1
|
Giuliani L, Pezzella P, Giordano GM, Fazio L, Mucci A, Perrottelli A, Blasi G, Amore M, Rocca P, Rossi A, Bertolino A, Galderisi S, Maj M. Illness-related variables and abnormalities of resting-state brain activity in schizophrenia. Front Psychiatry 2024; 15:1458624. [PMID: 39165501 PMCID: PMC11333936 DOI: 10.3389/fpsyt.2024.1458624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 07/17/2024] [Indexed: 08/22/2024] Open
Abstract
Background The development of neuroimaging biomarkers in patients with schizophrenia (SCZ) requires a refined clinical characterization. A limitation of the neuroimaging literature is the partial uptake of progress in characterizing disease-related features, particularly negative symptoms (NS) and cognitive impairment (CI). In the present study, we assessed NS and CI using up-to-date instruments and investigated the associations of abnormalities in brain resting-state (rs)-activity with disease-related features. Methods Sixty-two community-dwelling SCZ subjects participated in the study. Multiple regression analyses were performed with the rs-activity of nine regions of interest as dependent variables and disease-related features as explanatory variables. Results Attention/vigilance deficits were negatively associated with dorsal anterior cingulate rs-activity and, together with depression, were positively associated with right dorsolateral prefrontal cortex rs-activity. These deficits and impairment of Reasoning/problem-solving, together with conceptual disorganization, were associated with right inferior parietal lobule and temporal parietal junction rs-activity. Independent of other features, the NS Expressive Deficit domain was associated with the left ventral caudate, while the Motivational Deficit was associated with the dorsal caudate rs-activity. Conclusion Neurocognitive deficits and the two negative symptom domains are associated with different neural markers. Replications of these findings could foster the identification of clinically actionable biomarkers of poor functional outcomes.
Collapse
Affiliation(s)
- Luigi Giuliani
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | - Leonardo Fazio
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, Bari, Italy
- Department of Medicine and Surgery, Libera Università Mediterranea Giuseppe Degennaro, Casamassima, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Andrea Perrottelli
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giuseppe Blasi
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, Bari, Italy
| | - Mario Amore
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L’Aquila, L’Aquila, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, Bari, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| |
Collapse
|
2
|
Akgül Ö, Fide E, Özel F, Alptekin K, Bora E, Akdede BB, Yener G. Enhanced Punishment Responses in Patients With Schizophrenia: An Event-Related Potential Study. Clin EEG Neurosci 2024; 55:219-229. [PMID: 37563908 DOI: 10.1177/15500594231190966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
It is well known that abnormal reward processing is a characteristic feature of various psychopathologies including schizophrenia. Reduced reward anticipation has been suggested as a core symptom of schizophrenia. The Monetary Incentive Delay Task (MID) is frequently used to detect reward anticipation. The present study aims to evaluate the amplitude and latency of event-related potential (ERP) P300 in patients with schizophrenia (SCH) compared to healthy controls during the MID task. Twenty patients with SCH and 21 demographically matched healthy controls (HC) were included in the study. ERP P300 amplitude and latency values were compared between groups using an MID task in which reward and loss cues were presented. Relations between P300 and clinical facets were investigated in the patient group. SCH group had enhanced mean P300 amplitudes and delayed peak latency in the punishment condition compared with HC. These higher responses were also associated with negative symptoms. SCH group showed altered reward processing as being more sensitive to loss of reward conditions as firstly evidenced by electrophysiological methods, possibly due to abnormality in various systems including social withdrawal, social defeat, and behavioral inhibition system.
Collapse
Affiliation(s)
- Özge Akgül
- Faculty of Arts and Sciences, Department of Psychology, Izmir Democracy University, Izmir, Turkey
| | - Ezgi Fide
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
| | - Fatih Özel
- Department of Organismal Biology, Uppsala University, Uppsala, Sweden
| | - Köksal Alptekin
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Emre Bora
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Berna Binnur Akdede
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Görsev Yener
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Neurology, Izmir University of Economics, Izmir, Turkey
- Izmir International Biomedicine and Genome Institute, Dokuz Eylül University, Izmir, Turkey
| |
Collapse
|
3
|
Dark F, Galloway G, Gray M, Cella M, De Monte V, Gore-Jones V, Ritchie G. Reward Learning as a Potential Mechanism for Improvement in Schizophrenia Spectrum Disorders Following Cognitive Remediation: Protocol for a Clinical, Nonrandomized, Pre-Post Pilot Study. JMIR Res Protoc 2024; 13:e52505. [PMID: 38252470 PMCID: PMC10845020 DOI: 10.2196/52505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/23/2023] [Accepted: 12/04/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Cognitive impairment is common with schizophrenia spectrum disorders. Cognitive remediation (CR) is effective in improving global cognition, but not all individuals benefit from this type of intervention. A better understanding of the potential mechanism of action of CR is needed. One proposed mechanism is reward learning (RL), the cognitive processes responsible for adapting behavior following positive or negative feedback. It is proposed that the structure of CR enhances RL and motivation to engage in increasingly challenging tasks, and this is a potential mechanism by which CR improves cognitive functioning in schizophrenia. OBJECTIVE Our primary objective is to examine reward processing in individuals with schizophrenia before and after completing CR and to compare this with a group of matched clinical controls. We will assess whether RL mediates the relationship between CR and improved cognitive function and reduced negative symptoms. Potential differences in social RL and nonsocial RL in individuals with schizophrenia will also be investigated and compared with a healthy matched control group. METHODS We propose a clinical, nonrandomized, pre-post pilot study comparing the impact of CR on RL and neurocognitive outcomes. The study will use a combination of objective and subjective measures to assess neurocognitive, psychiatric symptoms, and neurophysiological domains. A total of 40 individuals with schizophrenia spectrum disorders (aged 18-35 years) will receive 12 weeks of CR therapy (n=20) or treatment as usual (n=20). Reward processing will be evaluated using a reinforcement learning task with 2 conditions (social reward vs nonsocial reward) at baseline and the 12-week follow-up. Functional magnetic resonance imaging responses will be measured during this task. To validate the reinforcement learning task, RL will also be assessed in 20 healthy controls, matched for age, sex, and premorbid functioning. Mixed-factorial ANOVAs will be conducted to evaluate treatment group differences. For the functional magnetic resonance imaging analysis, computational modeling will allow the estimation of learning parameters at each point in time, during each task condition, for each participant. We will use a variational Bayesian framework to measure how learning occurred during the experimental task and the subprocesses that underlie this learning. Second-level group analyses will examine how learning in patients differs from that observed in control participants and how CR alters learning efficiency and the underlying neural activity. RESULTS As of September 2023, this study has enrolled 15 participants in the CR group, 1 participant in the treatment-as-usual group, and 11 participants in the healthy control group. Recruitment is expected to be completed by September 2024. Data analysis is expected to be completed and published in early 2025. CONCLUSIONS The results of this study will contribute to the knowledge of CR and RL processes in severe mental illness and the understanding of the systems that impact negative symptoms and cognitive impairments within this population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52505.
Collapse
Affiliation(s)
- Frances Dark
- Metro South Addiction and Mental Health Services, Woolloongabba, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Graham Galloway
- Translational Research Institute, Woolloongabba, Australia
- Herston Imaging Research Facility, The University of Queensland, Brisbane, Australia
| | - Marcus Gray
- Translational Research Institute, Woolloongabba, Australia
| | | | - Veronica De Monte
- Metro South Addiction and Mental Health Services, Woolloongabba, Australia
| | | | - Gabrielle Ritchie
- Metro South Addiction and Mental Health Services, Woolloongabba, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| |
Collapse
|
4
|
Yang X, Song Y, Zou Y, Li Y, Zeng J. Neural correlates of prediction error in patients with schizophrenia: evidence from an fMRI meta-analysis. Cereb Cortex 2024; 34:bhad471. [PMID: 38061699 DOI: 10.1093/cercor/bhad471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 01/19/2024] Open
Abstract
Abnormal processes of learning from prediction errors, i.e. the discrepancies between expectations and outcomes, are thought to underlie motivational impairments in schizophrenia. Although dopaminergic abnormalities in the mesocorticolimbic reward circuit have been found in patients with schizophrenia, the pathway through which prediction error signals are processed in schizophrenia has yet to be elucidated. To determine the neural correlates of prediction error processing in schizophrenia, we conducted a meta-analysis of whole-brain neuroimaging studies that investigated prediction error signal processing in schizophrenia patients and healthy controls. A total of 14 studies (324 schizophrenia patients and 348 healthy controls) using the reinforcement learning paradigm were included. Our meta-analysis showed that, relative to healthy controls, schizophrenia patients showed increased activity in the precentral gyrus and middle frontal gyrus and reduced activity in the mesolimbic circuit, including the striatum, thalamus, amygdala, hippocampus, anterior cingulate cortex, insula, superior temporal gyrus, and cerebellum, when processing prediction errors. We also found hyperactivity in frontal areas and hypoactivity in mesolimbic areas when encoding prediction error signals in schizophrenia patients, potentially indicating abnormal dopamine signaling of reward prediction error and suggesting failure to represent the value of alternative responses during prediction error learning and decision making.
Collapse
Affiliation(s)
- Xun Yang
- School of Public Policy and Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
| | - Yuan Song
- School of Public Policy and Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
| | - Yuhan Zou
- School of Economics and Business Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
| | - Yilin Li
- Psychology and Neuroscience Department, University of St Andrews, Forbes 1 DRA, Buchanan Garden, St Andrews, Fife, United Kingdom
| | - Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, No. 174, Shazhengjie, Shapingba, Chongqing, China
| |
Collapse
|
5
|
Akgül Ö, Fide E, Özel F, Alptekin K, Bora E, Akdede BB, Yener G. Reduced Reward Processing in Schizophrenia: A Comprehensive EEG Event-Related Oscillation Study. Brain Topogr 2024; 37:126-137. [PMID: 38078985 DOI: 10.1007/s10548-023-01021-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/03/2023] [Indexed: 01/07/2024]
Abstract
It is well known that abnormal reward processing is a characteristic feature of various psychopathologies including schizophrenia (SZ). Reduced reward anticipation has been suggested as a core symptom of SZ. The present study aims to evaluate the event-related oscillations (EROs) delta, theta, alpha, beta, and gamma in patients with SZ during the Monetary Incentive Delay (MID) task, which elicits the neural activity of reward processing. Twenty-one patients with SZ and twenty-two demographically matched healthy controls were included in the study. EROs were compared between groups and correlation analyses were conducted to determine a possible relationship between clinical scores and ERO values. Compared with healthy controls, the SZ group had reduced (1) delta and theta amplitudes in the reward condition (2) total beta and non-incentive cue-related beta amplitudes, and (3) incentive cue-related frontal gamma amplitudes. These reductions can be interpreted as impaired dopaminergic neurotransmission and disrupted cognitive functioning in the reward processing of SZ. In contrast, SZ patients showed higher incentive cue-related theta and occipital gamma amplitudes compared to controls. These increments may reflect negative symptoms in SZ. Moreover, theta amplitudes showed a negative correlation with Calgary Depression Scale for Schizophrenia scores and a positive correlation with attentional impulsivity. This is the first study showing the impairments of SZ patients in EROs from delta to gamma frequency bands compared with healthy controls during reward anticipation. Being the first comprehensive study, our results can be interpreted as providing evidence for disrupted brain dynamics in the reward processing of SZ studied by EROs. It may become possible to help patients' wellness by improving our understanding of reward processing in schizophrenia and developing innovative rehabilitation treatments based on these findings.
Collapse
Affiliation(s)
- Özge Akgül
- Department of Psychology, Faculty of Arts and Sciences, İzmir Democracy University, Izmir, Turkey
| | - Ezgi Fide
- Department of Neurosciences, Dokuz Eylul University, Izmir, Turkey
| | - Fatih Özel
- Department of Organismal Biology, Uppsala University, Uppsala, Sweden
| | - Köksal Alptekin
- Department of Neurosciences, Dokuz Eylul University, Izmir, Turkey
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Emre Bora
- Department of Neurosciences, Dokuz Eylul University, Izmir, Turkey
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Berna Binnur Akdede
- Department of Neurosciences, Dokuz Eylul University, Izmir, Turkey
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Görsev Yener
- Department of Neurosciences, Dokuz Eylul University, Izmir, Turkey.
- Department of Neurology, Faculty of Medicine, İzmir University of Economics, Izmir, Turkey.
- Izmir International Biomedicine and Genome Institute, Izmir, Turkey.
| |
Collapse
|
6
|
Wang X, Zhang Y, Huang J, Wang Y, Niu Y, Lui SSY, Hui L, Chan RCK. Revisiting reward impairments in schizophrenia spectrum disorders: a systematic review and meta-analysis for neuroimaging findings. Psychol Med 2023; 53:7189-7202. [PMID: 36994747 DOI: 10.1017/s0033291723000703] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
BACKGROUND Abnormal reward functioning is central to anhedonia and amotivation symptoms of schizophrenia (SCZ). Reward processing encompasses a series of psychological components. This systematic review and meta-analysis examined the brain dysfunction related to reward processing of individuals with SCZ spectrum disorders and risks, covering multiple reward components. METHODS After a systematic literature search, 37 neuroimaging studies were identified and divided into four groups based on their target psychology components (i.e. reward anticipation, reward consumption, reward learning, effort computation). Whole-brain Seed-based d Mapping (SDM) meta-analyses were conducted for all included studies and each component. RESULTS The meta-analysis for all reward-related studies revealed reduced functional activation across the SCZ spectrum in the striatum, orbital frontal cortex, cingulate cortex, and cerebellar areas. Meanwhile, distinct abnormal patterns were found for reward anticipation (decreased activation of the cingulate cortex and striatum), reward consumption (decreased activation of cerebellum IV/V areas, insula and inferior frontal gyri), and reward learning processing (decreased activation of the striatum, thalamus, cerebellar Crus I, cingulate cortex, orbitofrontal cortex, and parietal and occipital areas). Lastly, our qualitative review suggested that decreased activation of the ventral striatum and anterior cingulate cortex was also involved in effort computation. CONCLUSIONS These results provide deep insights on the component-based neuro-psychopathological mechanisms for anhedonia and amotivation symptoms of the SCZ spectrum.
