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Fekih-Romdhane F, Ghrissi F, Abassi B, Loch AA, Cherif W, Damak R, Ellini S, Cheour M, Hallit S. Impulsivity as a predictor of clinical and psychological outcomes in a naturalistic prospective cohort of subjects at ultra-high risk (UHR) for psychosis from Tunisia. Psychiatry Res 2024; 340:116090. [PMID: 39116689 DOI: 10.1016/j.psychres.2024.116090] [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: 01/12/2024] [Revised: 07/10/2024] [Accepted: 07/16/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Impulsivity is associated with serious detrimental consequences on physical, mental, behavioral and social aspects of health among patients with psychosis. The present prospective 12-month follow-up study aimed to determine the prevalence of highly impulsive individuals among Ultra High Risk (UHR) patients, how impulsivity evolves over the follow-up period, and whether impulsivity impacts clinical, psychological and functional outcomes in this population. METHOD UHR patients were invited to complete a battery of measurements at three-time points: at baseline, and at 6 and 12 months of follow-up. Impulsivity was assessed using both behavioral (the Wisconsin Card Sorting Test, WCST) and self-report (the Barratt Impulsiveness Scale, BIS-11) measures. RESULTS Findings showed that at 6 months of follow-up, higher 6-month BIS-11 attentional and motor impulsivity were significantly associated with lower quality of life and greater general psychological distress. In addition, higher baseline BIS-11 motor impulsivity significantly predicted more severe positive psychotic symptoms at 12 months of follow-up. However, WCST scores did not show any significant associations with study variables at the different times of follow-up. CONCLUSION Interventions targeting impulsivity in UHR individuals could help decrease psychological distress and positive psychotic symptoms' severity, as well as improve quality of life in UHR individuals.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010 Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.
| | - Farah Ghrissi
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010 Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Bouthaina Abassi
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010 Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Alexandre Andrade Loch
- Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR, Brazil; Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Sao Paulo, Brazil
| | - Wissal Cherif
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010 Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Rahma Damak
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010 Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Sana Ellini
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010 Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Majda Cheour
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010 Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon; Applied Science Research Center, Applied Science Private University, Amman, Jordan; Psychology Department, College of Humanities, Effat University, Jeddah 21478, Saudi Arabia.
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2
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Young ME, Spencer-Salmon C, Mosher C, Tamang S, Rajan K, Rudebeck PH. Temporally specific patterns of neural activity in interconnected corticolimbic structures during reward anticipation. Neuron 2023; 111:3668-3682.e5. [PMID: 37586366 PMCID: PMC10840822 DOI: 10.1016/j.neuron.2023.07.012] [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: 02/04/2021] [Revised: 04/25/2023] [Accepted: 07/20/2023] [Indexed: 08/18/2023]
Abstract
Functional neuroimaging studies indicate that interconnected parts of the subcallosal anterior cingulate cortex (ACC), striatum, and amygdala play a fundamental role in affect in health and disease. Yet, although the patterns of neural activity engaged in the striatum and amygdala during affective processing are well established, especially during reward anticipation, less is known about subcallosal ACC. Here, we recorded neural activity in non-human primate subcallosal ACC and compared this with interconnected parts of the basolateral amygdala and rostromedial striatum while macaque monkeys performed reward-based tasks. Applying multiple analysis approaches, we found that neurons in subcallosal ACC and rostromedial striatum preferentially signal anticipated reward using short bursts of activity that form temporally specific patterns. By contrast, the basolateral amygdala uses a mixture of both temporally specific and more sustained patterns of activity to signal anticipated reward. Thus, dynamic patterns of neural activity across populations of neurons are engaged in affect, especially in subcallosal ACC.
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Affiliation(s)
- Megan E Young
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Camille Spencer-Salmon
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Clayton Mosher
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Sarita Tamang
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Kanaka Rajan
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Peter H Rudebeck
- Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
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3
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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.
