BACKGROUND Early childhood depression is associated with anhedonia and reduced event-related potential (ERP) responses to rewarding or pleasant stimuli. Whether these neural measures are indicators of target engagement or treatment outcome is not yet known. METHODS We measured ERP responses to win and loss feedback in a guessing task and to pleasant versus neutral pictures in young (4.0-6.9 years of age) depressed children before and after randomization to either 18 weeks of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) or waitlist. RESULTS Analyses included reward positivity (RewP) data from 118 children randomly assigned to PCIT-ED (n = 60) or waitlist (n = 58) at baseline and late positive potential (LPP) data from 99 children (44 assigned to PCIT-ED vs. 55 assigned to waitlist) at baseline. Children undergoing PCIT-ED showed a greater reduction in anhedonia (F1,103 = 10.32, p = .002, partial η2 = .09). RewP reward responses increased more (F1,86 = 5.98, p = .02, partial η2 = .07) for PCIT-ED, but a greater change in RewP was not significantly associated with a greater reduction in major depressive disorder symptoms (r = -.12, p > .4). Baseline RewP did not predict treatment change. LPPs to positive pictures did not change across treatment, but greater baseline LPPs to positive pictures predicted a higher likelihood of remission from major depressive disorder in children undergoing PCIT-ED (B = 0.14; SE = 0.07; odds ratio = 1.15; p = .03). CONCLUSIONS The ERP reward response improved in young children with depression during a treatment designed to enhance emotion development, providing evidence of target engagement of the neural systems associated with reward. Further, greater baseline LPP responses to positive pictures was associated with a greater likelihood of depression remission, suggesting that this ERP measure can predict which children are most likely to respond to treatment.

中文翻译：

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快感缺失的神经指标：儿童早期抑郁症随机临床试验中治疗变化的预测因素和机制

背景 儿童早期抑郁症与快感缺乏和对奖励或愉快刺激的事件相关电位 (ERP) 反应降低有关。这些神经测量是否是目标参与或治疗结果的指标尚不清楚。方法 我们测量了 ERP 对猜谜任务中的胜利和失败反馈以及年轻（4.0-6.9 岁）抑郁儿童在随机分配到 18 周的亲子互动治疗 - 情绪发展之前和之后对愉快与中性图片的反应。 PCIT-ED）或候补名单。结果 分析包括在基线时随机分配到 PCIT-ED（n = 60）或候补名单（n = 58）的 118 名儿童的奖励积极性 (RewP) 数据和来自 99 名儿童（44 名分配到 PCIT-ED）的晚期阳性电位 (LPP) 数据对比 55 分配到候补名单）在基线。接受 PCIT-ED 的儿童在快感缺乏方面表现出更大的减少（F1,103 = 10.32，p = .002，部分 η2 = .09）。对于 PCIT-ED，RewP 奖励反应增加更多（F1,86 = 5.98，p = .02，部分 η2 = .07），但 RewP 的更大变化与重度抑郁症症状的更大减少没有显着相关性（r = -.12，p > .4）。基线 RewP 不能预测治疗变化。LPP 与正面图片的变化在整个治疗过程中没有变化，但基线 LPP 与正面图片相比，预测接受 PCIT-ED 的儿童重度抑郁症缓解的可能性更高（B = 0.14；SE = 0.07；优势比 = 1.15；p = . 03)。结论 在旨在促进情绪发展的治疗期间，患有抑郁症的幼儿的 ERP 奖赏反应得到改善，提供与奖励相关的神经系统的目标参与的证据。此外，对积极图片的基线 LPP 反应越大，抑郁缓解的可能性越大，这表明这种 ERP 测量可以预测哪些儿童最有可能对治疗做出反应。