Brain stimulation over the left DLPFC enhances motivation for effortful rewards in patients with major depressive disorder.

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  • Additional Information
    • Source:
      Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Netherlands NLM ID: 7906073 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2517 (Electronic) Linking ISSN: 01650327 NLM ISO Abbreviation: J Affect Disord Subsets: MEDLINE
    • Publication Information:
      Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press.
    • Subject Terms:
      Depressive Disorder, Major*/therapy ; Depressive Disorder, Major*/physiopathology ; Depressive Disorder, Major*/psychology ; Motivation*/physiology ; Reward* ; Transcranial Magnetic Stimulation* ; Dorsolateral Prefrontal Cortex*/physiology; Humans ; Male ; Female ; Adult ; Middle Aged ; Evoked Potentials/physiology ; Electroencephalography ; Attention/physiology
    • Abstract:
      Background: Amotivation is a typical feature in major depressive disorder (MDD), which produces reduced willingness to exert effort. The dorsolateral prefrontal cortex (DLPFC) is a crucial structure in goal-directed actions and therefore is a potential target in modulating effortful motivation. However, it remains unclear whether the intervention is effective for patients with MDD.
      Methods: We employed transcranial magnetic stimulation (TMS), computational modelling and event-related potentials (ERPs) to reveal the causal relationship between the left DLPFC and motivation for effortful rewards in MDD. Fifty patients underwent both active and sham TMS sessions, each followed by performing an Effort-Expenditure for Rewards Task, during which participants chose and implemented between low-effort/low-reward and high-effort/high-reward options.
      Results: The patients showed increased willingness to exert effort for rewards during the DLPFC facilitated session, compared with the sham session. They also had a trend in larger P3 amplitude for motivated attention toward chosen options, larger CNV during preparing for effort exertion, and larger SPN during anticipating a high reward. Besides, while behavior indexes for effortful choices were negatively related to depression severity in the sham session, this correlation was weakened in the active stimulation session.
      Conclusions: These findings provide behavioral, computational, and neural evidence for the left DLPFC on effortful motivation for rewards. Facilitated DLPFC improves motor preparation and value anticipation after making decisions especially for highly effortful rewards in MDD. Facilitated DLPFC also has a potential function in enhancing motivated attention during cost-benefit trade-off. This neuromodulation effect provides a potential treatment for improving motivation in clinics.
      Competing Interests: Declaration of competing interest The authors declare no conflict of interest.
      (Copyright © 2024 Elsevier B.V. All rights reserved.)
    • Contributed Indexing:
      Keywords: Brain stimulation; Computational model; Dorsolateral prefrontal cortex; Effort; Major depressive disorder; Motivation
    • Publication Date:
      Date Created: 20240419 Date Completed: 20240506 Latest Revision: 20240506
    • Publication Date:
      20240507
    • Accession Number:
      10.1016/j.jad.2024.04.064
    • Accession Number:
      38640975