Trauma impacts prospective relationships between reward-related ventral striatal and amygdala activation and 1-year future hypo/mania trajectories

Abstract Objective Trauma exposure is associated with a more severe, persistent course of affective and anxiety symptoms. Markers of reward neural circuitry function, specifically activation to reward prediction error[RPE], are impacted by trauma and predict future course of affective symptoms. This study’s purpose was to determine how lifetime trauma exposure influences relationships between reward neural circuitry function and the course of future affective and anxiety symptoms in a naturalistic, transdiagnostic observational context. Methods 59 young adults ages 18 to 25[48F/11M, 21.5±2.0yrs] experiencing psychological distress completed the study. Participants were evaluated at baseline, six, and twelve months. At baseline, participants reported lifetime trauma events and completed a monetary reward fMRI task. Affective and anxiety symptoms were reported at each visit and trajectories were calculated using MPlus. Neural activation during RPE and other phases of reward processing were determined using SPM8. Trauma and reward neural activation were entered as predictors of symptom trajectories. Results Trauma exposure moderated prospective relationships between left ventral striatum(β= -1.29,p=0.02) and right amygdala(β=0.58,p=0.04) activation to RPE and future hypo/mania severity trajectory: the interaction between greater trauma and greater left VS activation to RPE was associated with a shallower increase in hypo/mania severity whereas the interaction between greater trauma and greater right amygdala activation to RPE was associated with increasing hypo/mania severity. Discussion. Trauma exposure impacts prospective relationships between markers of reward circuitry function and affective symptom trajectories. Evaluating trauma exposure is thus critically important in naturalistic and treatment studies aiming to identify neural predictors of future affective symptom course.