Abstract
Objective: Reward positivity (RewP), a neurophysiologic index of reward responsivity, is consistently reduced in participants with depression and, to a lesser extent, anxiety. It remains unknown, however, whether RewP can be altered as psychiatric symptoms change with treatment. The current study addressed this question by examining differences in RewP within patients before and after 12 weeks of treatment with a selective serotonin reuptake inhibitor (SSRI) or cognitive-behavioral therapy (CBT). We also examined the utility of RewP as a predictor of symptom change during CBT and SSRI treatment. Methods: Participants were recruited between 2014 and 2017 and included adults with a primary DSM-5 anxiety or depressive disorder (n = 63) and healthy controls (n = 25). At baseline and 12 weeks, participants completed a monetary award task while electroencephalogram (EEG) was recorded. Between EEG sessions, patients completed CBT or SSRI treatment. Results: At baseline, higher levels of depressive symptoms were associated with a more attenuated RewP. We found no significant differences between patients and healthy controls in the degree of RewP change across the 12 weeks; however, among patients, the extent of increase in RewP robustly correlated with the extent of decline in depressive (t= -2.21, P= .03) and anxiety (t= -2.57, P= .02) symptoms following CBT and SSRI treatment. Additionally, a more attenuated RewP at baseline predicted a greater reduction in depressive symptoms following treatment with SSRIs (t= -2.04, P< .05), but not after CBT. Conclusions: These findings highlight neural responsiveness to reward as both a mechanism and a predictor of depressive symptom change that may be used serve as an objective index of symptom improvement.
| Original language | English (US) |
|---|---|
| Article number | 17m11836 |
| Journal | Journal of Clinical Psychiatry |
| Volume | 79 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jul 1 2018 |
Funding
Submitted: July 31, 2017; accepted November 13, 2017. Published online: June 12, 2018. Author contributions: All authors were involved in study conception and design. Drs Burkhouse, Gorka, and Phan completed the data analysis. All authors assisted with data interpretation and provided important intellectual input. Drs Burkhouse and Phan wrote the first draft. All authors read and commented on the manuscript. The corresponding author had full access to the data in the study and had final responsibility for the decision to submit for publication. Potential conflicts of interest: All authors report no potential conflicts of interest or financial relationships with commercial interests. Funding/support: This study was funded by the National Institute of Mental Health (NIMH) of the National Institutes of Health grant R01MH101497 (to KLP) and Center for Clinical and Translational Science (CCTS) UL1RR029879. Dr Burkhouse is supported by NIMH Grant K23-MH113793-01. Dr Gorka is supported by National Institute of Alcohol Abuse and Alcoholism Grant K23-AA025111. Role of the sponsor: The sponsors had no role in the design, analysis, interpretation, or publication of this study.
ASJC Scopus subject areas
- Psychiatry and Mental health
