The Effects of Psychotherapy on Neural Responses to Rewards in Major Depression

Abstract

Background Unipolar major depressive disorder (MDD) is characterized by anomalous neurobiological responses to pleasant stimuli, a pattern that may be linked to symptoms of anhedonia. However, the potential for psychotherapy to normalize neurobiological responses to pleasant stimuli has not been evaluated. Methods Twelve adults with and 15 adults without MDD participated in two identical functional magnetic resonance imaging (fMRI) scans that utilized a Wheel of Fortune task. Between scans, MDD outpatients received Behavioral Activation Therapy for Depression, a psychotherapy modality designed to increase engagement with rewarding stimuli and reduce avoidance behaviors. Results 75% of adults with MDD were treatment responders, achieving post-treatment HAM-D score of six or below. Relative to changes in brain function in the matched nondepressed group, psychotherapy resulted in functional changes in structures that mediate responses to rewards, including the paracingulate gyrus during reward selection, the right caudate nucleus (i.e., the dorsal striatum), during reward anticipation, and the paracingulate and orbital frontal gyri during reward feedback. There was no effect of diagnostic status or psychotherapy on in-scanner task-related behavioral responses. Conclusions Behavioral Activation Therapy for Depression, a psychotherapy modality designed to increase engagement with rewarding stimuli and reduce avoidance behaviors, results in improved functioning of unique reward structures during different temporal phases of responses to pleasurable stimuli, including the dorsal striatum during reward anticipation.

Inflammation Effects on Motivation and Motor Activity: Role of Dopamine

“…As researchers began to focus more specifically on DAergic mechanisms, an increasing number of functional imaging studies have turned to paradigms that assess striatal responses to rewardpredicting cues or reward feedback, both of which have been linked to striatal DA (Ferenczi et al, 2016;Knutson and Gibbs, 2007). These latter approaches have been mostly consistent in their observation of blunted striatal responses to reward outcomes or reward-predicting cues in MDD patients (Dichter et al, 2009;Forbes et al, 2009;Gotlib et al, 2010;Pizzagalli et al, 2009), and these initial findings have been replicated in recent studies with larger patient samples. Indeed, one recent study of over 1500 adolescents found that reduced ventral striatal activity during reward anticipation was associated with clinical or subclinical depression, and that lower ventral striatal activity in non-depressed teens at the time of scanning was predictive of developing depressive symptoms over a 2-year follow-up period (Stringaris et al, 2015).…”

Neural effects of cognitive–behavioural therapy on dysfunctional attitudes in depression

“…The precentral gyrus plays an important role in successful response inhibition, while patients in an acute depressive episode tend to show impaired response inhibition (Schmid et al 2011). Increased activity in the left precental gyrus has been reported in patients following treatment with psychotherapy (Dichter et al 2009). Larisch et al (1997) found significant positive correlations between dopamine (D 2 ) binding changes in the left precentral gyrus and an improvement in depression scores following antidepressant treatment, and the left precentral gyrus shows increased functional connectivity with the orbitofrontal cortex at baseline in subsequent responders to antidepressant treatment relative to non-responders (Lisiecka et al 2011).…”

Effect of newly synthesized 1,2,4-triazino[5,6-b]indole-3-thione derivatives on olfactory bulbectomy induced depression in rats

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