Neural alterations of fronto-striatal circuitry during reward anticipation in euthymic bipolar disorder

Abstract

BackgroundBipolar disorder (BD), with the hallmark symptoms of elevated and depressed mood, is thought to be characterized by underlying alterations in reward-processing networks. However, to date the neural circuitry underlying abnormal responses during reward processing in BD remains largely unexplored. The aim of this study was to investigate whether euthymic BD is characterized by aberrant ventral striatal (VS) activation patterns and altered connectivity with the prefrontal cortex in response to monetary gains and losses.MethodDuring functional magnetic resonance imaging 20 euthymic BD patients and 20 age-, gender- and intelligence quotient-matched healthy controls completed a monetary incentive delay paradigm, to examine neural processing of reward and loss anticipation. A priori defined regions of interest (ROIs) included the VS and the anterior prefrontal cortex (aPFC). Psychophysiological interactions (PPIs) between these ROIs were estimated and tested for group differences for reward and loss anticipation separately.ResultsBD participants, relative to healthy controls, displayed decreased activation selectively in the left and right VS during anticipation of reward, but not during loss anticipation. PPI analyses showed decreased functional connectivity between the left VS and aPFC in BD patients compared with healthy controls during reward anticipation.ConclusionsThis is the first study showing decreased VS activity and aberrant connectivity in the reward-processing circuitry in euthymic, medicated BD patients during reward anticipation. Our findings contrast with research supporting a reward hypersensitivity model of BD, and add to the body of literature suggesting that blunted activation of reward processing circuits may be a vulnerability factor for mood disorders.

Anterior insular volume decrease is associated with dysfunction of the reward system in patients with chronic pain

“…More than 50% of patients with chronic pain suffer from depression (Chopra and Arora, ). Abnormality of the NAc is associated with depression (McCabe, ) and mood disorders (Schreiter et al., ). Pain catastrophizing is a negative cognitive and emotional response to pain involving factors of rumination, magnification and feeling of helplessness (Quartana et al., ).…”

Future Directions for Understanding Adolescent Bipolar Spectrum Disorders: A Reward Hypersensitivity Perspective

“…Currently euthymic individuals with a BSD exhibit higher self-reported reward sensitivity and increased behavioral and neurophysiological responses to rewards on reward-related tasks (see Alloy et al, 2016;Nusslock & Alloy, 2017, for reviews). In addition, fMRI studies employing reward task paradigms provide support for elevated VS and OFC reward responses in both manic and euthymic individuals with bipolar I and II disorders, and individuals at risk for BSD (see Alloy et al, 2016;Nusslock & Alloy, 2017, for reviews; but see Schreiter et al, 2016, andYip, Worhunsky, Rogers, &Goodwin, 2015, for alternative findings). Using diffusion imaging, Damme et al (2017) found that individuals at risk for BSD also show enhanced corticostriatal structural connectivity compared to low-risk individuals.…”

Human Striatal Response to Reward Anticipation Linked to Hippocampal Glutamate Levels

“…In addition, several functional MRI studies examined functional connectivity of the ventral striatum in a reward context. For example, Schreiter and colleagues (2016) showed decreased functional connectivity between the left ventral striatum and anterior prefrontal cortex in patients with bipolar disorder during reward anticipation. Weiland et al (2013) demonstrated increased connectivity between the ventral striatum and both paracentral lobule/precuneus and sensorimotor areas in youth with a family history of alcoholism during incentive anticipation (both reward and loss conditions).…”