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Randomized Controlled Trial
. 2024 Jul:178:104545.
doi: 10.1016/j.brat.2024.104545. Epub 2024 Apr 23.

Amplification of positivity for depression and anxiety: Neural prediction of treatment response

Maria Kryza-Lacombe  1 , Isabella Spaulding  1 , Cheuk King Ku  2 , Nana Pearson  2 , Murray B Stein  3 , Charles T Taylor  4
Affiliations
Randomized Controlled Trial

Amplification of positivity for depression and anxiety: Neural prediction of treatment response

Maria Kryza-Lacombe et al. Behav Res Ther. 2024 Jul.

Abstract

Psychosocial treatments targeting the positive valence system (PVS) in depression and anxiety demonstrate efficacy in enhancing positive affect (PA), but response to treatment varies. We examined whether individual differences in neural activation to positive and negative valence incentive cues underlies differences in benefitting from a PVS-targeted treatment. Individuals with clinically elevated depression and/or anxiety (N = 88, ages 18 to 55) participated in one of two randomized, waitlist-controlled trials of Amplification of Positivity (AMP; NCT02330627, NCT03196544), a cognitive and behavioral intervention targeting the PVS. Participants completed a monetary incentive delay (MID) task during fMRI acquisition at baseline measuring neural activation to the possibility of gaining or losing money. Change in PA from before to after treatment was assessed using the Positive and Negative Affect Schedule. No significant associations were observed between baseline neural activation during gain anticipation and AMP-related changes in PA in regions of interest (striatum and insula) or whole-brain analyses. However, higher baseline striatal and insula activation during loss anticipation was associated with greater increases in PA post-AMP. This study provides preliminary evidence suggesting neural reactivity to negative valence cues may inform who stands to benefit most from treatments targeting the PVS.

Keywords: Anxiety; Clinical trial; Depression; Neural prediction; Positive affect; fMRI.

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Conflict of interest statement

Declaration of competing interest Maria Kryza-Lacombe, Isabella Spaulding, Cheuk King Ku, and Nana Pearson declare that they have no conflicts of interest. Charles T. Taylor declares that in the past 3 years he has been a paid consultant for Bionomics and receives payment for editorial work for UpToDate and the journal Depression and Anxiety. Murray B. Stein declares that in the past 3 years he has received consulting income from Acadia Pharmaceuticals, Aptinyx, atai Life Sciences, BigHealth, Biogen, Bionomics, BioXcel Therapeutics, Boehringer Ingelheim, Clexio, Delix Therapeutics, Eisai, EmpowerPharm, Engrail Therapeutics, Janssen, Jazz Pharmaceuticals, NeuroTrauma Sciences, PureTech Health, Sage Therapeutics, Sumitomo Pharma, and Roche/Genentech. Dr. Stein has stock options in Oxeia Biopharmaceuticals and EpiVario. He has been paid for his editorial work on Depression and Anxiety (Editor-in-Chief), Biological Psychiatry (Deputy Editor), and UpToDate (Co-Editor-in-Chief for Psychiatry). He has also received research support from NIH, Department of Veterans Affairs, and the Department of Defense. He is on the scientific advisory board for the Brain and Behavior Research Foundation and the Anxiety and Depression Association of America.

Figures

Figure 1.
Figure 1.. Associations between ROI activation in response to high loss anticipation at baseline and change in positive affect and the AMP and WL groups.
AMP=treatment group that underwent Amplification of Positivity, WL=waitlist control group that did not undergo an intervention. For this and all figures, brain images represent axial sections (left=left).
Figure 2.
Figure 2.. Clusters that emerged in whole-brain analyses examining the association between activation in response to incentive anticipation and change in positive affect in AMP.
Voxel-level threshold p<0.005. All clusters 10 voxels or greater in size are displayed. AMP=treatment group that underwent Amplification of Positivity; WL=waitlist control group that did not undergo an intervention.
See this image and copyright information in PMC

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