Collapse
Affiliation(s)
- Xuan Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yinghao Zhang
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yanzhe Niu
- Department of Psychology, University of California, San Diego, La Jolla, USA
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Li Hui
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
7
|
Prasannakumar A, Kumar V, Rao NP. Trust and psychosis: a systematic review and meta-analysis. Psychol Med 2023; 53:5218-5226. [PMID: 35975354 DOI: 10.1017/s0033291722002562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Impaired trust in other humans is commonly seen in psychosis and it leads to poor societal functioning. However, examining trust behavior in an experimental setting is challenging. Investigators have used the trust game, a neuro-economic game to assess trust behavior in psychosis. However, the findings are inconsistent. Hence, we systematically reviewed the existing literature and conducted a meta-analysis to examine trust behavior in patients with psychosis, their relatives, and those at high risk for psychosis. METHODS We searched electronic databases for studies that have examined trust game in patients with psychosis, published up to November 2021. The primary outcome measure was the baseline trust in a trust game by patients and controls. The meta-analysis was performed if at least three data sets of control and patient groups were available for that measure/design. We conducted meta-analyses with a random-effects model. The results were described narratively wherever meta-analysis was not possible due to paucity of studies. RESULTS The searches across the databases including cross-references yielded 465 publications of which 10 studies were included in the final analysis. Baseline trust in the trust game was significantly lower in patients with psychosis compared to controls (SMD 0.39, 95% CI -0.14 to 0.64, p -0.002). However, a similar decrease in baseline trust was not present in relatives of patients (SMD 0.08, 95% CI -0.20 to 0.36, p -0.58). CONCLUSIONS The current meta-analysis suggests significant trust deficits in patients with psychosis. Future studies with a bigger sample size are required to understand the nature of trust deficits and factors affecting this impairment.
Collapse
Affiliation(s)
- Akash Prasannakumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| |
Collapse
|
8
|
Tangmose K, Rostrup E, Bojesen KB, Sigvard A, Glenthøj BY, Nielsen MØ. Clinical response to treatment with a partial dopamine agonist is related to changes in reward processing. Psychiatry Res 2023; 326:115308. [PMID: 37399765 DOI: 10.1016/j.psychres.2023.115308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 07/05/2023]
Abstract
Aberrant neuronal coding of reward processing has been linked to psychosis. It remains unresolved how treatment with a partial dopamine agonist affects reward processing, and whether treatment affects reward processing differently in patients responding and not responding to treatment. Here, 33 antipsychotic-naïve psychosis patients and 33 matched healthy controls underwent functional magnetic resonance imaging before and after patients received aripiprazole monotherapy for six weeks. Processing of motivational salient events and negative outcome evaluation (NOE) was examined using a monetary incentive delay task. Psychopathology was assessed with the Positive and Negative Syndrome Scale, and responders were identified by having ≥30% reduction in positive symptoms (N=21). At baseline, patients displayed an increased NOE signal in the caudate and dorsolateral prefrontal cortex compared to healthy controls. In the caudate, the NOE signal was normalized at follow-up, and normalization was driven by responders. In responders only, there was a significant improvement in the motivational salience signal in the caudate at follow-up. Motivational salience and NOE signals in the caudate may be associated with a dopaminergic mechanism in patients characterized as responders which may not be the case in non-responders. Likewise, non-dopaminergic mechanism may underly abnormal NOE processing in dorsolateral prefrontal cortex.
Collapse
Affiliation(s)
- Karen Tangmose
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, University of Copenhagen, Rigshospitalet, Glostrup, Denmark
| | - Kirsten Borup Bojesen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Anne Sigvard
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Birte Y Glenthøj
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Ødegaard Nielsen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
9
|
Zeng J, You L, Yang F, Luo Y, Yu S, Yan J, Liu M, Yang X. A meta-analysis of the neural substrates of monetary reward anticipation and outcome in alcohol use disorder. Hum Brain Mapp 2023; 44:2841-2861. [PMID: 36852619 PMCID: PMC10089105 DOI: 10.1002/hbm.26249] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 01/23/2023] [Accepted: 02/13/2023] [Indexed: 03/01/2023] Open
Abstract
The capacity to anticipate and detect rewarding outcomes is fundamental for the development of adaptive decision-making and goal-oriented behavior. Delineating the neural correlates of different stages of reward processing is imperative for understanding the neurobiological mechanism underlying alcohol use disorder (AUD). To examine the neural correlates of monetary anticipation and outcome in AUD patients, we performed two separate voxel-wise meta-analyses of functional neuroimaging studies, including 12 studies investigating reward anticipation and 7 studies investigating reward outcome using the monetary incentive delay task. During the anticipation stage, AUD patients displayed decreased activation in response to monetary cues in mesocortical-limbic circuits and sensory areas, including the ventral striatum (VS), insula, hippocampus, inferior occipital gyrus, supramarginal gyrus, lingual gyrus and fusiform gyrus. During the outcome stage, AUD patients exhibited reduced activation in the dorsal striatum, VS and insula, and increased activation in the orbital frontal cortex and medial temporal area. Our findings suggest that different activation patterns are associated with nondrug rewards during different reward processing stages, potentially reflecting a changed sensitivity to monetary reward in AUD.
Collapse
Affiliation(s)
- Jianguang Zeng
- School of Economics and Business AdministrationChongqing UniversityChongqingChina
| | - Lantao You
- School of Economics and Business AdministrationChongqing UniversityChongqingChina
| | - Fan Yang
- Department of Ultrasonography, West China Second University HospitalSichuan UniversityChengduChina
- Chengdu Chenghua District Maternal and Child Health HospitalSichuan UniversityChengduChina
| | - Ya Luo
- Department of Psychiatry, State Key Lab of BiotherapyWest China Hospital of Sichuan UniversityChengduChina
| | - Shuxian Yu
- School of Economics and Business AdministrationChongqing UniversityChongqingChina
| | - Jiangnan Yan
- School of Economics and Business AdministrationChongqing UniversityChongqingChina
| | - Mengqi Liu
- Department of RadiologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Xun Yang
- School of Public AffairsChongqing UniversityChongqingChina
| |
Collapse
|
10
|
Tangmose K, Rostrup E, Bojesen KB, Sigvard A, Jessen K, Johansen LB, Glenthøj BY, Nielsen MØ. Reward disturbances in antipsychotic-naïve patients with first-episode psychosis and their association to glutamate levels. Psychol Med 2023; 53:1629-1638. [PMID: 37010221 DOI: 10.1017/s0033291721003305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Aberrant anticipation of motivational salient events and processing of outcome evaluation in striatal and prefrontal regions have been suggested to underlie psychosis. Altered glutamate levels have likewise been linked to schizophrenia. Glutamatergic abnormalities may affect the processing of motivational salience and outcome evaluation. It remains unresolved, whether glutamatergic dysfunction is associated with the coding of motivational salience and outcome evaluation in antipsychotic-naïve patients with first-episode psychosis. METHODS Fifty-one antipsychotic-naïve patients with first-episode psychosis (22 ± 5.2 years, female/male: 31/20) and 52 healthy controls (HC) matched on age, sex, and parental education underwent functional magnetic resonance imaging and magnetic resonance spectroscopy (3T) in one session. Brain responses to motivational salience and negative outcome evaluation (NOE) were examined using a monetary incentive delay task. Glutamate levels were estimated in the left thalamus and anterior cingulate cortex using LCModel. RESULTS Patients displayed a positive signal change to NOE in the caudate (p = 0.001) and dorsolateral prefrontal cortex (DLPFC; p = 0.003) compared to HC. No group difference was observed in motivational salience or in levels of glutamate. There was a different association between NOE signal in the caudate and DLPFC and thalamic glutamate levels in patients and HC due to a negative correlation in patients (caudate: p = 0.004, DLPFC: p = 0.005) that was not seen in HC. CONCLUSIONS Our findings confirm prior findings of abnormal outcome evaluation as a part of the pathophysiology of schizophrenia. The results also suggest a possible link between thalamic glutamate and NOE signaling in patients with first-episode psychosis.
Collapse
Affiliation(s)
- Karen Tangmose
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Kirsten B Bojesen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Anne Sigvard
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Jessen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Louise Baruël Johansen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
| | - Birte Y Glenthøj
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Ødegaard Nielsen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
11
|
Giordano GM, Pezzella P, Giuliani L, Fazio L, Mucci A, Perrottelli A, Blasi G, Amore M, Rocca P, Rossi A, Bertolino A, Galderisi S. Resting-State Brain Activity Dysfunctions in Schizophrenia and Their Associations with Negative Symptom Domains: An fMRI Study. Brain Sci 2023; 13:brainsci13010083. [PMID: 36672064 PMCID: PMC9856573 DOI: 10.3390/brainsci13010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/07/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023] Open
Abstract
The aim of the present study was to examine the neurobiological correlates of the two negative symptom domains of schizophrenia, the Motivational Deficit domain (including avolition, anhedonia, and asociality) and the Expressive Deficit domain (including blunted affect and alogia), focusing on brain areas that are most commonly found to be associated with negative symptoms in previous literature. Resting-state (rs) fMRI data were analyzed in 62 subjects affected by schizophrenia (SZs) and 46 healthy controls (HCs). The SZs, compared to the HCs, showed higher rs brain activity in the right inferior parietal lobule and the right temporoparietal junction, and lower rs brain activity in the right dorsolateral prefrontal cortex, the bilateral anterior dorsal cingulate cortex, and the ventral and dorsal caudate. Furthermore, in the SZs, the rs brain activity in the left orbitofrontal cortex correlated with negative symptoms (r = -0.436, p = 0.006), in particular with the Motivational Deficit domain (r = -0.424, p = 0.002), even after controlling for confounding factors. The left ventral caudate correlated with negative symptoms (r = -0.407, p = 0.003), especially with the Expressive Deficit domain (r = -0.401, p = 0.003); however, these results seemed to be affected by confounding factors. In line with the literature, our results demonstrated that the two negative symptom domains might be underpinned by different neurobiological mechanisms.
Collapse
Affiliation(s)
- Giulia Maria Giordano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Luigi Giuliani
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: ; Tel.: +39-0815666512
| | - Leonardo Fazio
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy
- Department of Medicine and Surgery, LUM University, 70010 Casamassima, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Andrea Perrottelli
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Giuseppe Blasi
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy
| | - Mario Amore
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, 10126 Turin, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L’Aquila, 67100 L’Aquila, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | | |
Collapse
|
12
|
Fromm S, Katthagen T, Deserno L, Heinz A, Kaminski J, Schlagenhauf F. Belief Updating in Subclinical and Clinical Delusions. SCHIZOPHRENIA BULLETIN OPEN 2023; 4:sgac074. [PMID: 39145350 PMCID: PMC11207849 DOI: 10.1093/schizbullopen/sgac074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background and Hypothesis Current frameworks propose that delusions result from aberrant belief updating due to altered prediction error (PE) signaling and misestimation of environmental volatility. We aimed to investigate whether behavioral and neural signatures of belief updating are specifically related to the presence of delusions or generally associated with manifest schizophrenia. Methods Our cross-sectional design includes human participants (n[female/male] = 66[25/41]), stratified into four groups: healthy participants with minimal (n = 22) or strong delusional-like ideation (n = 18), and participants with diagnosed schizophrenia with minimal (n = 13) or strong delusions (n = 13), resulting in a 2 × 2 design, which allows to test for the effects of delusion and diagnosis. Participants performed a reversal learning task with stable and volatile task contingencies during fMRI scanning. We formalized learning with a hierarchical Gaussian filter model and conducted model-based fMRI analysis regarding beliefs of outcome uncertainty and volatility, precision-weighted PEs of the outcome- and the volatility-belief. Results Patients with schizophrenia as compared to healthy controls showed lower accuracy and heightened choice switching, while delusional ideation did not affect these measures. Participants with delusions showed increased precision-weighted PE-related neural activation in fronto-striatal regions. People with diagnosed schizophrenia overestimated environmental volatility and showed an attenuated neural representation of volatility in the anterior insula, medial frontal and angular gyrus. Conclusions Delusional beliefs are associated with altered striatal PE-signals. Juxtaposing, the potentially unsettling belief that the environment is constantly changing and weaker neural encoding of this subjective volatility seems to be associated with manifest schizophrenia, but not with the presence of delusional ideation.
