Decision value signals in the ventromedial prefrontal cortex and anhedonia across mood and psychotic disorders
AbstractBackgroundAnhedonia, or diminished pleasure, is a prominent symptom in mood and psychotic disorders. Anticipatory pleasure is particularly impaired in these conditions, which may be reflected in blunted activity in the fronto-striatal circuitry during evaluation of future rewards. This study examined the neural correlates of anhedonia during decision-making across mood and psychotic disorders.MethodsAnalyses included 81 adults with major depression (N=17), bipolar disorder (in depressed state, N=21), schizophrenia (N=23), or no history of psychopathology (N=20). Participants performed a delay discounting paradigm while functional imaging data were acquired at 3T. We examined the relationship between anhedonia and activity in two a priori regions of interest critical for valuation, the ventromedial prefrontal cortex (vmPFC) and ventral striatum. Anhedonia was measured using a semi-structured clinical interview; cognition, depression, and symptoms of psychosis were also evaluated.ResultsDiscounting behavior did not differ as function of primary diagnosis or level of anhedonia (F(3,77) = 0.28, p = 0.84; r = 0.03, p = 0.78). Value-related activity in the vmPFC was blunted in association with anhedonia (β = −0.27; 95% CI, −0.48 to −0.06; p = 0.01). This relationship remained significant while controlling for primary diagnosis, behavioral performance, cognitive functioning, smoking, depression severity, and both positive and negative symptoms of schizophrenia.ConclusionsHypofunction in the vmPFC during decision-making about future rewards is specifically linked to anhedonia, rather than a general feature of psychopathology. These findings help elucidate the pathophysiological underpinnings of anhedonia across mood and psychotic disorders and inform the development of novel treatment approaches.