Altered striatal activation predicting real-world positive affect in adolescent major depressive disorder

Abstract

Objective: Alterations in reward-related brain function and phenomenological aspects of positive affect are increasingly examined in the development of major depressive disorder. The authors tested differences in reward-related brain function in healthy and depressed adolescents, and the authors examined direct links between reward-related brain function and positive mood that occurred in real-world contexts.

Method: Fifteen adolescents with major depressive disorder and 28 adolescents with no history of psychiatric disorder, ages 8-17 years, completed a functional magnetic resonance imaging guessing task involving monetary reward. Participants also reported their subjective positive affect in natural environments during a 4-day cell-phone-based ecological momentary assessment.

Results: Adolescents with major depressive disorder exhibited less striatal response than healthy comparison adolescents during reward anticipation and reward outcome, but more response in dorsolateral and medial prefrontal cortex. Diminished activation in a caudate region associated with this depression group difference was correlated with lower subjective positive affect in natural environments, particularly within the depressed group.

Conclusions: Results support models of altered reward processing and related positive affect in young people with major depressive disorder and indicate that depressed adolescents' brain response to monetary reward is related to their affective experience in natural environments. Additionally, these results suggest that reward-processing paradigms capture brain function relevant to real-world positive affect.

Figures

FIGURE 1

Event-Related Guessing Task With Monetary Reward

FIGURE 2

Main Effects of Task Within Comparison Group (on left) and Major Depressive Disorder Group (on right) During A) Reward Anticipation and B) Reward Outcome (colored bars reflect t scores for each analysis)

FIGURE 3

Differences in Reward-Related Brain Function Between Young People With Major Depressive Disorder and Those With No History of Psychiatric Disordera a Images depict (A) striatal regions in which comparison subjects exhibited greater activation than subjects with major depressive disorder during reward anticipation; (b) striatal regions in which comparison > major depressive disorder during reward outcome; (C) prefrontal regions in which major depressive disorder > comparison during reward anticipation; and (D) prefrontal regions in which major depressive disorder > comparison during reward outcome. Boxplots in A–D depict BOLD signal change for evident or circled region by diagnostic group, in arbitrary units. Talaraich coordinates are indicated in y axis labels. Age and sex were included as covariates in all analyses. Results remained significant when outliers were excluded from analyses.

FIGURE 4

Correlation of (A) Reward Anticipation-Related Striatal Reactivity (BOLD signal change) and (B) Reward Outcome-Related Striatal Reactivity With Mean Subjective Positive Affect Measured in Natural Environmentsa a Results were masked for striatal regions in which the depression group exhibited less activation than the comparison group. Depicted are caudate clusters correlated with positive affect (for anticipation, 12 voxels; t=2.31, df=1, 38, p<0.02; for outcome, 37 voxels, t=3.18, df=1, 38, p<0.005) and scatterplots of caudate activation versus positive affect score, by group, with regression lines for the entire sample. Blood-oxygen-level-dependent signal change values in scatterplots are in arbitrary units. Colored bars reflect t scores for each analysis.