68) and sagittal (x = 12) views of the region of interest. Colour bar depicts TFCE scores (pFWE = 0.05 after TFCE). BOLD = blood-oxygen-level-dependent; FWE = family-wise error; TFCE = threshold-free cluster enhancement.
Figure 2
Figure 2
Scatterplot depicting peak BOLD response in the right OFC, from multiple regression analysis with anhedonia scores as covariates. Pearson correlation: r = −0.176, p = 0.016. BOLD = blood-oxygen-level-dependent; OFC = orbitofrontal cortex; SASPAS = Social and Physical Anhedonia Scale.
Figure 3
Figure 3
Scatterplot depicting peak BOLD response in the right insula, from multiple regression analysis with anhedonia scores as covariates. Pearson correlation: r = −0.227, p = 0.002. BOLD = blood-oxygen-level-dependent; SASPAS = Social and Physical Anhedonia Scale.
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