Collapse
Affiliation(s)
- Sophie Fromm
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health CCM, Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Germany
| | - Teresa Katthagen
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health CCM, Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin, Germany
| | - Lorenz Deserno
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, Technische Universität, Dresden, Germany
| | - Andreas Heinz
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health CCM, Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Jakob Kaminski
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health CCM, Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin, Germany
| | - Florian Schlagenhauf
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health CCM, Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
| |
Collapse
|
13
|
Zeng J, Yan J, Cao H, Su Y, Song Y, Luo Y, Yang X. Neural substrates of reward anticipation and outcome in schizophrenia: a meta-analysis of fMRI findings in the monetary incentive delay task. Transl Psychiatry 2022; 12:448. [PMID: 36244990 PMCID: PMC9573872 DOI: 10.1038/s41398-022-02201-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 01/10/2023] Open
Abstract
Dysfunction of the mesocorticolimbic dopaminergic reward system is a core feature of schizophrenia (SZ), yet its precise contributions to different stages of reward processing and their relevance to disease symptomology are not fully understood. We performed a coordinate-based meta-analysis, using the monetary incentive delay task, to identify which brain regions are implicated in different reward phases in functional magnetic resonance imaging in SZ. A total of 17 studies (368 SZ and 428 controls) were included in the reward anticipation, and 10 studies (229 SZ and 281 controls) were included in the reward outcome. Our meta-analysis revealed that during anticipation, patients showed hypoactivation in the striatum, anterior cingulate cortex, median cingulate cortex (MCC), amygdala, precentral gyrus, and superior temporal gyrus compared with controls. Striatum hypoactivation was negatively associated with negative symptoms and positively associated with the proportion of second-generation antipsychotic users (percentage of SGA users). During outcome, patients displayed hyperactivation in the striatum, insula, amygdala, hippocampus, parahippocampal gyrus, cerebellum, postcentral gyrus, and MCC, and hypoactivation in the dorsolateral prefrontal cortex (DLPFC) and medial prefrontal cortex (mPFC). Hypoactivity of mPFC during outcome was negatively associated with positive symptoms. Moderator analysis showed that the percentage of SGA users was a significant moderator of the association between symptom severity and brain activity in both the anticipation and outcome stages. Our findings identified the neural substrates for different reward phases in SZ and may help explain the neuropathological mechanisms underlying reward processing deficits in the disorder.
Collapse
Affiliation(s)
- Jianguang Zeng
- grid.190737.b0000 0001 0154 0904School of Economics and Business Administration, Chongqing University, Chongqing, 400044 China
| | - Jiangnan Yan
- grid.190737.b0000 0001 0154 0904School of Economics and Business Administration, Chongqing University, Chongqing, 400044 China
| | - Hengyi Cao
- grid.250903.d0000 0000 9566 0634Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Hempstead, NY USA ,grid.440243.50000 0004 0453 5950Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY USA
| | - Yueyue Su
- grid.190737.b0000 0001 0154 0904School of Public Affairs, Chongqing University, Chongqing, 400044 China
| | - Yuan Song
- grid.190737.b0000 0001 0154 0904School of Public Affairs, Chongqing University, Chongqing, 400044 China
| | - Ya Luo
- grid.412901.f0000 0004 1770 1022Department of Psychiatry, State Key Lab of Biotherapy, West China Hospital of Sichuan University, Chengdu, 610041 China
| | - Xun Yang
- School of Public Affairs, Chongqing University, Chongqing, 400044, China.
| |
Collapse
|
14
|
Nielsen MØ, Rostrup E, Hilker R, Legind C, Anhøj S, Robbins TW, Sahakian BJ, Fagerlund B, Glenthøj B. Reward Processing as an Indicator of Vulnerability or Compensatory Resilience in Psychoses? Results From a Twin Study. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 3:47-55. [PMID: 36712565 PMCID: PMC9874133 DOI: 10.1016/j.bpsgos.2022.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 02/01/2023] Open
Abstract
Background Findings of reward disturbances in unaffected relatives of patients with schizophrenia suggest reward disturbances as an endophenotype for schizophrenia. Twin studies, where 1 twin has been diagnosed with a schizophrenia spectrum disorder, can further explore this. Methods We used Danish registries to identify twin pairs with at least 1 twin having a schizophrenia spectrum disorder diagnosis and control twin pairs matched on age, sex, and zygosity. The analyses included data from 34 unaffected co-twins (16 females), 42 probands with schizophrenia spectrum disorder (17 females), and 83 control twins (42 females). Participants performed a modified incentive delay task during functional magnetic resonance imaging. Whole-brain group differences were analyzed by performing comparisons between co-twins and control twins. Correlations with cognitive flexibility were tested. Results Compared with control twins, co-twins showed no differences in striatal regions, but increased signal in the dorsolateral prefrontal cortex (DLPFC) during missed target contrast was observed. In co-twins, increased DLPFC signal was associated with lower intra-extra dimensional set-shifting scores indicative of higher cognitive flexibility. Conclusions Unaffected co-twins did not have decreased striatal activity during anticipation as previously reported for patients with schizophrenia. Instead, they showed increased activity in the DLPFC during evaluation of missed target contrast, which correlated with their level of cognitive flexibility. Unaffected co-twins had no diagnosis at a mean age of 40 years. This could indicate that greater cognitive flexibility and increased activity in the right DLPFC during processing of unexpected negative outcome represents a compensatory resilience mechanism in predisposed twins.
Collapse
Affiliation(s)
- Mette Ødegaard Nielsen
- Center for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark,Address correspondence to Mette Ødegaard Nielsen, M.D., Ph.D.
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen, Denmark,Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Glostrup, Denmark
| | - Rikke Hilker
- Center for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Christian Legind
- Center for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Simon Anhøj
- Center for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen, Denmark
| | - Trevor William Robbins
- Department of Psychology, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Barbara J. Sahakian
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Birgitte Fagerlund
- Center for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen, Denmark,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
15
|
Abstract
Anhedonia has long been considered a cardinal symptom of schizophrenia. This symptom is strongly associated with poor functional outcome, and limited treatment options are available. While originally conceptualized as an inability to experience pleasure, recent work has consistently shown that individuals with schizophrenia have an intact capacity to experience pleasure in-the-moment. Adjacent work in basic affective neuroscience has broadened the conceptualization of anhedonia to include not only the capacity to experience pleasure but highlights important temporal affective dynamics and decision-making processes that go awry in schizophrenia. Here we detail these mechanisms for emotional and motivational impairment in people with schizophrenia including: (1) initial response to reward; (2) reward anticipation; (3) reward learning; (4) effort-cost decision-making; (5) working memory and cognitive control. We will review studies that utilized various types of rewards (e.g., monetary, social), in order to draw conclusions regarding whether findings vary by reward type. We will then discuss how modern assessment methods may best incorporate each of the mechanisms, to provide a more fine-grained understanding of anhedonia in individuals with schizophrenia. We will close by providing a discussion of relevant future directions.
Collapse
Affiliation(s)
- Erin K Moran
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Adam J Culbreth
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, College Park, MD, USA
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
| |
Collapse
|
16
|
Culbreth AJ, Kasanova Z, Ross TJ, Salmeron BJ, Gold JM, Stein EA, Waltz JA. Schizophrenia Patients Show Largely Similar Salience Signaling Compared to Healthy Controls in an Observational Task Environment. Brain Sci 2021; 11:brainsci11121610. [PMID: 34942913 PMCID: PMC8699423 DOI: 10.3390/brainsci11121610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Recent evidence suggests that the aberrant signaling of salience is associated with psychotic illness. Salience, however, can take many forms in task environments. For example, salience may refer to any of the following: (1) the valence of an outcome, (2) outcomes that are unexpected, called reward prediction errors (PEs), or (3) cues associated with uncertain outcomes. Here, we measure brain responses to different forms of salience in the context of a passive PE-signaling task, testing whether patients with schizophrenia (SZ) showed aberrant signaling of particular types of salience. We acquired event-related MRI data from 29 SZ patients and 23 controls during the performance of a passive outcome prediction task. Across groups, we found that the anterior insula and posterior parietal cortices were activated to multiple different types of salience, including PE magnitude and heightened levels of uncertainty. However, BOLD activation to salient events was not significantly different between patients and controls in many regions, including the insula, posterior parietal cortices, and default mode network nodes. Such results suggest that deficiencies in salience processing in SZ may not result from an impaired ability to signal salience per se, but instead the ability to use such signals to guide future actions. Notably, no between-group differences were observed in BOLD signal changes associated with PE-signaling in the striatum. However, positive symptom severity was found to significantly correlate with the magnitudes of salience contrasts in default mode network nodes. Our results suggest that, in an observational environment, SZ patients may show an intact ability to activate striatal and cortical regions to rewarding and non-rewarding salient events. Furthermore, reduced deactivation of a hypothesized default mode network node for SZ participants with high levels of positive symptoms, following salient events, point to abnormalities in interactions of the salience network with other brain networks, and their potential importance to positive symptoms.
Collapse
Affiliation(s)
- Adam J. Culbreth
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA; (J.M.G.); (J.A.W.)
- Correspondence:
| | - Zuzana Kasanova
- Leuven Research & Development Spin-off & Innovation Unit, KU Leuven, Waaistraat 6-Box 5105, 3000 Leuven, Belgium;
| | - Thomas J. Ross
- Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD 21224, USA; (T.J.R.); (B.J.S.); (E.A.S.)
| | - Betty J. Salmeron
- Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD 21224, USA; (T.J.R.); (B.J.S.); (E.A.S.)
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA; (J.M.G.); (J.A.W.)
| | - Elliot A. Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD 21224, USA; (T.J.R.); (B.J.S.); (E.A.S.)
| | - James A. Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA; (J.M.G.); (J.A.W.)
| |
Collapse
|
17
|
Kaliuzhna M, Kirschner M, Carruzzo F, Hartmann-Riemer MN, Bischof M, Seifritz E, Tobler PN, Kaiser S. How far to go in deconstructing negative symptoms? Behavioural and neural level evidence for the amotivation domain. Schizophr Res 2021; 236:41-47. [PMID: 34390980 DOI: 10.1016/j.schres.2021.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 06/06/2021] [Accepted: 08/04/2021] [Indexed: 11/15/2022]
Abstract
Negative symptoms in schizophrenia are conceptualised as loading onto two factors: amotivation and diminished expression, which relate to different behavioural and neural markers. This distinction has proven useful for understanding the cognitive, motivational and neural mechanisms involved in negative symptoms, and for the development of treatments. Recently, it has been advocated that an even finer distinction into five subdomains is needed to understand the mechanisms underlying negative symptoms, and to prevent masking specific treatment and intervention effects. However, it is currently unclear whether such a fine-grained approach offers additional insights grounded in theory. In the present work, we focused on the factor amotivation, which has been shown to selectively correlate with the propensity to discount rewards in the face of effort and with the activity in the ventral striatum during reward anticipation. In a reanalysis of these studies we explored whether subdomains of amotivation - avolition, asociality, anhedonia - showed preferential correlation with these previously identified behavioural and neural markers. We show that for both behavioural and neural markers, a fine-grained model with the three subdomains did not better explain the data than a model with the amotivation factor only. Moreover, none of the three subdomains correlated significantly more or less with the behavioural or neural markers. Thus, no additional information was gained on amotivation in schizophrenia by selectively looking at its three subdomains. Consequently, the two-factor solution currently remains a valid option for the study of negative symptoms and further research is needed for behavioural and neural validation of the five-factor model.
Collapse
Affiliation(s)
- Mariia Kaliuzhna
- Clinical and Experimental Psychopathology Group, Department of Psychiatry, University of Geneva, Switzerland.
| | - Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Fabien Carruzzo
- Clinical and Experimental Psychopathology Group, Department of Psychiatry, University of Geneva, Switzerland
| | - Matthias N Hartmann-Riemer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Martin Bischof
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Philippe N Tobler
- Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Switzerland
| | - Stefan Kaiser
- Clinical and Experimental Psychopathology Group, Department of Psychiatry, University of Geneva, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| |
Collapse
|
18
|
Fish S, Christidi F, Karavasilis E, Velonakis G, Kelekis N, Klein C, Stefanis NC, Smyrnis N. Interaction of schizophrenia and chronic cannabis use on reward anticipation sensitivity. NPJ SCHIZOPHRENIA 2021; 7:33. [PMID: 34135344 PMCID: PMC8209034 DOI: 10.1038/s41537-021-00163-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/28/2021] [Indexed: 11/09/2022]
Abstract
Chronic cannabis use and schizophrenia are both thought to affect reward processing. While behavioural and neural effects on reward processing have been investigated in both conditions, their interaction has not been studied, although chronic cannabis use is common among these patients. In the present study eighty-nine participants divided into four groups (control chronic cannabis users and non-users; schizophrenia patient cannabis users and non-users) performed a two-choice decision task, preceded by monetary cues (high/low reward/punishment or neutral), while being scanned using functional magnetic resonance imaging. Reward and punishment anticipation resulted in activation of regions of interest including the thalamus, striatum, amygdala and insula. Chronic cannabis use and schizophrenia had opposing effects on reward anticipation sensitivity. More specifically control users and patient non-users showed faster behavioural responses and increased activity in anterior/posterior insula for high magnitude cues compared to control non-users and patient users. The same interaction pattern was observed in the activation of the right thalamus for reward versus punishment cues. This study provided evidence for interaction of chronic cannabis use and schizophrenia on reward processing and highlights the need for future research addressing the significance of this interaction for the pathophysiology of these conditions and its clinical consequences.
