Description: Many neuroimaging studies have investigated reward processing dysfunction in major depressive disorder (MDD). These studies have led to the common idea that MDD is associated with blunted reward-related responses, particularly in the ventral striatum (VS). Yet, the link between MDD and reward-related responses in other regions remains inconclusive, thus limiting our understanding of the pathophysiology of MDD. To address this issue, we performed a coordinate-based meta-analysis of 41 neuroimaging studies encompassing reward-related responses from a total of 794 patients with MDD and 803 healthy controls. Our findings argue against the idea that MDD is linked to a monolithic deficit within the reward system. Instead, our results demonstrate that MDD is associated with opposing abnormalities in the reward circuit: hypo-responses in the VS and hyper-responses in the orbitofrontal cortex. These findings help to reconceptualize our understanding of reward processing abnormalities in MDD and suggest a role for dysregulated corticostriatal connectivity.
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