Common and Dissociable Dysfunction of the Reward System in Bipolar and Unipolar Depression.

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TitleCommon and Dissociable Dysfunction of the Reward System in Bipolar and Unipolar Depression.
Publication TypeJournal Article
Year of Publication2015
AuthorsSatterthwaite, TD, Kable, JW, Vandekar, L, Katchmar, N, Bassett, DS, Baldassano, CF, Ruparel, K, Elliott, MA, Sheline, YI, Gur, RC, Gur, RE, Davatzikos, C, Leibenluft, E, Thase, ME, Wolf, DH
JournalNeuropsychopharmacology
Volume40
Issue9
Pagination2258-68
Date Published2015 Aug
ISSN1740-634X
KeywordsAdult, Bipolar Disorder, Brain, Depression, Dissociative Disorders, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Oxygen, Psychiatric Status Rating Scales, Rest, Reward
Abstract

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.

DOI10.1038/npp.2015.75
Alternate JournalNeuropsychopharmacology
PubMed ID25767910
PubMed Central IDPMC4613620
Grant ListT32 MH019112 / MH / NIMH NIH HHS / United States
K23 MH098130 / MH / NIMH NIH HHS / United States
R01 MH101111 / MH / NIMH NIH HHS / United States
K23MH098130 / MH / NIMH NIH HHS / United States
K23MH085096 / MH / NIMH NIH HHS / United States
K23 MH085096 / MH / NIMH NIH HHS / United States
R01MH101111 / MH / NIMH NIH HHS / United States
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