Collapse
Affiliation(s)
- Simon Fish
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "COSTAS STEFANIS", Athens, Greece.,1st Department of Psychiatry, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Athens, Greece
| | - Foteini Christidi
- Department of Medical Physics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Efstratios Karavasilis
- 2nd Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "ATTIKON", Athens, Greece
| | - Georgios Velonakis
- 2nd Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "ATTIKON", Athens, Greece
| | - Nikolaos Kelekis
- 2nd Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "ATTIKON", Athens, Greece
| | - Christoph Klein
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "ATTIKON", Athens, Greece.,Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Freiburg, Germany.,Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Nicholas C Stefanis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Athens, Greece
| | - Nikolaos Smyrnis
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "COSTAS STEFANIS", Athens, Greece. .,2nd Department of Psychiatry, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "ATTIKON", Athens, Greece.
| |
Collapse
|
19
|
Arsalidou M, Vijayarajah S, Sharaev M. Basal ganglia lateralization in different types of reward. Brain Imaging Behav 2021; 14:2618-2646. [PMID: 31927758 DOI: 10.1007/s11682-019-00215-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Reward processing is a fundamental human activity. The basal ganglia are recognized for their role in reward processes; however, specific roles of the different nuclei (e.g., nucleus accumbens, caudate, putamen and globus pallidus) remain unclear. Using quantitative meta-analyses we assessed whole-brain and basal ganglia specific contributions to money, erotic, and food reward processing. We analyzed data from 190 fMRI studies which reported stereotaxic coordinates of whole-brain, within-group results from healthy adult participants. Results showed concordance in overlapping and distinct cortical and sub-cortical brain regions as a function of reward type. Common to all reward types was concordance in basal ganglia nuclei, with distinct differences in hemispheric dominance and spatial extent in response to the different reward types. Food reward processing favored the right hemisphere; erotic rewards favored the right lateral globus pallidus and left caudate body. Money rewards engaged the basal ganglia bilaterally including its most anterior part, nucleus accumbens. We conclude by proposing a model of common reward processing in the basal ganglia and separate models for money, erotic, and food rewards.
Collapse
Affiliation(s)
- Marie Arsalidou
- Department of Psychology, National Research University Higher School of Economics, Moscow, Russian Federation. .,Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada.
| | - Sagana Vijayarajah
- Department of Psychology, Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | - Maksim Sharaev
- Skolkovo Institute of Science and Technology, Moscow, Russian Federation
| |
Collapse
|
20
|
Kirschner M, Schmidt A, Hodzic-Santor B, Burrer A, Manoliu A, Zeighami Y, Yau Y, Abbasi N, Maatz A, Habermeyer B, Abivardi A, Avram M, Brandl F, Sorg C, Homan P, Riecher-Rössler A, Borgwardt S, Seifritz E, Dagher A, Kaiser S. Orbitofrontal-Striatal Structural Alterations Linked to Negative Symptoms at Different Stages of the Schizophrenia Spectrum. Schizophr Bull 2020; 47:849-863. [PMID: 33257954 PMCID: PMC8084448 DOI: 10.1093/schbul/sbaa169] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Negative symptoms such as anhedonia and apathy are among the most debilitating manifestations of schizophrenia (SZ). Imaging studies have linked these symptoms to morphometric abnormalities in 2 brain regions implicated in reward and motivation: the orbitofrontal cortex (OFC) and striatum. Higher negative symptoms are generally associated with reduced OFC thickness, while higher apathy specifically maps to reduced striatal volume. However, it remains unclear whether these tissue losses are a consequence of chronic illness and its treatment or an underlying phenotypic trait. Here, we use multicentre magnetic resonance imaging data to investigate orbitofrontal-striatal abnormalities across the SZ spectrum from healthy populations with high schizotypy to unmedicated and medicated first-episode psychosis (FEP), and patients with chronic SZ. Putamen, caudate, accumbens volume, and OFC thickness were estimated from T1-weighted images acquired in all 3 diagnostic groups and controls from 4 sites (n = 337). Results were first established in 1 discovery dataset and replicated in 3 independent samples. There was a negative correlation between apathy and putamen/accumbens volume only in healthy individuals with schizotypy; however, medicated patients exhibited larger putamen volume, which appears to be a consequence of antipsychotic medications. The negative association between reduced OFC thickness and total negative symptoms also appeared to vary along the SZ spectrum, being significant only in FEP patients. In schizotypy, there was increased OFC thickness relative to controls. Our findings suggest that negative symptoms are associated with a temporal continuum of orbitofrontal-striatal abnormalities that may predate the occurrence of SZ. Thicker OFC in schizotypy may represent either compensatory or pathological mechanisms prior to the disease onset.
Collapse
Affiliation(s)
- Matthias Kirschner
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland,To whom correspondence should be addressed; 3801 Rue University, Montréal QC, H3A 2B4 Canada; tel: +1 514-398-1726, fax: +1 514–398–8948, e-mail:
| | - André Schmidt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | | | - Achim Burrer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Andrei Manoliu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland,Wellcome Centre for Human Neuroimaging, University College London, London, UK,Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, UK
| | - Yashar Zeighami
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Yvonne Yau
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Nooshin Abbasi
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Anke Maatz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | | | - Aslan Abivardi
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Mihai Avram
- Department of Neuroradiology and TUM-NIC Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany,Department of Psychiatry, Psychosomatics and Psychotherapy, Schleswig Holstein University Hospital, University Lübeck, Lübeck Germany
| | - Felix Brandl
- Department of Psychiatry and TUM-NIC Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Christian Sorg
- Department of Neuroradiology and TUM-NIC Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany,Department of Psychiatry and TUM-NIC Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Philipp Homan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY,Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY,Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY
| | | | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Stefan Kaiser
- Department of Psychiatry, Division of Adult Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
21
|
Leicht G, Andreou C, Nafe T, Nägele F, Rauh J, Curic S, Schauer P, Schöttle D, Steinmann S, Mulert C. Alterations of oscillatory neuronal activity during reward processing in schizophrenia. J Psychiatr Res 2020; 129:80-87. [PMID: 32619750 DOI: 10.1016/j.jpsychires.2020.05.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Reward system dysfunctions are considered to be a pathophysiological mechanism in schizophrenia. Electrophysiological studies of reward system functions have identified frequency-specific brain networks for the processing of positive (high-beta frequency) and negative (theta frequency) events. Remarkably, midbrain dopaminergic signalling also includes theta and high-beta frequency modes, which have been assumed to reflect tonic and phasic dopamine responses, respectively. The aim of the present study was to identify alterations of oscillatory responses to reward feedback in patients with schizophrenia. METHODS Seventeen patients with schizophrenia and 18 healthy controls performed a gambling task during recording of 64-channel electroencephalography. The theta and high-beta band total power were investigated in response to feedback events depending on feedback valence (loss or gain) and magnitude (5 vs. 25 points). RESULTS Both the increase of theta oscillatory activity in response to loss feedback (compared to gain feedback) and the increase of high-beta oscillatory activity in response to gain feedback (compared to loss feedback) were reduced in patients. The difference in high-beta responses to gain versus loss feedback in patients was associated with the severity of negative symptoms. CONCLUSIONS Our findings are consistent with current models of reward system dysfunction in schizophrenia, and indicate deficits in both cortical tonic and subcortical phasic dopamine activity, consistent with the complex dopaminergic abnormalities in schizophrenia.
Collapse
Affiliation(s)
- Gregor Leicht
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany.
| | - Christina Andreou
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany; Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Till Nafe
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Felix Nägele
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Jonas Rauh
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Stjepan Curic
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Paul Schauer
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Daniel Schöttle
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Saskia Steinmann
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Christoph Mulert
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany; Center of Psychiatry, Justus-Liebig University, Klinikstr. 36, 35385, Giessen, Germany
| |
Collapse
|
22
|
Bègue I, Kaiser S, Kirschner M. Pathophysiology of negative symptom dimensions of schizophrenia – Current developments and implications for treatment. Neurosci Biobehav Rev 2020; 116:74-88. [DOI: 10.1016/j.neubiorev.2020.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/13/2020] [Accepted: 06/02/2020] [Indexed: 02/06/2023]
|
23
|
Apathy is not associated with reduced ventral striatal volume in patients with schizophrenia. Schizophr Res 2020; 223:279-288. [PMID: 32928618 DOI: 10.1016/j.schres.2020.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 05/04/2020] [Accepted: 08/24/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND A growing body of neuroimaging research has revealed a relationship between blunted activation of the ventral striatum (VS) and apathy in schizophrenia. In contrast, the association between reduced striatal volume and apathy is less well established, while the relationship between VS function and structure in patients with schizophrenia remains an open question. Here, we aimed to replicate previous structural findings in a larger independent sample and to investigate the relationship between VS hypoactivation and VS volume. METHODS We included brain structural magnetic resonance imaging (MRI) data from 60 patients with schizophrenia (SZ) that had shown an association of VS hypoactivation with apathy during reward anticipation and 58 healthy controls (HC). To improve replicability, we applied analytical methods employed in two previously published studies: Voxel-based morphometry and the Multiple Automatically Generated Templates (MAGeT) algorithm. VS and dorsal striatum (DS) volume were correlated with apathy correcting for age, gender and total brain volume. Additionally, left VS activity was correlated with left VS volume. RESULTS We failed to replicate the association between apathy and reduced VS volume and did not find a correlation with DS volume. Functional and structural left VS measures exhibited a trend-level correlation (rs = 0.248, p = 0.067, r2 = 0.06). CONCLUSIONS Our present data suggests that functional and structural striatal neuroimaging correlates of apathy can occur independently. Replication of previous findings may have been limited by other factors (medication, illness duration, age) potentially related to striatal volume changes in SZ. Finally, associations between reward-related VS function and structure should be further explored.
Collapse
|
24
|
Howes OD, Hird EJ, Adams RA, Corlett PR, McGuire P. Aberrant Salience, Information Processing, and Dopaminergic Signaling in People at Clinical High Risk for Psychosis. Biol Psychiatry 2020; 88:304-314. [PMID: 32430200 DOI: 10.1016/j.biopsych.2020.03.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 01/24/2023]
Abstract
The aberrant salience hypothesis proposes that striatal dopamine dysregulation causes misattribution of salience to irrelevant stimuli leading to psychosis. Recently, new lines of preclinical evidence on information coding by subcortical dopamine coupled with computational models of the brain's ability to predict and make inferences about the world (predictive processing) provide a new perspective on this hypothesis. We review these and summarize the evidence for dopamine dysfunction, reward processing, and salience abnormalities in people at clinical high risk of psychosis (CHR) relative to findings in patients with psychosis. This review identifies consistent evidence for dysregulated subcortical dopamine function in people at CHR, but also indicates a number of areas where neurobiological processes are different in CHR subjects relative to patients with psychosis, particularly in reward processing. We then consider how predictive processing models may explain psychotic symptoms in terms of alterations in prediction error and precision signaling using Bayesian approaches. We also review the potential role of environmental risk factors, particularly early adverse life experiences, in influencing the prior expectations that individuals have about their world in terms of computational models of the progression from being at CHR to frank psychosis. We identify a number of key outstanding questions, including the relative roles of prediction error or precision signaling in the development of symptoms and the mechanism underlying dopamine dysfunction. Finally, we discuss how the integration of computational psychiatry with biological investigation may inform the treatment for people at CHR of psychosis.
Collapse
Affiliation(s)
- Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Institute of Health Research Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust, London, United Kingdom; Medical Research Council London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom.
| | - Emily J Hird
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Institute of Health Research Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Rick A Adams
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom; Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, United Kingdom
| | - Philip R Corlett
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Institute of Health Research Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| |
Collapse
|
25
|
Learning and Motivation for Rewards in Schizophrenia: Implications for Behavioral Rehabilitation. Curr Behav Neurosci Rep 2020. [DOI: 10.1007/s40473-020-00210-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
26
|
Culbreth AJ, Moran EK, Kandala S, Westbrook A, Barch DM. Effort, avolition and motivational experience in schizophrenia: Analysis of behavioral and neuroimaging data with relationships to daily motivational experience. Clin Psychol Sci 2020; 8:555-568. [PMID: 33758684 PMCID: PMC7983405 DOI: 10.1177/2167702620901558] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Recent research suggests that schizophrenia is associated with reduced effort allocation. We examined willingness to expend effort, neural correlates of effort allocation, and the relationship of effort to daily motivational experience in schizophrenia. We recruited 28 individuals with schizophrenia and 30 controls to perform an effort task during fMRI. Individuals with schizophrenia also completed an ecological momentary assessment (EMA) protocol. Individuals with schizophrenia with high negative symptoms were less willing to expend effort for rewards. Daily EMA assessments of motivation were positively associated with effort allocation at a trend-level. Individuals with schizophrenia and controls displayed similar increases in BOLD activation in frontal, cingulate, parietal, and insular regions during effort-based decision-making. However, negative symptoms were associated with reduced BOLD activation in bilateral ventral striatum. These results replicate previous reports of reduced effort allocation in schizophrenia patients with severe negative symptoms, and provide evidence for the role of ventral striatum in effort impairments.
