Reward Processing and Depressive Subtypes: Identifying Neural Biotypes Related to Suicide Risk, Resilience, and Treatment Response
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Depression
- Sponsor
- San Francisco Veterans Affairs Medical Center
- Enrollment
- 150
- Locations
- 1
- Primary Endpoint
- fMRI response to win vs. loss reward feedback
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
Deficits in motivation and pleasure are common in depression, and thought to be caused by alterations in the ways in which the brain anticipates, evaluates, and adaptively uses reward-related information. However, reward processing is a complex, multi-circuit phenomenon, and the precise neural mechanisms that contribute to the absence or reduction of pleasure and motivation are not well understood. Variation in the clinical presentation of depression has long been a rule rather than an exception, including individual variation in symptoms, severity, and treatment response. This heterogeneity complicates understanding of depression and thwarts progress toward disease classification and treatment planning. Discovery of depression-specific biomarkers that account for neurobiological variation that presumably underlies distinct clinical manifestations is critical to this larger effort.
Detailed Description
This study combines clinically motivated questions with in-depth study of neurobiological mechanisms to evaluate how reward system neurobiology contributes to expression of reward-related deficits, such as decreased pleasure and motivation in major depressive disorder (MDD). Conceptually, the investigator will use a multi-measure approach, by studying basic brain responses to reward anticipation as well as higher-order aspects of reward processing necessary for decision-making. Methodologically, the investigator will combine fMRI, EEG, and behavioral assessment, to more fully characterize reward-related brain functions and their clinical correlates. In addition to evaluating reward effects between MDD and healthy controls (HC), the investigator will also focus on understanding the relationship between reward processing and clinical features of high relevance to depression, with an emphasis on suicidality.
Investigators
Susanna Fryer, PhD
Staff Psychologist/Clinician Investigator
San Francisco Veterans Affairs Medical Center
Eligibility Criteria
Inclusion Criteria
- •18-70 years with a diagnosis of major depressive disorder (MDD) for MDD group, or without for unaffected comparison (UC) group
- •Negative metal screen for MRI safety
- •Normal (or corrected to normal) vision
Exclusion Criteria
- •Past or present neurological problems (including seizures and head trauma resulting in neurological or cognitive symptoms)
- •Loss of consciousness (LOC) greater than 30 minutes or any LOC with neurologic symptoms
- •Major medical conditions (e.g., seizure disorders, treatment with anticonvulsant medication, endocrine disorders, significant cardiac pathology)
- •Substance dependence, within the past year, or failed urine toxicology on the day of neuroimaging sessions
- •Known claustrophobia
- •Current Pregnancy
- •IQ estimate \< 70
Outcomes
Primary Outcomes
fMRI response to win vs. loss reward feedback
Time Frame: 1 month (fMRI data)
fMRI response to win vs. loss reward feedback of reward-related brain activation patterns and EEG responses on participants
Late positive potential
Time Frame: 1 month (EEG measure of effective salience)
Late positive potential (EEG measure of affective salience) of reward-related brain activation patterns and EEG responses on participants
Stimulus preceding negativity
Time Frame: 1 month (EEG measure of reward anticipation)
Stimulus preceding negativity (EEG measure of reward anticipation) of reward-related brain activation patterns and EEG responses on participants
Reward positivity
Time Frame: 1 month (EEG measure of reward feedback)
Reward positivity (EEG measure of reward feedback) of reward-related brain activation patterns and EEG responses on participants