Anhedonia Reduction and the Association Between Left Ventral Striatal Reward Response and 6-Month Improvement in Life Satisfaction Among Young Adults

Abstract

IMPORTANCE Anhedonia is a symptom of multiple psychiatric conditions in young adults that is associated with poorer mental health and psychosocial function and abnormal ventral striatum reward processing. Aberrant function of neural reward circuitry is well documented in anhedonia and other psychiatric disorders. Longitudinal studies to identify potential biomarkers associated with a reduction in anhedonia are necessary for the development of novel treatment targets. OBJECTIVE To identify neural reward-processing factors associated with improved psychiatric symptoms and psychosocial function in a naturalistic, observational context. DESIGN, SETTING, AND PARTICIPANTS A longitudinal cohort follow-up study was conducted from March 1, 2014, to June 5, 2018, at the University of Pittsburgh Medical Center after baseline functional magnetic resonance imaging in 52 participants between the ages of 18 and 25 years who were experiencing psychological distress. MAIN OUTCOMES AND MEASURES Participants were evaluated at baseline and 6 months. At baseline, participants underwent functional magnetic resonance imaging during a card-guessing monetary reward task. Participants completed measures of affective symptoms and psychosocial function at each visit. Neural activation during reward prediction error (RPE), a measure of reward learning, was determined using Statistical Parametric Mapping software. Neural reward regions with significant RPE activation were entered as regions associated with future symptoms in multiple linear regression models. RESULTS A total of 52 young adults (42 women and 10 men; mean [SD] age, 21.4 [2.2] years) completed the study. Greater RPE activation in the left ventral striatum was associated with a decrease in anhedonia symptoms during a 6-month period (β = −6.152; 95% CI,-11.870 to-0.433; P = .04). The decrease in anhedonia between baseline and 6 months mediated the association between left ventral striatum activation to RPE and improvement in life satisfaction between baseline and 6 months (total [c path] association: β = 0.245; P = .01; direct [c′ path] association: β = 0.133; P = .16; and indirect [ab path] association: 95% CI, 0.026-0.262). Results were not associated with psychotropic medication use. CONCLUSIONS AND RELEVANCE Greater left ventral striatum responsiveness to RPE may serve as a biomarker or potential target for novel treatments to improve the severity of anhedonia, overall mental health, and psychosocial function.

The association between psychopathology, childhood trauma, and emotion processing.

“…We conducted repeated-measures ANCOVAs with the between-subjects factor group (HV, PTSD, MDD, SSD) and the within-subject factors emotion (happy, neutral, angry, fearful) and initial fixation (mouth, eyes) as well as the CTQ total score as continuous predictor. Medication indices were calculated following Eckstrand et al (2019) and entered as an additional covariate to investigate potential influences.…”

Life satisfaction prevents decline in working memory, spatial cognition, and processing speed: Latent change score analyses across 23 years

“…This cascade of events may occur in the long term (e.g., 9-23 years) [24,25], plausibly via higher levels of markers of inflammatory activity (e.g., peripheral cytokines) and chronic stress (e.g., cortisol) in the bloodstream [23,98]. The continuing effect of decreased LS on allostatic load may alter cardiorespiratory and neurophysiological pathways in the amygdala and left precuneus, ventromedial prefrontal cortex, and striatum brain regions over long durations [99,100]. Importantly, these areas have been identified as essential for executive functioning, optimal reward processing, and emotion modulation [101].…”

A specific neural substrate predicting current and future impulsivity in young adults

“…Although affective images have been used effectively to study anhedonia in specific populations [ 26 , 36 , 37 ], one consideration is whether these results generalize to a transdiagnostic sample as facial expressions are likely less intrinsically rewarding or pleasurable than actual rewards. Thus, reward processing paradigms might be more relevant to study neural mechanisms of anhedonia, and have been used effectively in transdiagnostic samples [ 40 ]. One neural activity measure, left vlPFC activity facial anger, was inversely related to baseline mania/hypomania.…”

“…Recent neuroimaging studies identified neural marker predictors of future affective symptoms in adolescents [ 38 , 39 ] and future changes in anhedonia in young adults [ 40 ]. Yet, to our knowledge, no studies attempted to identify neural marker predictors of future impulsivity.…”