Elsevier

Biological Psychiatry

Volume 63, Issue 7, 1 April 2008, Pages 686-692
Biological Psychiatry

Original Article
Neural Responses to Monetary Incentives in Major Depression

https://doi.org/10.1016/j.biopsych.2007.07.023Get rights and content

Background

Reduced responsiveness to positive incentives is a central feature of Major Depressive Disorder (MDD). In the present study, we compared neural correlates of monetary incentive processing in unmedicated depressed participants and never-depressed control subjects.

Methods

Fourteen currently depressed and 12 never-depressed participants underwent functional magnetic resonance imaging while participating in a monetary incentive delay task. During the task, participants were cued to anticipate and respond to a rapidly presented target to gain or avoid losing varying amounts of money.

Results

Depressed and never-depressed participants did not differ in nucleus accumbens (NAcc) activation or in affective or behavioral responses during gain anticipation. Depressed participants did, however, exhibit increasing anterior cingulate activation during anticipation of increasing gains, whereas never-depressed participants showed increasing anterior cingulate activation during anticipation of increasing loss. Depressed participants also showed reduced discrimination of gain versus nongain outcomes.

Conclusions

The present findings indicate that although unmedicated depressed individuals have the capacity to experience positive arousal and recruit NAcc activation during gain anticipation, they also exhibit increased anterior cingulate cortex activation, suggestive of increased conflict during anticipation of gains, in addition to showing reduced discrimination of gain versus nongain outcomes.

Section snippets

Participants

Fourteen individuals (5 male) diagnosed with MDD but no other current Axis I Disorders with the Structured Clinical Interview for DSM (44) and 12 individuals (4 male) with no history of any Axis I disorder participated in the present study. All participants spoke fluent English and ranged in age from 18 to 48 years. Approximately one-half of the MDD participants were recruited from two outpatient university hospital psychiatry clinics, whereas the other one-half were self-referred from the

Participant Characteristics

As expected, MDD participants scored lower in general functioning and higher in depressive symptomatology than CTL participants (Table 1). Whereas the GAF scores of the MDD participants indicated the presence of serious symptoms and impairment, the GAF scores of the CTL participants reflected absent or minor symptoms. The MDD participants had a mean of four previous depressive episodes. The groups did not differ in terms of age, handedness, or vocabulary scores.

Behavior and Affect

The three-way ANOVA conducted on

Discussion

The present study was designed to contrast neural and subjective responses to monetary incentives in unmedicated depressed participants and never-depressed participants. Because affective disturbances are central symptoms of MDD, incentive processing might be altered. Moreover, anticipation represents a critical phase of incentive processing, because it has the potential to influence subsequent thought and behavior (54).

This research yielded three relevant results. First, because depressed

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