Task-induced deactivation dysfunction during reward processing is associated with low self-esteem in a possible subtype of major depression

Introduction Low self-esteem is a frequent symptom in major depressive disorder (MDD). This functional magnetic resonance imaging study investigated whether MDD patients with low self-esteem show a distinct neural pathophysiology. Previous studies linked low self-esteem to reduced task-induced deact...

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Main Authors: Jüllig, Antonia (Author) , Hebib, Sandi (Author) , Metzker, Helena (Author) , Gruber, Eva Stefanie (Author) , Gruber, Oliver (Author)
Format: Article (Journal)
Language:English
Published: June 2024
In: Brain and behavior
Year: 2024, Volume: 14, Issue: 6, Pages: 1-11
ISSN:2162-3279
DOI:10.1002/brb3.3545
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1002/brb3.3545
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/brb3.3545
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Author Notes:Antonia K. Jüllig, Sandi Hebib, Helena Metzker, Eva Gruber, Oliver Gruber

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520 |a Introduction Low self-esteem is a frequent symptom in major depressive disorder (MDD). This functional magnetic resonance imaging study investigated whether MDD patients with low self-esteem show a distinct neural pathophysiology. Previous studies linked low self-esteem to reduced task-induced deactivation of the pregenual anterior cingulate cortex (pgACC) as a part of the default mode network, and to reduced connectivity between pgACC and reward system. Goya-Maldonado et al. identified an MDD subtype with pgACC and ventral striatal overactivations during reward processing. We hypothesized that this subtype might be characterized by low self-esteem. Methods Eighty-three MDD patients performed the desire-reason dilemma task and completed the Rosenberg Self-Esteem Scale (RSES). Brain activity during bottom-up reward processing was regressed upon the RSES scores, controlling for depression severity measured by the Montgomery-Åsberg Depression Rating Scale. To corroborate the findings, we compared self-esteem scores between patient subgroups with impaired task-induced deactivation (n = 31) and with preserved task-induced deactivation (n = 31) of the pgACC. Results Consistent with our a priori hypothesis, activity in a bilateral fronto-striatal network including pgACC and ventral striatum correlated negatively with RSES scores, also when controlling for depression severity. In the additional analysis, patients with impaired task-induced pgACC deactivation showed lower self-esteem (t (52.82) = −2.27; p = .027, d = 0.58) compared to those with preserved task-induced pgACC deactivation. Conclusions We conclude that low self-esteem in MDD patients is linked to a task-induced deactivation dysfunction of the pgACC. Our findings suggest that a previously described possible subtype of MDD with pgACC and ventral striatal overactivations during reward processing is clinically characterized by low self-esteem. 
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