Neural Indicators of Anhedonia: Predictors and Mechanisms of Treatment Change in a Randomized Clinical Trial in Early Childhood Depression

Deanna M Barch; Diana Whalen; Kirsten Gilbert; Danielle Kelly; Emily S Kappenman; Greg Hajcak; Joan L Luby

doi:10.1016/j.biopsych.2020.06.032

Neural Indicators of Anhedonia: Predictors and Mechanisms of Treatment Change in a Randomized Clinical Trial in Early Childhood Depression

Biol Psychiatry. 2020 Dec 1;88(11):879-887. doi: 10.1016/j.biopsych.2020.06.032.

Authors

Deanna M Barch¹, Diana Whalen², Kirsten Gilbert², Danielle Kelly², Emily S Kappenman³, Greg Hajcak⁴, Joan L Luby²

Affiliations

¹ Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri; Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri; Department of Radiology, Washington University in St. Louis, St. Louis, Missouri. Electronic address: dbarch@wustl.edu.
² Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri.
³ Department of Psychology, San Diego State University, San Diego, California.
⁴ Department of Biomedical Science and Psychology, Florida State University, Tallahassee, Florida.

PMID: 33153527
DOI: 10.1016/j.biopsych.2020.06.032

Abstract

Background: Early childhood depression is associated with anhedonia and reduced event-related potential (ERP) responses to rewarding or pleasant stimuli. Whether these neural measures are indicators of target engagement or treatment outcome is not yet known.

Methods: We measured ERP responses to win and loss feedback in a guessing task and to pleasant versus neutral pictures in young (4.0-6.9 years of age) depressed children before and after randomization to either 18 weeks of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) or waitlist.

Results: Analyses included reward positivity (RewP) data from 118 children randomly assigned to PCIT-ED (n = 60) or waitlist (n = 58) at baseline and late positive potential (LPP) data from 99 children (44 assigned to PCIT-ED vs. 55 assigned to waitlist) at baseline. Children undergoing PCIT-ED showed a greater reduction in anhedonia (F_1,103 = 10.32, p = .002, partial η² = .09). RewP reward responses increased more (F_1,86 = 5.98, p = .02, partial η² = .07) for PCIT-ED, but a greater change in RewP was not significantly associated with a greater reduction in major depressive disorder symptoms (r = -.12, p > .4). Baseline RewP did not predict treatment change. LPPs to positive pictures did not change across treatment, but greater baseline LPPs to positive pictures predicted a higher likelihood of remission from major depressive disorder in children undergoing PCIT-ED (B = 0.14; SE = 0.07; odds ratio = 1.15; p = .03).

Conclusions: The ERP reward response improved in young children with depression during a treatment designed to enhance emotion development, providing evidence of target engagement of the neural systems associated with reward. Further, greater baseline LPP responses to positive pictures was associated with a greater likelihood of depression remission, suggesting that this ERP measure can predict which children are most likely to respond to treatment.

Trial registration: ClinicalTrials.gov NCT02076425.

Keywords: Anhedonia; Clinical trial; Depression; ERP; Preschool; Reward.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural

MeSH terms

Anhedonia*
Child
Child, Preschool
Depression / therapy
Depressive Disorder, Major* / therapy
Evoked Potentials
Humans
Infant
Reward

Associated data

ClinicalTrials.gov/NCT02076425

Abstract

Publication types

MeSH terms

Associated data

Grants and funding