Negative learning bias in depression revisited: Enhanced neural response to surprising reward across psychiatric disorders
Number of pages
SourceBiological Psychiatry : Cognitive Neuroscience and Neuroimaging, 6, 3, (2021), pp. 280-289
Article / Letter to editor
Display more detailsDisplay less details
PI Group Motivational & Cognitive Control
PI Group Memory and Emotion
SW OZ BSI KLP
Biological Psychiatry : Cognitive Neuroscience and Neuroimaging
Subject130 000 Cognitive Neurology & Memory; 170 000 Motivational & Cognitive Control; Experimental Psychopathology and Treatment; Radboudumc 0: Other Research RIHS: Radboud Institute for Health Sciences; Radboudumc 13: Stress-related disorders DCMN: Donders Center for Medical Neuroscience
Background: Prior work has proposed that major depressive disorder (MDD) is associated with a specific cognitive bias: Depressed patients seem to learn more from punishment than reward. This learning bias has been associated with blunting of reward-related neural responses in the striatum. A key question is whether negative learning bias is also present in MDD patients with comorbid disorders, and whether this bias is specific to depression, or shared across disorders. Methods: We employed a transdiagnostic approach, assessing a heterogenous group of (non-psychotic) psychiatric patients from the MIND-Set cohort (Radboudumc, the Netherlands), with and without MDD but also suffering from anxiety, ADHD and/or autism (n=66) and healthy controls (n=24). To investigate reward and punishment learning, we employed a deterministic reversal learning task with functional MRI. Results: In contrast to previous studies, MDD patients did not exhibit impaired reward learning or reduced reward-related neural activity anywhere in the brain. Interestingly, we observed consistently increased neural responses in bilateral lateral prefrontal cortex of patients when they received a surprising reward. This increase was not specific to MDD, but generalized to anxiety, ADHD and autism. Critically, increased prefrontal activity to surprising reward scaled with transdiagnostic symptom severity, particularly those associated with concentration and attention, as well as the number of diagnoses; patients with more comorbidities showed a stronger prefrontal response to surprising reward. Conclusions: Prefrontal enhancement may reflect compensatory working-memory recruitment, possibly to counteract the inability to swiftly update reward expectations. This neural mechanism may provide a candidate transdiagnostic index of psychiatric severity.
Upload full text
Use your RU credentials (u/z-number and password) to log in with SURFconext to upload a file for processing by the repository team.