Collapse
Affiliation(s)
- Adam J Culbreth
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130
| | - Erin K Moran
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Sri Kandala
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Andrew Westbrook
- Department of Cognitive, Linguistics, and Psychological Sciences, Brown University, Providence, RI 02906
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 EN Nijmegen, The Netherlands
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110
| |
Collapse
|
27
|
Katthagen T, Kaminski J, Heinz A, Buchert R, Schlagenhauf F. Striatal Dopamine and Reward Prediction Error Signaling in Unmedicated Schizophrenia Patients. Schizophr Bull 2020; 46:1535-1546. [PMID: 32318717 PMCID: PMC7751190 DOI: 10.1093/schbul/sbaa055] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Increased striatal dopamine synthesis capacity has consistently been reported in patients with schizophrenia. However, the mechanism translating this into behavior and symptoms remains unclear. It has been proposed that heightened striatal dopamine may blunt dopaminergic reward prediction error signaling during reinforcement learning. In this study, we investigated striatal dopamine synthesis capacity, reward prediction errors, and their association in unmedicated schizophrenia patients (n = 19) and healthy controls (n = 23). They took part in FDOPA-PET and underwent functional magnetic resonance imaging (fMRI) scanning, where they performed a reversal-learning paradigm. The groups were compared regarding dopamine synthesis capacity (Kicer), fMRI neural prediction error signals, and the correlation of both. Patients did not differ from controls with respect to striatal Kicer. Taking into account, comorbid alcohol abuse revealed that patients without such abuse showed elevated Kicer in the associative striatum, while those with abuse did not differ from controls. Comparing all patients to controls, patients performed worse during reversal learning and displayed reduced prediction error signaling in the ventral striatum. In controls, Kicer in the limbic striatum correlated with higher reward prediction error signaling, while there was no significant association in patients. Kicer in the associative striatum correlated with higher positive symptoms and blunted reward prediction error signaling was associated with negative symptoms. Our results suggest a dissociation between striatal subregions and symptom domains, with elevated dopamine synthesis capacity in the associative striatum contributing to positive symptoms while blunted prediction error signaling in the ventral striatum related to negative symptoms.
Collapse
Affiliation(s)
- Teresa Katthagen
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,To whom correspondence should be addressed; Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany; tel: +49-(0)-30-450-517389, fax: +49-(0)-30-450-517962, e-mail:
| | - Jakob Kaminski
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,Berlin Institute of Health, Berlin, Germany,Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,Berlin Institute of Health, Berlin, Germany,Cluster of Excellence NeuroCure, Charité-Universitätsmedizin, Berlin, Germany
| | - Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Schlagenhauf
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany,Bernstein Center for Computational Neuroscience, Berlin, Germany
| |
Collapse
|
28
|
Michielse S, Lange I, Bakker J, Goossens L, Verhagen S, Papalini S, Wichers M, Lieverse R, Schruers K, van Amelsvoort T, van Os J, Murray GK, Marcelis M. Reward anticipation in individuals with subclinical psychotic experiences: A functional MRI approach. Eur Neuropsychopharmacol 2019; 29:1374-1385. [PMID: 31685359 DOI: 10.1016/j.euroneuro.2019.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 07/15/2019] [Accepted: 10/07/2019] [Indexed: 11/18/2022]
Abstract
Previous research in patients with psychotic disorder has shown widespread abnormalities in brain activation during reward anticipation. Research at the level of subclinical psychotic experiences in individuals unexposed to antipsychotic medication is limited with inconclusive results. Therefore, brain activation during reward anticipation was examined in a larger sample of individuals with subclinical psychotic experiences (PE). Participants in the PE-group were included based on CAPE scores. A sample of emerging adults aged 16-26 years (n = 47) with PE and healthy controls (HC) (n = 40) underwent fMRI scanning. The Monetary Incentive Delay task was conducted with cues related to win, loss or neutral conditions. fMRI nonparametric tests were used to examine the reward versus neutral cue contrast. A significant main effect of the large win (€3.00) > neutral contrast was found in both groups showing activation in many brain areas, including classic reward regions. Whole brain analysis on the group comparison regarding the large win > neutral contrast showed significantly decreased activation in the right insula, putamen and supramarginal gyrus in the PE-group compared to controls. There was no group difference in the hypothesized reward-related region. Decreased activation in the right insula, putamen and supramarginal gyrus during reward anticipation in individuals with PE may be consistent with altered processing of sensory information, related to decreased emotional valuing and motivational tendencies and/or altered motor-cognitive processes. The absence of group differences in striatal activation suggests that activation here is intact in the earliest stages of psychosis and may exhibit progressive deterioration in as the disease develops.
Collapse
Affiliation(s)
- Stijn Michielse
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands.
| | - Iris Lange
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Jindra Bakker
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands; Department of Neuroscience, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Liesbet Goossens
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Simone Verhagen
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Silvia Papalini
- Laboratory of Biological Psychology, Faculty of Psychology and Educational Sciences, Leuven Brain Institute, KU Leuven, Belgium
| | - Marieke Wichers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ritsaert Lieverse
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Koen Schruers
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands; Faculty of Psychology, Center for Experimental and Learning Psychology, University of Leuven, Leuven, Belgium
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands; King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, England; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands
| |
Collapse
|
29
|
Motivational deficits in schizophrenia relate to abnormalities in cortical learning rate signals. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 18:1338-1351. [PMID: 30276616 DOI: 10.3758/s13415-018-0643-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Individuals from across the psychosis spectrum display impairments in reinforcement learning. In some individuals, these deficits may result from aberrations in reward prediction error (RPE) signaling, conveyed by dopaminergic projections to the ventral striatum (VS). However, there is mounting evidence that VS RPE signals are relatively intact in medicated people with schizophrenia (PSZ). We hypothesized that, in PSZ, reinforcement learning deficits often are not related to RPE signaling per se but rather their impact on learning and behavior (i.e., learning rate modulation), due to dysfunction in anterior cingulate and dorsomedial prefrontal cortex (dmPFC). Twenty-six PSZ and 23 healthy volunteers completed a probabilistic reinforcement learning paradigm with occasional, sudden, shifts in contingencies. Using computational modeling, we found evidence of an impairment in trial-wise learning rate modulation (α) in PSZ before and after a reinforcement contingency shift, expressed most in PSZ with more severe motivational deficits. In a subsample of 22 PSZ and 22 healthy volunteers, we found little evidence for between-group differences in VS RPE and dmPFC learning rate signals, as measured with fMRI. However, a follow-up psychophysiological interaction analysis revealed decreased dmPFC-VS connectivity concurrent with learning rate modulation, most prominently in individuals with the most severe motivational deficits. These findings point to an impairment in learning rate modulation in PSZ, leading to a reduced ability to adjust task behavior in response to unexpected outcomes. At the level of the brain, learning rate modulation deficits may be associated with decreased involvement of the dmPFC within a greater RL network.
Collapse
|
30
|
Shukla DK, Chiappelli JJ, Sampath H, Kochunov P, Hare SM, Wisner K, Rowland LM, Hong LE. Aberrant Frontostriatal Connectivity in Negative Symptoms of Schizophrenia. Schizophr Bull 2019; 45:1051-1059. [PMID: 30576563 PMCID: PMC6737477 DOI: 10.1093/schbul/sby165] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Negative symptoms represent a distinct component of psychopathology in schizophrenia (SCZ) and are a stable construct over time. Although impaired frontostriatal connectivity has been frequently described in SCZ, its link with negative symptoms has not been carefully studied. We tested the hypothesis that frontostriatal connectivity at rest may be associated with the severity of negative symptoms in SCZ. Resting state functional connectivity (rsFC) data from 95 mostly medicated patients with SCZ and 139 healthy controls (HCs) were acquired. Negative symptoms were assessed using the Brief Negative Symptom Scale. The study analyzed voxel-wise rsFC between 9 frontal "seed regions" and the entire striatum, with the intention to reduce potential biases introduced by predefining any single frontal or striatal region. SCZ showed significantly reduced rsFC between the striatum and the right medial and lateral orbitofrontal cortex (OFC), lateral prefrontal cortex, and rostral anterior cingulate cortex compared with HCs. Further, rsFC between the striatum and the right medial OFC was significantly associated with negative symptom severity. The involved striatal regions were primarily at the ventral putamen. Our results support reduced frontostriatal functional connectivity in SCZ and implicate striatal connectivity with the right medial OFC in negative symptoms. This task-independent resting functional magnetic resonance imaging study showed that medial OFC-striatum functional connectivity is reduced in SCZ and associated with severity of negative symptoms. This finding supports a significant association between frontostriatal connectivity and negative symptoms and thus may provide a potential circuitry-level biomarker to study the neurobiological mechanisms of negative symptoms.
Collapse
Affiliation(s)
- Dinesh K Shukla
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD,To whom correspondence should be addressed; Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, PO Box 21247, Baltimore, MD 21228, US; tel: 410-402-6028, fax: 410-402-6077, e-mail:
| | - Joshua John Chiappelli
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Hemalatha Sampath
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Peter Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Stephanie M Hare
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Krista Wisner
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Laura M Rowland
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - L Elliot Hong
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| |
Collapse
|
31
|
Lee J, Jimenez AM, Reavis EA, Horan WP, Wynn JK, Green MF. Reduced Neural Sensitivity to Social vs Nonsocial Reward in Schizophrenia. Schizophr Bull 2019; 45:620-628. [PMID: 30189096 PMCID: PMC6483569 DOI: 10.1093/schbul/sby109] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Human beings find social stimuli rewarding, which is thought to facilitate efficient social functioning. Although reward processing has been extensively studied in schizophrenia, a few studies have examined neural processes specifically involved in social reward processing. This study examined neural sensitivity to social and nonsocial rewards in schizophrenia. METHODS Twenty-seven patients with schizophrenia and 25 community controls completed a One-Armed Bandit Task, an implicit reinforcement learning task, in the scanner. There were 2 conditions with an identical trial structure, one with social rewards and the other with nonsocial rewards. The data were analyzed using a region of interest (ROI) approach, focusing on the ventral striatum, ventromedial prefrontal cortex, and anterior cingulate cortex. RESULTS Across all 3 ROIs, patients showed reduced activation for social rewards compared to controls. However, the 2 groups showed comparable levels of activation for nonsocial rewards. Within the patient group, levels of neural activation in these ROIs during the social reward condition were associated with better performance. CONCLUSIONS This study found reduced neural sensitivity in patients with schizophrenia in key reward-processing regions for social but not for nonsocial rewards. These findings suggest a relatively specific social reward-processing deficit in schizophrenia during an implicit reinforcement learning task.
Collapse
Affiliation(s)
- Junghee Lee
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA,Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA,To whom correspondence should be addressed; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, 760 Westwood Plaza, Room 27-460, Los Angeles, CA 90211, USA; tel: 310-794-9010, fax: 310-268-4056, e-mail:
| | - Amy M Jimenez
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA,Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Eric A Reavis
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA,Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA,Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Jonathan K Wynn
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA,Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA,Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA
| |
Collapse
|
32
|
Schneider K, Michels L, Hartmann-Riemer MN, Burrer A, Tobler PN, Stämpfli P, Kirschner M, Seifritz E, Kaiser S. Cerebral blood flow in striatal regions is associated with apathy in patients with schizophrenia. J Psychiatry Neurosci 2019; 44:102-110. [PMID: 30246686 PMCID: PMC6397041 DOI: 10.1503/jpn.170150] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Striatal dysfunction has been proposed as a pathomechanism for negative symptoms in schizophrenia. There is consensus that negative symptoms can be grouped into 2 dimensions: apathy and diminished expression. Recent studies suggest that different neural mechanisms underlie these dimensions, but the relationship between regional resting-state cerebral blood flow (rCBF) and negative symptom dimensions has not been investigated. METHODS This study included 29 patients with schizophrenia and 20 healthy controls. We measured rCBF in the striatum using arterial spin labelling (ASL) MRI. We assessed negative symptoms using the Brief Negative Symptom Scale. RESULTS In the ventral and dorsal striatum, rCBF was not different between patients with schizophrenia and controls. However, we did find a positive association between the severity of apathy and increased rCBF in the ventral and dorsal striatum in patients with schizophrenia. This effect was not present for diminished expression. LIMITATIONS All patients were taking atypical antipsychotics, so an effect of antipsychotic medication on rCBF could not be excluded, although we did not find a significant association between rCBF and chlorpromazine equivalents. CONCLUSION The main finding of this study was a specific association between increased striatal rCBF and the negative symptom dimension of apathy. Our results further support the separate assessment of apathy and diminished expression when investigating the neural basis of negative symptoms. The ASL technique can provide a direct and quantitative approach to investigating the role of rCBF changes in the pathophysiology of negative symptoms.