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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
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4
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Siegel JS, Pearson C, Lenze EJ. Better Biomarkers, Faster Drugs, Stronger Models: Progress Towards Precision Psychiatry. MISSOURI MEDICINE 2023; 120:292-298. [PMID: 37609458 PMCID: PMC10441262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
The 21st century has brought novel therapies and new therapeutic targets for major depressive disorder (MDD). Until recently all antidepressant medications targeted monoamines-serotonin, norepinephrine, and dopamine- and their regulatory systems. But growing evidence has suggested that individuals who fail to respond to a monoaminergic treatment are likely to fail to respond to other monoaminergic options. The emergence in recent years of treatment targets beyond the monoaminergic systems (e.g. κ-opioid antagonists, ketamine and other NMDA modulators, neurosteroids) has cultivated hopes for not only greater efficacy in treating depression, but also improved precision in targeting specific phenotypes and symptoms. Concurrently, an expanding repertoire of diagnostic and assessment tools-such as smartphone-based experience sampling and brain imaging-is moving the field toward more reliable and symptom-specific measurement with greater descriptive and prescriptive power. Taken together, these diagnostic tools and treatment options herald a new era of "precision psychiatry"-the selection and implementation of an optimal treatment for an individual patient's particular needs. Anhedonia offers an example of the new precision psychiatry. Anhedonia has moved from merely one among several criteria for depression to a transdiagnostic psychopathology which can be understood neurobiologically, assessed quantitatively, and centered as a primary target in research and development of novel pharmacotherapies. We describe functional testing of reward circuits in the development of kappa-opioid antagonists for anhedonia. This offers a lens for understanding how and under what circumstances other novel treatments, such as psychedelics, might find a place in the future landscape of precision psychiatric care.
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Affiliation(s)
- Joshua S Siegel
- Instructor of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Craig Pearson
- Medical student, Washington University School of Medicine, St. Louis, Missouri
| | - Eric J Lenze
- Chair of the Department of Psychiatry and Director of the Health Mind Lab, Washington University School of Medicine, St. Louis, Missouri
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5
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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.
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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
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Larsen EM, Donaldson KR, Jonas KG, Lian W, Bromet EJ, Kotov R, Mohanty A. Pleasant and unpleasant odor identification ability is associated with distinct dimensions of negative symptoms transdiagnostically in psychotic disorders. Schizophr Res 2022; 248:183-193. [PMID: 36084492 PMCID: PMC10774004 DOI: 10.1016/j.schres.2022.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/12/2022] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
Negative symptoms are among the greatest sources of functional impairment for individuals with schizophrenia, yet their mechanisms remain poorly understood. Olfactory impairment is associated with negative symptoms. The processing of pleasant olfactory stimuli is subserved by reward-related neural circuitry while unpleasant olfactory processing is subserved by emotion-related neural circuitry, suggesting that these two odor dimensions may offer a window into differential mechanisms of negative symptoms. We examined whether pleasant and unpleasant odor identification bears differential relationships with avolition and inexpressivity dimensions of negative symptoms, whether these relationships are transdiagnostic, and whether pleasant and unpleasant odor processing also relate differently to other domains of functioning in a sample of individuals diagnosed with schizophrenia (N = 54), other psychotic disorders (N = 65), and never-psychotic adults (N = 160). Hierarchical regressions showed that pleasant odor identification was uniquely associated with avolition, while unpleasant odor identification was uniquely associated with inexpressivity. These relationships were largely transdiagnostic across groups. Additionally, pleasant and unpleasant odor identification displayed signs of specificity with other functional and cognitive measures. These results align with past work suggesting dissociable pathomechanisms of negative symptoms and provide a potential avenue for future work using valence-specific olfactory dysfunction as a semi-objective and low-cost marker for understanding and predicting the severity of specific negative symptom profiles.
