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Differential frontal–striatal and paralimbic activity during reversal learning in major depressive disorder and obsessive–compulsive disorder

Published online by Cambridge University Press:  27 January 2009

P. L. Remijnse ,
M. M. A. Nielen ,
A. J. L. M. van Balkom ,
G.-J. Hendriks ,
W. J. Hoogendijk ,
H. B. M. Uylings  and
D. J. Veltman
P. L. Remijnse*
Affiliation:
Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands Amsterdam, The Netherlands
M. M. A. Nielen
Affiliation:
Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
A. J. L. M. van Balkom
Affiliation:
Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands Out-patient Academic Clinic for Anxiety and Mood Disorders, GGZ Buitenamstel, Amsterdam, The Netherlands
G.-J. Hendriks
Affiliation:
Out-patient Clinic for Anxiety Disorders, GGZ Nijmegen, The Netherlands Department of Psychiatry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
W. J. Hoogendijk
Affiliation:
Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands Out-patient Academic Clinic for Anxiety and Mood Disorders, GGZ Buitenamstel, Amsterdam, The Netherlands
H. B. M. Uylings
Affiliation:
Amsterdam, The Netherlands Department of Anatomy and Neuroscience, VU University Medical Center, Amsterdam, The Netherlands School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, University of Maastricht, The Netherlands
D. J. Veltman
Affiliation:
Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands Amsterdam, The Netherlands Out-patient Academic Clinic for Anxiety and Mood Disorders, GGZ Buitenamstel, Amsterdam, The Netherlands
*
*Address for correspondence: P. L. Remijnse, M.D., VU University Medical Center, Department of Anatomy and Neurosciences, room G102B, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. (Email: [email protected])
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Abstract

Background

Several lines of research suggest a disturbance of reversal learning (reward and punishment processing, and affective switching) in patients with major depressive disorder (MDD). Obsessive–compulsive disorder (OCD) is also characterized by abnormal reversal learning, and is often co-morbid with MDD. However, neurobiological distinctions between the disorders are unclear. Functional neuroimaging (activation) studies comparing MDD and OCD directly are lacking.

Method

Twenty non-medicated OCD-free patients with MDD, 20 non-medicated MDD-free patients with OCD, and 27 healthy controls performed a self-paced reversal learning task in an event-related design during functional magnetic resonance imaging (fMRI).

Results

Compared with healthy controls, both MDD and OCD patients displayed prolonged mean reaction times (RTs) but normal accuracy. In MDD subjects, mean RTs were correlated with disease severity. Imaging results showed MDD-specific hyperactivity in the anterior insula during punishment processing and in the putamen during reward processing. Moreover, blood oxygen level-dependent (BOLD) responses in the dorsolateral prefrontal cortex (DLPFC) and the anterior PFC during affective switching showed a linear decrease across controls, MDD and OCD. Finally, the OCD group showed blunted responsiveness of the orbitofrontal (OFC)–striatal loop during reward, and in the OFC and anterior insula during affective switching.

Conclusions

This study shows frontal–striatal and (para)limbic functional abnormalities during reversal learning in MDD, in the context of generic psychomotor slowing. These data converge with currently influential models on the neuropathophysiology of MDD. Moreover, this study reports differential neural patterns in frontal–striatal and paralimbic structures on this task between MDD and OCD, confirming previous findings regarding the neural correlates of deficient reversal learning in OCD.

Keywords

Functional MRImajor depressive disorderobsessive–compulsive disorderorbitofrontal cortexreversal learning
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 9 , September 2009 , pp. 1503 - 1518
Copyright
Copyright © 2009 Cambridge University Press

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