Collapse
Affiliation(s)
- Karoline Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich (Schneider, Hartmann-Riemer, Burrer, Stämpfli, Kirschner, Seifritz); Institute of Neuroradiology, University Hospital Zurich (Michels); Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich (Hartmann-Riemer, Tobler); MR Center of the Psychiatric University Hospital and the Department of Child and Adolescent Psychiatry, University of Zurich (Stämpfli); and the Adult Psychiatry Division, Department of Mental Health and Psychiatry, Geneva University Hospitals (Kaiser)
| | - Lars Michels
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich (Schneider, Hartmann-Riemer, Burrer, Stämpfli, Kirschner, Seifritz); Institute of Neuroradiology, University Hospital Zurich (Michels); Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich (Hartmann-Riemer, Tobler); MR Center of the Psychiatric University Hospital and the Department of Child and Adolescent Psychiatry, University of Zurich (Stämpfli); and the Adult Psychiatry Division, Department of Mental Health and Psychiatry, Geneva University Hospitals (Kaiser)
| | - Matthias N Hartmann-Riemer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich (Schneider, Hartmann-Riemer, Burrer, Stämpfli, Kirschner, Seifritz); Institute of Neuroradiology, University Hospital Zurich (Michels); Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich (Hartmann-Riemer, Tobler); MR Center of the Psychiatric University Hospital and the Department of Child and Adolescent Psychiatry, University of Zurich (Stämpfli); and the Adult Psychiatry Division, Department of Mental Health and Psychiatry, Geneva University Hospitals (Kaiser)
| | - Achim Burrer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich (Schneider, Hartmann-Riemer, Burrer, Stämpfli, Kirschner, Seifritz); Institute of Neuroradiology, University Hospital Zurich (Michels); Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich (Hartmann-Riemer, Tobler); MR Center of the Psychiatric University Hospital and the Department of Child and Adolescent Psychiatry, University of Zurich (Stämpfli); and the Adult Psychiatry Division, Department of Mental Health and Psychiatry, Geneva University Hospitals (Kaiser)
| | - Philippe N Tobler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich (Schneider, Hartmann-Riemer, Burrer, Stämpfli, Kirschner, Seifritz); Institute of Neuroradiology, University Hospital Zurich (Michels); Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich (Hartmann-Riemer, Tobler); MR Center of the Psychiatric University Hospital and the Department of Child and Adolescent Psychiatry, University of Zurich (Stämpfli); and the Adult Psychiatry Division, Department of Mental Health and Psychiatry, Geneva University Hospitals (Kaiser)
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich (Schneider, Hartmann-Riemer, Burrer, Stämpfli, Kirschner, Seifritz); Institute of Neuroradiology, University Hospital Zurich (Michels); Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich (Hartmann-Riemer, Tobler); MR Center of the Psychiatric University Hospital and the Department of Child and Adolescent Psychiatry, University of Zurich (Stämpfli); and the Adult Psychiatry Division, Department of Mental Health and Psychiatry, Geneva University Hospitals (Kaiser)
| | - Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich (Schneider, Hartmann-Riemer, Burrer, Stämpfli, Kirschner, Seifritz); Institute of Neuroradiology, University Hospital Zurich (Michels); Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich (Hartmann-Riemer, Tobler); MR Center of the Psychiatric University Hospital and the Department of Child and Adolescent Psychiatry, University of Zurich (Stämpfli); and the Adult Psychiatry Division, Department of Mental Health and Psychiatry, Geneva University Hospitals (Kaiser)
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich (Schneider, Hartmann-Riemer, Burrer, Stämpfli, Kirschner, Seifritz); Institute of Neuroradiology, University Hospital Zurich (Michels); Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich (Hartmann-Riemer, Tobler); MR Center of the Psychiatric University Hospital and the Department of Child and Adolescent Psychiatry, University of Zurich (Stämpfli); and the Adult Psychiatry Division, Department of Mental Health and Psychiatry, Geneva University Hospitals (Kaiser)
| | - Stefan Kaiser
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich (Schneider, Hartmann-Riemer, Burrer, Stämpfli, Kirschner, Seifritz); Institute of Neuroradiology, University Hospital Zurich (Michels); Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich (Hartmann-Riemer, Tobler); MR Center of the Psychiatric University Hospital and the Department of Child and Adolescent Psychiatry, University of Zurich (Stämpfli); and the Adult Psychiatry Division, Department of Mental Health and Psychiatry, Geneva University Hospitals (Kaiser)
| |
Collapse
|
33
|
Lemmers-Jansen ILJ, Fett AKJ, Van Doesum NJ, Van Lange PAM, Veltman DJ, Krabbendam L. Social Mindfulness and Psychosis: Neural Response to Socially Mindful Behavior in First-Episode Psychosis and Patients at Clinical High-Risk. Front Hum Neurosci 2019; 13:47. [PMID: 30814943 PMCID: PMC6381043 DOI: 10.3389/fnhum.2019.00047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/29/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Psychosis is characterized by problems in social functioning and trust, the assumed glue to positive social relations. But what helps building trust? A prime candidate could be social mindfulness: the ability and willingness to see and consider another person’s needs and wishes during social decision making. We investigated whether first-episode psychosis patients (FEP) and patients at clinical high-risk (CHR) show reduced social mindfulness, and examined the underlying neural mechanisms. Methods: Twenty FEP, 17 CHR and 46 healthy controls, aged 16–31, performed the social mindfulness task (SoMi) during fMRI scanning, spontaneously and after the instruction “to keep the other’s best interest in mind.” As first of two people, participants had to choose one out of four products, of which three were identical and one was unique, differing in a single aspect (e.g., color). Results: FEP tended to choose the unique item (unmindful choice) more often than controls. After instruction, all groups significantly increased the number of mindful choices compared to the spontaneous condition. FEP showed reduced activation of the caudate and medial prefrontal cortex (mPFC) during mindful, and of the anterior cingulate cortex (ACC), mPFC, and left dorsolateral prefrontal cortex (dlPFC) during unmindful decisions. CHR showed reduced activation of the ACC compared to controls. Discussion: FEP showed a trend toward more unmindful choices. A similar increase of mindful choices after instruction indicated the ability for social mindfulness when prompted. Results suggested reduced sensitivity to the rewarding aspects of social mindfulness in FEP, and reduced consideration for the other player. FEP (and CHR to a lesser extent) might perceive unmindful choices as less incongruent with the automatic mindful responses than controls. Reduced socially mindful behavior in FEP may hinder the building of trust and cooperative interactions.
Collapse
Affiliation(s)
- Imke L J Lemmers-Jansen
- Section of Educational Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Section Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Anne-Kathrin J Fett
- Department of Psychology, City, University of London, London, United Kingdom
| | - Niels J Van Doesum
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Social and Organisational Psychology, Leiden University, Leiden, Netherlands
| | - Paul A M Van Lange
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Dick J Veltman
- Neuroscience Campus Amsterdam, Vrije Universiteit Amsterdam, VU Medical Center Amsterdam, Amsterdam, Netherlands
| | - Lydia Krabbendam
- Section Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
34
|
Vanes LD, Mouchlianitis E, Collier T, Averbeck BB, Shergill SS. Differential neural reward mechanisms in treatment-responsive and treatment-resistant schizophrenia. Psychol Med 2018; 48:2418-2427. [PMID: 29439750 PMCID: PMC6704377 DOI: 10.1017/s0033291718000041] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The significant proportion of schizophrenia patients refractory to treatment, primarily directed at the dopamine system, suggests that multiple mechanisms may underlie psychotic symptoms. Reinforcement learning tasks have been employed in schizophrenia to assess dopaminergic functioning and reward processing, but these have not directly compared groups of treatment-refractory and non-refractory patients. METHODS In the current functional magnetic resonance imaging study, 21 patients with treatment-resistant schizophrenia (TRS), 21 patients with non-treatment-resistant schizophrenia (NTR), and 24 healthy controls (HC) performed a probabilistic reinforcement learning task, utilizing emotionally valenced face stimuli which elicit a social bias toward happy faces. Behavior was characterized with a reinforcement learning model. Trial-wise reward prediction error (RPE)-related neural activation and the differential impact of emotional bias on these reward signals were compared between groups. RESULTS Patients showed impaired reinforcement learning relative to controls, while all groups demonstrated an emotional bias favoring happy faces. The pattern of RPE signaling was similar in the HC and TRS groups, whereas NTR patients showed significant attenuation of RPE-related activation in striatal, thalamic, precentral, parietal, and cerebellar regions. TRS patients, but not NTR patients, showed a positive relationship between emotional bias and RPE signal during negative feedback in bilateral thalamus and caudate. CONCLUSION TRS can be dissociated from NTR on the basis of a different neural mechanism underlying reinforcement learning. The data support the hypothesis that a favorable response to antipsychotic treatment is contingent on dopaminergic dysfunction, characterized by aberrant RPE signaling, whereas treatment resistance may be characterized by an abnormality of a non-dopaminergic mechanism - a glutamatergic mechanism would be a possible candidate.
Collapse
Affiliation(s)
- Lucy D Vanes
- Institute of Psychiatry, Psychology and Neuroscience,de Crespigny Park,London, SE5 8AF,UK
| | - Elias Mouchlianitis
- Institute of Psychiatry, Psychology and Neuroscience,de Crespigny Park,London, SE5 8AF,UK
| | - Tracy Collier
- Institute of Psychiatry, Psychology and Neuroscience,de Crespigny Park,London, SE5 8AF,UK
| | - Bruno B Averbeck
- Unit on Learning and Decision Making, Laboratory of Neuropsychology,NIMH,NIH, Bethesda, MD 20892,USA
| | - Sukhi S Shergill
- Institute of Psychiatry, Psychology and Neuroscience,de Crespigny Park,London, SE5 8AF,UK
| |
Collapse
|
35
|
Martin EA, McCleery A, Moore MM, Wynn JK, Green MF, Horan WP. ERP indices of performance monitoring and feedback processing in psychosis: A meta-analysis. Int J Psychophysiol 2018; 132:365-378. [PMID: 30102934 PMCID: PMC6157731 DOI: 10.1016/j.ijpsycho.2018.08.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although individuals with, or at risk for, psychotic disorders often show difficulties with performance monitoring and feedback processing, findings from studies using event-related potentials (ERPs) to index these processes are not consistent. This meta-analytic review focused on studies of two different indexes of performance monitoring, the early error-related negativity (ERN; n = 25) and the later error positivity (Pe; n = 17), and one index of feedback processing, the feedback negativity (FN; n = 6). METHODS We evaluated whether individuals (1) with psychotic disorders, or (2) at heightened risk for these disorders differ from healthy controls in available studies of the ERN, Pe, and FN. RESULTS There was a significant, large ERN reduction in those with psychosis (g = -0.96) compared to controls, and a significant, moderate ERN reduction in those at-risk (g = -0.48). In contrast, there were uniformly non-significant, small between-group differences for Pe and FN (gs ≤ |0.16|). CONCLUSIONS The results reveal a differential pattern of impairment in psychosis. Early performance monitoring (ERN) impairments are substantial among those with psychotic disorders in general and may be a useful vulnerability indicator for these disorders. However, later performance monitoring (Pe) and basic feedback processing (FN) appear to be relatively spared in psychosis.
Collapse
Affiliation(s)
- Elizabeth A Martin
- Department of Psychological Science, University of California, Irvine, United States of America.
| | - Amanda McCleery
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
| | - Melody M Moore
- Department of Psychological Science, University of California, Irvine, United States of America
| | - Jonathan K Wynn
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
| | - Michael F Green
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
| | - William P Horan
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
| |
Collapse
|
36
|
Apathy in schizophrenia: A review of neuropsychological and neuroanatomical studies. Neuropsychologia 2018; 118:22-33. [DOI: 10.1016/j.neuropsychologia.2017.09.033] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 07/28/2017] [Accepted: 09/26/2017] [Indexed: 01/28/2023]
|
37
|
Abstract
Motivational impairment has long been associated with schizophrenia but the underlying mechanisms are not clearly understood. Recently, a small but growing literature has suggested that aberrant effort-based decision-making may be a potential contributory mechanism for motivational impairments in psychosis. Specifically, multiple reports have consistently demonstrated that individuals with schizophrenia are less willing than healthy controls to expend effort to obtain rewards. Further, this effort-based decision-making deficit has been shown to correlate with severity of negative symptoms and level of functioning, in many but not all studies. In the current review, we summarize this literature and discuss several factors that may underlie aberrant effort-based decision-making in schizophrenia.
Collapse
Affiliation(s)
- Adam J. Culbreth
- Department of Psychological and Brain Sciences, Washington University in Saint Louis
| | - Erin K. Moran
- Department of Psychiatry, Washington University in Saint Louis
| | - Deanna M. Barch
- Department of Psychological and Brain Sciences, Washington University in Saint Louis
- Department of Psychiatry, Washington University in Saint Louis
- Department of Radiology, Washington University in Saint Louis
| |
Collapse
|
38
|
Stepien M, Manoliu A, Kubli R, Schneider K, Tobler PN, Seifritz E, Herdener M, Kaiser S, Kirschner M. Investigating the association of ventral and dorsal striatal dysfunction during reward anticipation with negative symptoms in patients with schizophrenia and healthy individuals. PLoS One 2018; 13:e0198215. [PMID: 29912880 PMCID: PMC6005482 DOI: 10.1371/journal.pone.0198215] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/15/2018] [Indexed: 12/21/2022] Open
Abstract
Background Negative symptoms are a core feature of schizophrenia and also found in healthy individuals in subclinical forms. According to the current literature the two negative symptom domains, apathy and diminished expression may have different underlying neural mechanisms. Previous observations suggest that striatal dysfunction is associated with apathy in schizophrenia. However, it is unclear whether apathy is specifically related to ventral or dorsal striatal alterations. Here, we investigated striatal dysfunction during reward anticipation in patients with schizophrenia and a non-clinical population, to determine whether it is associated with apathy. Methods Chronic schizophrenia patients (n = 16) and healthy controls (n = 23) underwent an event- related functional MRI, while performing a variant of the Monetary Incentive Delay Task. The two negative symptom domains were assessed in both groups using the Brief Negative Symptoms Scale. Results In schizophrenia patients, we saw a strong negative correlation between apathy and ventral and dorsal striatal activation during reward anticipation. In contrast, there was no correlation with diminished expression. In healthy controls, apathy was not correlated with ventral or dorsal striatal activation during reward anticipation. Conclusion This study replicates our previous findings of a correlation between ventral striatal activity and apathy but not diminished expression in chronic schizophrenia patients. The association between apathy and reduced dorsal striatal activity during reward anticipation suggests that impaired action-outcome selection is involved in the pathophysiology of motivational deficits in schizophrenia.
