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It still hurts: altered endogenous opioid activity in the brain during social rejection and acceptance in major
D T Hsu1, B J Sanford2, K K Meyers3
11] Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA [2] Department of Psychiatry, The Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA.
Abstract:
The μ-opioid receptor (MOR) system, well known for dampening physical pain, is also hypothesized to dampen 'social pain.' We used positron emission tomography scanning with the selective MOR radioligand [(11)C]carfentanil to test the hypothesis that MOR system activation (reflecting endogenous opioid release) in response to social rejection and acceptance is altered in medication-free patients diagnosed with current major depressive disorder (MDD, n=17) compared with healthy controls (HCs, n=18). During rejection, MDD patients showed reduced endogenous opioid release in brain regions regulating stress, mood and motivation, and slower emotional recovery compared with HCs. During acceptance, only HCs showed increased social motivation, which was positively correlated with endogenous opioid release in the nucleus accumbens, a reward structure. Altered endogenous opioid activity in MDD may hinder emotional recovery from negative social interactions and decrease pleasure derived from positive interactions. Both effects may reinforce depression, trigger relapse and contribute to poor treatment outcomes.
Insights
Major depressive disorder (MDD) patients exhibit reduced opioid system activity during social rejection, hindering emotional recovery. This altered endogenous opioid release may worsen depression and impede treatment outcomes.
Area of Science:
- Neuroscience
- Psychiatry
- Molecular Biology
Background:
- The μ-opioid receptor (MOR) system modulates physical pain and is implicated in social pain processing.
- Major Depressive Disorder (MDD) is associated with altered emotional regulation and social functioning.
Purpose of the Study:
- To investigate endogenous opioid system activity in response to social rejection and acceptance in individuals with MDD compared to healthy controls (HCs).
- To determine if MOR system activation differs between MDD patients and HCs during social emotional challenges.
Main Methods:
- Positron emission tomography (PET) scanning using the selective MOR radioligand [(11)C]carfentanil.
- Comparison of MOR system activation, reflecting endogenous opioid release, between medication-free MDD patients (n=17) and HCs (n=18) during social rejection and acceptance tasks.
Main Results:
- MDD patients demonstrated reduced endogenous opioid release in stress, mood, and motivation-regulating brain regions during social rejection, with slower emotional recovery than HCs.
- Healthy controls, but not MDD patients, showed increased social motivation during acceptance, correlated with opioid release in the nucleus accumbens.
Conclusions:
- Altered endogenous opioid system activity in MDD may impair recovery from negative social experiences and diminish pleasure from positive social interactions.
- These MOR system dysfunctions could reinforce depressive symptoms, precipitate relapse, and negatively impact treatment effectiveness in MDD.
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