Neuropsychiatric Disease and Treatment (Jul 2022)
Anhedonia in Depression and Schizophrenia: Brain Reward and Aversion Circuits
Abstract
Sugai Liang,1,* Yue Wu,1,* Li Hanxiaoran,1,* Andrew J Greenshaw,2 Tao Li1 1Affiliated Mental Health Centre & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, People’s Republic of China; 2Department of Psychiatry, University of Alberta, Edmonton, AB, T6G 2B7, Canada*These authors contributed equally to this workCorrespondence: Tao Li, Affiliated Mental Health Centre & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310013, Zhejiang, People’s Republic of China, Tel +86 571 85126501, Fax +86 571 85121532, Email [email protected]: Anhedonia, which is defined as markedly diminished interest or pleasure, is a prominent symptom of psychiatric disorders, most notably major depressive disorder (MDD) and schizophrenia. Anhedonia is considered a transdiagnostic symptom that is associated with deficits in neural reward and aversion functions. Here, we review the characteristics of anhedonia in depression and schizophrenia as well as shared or disorder-specific anhedonia-related alterations in reward and aversion pathways of the brain. In particular, we highlight that anhedonia is characterized by impairments in anticipatory pleasure and integration of reward-related information in MDD, whereas anhedonia in schizophrenia is associated with neurocognitive deficits in representing the value of rewards. Dysregulation of the frontostriatal circuit and mesocortical and mesolimbic circuit systems may be the transdiagnostic neurobiological basis of reward and aversion impairments underlying anhedonia in these two disorders. Blunted aversion processing in depression and relatively strong aversion in schizophrenia are primarily attributed to the dysfunction of the habenula, insula, amygdala, and anterior cingulate cortex. Furthermore, patients with schizophrenia appear to exhibit greater abnormal activation and extended functional coupling than those with depression. From a transdiagnostic perspective, understanding the neural mechanisms underlying anhedonia in patients with psychiatric disorders may help in the development of more targeted and efficacious treatment and intervention strategies.Keywords: anhedonia, reward pathway, aversion circuit, depression, schizophrenia