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Affiliation(s)
- Emmett M. Larsen
- Department of Psychology, Stony Brook University, Stony Brook, NY
| | | | - Katherine G. Jonas
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
| | - Wenxuan Lian
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY
| | - Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
| | - Aprajita Mohanty
- Department of Psychology, Stony Brook University, Stony Brook, NY
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7
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Geana A, Barch DM, Gold JM, Carter CS, MacDonald AW, Ragland JD, Silverstein SM, Frank MJ. Using Computational Modeling to Capture Schizophrenia-Specific Reinforcement Learning Differences and Their Implications on Patient Classification. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1035-1046. [PMID: 33878489 PMCID: PMC9272137 DOI: 10.1016/j.bpsc.2021.03.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Psychiatric diagnosis and treatment have historically taken a symptom-based approach, with less attention on identifying underlying symptom-producing mechanisms. Recent efforts have illuminated the extent to which different underlying circuitry can produce phenotypically similar symptomatology (e.g., psychosis in bipolar disorder vs. schizophrenia). Computational modeling makes it possible to identify and mathematically differentiate behaviorally unobservable, specific reinforcement learning differences in patients with schizophrenia versus other disorders, likely owing to a higher reliance on prediction error-driven learning associated with basal ganglia and underreliance on explicit value representations associated with orbitofrontal cortex. METHODS We used a well-established probabilistic reinforcement learning task to replicate those findings in individuals with schizophrenia both on (n = 120) and off (n = 44) antipsychotic medications and included a patient comparison group of bipolar patients with psychosis (n = 60) and healthy control subjects (n = 72). RESULTS Using accuracy, there was a main effect of group (F3,279 = 7.87, p < .001), such that all patient groups were less accurate than control subjects. Using computationally derived parameters, both medicated and unmediated individuals with schizophrenia, but not patients with bipolar disorder, demonstrated a reduced mixing parameter (F3,295 = 13.91, p < .001), indicating less dependence on learning explicit value representations as well as greater learning decay between training and test (F1,289 = 12.81, p < .001). Unmedicated patients with schizophrenia also showed greater decision noise (F3,295 = 2.67, p = .04). CONCLUSIONS Both medicated and unmedicated patients showed overreliance on prediction error-driven learning as well as significantly higher noise and value-related memory decay, compared with the healthy control subjects and the patients with bipolar disorder. Additionally, the computational model parameters capturing these processes can significantly improve patient/control classification, potentially providing useful diagnosis insight.
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Affiliation(s)
- Andra Geana
- Department of Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, Rhode Island.
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri; Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri; Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, Baltimore, Maryland
| | - Cameron S Carter
- Department of Psychiatry, University of California, Davis, California
| | - Angus W MacDonald
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - J Daniel Ragland
- Department of Psychiatry, University of California, Davis, California
| | | | - Michael J Frank
- Department of Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, Rhode Island
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8
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Giordano GM, Caporusso E, Pezzella P, Galderisi S. Updated perspectives on the clinical significance of negative symptoms in patients with schizophrenia. Expert Rev Neurother 2022; 22:541-555. [PMID: 35758871 DOI: 10.1080/14737175.2022.2092402] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Negative symptoms in schizophrenia are associated with poor response to available treatments, poor quality of life, and functional outcome. Therefore, they represent a substantial burden for people with schizophrenia, their families, and health-care systems. AREAS COVERED In this manuscript, we will provide an update on the conceptualization, assessment, and treatment of this complex psychopathological dimension of schizophrenia. EXPERT OPINION Despite the progress in the conceptualization of negative symptoms and in the development of state-of-the-art assessment instruments made in the last decades, these symptoms are still poorly recognized, and not always assessed in line with current conceptualization. Every effort should be made to disseminate the current knowledge on negative symptoms, on their assessment instruments and available treatments whose efficacy is supported by research evidence. Longitudinal studies should be promoted to evaluate the natural course of negative symptoms, improve our ability to identify the different sources of secondary negative symptoms, provide effective interventions, and target primary and persistent negative symptoms with innovative treatment strategies. Further research is needed to identify pathophysiological mechanisms of primary negative symptoms and foster the development of new treatments.
