Reward network mechanism in anhedonia and depression

Depression is one of the most burdensome mental disorders. Anhedonia, a core symptom of major depressive disorder (MDD), is characterized by abnormal resting-state reward network (RN). However, it is unclear whether anhedonia symptom and depressive episode share similar resting-state RN mechanism, as well as whether the RN mechanism is a state or trait-like marker of depression. This study aims to clarify the two points by recruitingboth current and remitted depression.

Using functional Magnetic Resonance Imaging (fMRI) scans, this study observed the resting-state RN function connectivity (with the seed of ventral striatum) in patients with remitted depression (RMD, n = 27) and current depression (n = 30) and 33 normal controls. The low-frequency fluctuation (ALFF) and T1 image were further analyzed.

Three groups differed in anhedonia scores, with highest anhedonia in the MDD group and lowest anhedonia in the NC group. In total sample, higher anhedonia was correlated with weaker connectivity between the striatum seed and the putamen, inferior frontal cortex, insula, AC, and thalamus, while in the RMD group, anhedonia correlated with higher AC, thalamus, and caudate connectivity. In resting-state function connectivity, the MDD group possessed weaker connectivity between the striatum seed and inferior frontal cortex and insula, while the RMD group showed weaker connectivity with the caudate, and both the MDD and RMD groups possessed lower connectivity with the AC. ALFF data indicated a higher anterior cingulate (AC) activation in the MDD group than the RMD group.T1 image indicated a bigger thalamus volume in the MDD group than the RMD group.

The current study is among the first to confirm that RMD patients possess different RN pattern compared with MDD. Importantly, caudate playsa unique role in depression remission, AC and thalamus mechanisms are trait-like markers of depression. Surprisingly, insula and inferior frontal mechanisms share by depressive episode and anhedonia, while putamen discriminates depressive episode and anhedonia. The results suggest candidate biomarkers for the treatment of clinical depression.