Key result
Reduced pupil dilation during reward anticipation was negatively correlated with depressive symptom load (r = -0.44) and specifically with anhedonia items in patients with major depressive disorder.
Why the study?
Major depressive disorder has no approved biomarkers, and findings identifying anticipatory hypo-arousal indexed by pupil responses required replication and extension.
Does pupil dilation during reward anticipation correlate with anhedonia in unmedicated patients with major depressive disorder?
Observational (n=136)
No
Does pupil dilation during reward anticipation correlate with anhedonia in unmedicated patients with major depressive disorder?
Effect estimate: r = -0.44
p-value: p=BF(-) = 2999
Pupillometry during reward anticipation can index noradrenergically mediated hypo-arousal, which correlates with anhedonia in major depressive disorder.
Replication supports pupil-indexed anticipatory hypo-arousal as MDD correlate; leaves open biomarker validation in prospective trials.
Major depressive disorder (MDD) is a devastating and heterogenous disorder for which there are no approved biomarkers in clinical practice. We recently identified anticipatory hypo-arousal indexed by pupil responses as a candidate mechanism subserving depression symptomatology. Here, we conducted a replication and extension study of these findings. We analyzed a replication sample of 40 unmedicated patients with a diagnosis of depression and 30 healthy control participants, who performed a reward anticipation task while pupil responses were measured. Using a Bayesian modelling approach taking measurement uncertainty into account, we could show that the negative correlation between pupil dilation and symptom load during reward anticipation is replicable within MDD patients, albeit with a lower effect size. Furthermore, with the combined sample of 136 participants (81 unmedicated depressed and 55 healthy control participants), we further showed that reduced pupil dilation in anticipation of reward is inversely associated with anhedonia items of the Beck Depression Inventory in particular. Moreover, using simultaneous fMRI, particularly the right anterior insula as part of the salience network was negatively correlated with depressive symptom load in general and anhedonia items specifically. The present study supports the utility of pupillometry in assessing noradrenergically mediated hypo-arousal during reward anticipation in MDD, a physiological process that appears to subserve anhedonia.
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Brendler et al. (2024) conducted an observational in Major Depressive Disorder (n=136). Pupil dilation during reward anticipation vs. Healthy controls was evaluated on Correlation between pupil dilation during reward anticipation and depressive symptom load (r = -0.44, p=BF(-) = 2999). Reduced pupil dilation during reward anticipation was negatively correlated with depressive symptom load (r = -0.44) and specifically with anhedonia items in patients with major depressive disorder.
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