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9
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Gandhi A, Mote J, Fulford D. A transdiagnostic meta-analysis of physical and social Anhedonia in major depressive disorder and schizophrenia spectrum disorders. Psychiatry Res 2022; 309:114379. [PMID: 35123252 DOI: 10.1016/j.psychres.2021.114379] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/09/2021] [Accepted: 12/29/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Anhedonia is a transdiagnostic construct conceptualized as physical or social, however, the extent to which these subtypes differ across psychotic and mood pathology remains poorly understood. We aimed to quantify the severity of physical and social anhedonia across Major Depressive Disorder (MDD) and Schizophrenia Spectrum Disorder (SSDs). METHODS We conducted meta-analyses of the Chapman Physical and Social Anhedonia Scales (PAS;SAS). We reviewed data from participants with MDD, and SSDs separately. RESULTS Our first meta-analysis (n = 8 studies, 409 participants) with MDD revealed elevated SAS and PAS in MDD compared to controls. Within-group differences were not significant. Depressive symptom severity moderated the between-group effect of PAS. Our second meta-analysis (n = 44 studies, 3352 participants) revealed elevated SAS and PAS in SSDs compared to controls. We detected a moderate difference between the SAS and PAS within the SSD group. Age moderated within-group differences of SAS and PAS. DISCUSSION People with SSD or MDD experience elevated SAS and PAS compared to controls. People with SSDs endorse greater challenges experiencing social rewards relative to physical rewards. People with MDD experience social and physical rewards similarly. The moderating role of depressive symptoms in MDD suggests that physical anhedonia is more state-like than social anhedonia.
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Affiliation(s)
- Arti Gandhi
- Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Ave, Boston MA, 02215, USA.
| | - Jasmine Mote
- Department of Occupational Therapy, Tufts University, 574 Boston Avenue, School of Arts and Sciences, Tufts University, Medford, MA, 02155, USA
| | - Daniel Fulford
- Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Ave, Boston MA, 02215, USA; Department of Psychological & Brain Sciences, Boston University, 900 Commonwealth Ave, Boston MA, 02215, USA
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10
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Pillny M, Krkovic K, Buck L, Lincoln TM. From Memories of Past Experiences to Present Motivation? A Meta-analysis on the Association Between Episodic Memory and Negative Symptoms in People With Psychosis. Schizophr Bull 2022; 48:307-324. [PMID: 34635918 PMCID: PMC8886596 DOI: 10.1093/schbul/sbab120] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Based on findings from cognitive science, it has been theorized that the reductions in motivation and goal-directed behavior in people with psychosis could stem from impaired episodic memory. In the current meta-analysis, we investigated this putative functional link between episodic memory deficits and negative symptoms. We hypothesized that episodic memory deficits in psychosis would be related to negative symptoms in general but would be more strongly related to amotivation than to reduced expressivity. We included 103 eligible studies (13,622 participants) in the analyses. Results revealed significant, moderate negative associations of episodic memory with negative symptoms in general (k = 103; r = -.23; z = -13.40; P ≤ .001; 95% CI [-.26; -.20]), with amotivation (k = 16; r = -.18; z = -6.6; P ≤ .001; 95% CI [-.23; -.13]) and with reduced expressivity (k = 15; r = -.18; z = -3.30; P ≤.001; 95% CI[-.29; -.07]). These associations were not moderated by sociodemographic characteristics, positive symptoms, depression, antipsychotic medication or type of negative symptom scale. Although these findings provide sound evidence for the association between episodic memory deficits and amotivation, the rather small magnitude and the unspecific pattern of this relationship also indicate that episodic memory deficits are unlikely to be the only factor relevant to amotivation. This implicates that future research should investigate episodic memory in conjunction with other factors that could account for the association of episodic memory deficits and amotivation in psychosis.
