Transdiagnostic divergent neural development of reward anticipation in early adolescents at risk for depression and psychosis.

BACKGROUND

Reward anticipation is a transdiagnostic factor relevant to both depression and psychosis. Adolescence is a critical neurodevelopmental period when these reward-related circuits-including frontostriatal, limbic/insular, and striatal circuits may contribute to shared vulnerability across disorders, yet longitudinal transdiagnostic comparisons in early adolescents remain scarce.

METHODS

Longitudinal functional magnetic resonance imaging (fMRI) data acquired during the monetary incentive delay (MID) task were analyzed in 1839 adolescents from the Adolescent Brain Cognitive Development (ABCD) study, assessed at three time points over four years (baseline, 2- and 4-year follow-ups) and classified as a control group (HC; n = 1380; baseline Mage = 9.51, 47.0% girls), high-risk for depression (HR_Dep; n = 217; Mage = 9.49, 44.7% girls), high-risk for psychosis (HR_Psy; n = 202; Mage = 9.51, 47.5% girls), and combined risk groups (HR_Com; n = 40; Mage =9.45, 55.0% girls). Linear and quadratic within-group trajectories and between-group differences in activation and developmental slopes were assessed.

RESULTS

HC showed widespread linear increases in prefrontal, limbic/insular, and striatal regions (ps < 0.05), with neural activation changes in the left middle frontal gyrus and right accumbens following a quadratic trend (ps = 0.016-0.018). Compared with HC, HR_Dep exhibited progressive OFC activation and biphasic parahippocampal gyrus (ps < 0.020), HR_Psy showed reduced left NAcc (F = 5.77, p = 0.017), and HR_Com exhibited no significant longitudinal changes. Controls exhibited steeper longitudinal slopes than the HR_Dep and HR_Psy in the right suborbital sulcus, right subcallosal gyrus, and left nucleus accumbens (ps < 0.05).

CONCLUSION

High-risk adolescents primarily show disorder-specific reward anticipation abnormalities, with prefrontal-limbic imbalance in HR_Dep and striatal dysfunction in HR_Psy, while prefrontal deficits in HR_Com may index a shared transdiagnostic vulnerability across depressive and psychosis-spectrum risk.