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Biol Psychiatry Cogn Neurosci Neuroimaging. 2019 Nov;4(11):966-974. doi: 10.1016/j.bpsc.2019.06.014. Epub 2019 Jul 10.

Reward-Related Striatal Responses Following Stress in Healthy Individuals and Patients With Bipolar Disorder.

Author information

1
Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: j.vanleeuwen@donders.ru.nl.
2
Department of Experimental Psychology, Utrecht University, Utrecht, the Netherlands.
3
Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands; University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
4
Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.
5
Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
6
Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Psychiatry/GGZ InGeest, Amsterdam UMC (location VUmc), Amsterdam, the Netherlands; Department of Anatomy and Neurosciences, Amsterdam UMC (location VUmc), Amsterdam, the Netherlands.

Abstract

BACKGROUND:

Stress has a major impact on the onset and recurrence of mood episodes in bipolar disorder (BD), but the underlying mechanisms remain unknown. Previous studies have shown distinct time-dependent effects of stress on reward processing in healthy individuals. Impaired reward processing is a core characteristic of BD, and altered reward processing during recovery from stress could influence the development and course of bipolar disorder.

METHODS:

We investigated brain responses during reward processing 50 minutes after stress using functional magnetic resonance imaging in 40 healthy control subjects and 40 patients with euthymic BD assigned to either an acute stress test (Trier Social Stress Test) or a no-stress condition.

RESULTS:

Acute stress increased cortisol levels in both healthy control subjects and patients with BD. Ventral striatal responses to reward outcome were increased in healthy control subjects during stress recovery but not in patients with BD. For anticipation, no differences were found between the groups following stress.

CONCLUSIONS:

For the first time, we show altered reward processing in patients with BD during the recovery phase of stress. These data suggest reduced neural flexibility of hedonic signaling in response to environmental challenges. This may increase the susceptibility to stressful life events in the future and play a role in the development of further psychopathology in the longer term.

KEYWORDS:

Bipolar disorder; Cortisol; Imaging; Reward; Stress; Trier Social Stress Test

PMID:
31471186
DOI:
10.1016/j.bpsc.2019.06.014

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