Effects of gonadal steroids on reward circuitry function and anhedonia in women with a history of postpartum depression

• Published in: Journal of affective disorders 2022-10, Vol.314, p.176-184
• Main Authors: Schiller, C.E., Walsh, E., Eisenlohr-Moul, T.A., Prim, J., Dichter, G.S., Schiff, L., Bizzell, J., Slightom, S.L., Richardson, E.C., Belger, A., Schmidt, P., Rubinow, D.R.
• Format: Article
• Language: English
• Subjects: Anhedonia; Anhedonia - physiology; Brain - diagnostic imaging; Brain Mapping; Depression; Depression, Postpartum - diagnostic imaging; Estrogen; Female; fMRI; Humans; Magnetic Resonance Imaging; Postpartum; Pregnancy; Progesterone; Reward
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2022.06.078

Reward system dysfunction is evident across neuropsychiatric conditions. Here we present data from a double-blinded pharmaco-fMRI study investigating the triggering of anhedonia and reward circuit activity in women. The hormonal states of pregnancy and parturition were simulated in euthymic women with a history of postpartum depression (PPD+; n = 15) and those without such a history (PPD−; n = 15) by inducing hypogonadism, adding back estradiol and progesterone for 8 weeks (“addback”), and then withdrawing both steroids (“withdrawal”). Anhedonia was assessed using the Inventory of Depression and Anxiety Symptoms (IDAS) during each hormone phase. Those who reported a 30 % or greater increase in IDAS anhedonia, dysphoria, or ill temper during addback or withdrawal, compared with pre-treatment, were identified as hormone sensitive (HS+) and all others were identified as non-hormone sensitive (HS−). The monetary incentive delay (MID) task was administered during fMRI sessions at pre-treatment and during hormone withdrawal to assess brain activation during reward anticipation and feedback. On average, anhedonia increased during addback and withdrawal in PPD+ but not PPD−. During reward feedback, both HS+ (n = 10) and HS− (n = 18) showed decreased activation in clusters in the right putamen (p