TY - JOUR
T1 - Common and Dissociable Dysfunction of the Reward System in Bipolar and Unipolar Depression
AU - Satterthwaite, Theodore D.
AU - Kable, Joseph W.
AU - Vandekar, Lillie
AU - Katchmar, Natalie
AU - Bassett, Danielle S.
AU - Baldassano, Claudia F.
AU - Ruparel, Kosha
AU - Elliott, Mark A.
AU - Sheline, Yvette I.
AU - Gur, Ruben C.
AU - Gur, Raquel E.
AU - Davatzikos, Christos
AU - Leibenluft, Ellen
AU - Thase, Michael E.
AU - Wolf, Daniel H.
N1 - Publisher Copyright:
© 2015 American College of Neuropsychopharmacology. All rights reserved.
PY - 2015/8/16
Y1 - 2015/8/16
N2 - Unipolar and bipolar depressive episodes have a similar clinical presentation that suggests common dysfunction of the brain's reward system. Here, we evaluated the relationship of both dimensional depression severity and diagnostic category to reward system function in both bipolar and unipolar depression. In total, 89 adults were included, including 27 with bipolar depression, 25 with unipolar depression, and 37 healthy comparison subjects. Subjects completed both a monetary reward task and a resting-state acquisition during 3T BOLD fMRI. Across disorders, depression severity was significantly associated with reduced activation for wins compared with losses in bilateral ventral striatum, anterior cingulate cortex, posterior cingulate cortex, and right anterior insula. Resting-state connectivity within this reward network was also diminished in proportion to depression severity, most notably connectivity strength in the left ventral striatum. In addition, there were categorical differences between patient groups: resting-state connectivity at multiple reward network nodes was higher in bipolar than in unipolar depression. Reduced reward system task activation and resting-state connectivity therefore appear to be a brain phenotype that is dimensionally related to depression severity in both bipolar and unipolar depression. In contrast, categorical differences in reward system resting connectivity between unipolar and bipolar depression may reflect differential risk of mania. Reward system dysfunction thus represents a common brain mechanism with relevance that spans categories of psychiatric diagnosis.
AB - Unipolar and bipolar depressive episodes have a similar clinical presentation that suggests common dysfunction of the brain's reward system. Here, we evaluated the relationship of both dimensional depression severity and diagnostic category to reward system function in both bipolar and unipolar depression. In total, 89 adults were included, including 27 with bipolar depression, 25 with unipolar depression, and 37 healthy comparison subjects. Subjects completed both a monetary reward task and a resting-state acquisition during 3T BOLD fMRI. Across disorders, depression severity was significantly associated with reduced activation for wins compared with losses in bilateral ventral striatum, anterior cingulate cortex, posterior cingulate cortex, and right anterior insula. Resting-state connectivity within this reward network was also diminished in proportion to depression severity, most notably connectivity strength in the left ventral striatum. In addition, there were categorical differences between patient groups: resting-state connectivity at multiple reward network nodes was higher in bipolar than in unipolar depression. Reduced reward system task activation and resting-state connectivity therefore appear to be a brain phenotype that is dimensionally related to depression severity in both bipolar and unipolar depression. In contrast, categorical differences in reward system resting connectivity between unipolar and bipolar depression may reflect differential risk of mania. Reward system dysfunction thus represents a common brain mechanism with relevance that spans categories of psychiatric diagnosis.
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U2 - 10.1038/npp.2015.75
DO - 10.1038/npp.2015.75
M3 - Article
C2 - 25767910
AN - SCOPUS:84937161625
SN - 0893-133X
VL - 40
SP - 2258
EP - 2268
JO - Neuropsychopharmacology
JF - Neuropsychopharmacology
IS - 9
ER -