Collapse
Affiliation(s)
- Marta Stepien
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Andrei Manoliu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Roman Kubli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Karoline Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Philippe N. Tobler
- Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Marcus Herdener
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Center for Addictive Disorders, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Stefan Kaiser
- Division of Adult Psychiatry, Department of Mental Health and Psychiatry, Geneva University Hospitals, Chemin du Petit-Bel-Air, Chêne-Bourg, Switzerland
| | - Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Center for Addictive Disorders, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- * E-mail:
| |
Collapse
|
39
|
Striatal dysfunction in patients with schizophrenia and their unaffected first-degree relatives. Schizophr Res 2018; 195:215-221. [PMID: 28867519 DOI: 10.1016/j.schres.2017.08.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/20/2017] [Accepted: 08/21/2017] [Indexed: 12/15/2022]
Abstract
Despite empirical findings showing that patients with schizophrenia and their unaffected first-degree relatives have deficits in processing monetary incentives, it is unclear whether similar deficits could be demonstrated for affective incentives. Twenty-six patients with schizophrenia and 26 age and gender matched healthy controls; 23 unaffected first-degree relatives and 23 matched healthy controls were recruited to complete a Monetary Incentive Delay (MID) task and an Affective Incentive Delay (AID) task in a 3-Tesla MRI scanner. Hypoactivation in the dorsal striatum when anticipating monetary incentives were found in patients with schizophrenia and their unaffected first-degree relatives compared with healthy controls. Furthermore, patients with schizophrenia showed hyperactivation in the ventral striatum when receiving both monetary and affective incentives. These findings suggest that disorganized striatal function, regardless of incentive types, may be present in patients with schizophrenia and before the onset of illness in their first-degree unaffected relatives.
Collapse
|
40
|
Lambert C, Da Silva S, Ceniti AK, Rizvi SJ, Foussias G, Kennedy SH. Anhedonia in depression and schizophrenia: A transdiagnostic challenge. CNS Neurosci Ther 2018; 24:615-623. [PMID: 29687627 DOI: 10.1111/cns.12854] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/10/2018] [Accepted: 03/12/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Anhedonia, as a dysregulation of the reward circuit, is present in both Major Depressive Disorder (MDD) and schizophrenia (SZ). AIMS To elucidate the clinical and neurobiological differences between schizophrenia (SZ) and depression (MDD) in regard to anhedonia, while reconciling the challenges and benefits of assessing anhedonia as a transdiagnostic feature under the Research Domain Criteria (RDoC) framework. METHODS In this review, we summarize data from publications examining anhedonia or its underlying reward deficits in SZ and MDD. A literature search was conducted in OVID Medline, PsycINFO and EMBASE databases between 2000 and 2017. RESULTS While certain subgroups share commonalities, there are also important differences. SZ may be characterized by a disorganization, rather than a deficiency, in reward processing and cognitive function, including inappropriate energy expenditure and focus on irrelevant cues. In contrast, MDD has been characterized by deficits in anticipatory pleasure, development of reward associations, and integration of information from past experience. Understanding the roles of neurotransmitters and aberrant brain circuitry is necessary to appreciate differences in reward function in SZ and MDD. CONCLUSION Anhedonia as a clinical presentation of reward circuit dysregulation is an important and relatively undertreated symptom of both SZ and MDD. In order to improve patient outcomes and quality of life, it is important to consider how anhedonia fits into both diagnoses.
Collapse
Affiliation(s)
- Clare Lambert
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada.,Royal College of Surgeons in Ireland, School of Medicine, Dublin, Ireland
| | - Susana Da Silva
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Amanda K Ceniti
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Sakina J Rizvi
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Mental Health and Addiction Service, St. Michael's Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - George Foussias
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sidney H Kennedy
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Mental Health and Addiction Service, St. Michael's Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
41
|
Culbreth AJ, Moran EK, Barch DM. Effort-cost decision-making in psychosis and depression: could a similar behavioral deficit arise from disparate psychological and neural mechanisms? Psychol Med 2018; 48:889-904. [PMID: 28889803 DOI: 10.1017/s0033291717002525] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Motivational impairment is a common feature of both depression and psychosis; however, the psychological and neural mechanisms that give rise to motivational impairment in these disorders are poorly understood. Recent research has suggested that aberrant effort-cost decision-making (ECDM) may be a potential contributor to motivational impairment in both psychosis and depression. ECDM refers to choices that individuals make regarding the amount of 'work' they are willing to expend to obtain a certain outcome or reward. Recent experimental work has suggested that those with psychosis and depression may be less willing to expend effort to obtain rewards compared with controls, and that this effort deficit is related to motivational impairment in both disorders. In the current review, we aim to summarize the current literature on ECDM in psychosis and depression, providing evidence for transdiagnostic impairment. Next, we discuss evidence for the hypothesis that a seemingly similar behavioral ECDM deficit might arise from disparate psychological and neural mechanisms. Specifically, we argue that effort deficits in psychosis might be largely driven by deficits in cognitive control and the neural correlates of cognitive control processes, while effort deficits in depression might be largely driven by reduced reward responsivity and the associated neural correlates of reward responsivity. Finally, we will provide some discussion regarding future directions, as well as interpretative challenges to consider when examining ECDM transdiagnostically.
Collapse
Affiliation(s)
- A J Culbreth
- Department of Psychological and Brain Sciences,Washington University in Saint Louis,St. Louis, MO,USA
| | - E K Moran
- Department of Psychiatry,Washington University in Saint Louis,St. Louis, MO,USA
| | - D M Barch
- Department of Psychological and Brain Sciences,Washington University in Saint Louis,St. Louis, MO,USA
| |
Collapse
|
42
|
Nielsen MØ, Rostrup E, Broberg BV, Wulff S, Glenthøj B. Negative Symptoms and Reward Disturbances in Schizophrenia Before and After Antipsychotic Monotherapy. Clin EEG Neurosci 2018; 49:36-45. [PMID: 29145751 DOI: 10.1177/1550059417744120] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Negative symptoms (NS) are a central part of the symptomatology of schizophrenia, which is highly correlated to the functional outcome. Disturbances of the brain reward system are suggested to be central in the pathogenesis of NS by decreasing motivation and hedonic experiences. In this study, we compared reward-related brain activity in patients improving and not improving in NS after treatment with amisulpride. METHODS Thirty-nine antipsychotic-naive patients and 49 healthy controls completed functional magnetic resonance imaging with a modified monetary incentive delay task. Psychopathology of the patients was characterised with Positive and Negative Syndrome Scale (PANSS), and they were treated with individual doses of amisulpride (mean 271 mg) for 6 weeks, after which the examinations were repeated. RESULTS Patients improved on positive, general, and total PANSS score after treatment ( P < .001). Fourteen patients had ≥20% improvement of NS, whereas 25 patients improved <20%. At baseline, one-way analysis of variance showed group difference bilaterally in the caudate nucleus and in the right nucleus accumbens (all P < .002), which was caused by decreased reward anticipation activity in the nonimproving patients compared to healthy controls. There was a significant group × time interaction, with the healthy controls and the improvers decreasing and the nonimprovers increasing in reward anticipation activity after treatment, most pronounced in the left caudate nucleus ( P = .001). DISCUSSION Patients improving in NS score had a less aberrant reward system at baseline, but reward related activity was reduced over time. Patients not improving in NS showed decreased striatal reward-activity at baseline, which improved over time. Whether this is associated with alteration in working memory and reward learning or with pronounced symptoms within specific domains of NS may be addressed in future studies.
Collapse
Affiliation(s)
- Mette Ødegaard Nielsen
- 1 Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Copenhagen University Hospital, Mental Health Centre Glostrup, Denmark
| | - Egill Rostrup
- 1 Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Copenhagen University Hospital, Mental Health Centre Glostrup, Denmark.,2 Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine Rigshospitalet, Glostrup, Denmark
| | - Brian Villumsen Broberg
- 1 Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Copenhagen University Hospital, Mental Health Centre Glostrup, Denmark
| | - Sanne Wulff
- 1 Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Copenhagen University Hospital, Mental Health Centre Glostrup, Denmark
| | - Birte Glenthøj
- 1 Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Copenhagen University Hospital, Mental Health Centre Glostrup, Denmark
| |
Collapse
|
43
|
Kirschner M, Hager OM, Muff L, Bischof M, Hartmann-Riemer MN, Kluge A, Habermeyer B, Seifritz E, Tobler PN, Kaiser S. Ventral Striatal Dysfunction and Symptom Expression in Individuals With Schizotypal Personality Traits and Early Psychosis. Schizophr Bull 2018; 44:147-157. [PMID: 27798223 PMCID: PMC5767950 DOI: 10.1093/schbul/sbw142] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Striatal abnormalities play a crucial role in the pathophysiology of schizophrenia. Growing evidence suggests an association between aberrant striatal activity during reward anticipation and symptom dimensions in schizophrenia. However, it is not clear whether this holds across the psychosis continuum. The aim of the present study was to investigate alterations of ventral striatal activation during reward anticipation and its relationship to symptom expression in persons with schizotypal personality traits (SPT) and first-episode psychosis. Twenty-six individuals with high SPT, 26 patients with non-affective first-episode psychosis (including 13 with brief psychotic disorder (FEP-BPD) and 13 with first-episode schizophrenia [FEP-SZ]) and 25 healthy controls underwent event-related functional magnetic resonance imaging while performing a variant of the Monetary Incentive Delay task. Ventral striatal activation was positively correlated with total symptom severity, in particular with levels of positive symptoms. This association was observed across the psychosis continuum and within each subgroup. Patients with FEP-SZ showed the strongest elevation of striatal activation during reward anticipation, although symptom levels did not differ between groups in the psychosis continuum. While our results provide evidence that variance in striatal activation is mainly explained by dimensional symptom expression, patients with schizophrenia show an additional dysregulation of striatal activation. Trans-diagnostic approaches are promising in order to disentangle dimensional and categorical neural mechanisms in the psychosis continuum.
Collapse
Affiliation(s)
- Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland,To whom correspondence should be addressed; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland; tel: +41-44-384-36-14, fax: +41-44-383-44-56, e-mail:
| | - Oliver M Hager
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland,Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Larissa Muff
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Martin Bischof
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Matthias N Hartmann-Riemer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland,Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Agne Kluge
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Benedikt Habermeyer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Philippe N Tobler
- Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Stefan Kaiser
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| |
Collapse
|
44
|
Zhang B, Lin P, Shi H, Öngür D, Auerbach RP, Wang X, Yao S, Wang X. Mapping anhedonia-specific dysfunction in a transdiagnostic approach: an ALE meta-analysis. Brain Imaging Behav 2017; 10:920-39. [PMID: 26487590 PMCID: PMC4838562 DOI: 10.1007/s11682-015-9457-6] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Anhedonia is a prominent symptom in neuropsychiatric disorders, most markedly in major depressive disorder (MDD) and schizophrenia (SZ). Emerging evidence indicates an overlap in the neural substrates of anhedonia between MDD and SZ, which supported a transdiagnostic approach. Therefore, we used activation likelihood estimation (ALE) meta-analysis of functional magnetic resonance imaging studies in MDD and SZ to examine the neural bases of three subdomains of anhedonia: consummatory anhedonia, anticipatory anhedonia and emotional processing. ALE analysis focused specifically on MDD or SZ was used later to dissociate specific anhedonia-related neurobiological impairments from potential disease general impairments. ALE results revealed that consummatory anhedonia was associated with decreased activation in ventral basal ganglia areas, while anticipatory anhedonia was associated with more substrates in frontal-striatal networks except the ventral striatum, which included the dorsal anterior cingulate, middle frontal gyrus and medial frontal gyrus. MDD and SZ patients showed similar neurobiological impairments in anticipatory and consummatory anhedonia, but differences in the emotional experience task, which may also involve affective/mood general processing. These results support that anhedonia is characterized by alterations in reward processing and relies on frontal-striatal brain circuitry. The transdiagnostic approach is a promising way to reveal the overall neurobiological framework that contributes to anhedonia and could help to improve targeted treatment strategies.
