It still hurts: altered endogenous opioid activity in the brain during social rejection and acceptance in major depressive disorder

The μ-opioid receptor (MOR) system, well known for dampening physical pain, is also hypothesized to dampen 'social pain.' We used positron emission tomography scanning with the selective MOR radioligand [(11)C]carfentanil to test the hypothesis that MOR system activation (reflecting endoge...

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Bibliographic Details
Published in:Molecular psychiatry 2015-02, Vol.20 (2), p.193-200
Main Authors: Hsu, D T, Sanford, B J, Meyers, K K, Love, T M, Hazlett, K E, Walker, S J, Mickey, B J, Koeppe, R A, Langenecker, S A, Zubieta, J-K
Format: Article
Language:English
Subjects:
Adult
Analgesics, Opioid - pharmacokinetics
Brain - diagnostic imaging
Brain - drug effects
Brain - metabolism
Carbon Radioisotopes - pharmacokinetics
Depressive Disorder, Major - pathology
Depressive Disorder, Major - psychology
Diagnosis
Drug therapy
Emission analysis
Emotions
Feedback
Female
Fentanyl - analogs & derivatives
Fentanyl - pharmacokinetics
Health aspects
Humans
Hydrocortisone - blood
Hypotheses
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Major depressive disorder
Male
Menstruation
Mental depression
Mood
Motivation
Narcotics
Nucleus accumbens
Opioid receptors
Opioids
Pain
PET imaging
Positron emission tomography
Protein Binding - drug effects
Psychiatric Status Rating Scales
Psychiatry
Radiography
Ratings & rankings
Receptors, Opioid, mu - metabolism
Reinforcement
Risk factors
Self esteem
Social Distance
Social Facilitation
Social interaction
Social interactions
Tomography
Young Adult
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Summary:The μ-opioid receptor (MOR) system, well known for dampening physical pain, is also hypothesized to dampen 'social pain.' We used positron emission tomography scanning with the selective MOR radioligand [(11)C]carfentanil to test the hypothesis that MOR system activation (reflecting endogenous opioid release) in response to social rejection and acceptance is altered in medication-free patients diagnosed with current major depressive disorder (MDD, n=17) compared with healthy controls (HCs, n=18). During rejection, MDD patients showed reduced endogenous opioid release in brain regions regulating stress, mood and motivation, and slower emotional recovery compared with HCs. During acceptance, only HCs showed increased social motivation, which was positively correlated with endogenous opioid release in the nucleus accumbens, a reward structure. Altered endogenous opioid activity in MDD may hinder emotional recovery from negative social interactions and decrease pleasure derived from positive interactions. Both effects may reinforce depression, trigger relapse and contribute to poor treatment outcomes.
ISSN:1359-4184
1476-5578
DOI:10.1038/mp.2014.185