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Affiliation(s)
- Matthias Pillny
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Katarina Krkovic
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Laura Buck
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
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11
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Brakowski J, Manoliu A, Homan P, Bosch OG, Herdener M, Seifritz E, Kaiser S, Kirschner M. Aberrant striatal coupling with default mode and central executive network relates to self-reported avolition and anhedonia in schizophrenia. J Psychiatr Res 2022; 145:263-275. [PMID: 33187692 DOI: 10.1016/j.jpsychires.2020.10.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 10/13/2020] [Accepted: 10/30/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Avolition and anhedonia are common symptoms in schizophrenia and are related to poor long-term prognosis. There is evidence for aberrant cortico-striatal function and connectivity as neural substrate of avolition and anhedonia. However, it remains unclear how both relate to shared or distinct striatal coupling with large-scale intrinsic networks. Using resting state functional magnetic resonance imaging (rs-fMRI) this study investigated the association of large-scale cortico-striatal functional connectivity with self-reported and clinician-rated avolition and anhedonia in subjects with schizophrenia. METHODS Seventeen subjects with schizophrenia (SZ) and 28 healthy controls (HC) underwent rs-fMRI. Using Independent Component Analysis (ICA), we assessed Independent Components (ICs) reflecting intrinsic connectivity networks (ICNs), intra intrinsic functional connectivity within the ICs (intra-iFC), and intrinsic functional connectivity between different ICs (inter-iFC). Avolition and anhedonia were assessed using the Self Evaluation Scale for Negative Symptoms and the Brief Negative Symptom Scale. RESULTS ICA revealed three striatal components and six cortical ICNs. Both self-rated avolition and anhedonia correlated with increased inter-iFC between the caudate and posterior Default Mode Network (pDMN) and between the caudate and Central Executive Network (CEN). In contrast, clinician-rated avolition and anhedonia were not correlated with cortico-striatal connectivity. Group comparison revealed trend-wise decreased inter-iFC between the caudate and Salience Network (SN) in schizophrenia patients compared to HC. DISCUSSION Self-rated, but not clinician-rated, avolition and anhedonia was associated with aberrant striatal coupling with the default mode and the central executive network. These findings suggest that self-reported and clinician-rated scores might capture different aspects of motivational and hedonic deficits in schizophrenia and therefore relate to different cortico-striatal functional abnormalities.
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Affiliation(s)
- Janis Brakowski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland.
| | - Andrei Manoliu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland; Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Russell Square House, 10-12, Russell Square London, WC1B 5EH, United Kingdom
| | - Philipp Homan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
| | - Oliver G Bosch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
| | - Marcus Herdener
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
| | - Stefan Kaiser
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Chemin Du Petit-Bel-Air, 1226, Thônex, Switzerland
| | - Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland; Montreal Neurological Institute, McGill University, 3801 University St, Montréal, QC, H3A 2B4, Canada.
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12
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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.
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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.
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13
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Kesby JP, Murray GK, Knolle F. Neural Circuitry of Salience and Reward Processing in Psychosis. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 3:33-46. [PMID: 36712572 PMCID: PMC9874126 DOI: 10.1016/j.bpsgos.2021.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 02/01/2023] Open
Abstract
The processing of salient and rewarding stimuli is integral to engaging our attention, stimulating anticipation for future events, and driving goal-directed behaviors. Widespread impairments in these processes are observed in psychosis, which may be associated with worse functional outcomes or mechanistically linked to the development of symptoms. Here, we summarize the current knowledge of behavioral and functional neuroimaging in salience, prediction error, and reward. Although each is a specific process, they are situated in multiple feedback and feedforward systems integral to decision making and cognition more generally. We argue that the origin of salience and reward processing dysfunctions may be centered in the subcortex during the earliest stages of psychosis, with cortical abnormalities being initially more spared but becoming more prominent in established psychotic illness/schizophrenia. The neural circuits underpinning salience and reward processing may provide targets for delaying or preventing progressive behavioral and neurobiological decline.
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Affiliation(s)
- James P. Kesby
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia,Address correspondence to James Kesby, Ph.D.
| | - Graham K. Murray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Franziska Knolle
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom,Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany,Franziska Knolle, Ph.D.
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14
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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.
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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.)
