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Decreased brain response to reward anticipation may be a predictor of adolescent depression

Reduced brain response to reward anticipation varied across the risk spectrum for depression among adolescents, and increased risk for anhedonia, low mood and depressive disorder.

“Alterations in the brain’s reward network are evident in adolescents with depressive disorder as well as in unaffected first-degree relatives of patients with depression and therefore have great potential as risk markers and intervention targets. However, crucial evidence for reward network alterations as a mechanism for depressive disorder is still lacking,” study researcher Argyris Stringaris, MD, PhD, of King’s College London, and colleagues wrote in the American Journal of Psychiatry.

Argyris Stringaris

Researchers used functional MRI scan results to collect and compare blood-oxygen-level-dependent responses from 1,576 adolescents with current subthreshold depression, clinical depression and no mental illness.

Patients with subthreshold depression and clinical depression had reduced activity in the ventral striatum compared with healthy controls.

Low activation of the ventral striatum among previously healthy adolescents was a predictor of transition to subthreshold or clinical depression at 2-year follow-up.

Brain responses during reward anticipation decreased as depression threshold increased among healthy adolescents, adolescents with current or future subthreshold depression and adolescents with current or future clinical depression.

Decreased activity in the ventral striatum was associated with anhedonia but not low mood, however, patients with both of these symptoms had the lowest ventral striatum activity in all analyses.

“These findings of reduced activation during reward anticipation in frontostriatal regions, both in adolescents with subthreshold depression and in those with clinical depression, are consistent with findings from high-risk studies of depression,” Stringaris and colleagues wrote. “Our finding of a graded significant decrease in brain activation across groups suggests that frontostriatal response to reward anticipation operates as a mechanism across the spectrum of risk for depression.” – by Amanda Oldt

Disclosure: Stringaris has received funding from the Wellcome Trust and the U.K.

National Institutes of Health Research, funds from University College London for a joint project with Johnson & Johnson, and royalties from Cambridge University Press and Oxford University Press. Please see the full study for a list of all other authors’ relevant financial disclosures.