Collapse
Affiliation(s)
- Bei Zhang
- Medical Psychological Institute, The Second Xiangya Hospital of Central South University, 139 Renmin (M) Road, Changsha, Hunan, 410011, People's Republic of China
| | - Pan Lin
- Key Laboratory of Biomedical Information Engineering of Education Ministry, Institute of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shanxi, 710049, People's Republic of China
| | - Huqing Shi
- Department of Psychology, Shanghai Normal University, Shanghai, 200234, People's Republic of China
| | - Dost Öngür
- Harvard Medical School and McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA
| | - Randy P Auerbach
- Harvard Medical School and McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA
| | - Xiaosheng Wang
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China
| | - Shuqiao Yao
- Medical Psychological Institute, The Second Xiangya Hospital of Central South University, 139 Renmin (M) Road, Changsha, Hunan, 410011, People's Republic of China
| | - Xiang Wang
- Medical Psychological Institute, The Second Xiangya Hospital of Central South University, 139 Renmin (M) Road, Changsha, Hunan, 410011, People's Republic of China.
| |
Collapse
|
45
|
Waltz JA, Xu Z, Brown EC, Ruiz RR, Frank MJ, Gold JM. Motivational Deficits in Schizophrenia Are Associated With Reduced Differentiation Between Gain and Loss-Avoidance Feedback in the Striatum. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 3:239-247. [PMID: 29486865 DOI: 10.1016/j.bpsc.2017.07.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 07/20/2017] [Accepted: 07/23/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The current study was designed to test the hypothesis that motivational deficits in schizophrenia (SZ) are tied to a reduced ability to differentially signal gains and instances of loss-avoidance in the brain, leading to reduced ability to form adaptive representations of expected value. METHODS We administered a reinforcement learning paradigm to 27 medicated SZ patients and 27 control subjects in which participants learned three probabilistic discriminations. In regions of interest in reward networks identified a priori, we examined contrasts between trial types with different expected values (e.g., expected gain-nonmonetary) and between outcomes with the same prediction error valence but different experienced values (e.g., gain-loss-avoidance outcome, miss-loss outcome). RESULTS Both whole-brain and region of interest analyses revealed that SZ patients showed reduced differentiation between gain and loss-avoidance outcomes in the dorsal anterior cingulate cortex and bilateral anterior insula. That is, SZ patients showed reduced contrasts between positive prediction errors of different objective values in these areas. In addition, we observed significant correlations between gain-loss-avoidance outcome contrasts in the ventral striatum and ratings for avolition/anhedonia and between expected gain-nonmonetary contrasts in the ventral striatum and ventromedial prefrontal cortex. CONCLUSIONS These results provide further evidence for intact prediction error signaling in medicated SZ patients, especially with regard to loss-avoidance. By contrast, components of frontostriatal circuits appear to show reduced sensitivity to the absolute valence of expected and experienced outcomes, suggesting a mechanism by which motivational deficits may emerge.
Collapse
Affiliation(s)
- James A Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland.
| | - Ziye Xu
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | - Elliot C Brown
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Rebecca R Ruiz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Michael J Frank
- Department of Psychiatry and Brown Institute for Brain Science, Brown University, Providence, Rhode Island
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| |
Collapse
|
46
|
Kaiser S, Lyne J, Agartz I, Clarke M, Mørch-Johnsen L, Faerden A. Individual negative symptoms and domains - Relevance for assessment, pathomechanisms and treatment. Schizophr Res 2017; 186:39-45. [PMID: 27453425 DOI: 10.1016/j.schres.2016.07.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 07/07/2016] [Accepted: 07/15/2016] [Indexed: 12/12/2022]
Abstract
The negative symptoms of schizophrenia can be divided into two domains. Avolition/apathy includes the individual symptoms of avolition, asociality and anhedonia. Diminished expression includes blunted affect and alogia. Until now, causes and treatment of negative symptoms have remained a major challenge, which is partially related to the focus on negative symptoms as a broad entity. Here, we propose that negative symptoms may become more tractable when the different domains and individual symptoms are taken into account. There is now increasing evidence that the relationship with clinical variables - in particular outcome - differs between the domains of avolition/apathy and diminished expression. Regarding models of negative symptom formation, those relevant to avolition/apathy are now converging on processes underlying goal-directed behavior and dysfunctions of the reward system. In contrast, models of the diminished expression domains are only beginning to emerge. The aim of this article is to review the specific clinical, behavioral and neural correlates of individual symptoms and domains as a better understanding of these areas may facilitate specific treatment approaches.
Collapse
Affiliation(s)
- Stefan Kaiser
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - John Lyne
- Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland; North Dublin Mental Health Services, Ashlin Centre, Beaumont Road, Dublin 9, Ireland; Dublin and East Treatment and Early Care Team (DETECT) Services, Dublin, Ireland
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway
| | - Mary Clarke
- Dublin and East Treatment and Early Care Team (DETECT) Services, Dublin, Ireland; College of Life Sciences, University College Dublin, Dublin, Ireland
| | - Lynn Mørch-Johnsen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway
| | - Ann Faerden
- NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
47
|
Abstract
In the DSM5, negative symptoms are 1 of the 5 core dimensions of psychopathology evaluated for schizophrenia. However, negative symptoms are not pathognomonic-they are also part of the diagnostic criteria for other schizophrenia-spectrum disorders, disorders that sometimes have comorbid psychosis, diagnoses not in the schizophrenia-spectrum, and the general "nonclinical" population. Although etiological models of negative symptoms have been developed for chronic schizophrenia, there has been little attention given to whether these models have transdiagnostic applicability. In the current review, we examine areas of commonality and divergence in the clinical presentation and etiology of negative symptoms across diagnostic categories. It was concluded that negative symptoms are relatively frequent across diagnostic categories, but individual disorders may differ in whether their negative symptoms are persistent/transient or primary/secondary. Evidence for separate dimensions of volitional and expressive symptoms exists, and there may be multiple mechanistic pathways to the same symptom phenomenon among DSM-5 disorders within and outside the schizophrenia-spectrum (ie, equifinality). Evidence for a novel transdiagnostic etiological model is presented based on the Research Domain Criteria (RDoC) constructs, which proposes the existence of 2 such pathways-a hedonic pathway and a cognitive pathway-that can both lead to expressive or volitional symptoms. To facilitate treatment breakthroughs, future transdiagnostic studies on negative symptoms are warranted that explore mechanisms underlying volitional and expressive pathology.
Collapse
Affiliation(s)
- Gregory P Strauss
- Department of Psychology, University of Georgia, 125 Baldwin Street, Athens, GA 30602
| | - Alex S Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA
| |
Collapse
|
48
|
Neural basis of self-initiative in relation to apathy in a student sample. Sci Rep 2017; 7:3264. [PMID: 28607405 PMCID: PMC5468419 DOI: 10.1038/s41598-017-03564-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 05/02/2017] [Indexed: 12/04/2022] Open
Abstract
Human behaviour can be externally driven, e.g. catching a falling glass, or self-initiated and goal-directed, e.g. drinking a cup of coffee when one deems it is time for a break. Apathy refers to a reduction of self-initiated goal-directed or motivated behaviour, frequently present in neurological and psychiatric disorders. The amount of undertaken goal-directed behaviour varies considerably in clinical as well as healthy populations. In the present study, we investigated behavioural and neural correlates of self-initiated action in a student sample (N = 39) with minimal to high levels of apathy. We replicated activation of fronto-parieto-striatal regions during self-initiation. The neural correlates of self-initiated action did not explain varying levels of apathy in our sample, neither when mass-univariate analysis was used, nor when multivariate patterns of brain activation were considered. Other hypotheses, e.g. regarding a putative role of deficits in reward anticipation, effort expenditure or executive difficulties, deserve investigation in future studies.
Collapse
|
49
|
Effort-Based Reinforcement Processing and Functional Connectivity Underlying Amotivation in Medicated Patients with Depression and Schizophrenia. J Neurosci 2017; 37:4370-4380. [PMID: 28283562 DOI: 10.1523/jneurosci.2524-16.2017] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 02/25/2017] [Accepted: 02/28/2017] [Indexed: 11/21/2022] Open
Abstract
Amotivation is a common phenotype of major depressive disorder and schizophrenia, which are clinically distinct disorders. Effective treatment targets and strategies can be discovered by examining the dopaminergic reward network function underlying amotivation between these disorders. We conducted an fMRI study in healthy human participants and medicated patients with depression and schizophrenia using an effort-based reinforcement task. We examined regional activations related to reward type (positive and negative reinforcement), effort level, and their composite value, as well as resting-state functional connectivities within the meso-striatal-prefrontal pathway. We found that integrated reward and effort values of low effort-positive reinforcement and high effort-negative reinforcement were behaviorally anticipated and represented in the putamen and medial orbitofrontal cortex activities. Patients with schizophrenia and depression did not show anticipation-related and work-related reaction time reductions, respectively. Greater amotivation severity correlated with smaller work-related putamen activity changes according to reward type in schizophrenia and effort level in depression. Patients with schizophrenia showed feedback-related putamen hyperactivity of low effort compared with healthy controls and depressed patients. The strength of medial orbitofrontal-striatal functional connectivity predicted work-related reaction time reduction of high effort negative reinforcement in healthy controls and amotivation severity in both patients with schizophrenia and those with depression. Patients with depression showed deficient medial orbitofrontal-striatal functional connectivity compared with healthy controls and patients with schizophrenia. These results indicate that amotivation in depression and schizophrenia involves different pathophysiology in the prefrontal-striatal circuitry.SIGNIFICANCE STATEMENT Amotivation is present in both depression and schizophrenia. However, treatment involves the use of drugs that enhance serotonin activity in depression and inhibit serotonin and dopamine activity in schizophrenia. Understanding how motivation processed in the mesocorticolimbic and nigostriatal pathways is affected in depression and schizophrenia is important in discovering treatment targets and strategies for amotivation. To our knowledge, this is the first study to compare patients with depression and schizophrenia in a common functional construct. By using an effort-based reinforcement task and examining resting-state functional connectivity in the dopaminergic network, we propose that difference in striato-orbitofrontal dysfunction in effort-based reinforcement between depression and schizophrenia may be related to differences in the extent of functional dysconnectivity in the dopaminergic pathway.
Collapse
|
50
|
Eisenstein SA, Bogdan R, Chen L, Moerlein SM, Black KJ, Perlmutter JS, Hershey T, Barch DM. Preliminary evidence that negative symptom severity relates to multilocus genetic profile for dopamine signaling capacity and D2 receptor binding in healthy controls and in schizophrenia. J Psychiatr Res 2017; 86:9-17. [PMID: 27886638 PMCID: PMC5272837 DOI: 10.1016/j.jpsychires.2016.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/07/2016] [Accepted: 11/15/2016] [Indexed: 12/31/2022]
Abstract
Deficits in central, subcortical dopamine (DA) signaling may underlie negative symptom severity, particularly anhedonia, in healthy individuals and in schizophrenia. To investigate these relationships, we assessed negative symptoms with the Schedule for the Assessment of Negative Symptoms and the Brief Negative Symptom Scale (BNSS) and self-reported anhedonia with the Scales for Physical and Social Anhedonia (SPSA), Temporal Experience of Pleasure Scale, and Snaith-Hamilton Pleasure Scale in 36 healthy controls (HC), 27 siblings (SIB) of individuals with schizophrenia, and 66 individuals with schizophrenia or schizoaffective disorder (SCZ). A subset of participants (N = 124) were genotyped for DA-related polymorphisms in genes for DRD4, DRD2/ANKK1, DAT1, and COMT, which were used to construct biologically-informed multi-locus genetic profile (MGP) scores reflective of subcortical dopaminergic signaling. DA receptor type 2 (D2R) binding was assessed among a second subset of participants (N = 23) using PET scans with the D2R-selective, non-displaceable radioligand (N-[11C]methyl)benperidol. Higher MGP scores, reflecting elevated subcortical dopaminergic signaling capacity, were associated with less negative symptom severity, as measured by the BNSS, across all participants. In addition, higher striatal D2R binding was associated with less physical and social anhedonia, as measured by the SPSA, across HC, SIB, and SCZ. The current preliminary findings support the hypothesis that subcortical DA function may contribute to negative symptom severity and self-reported anhedonia, independent of diagnostic status.
Collapse
Affiliation(s)
- Sarah A. Eisenstein
- Psychiatry Department, Washington University School of Medicine, St. Louis, MO, USA,Radiology Department, Washington University School of Medicine, St. Louis, MO, USA,Corresponding author, Sarah A. Eisenstein, Psychiatry Department, Campus Box 8225, Washington University School of Medicine, St. Louis, MO 63110, Phone: (314) 362-7107, Fax: (314) 362-0168,
| | - Ryan Bogdan
- Psychological & Brain Sciences Department, Washington University in St. Louis, St. Louis, MO, USA.
| | - Ling Chen
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA.
| | - Stephen M. Moerlein
- Radiology Department, Washington University School of Medicine, St. Louis, MO, USA,Biochemistry Department, Washington University School of Medicine, St. Louis, MO, USA
| | - Kevin J. Black
- Psychiatry Department, Washington University School of Medicine, St. Louis, MO, USA,Radiology Department, Washington University School of Medicine, St. Louis, MO, USA,Neurology Department, Washington University School of Medicine, St. Louis, MO, USA,Neuroscience Department, Washington University School of Medicine, MO, USA
| | - Joel S. Perlmutter
- Radiology Department, Washington University School of Medicine, St. Louis, MO, USA,Biochemistry Department, Washington University School of Medicine, St. Louis, MO, USA,Programs in Physical Therapy and Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Tamara Hershey
- Psychiatry Department, Washington University School of Medicine, St. Louis, MO, USA; Radiology Department, Washington University School of Medicine, St. Louis, MO, USA; Psychological & Brain Sciences Department, Washington University in St. Louis, St. Louis, MO, USA; Neurology Department, Washington University School of Medicine, St. Louis, MO, USA.
| | - Deanna M. Barch
- Psychiatry Department, Washington University School of Medicine, St. Louis, MO, USA,Radiology Department, Washington University School of Medicine, St. Louis, MO, USA,Psychological & Brain Sciences Department, Washington University in St. Louis, St. Louis, MO, USA
| |
Collapse
|