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15
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Prettyman GE, Kable JW, Didier P, Shankar S, Satterthwaite TD, Davatzikos C, Bilker WB, Elliott MA, Ruparel K, Wolf DH. Relationship of ventral striatum activation during effort discounting to clinical amotivation severity in schizophrenia. NPJ SCHIZOPHRENIA 2021; 7:48. [PMID: 34625567 PMCID: PMC8501117 DOI: 10.1038/s41537-021-00178-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/17/2021] [Indexed: 12/04/2022]
Abstract
Motivational deficits play a central role in disability due to negative symptoms of schizophrenia (SZ), but limited pathophysiological understanding impedes critically needed therapeutic development. We applied an fMRI Effort Discounting Task (EDT) that quantifies motivation using a neuroeconomic decision-making approach, capturing the degree to which effort requirements produce reductions in the subjective value (SV) of monetary reward. An analyzed sample of 21 individuals with SZ and 23 group-matched controls performed the EDT during fMRI. We hypothesized that ventral striatum (VS) as well as extended brain motivation circuitry would encode SV, integrating reward and effort costs. We also hypothesized that VS hypoactivation during EDT decisions would demonstrate a dimensional relationship with clinical amotivation severity, reflecting greater suppression by effort costs. As hypothesized, VS as well as a broader cortico-limbic network were activated during the EDT and this activation correlated positively with SV. In SZ, activation to task decisions was reduced selectively in VS. Greater VS reductions correlated with more severe clinical amotivation in SZ and across all participants. However, these diagnosis and amotivation effects could not be explained by the response to parametric variation in reward, effort, or model-based SV. Our findings demonstrate that VS hypofunction in schizophrenia is manifested during effort-based decisions and reflects dimensional motivation impairment. Dysfunction of VS impacting effort-based decision-making can provide a target for biomarker development to guide novel efforts to assess and treat disabling amotivation.
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Affiliation(s)
- Greer E Prettyman
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Joseph W Kable
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Paige Didier
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Sheila Shankar
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Theodore D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Warren B Bilker
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Mark A Elliott
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Kosha Ruparel
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Daniel H Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, 19104, USA
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16
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Saleh Y, Jarratt-Barnham I, Fernandez-Egea E, Husain M. Mechanisms Underlying Motivational Dysfunction in Schizophrenia. Front Behav Neurosci 2021; 15:709753. [PMID: 34566594 PMCID: PMC8460905 DOI: 10.3389/fnbeh.2021.709753] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/20/2021] [Indexed: 12/24/2022] Open
Abstract
Negative symptoms are a debilitating feature of schizophrenia which are often resistant to pharmacological intervention. The mechanisms underlying them remain poorly understood, and diagnostic methods rely on phenotyping through validated questionnaires. Deeper endo-phenotyping is likely to be necessary in order to improve current understanding. In the last decade, valuable behavioural insights have been gained through the use of effort-based decision making (EBDM) tasks. These have highlighted impairments in reward-related processing in schizophrenia, particularly associated with negative symptom severity. Neuroimaging investigations have related these changes to dysfunction within specific brain networks including the ventral striatum (VS) and frontal brain regions. Here, we review the behavioural and neural evidence associated with negative symptoms, shedding light on potential underlying mechanisms and future therapeutic possibilities. Findings in the literature suggest that schizophrenia is characterised by impaired reward based learning and action selection, despite preserved hedonic responses. Associations between amotivation and reward-processing deficits have not always been clear, and may be mediated by factors including cognitive dysfunction or dysfunctional or self-defeatist beliefs. Successful endo-phenotyping of negative symptoms as a function of objective behavioural and neural measurements is crucial in advancing our understanding of this complex syndrome. Additionally, transdiagnostic research–leveraging findings from other brain disorders, including neurological ones–can shed valuable light on the possible common origins of motivation disorders across diseases and has important implications for future treatment development.
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Affiliation(s)
- Youssuf Saleh
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Isaac Jarratt-Barnham
- Department of Psychiatry, Herchel Smith Building for Brain & Mind Sciences, University of Cambridge, Cambridge, United Kingdom.,Cambridge Psychosis Centre, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Emilio Fernandez-Egea
- Department of Psychiatry, Herchel Smith Building for Brain & Mind Sciences, University of Cambridge, Cambridge, United Kingdom.,Cambridge Psychosis Centre, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
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17
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Yi X, Li M, He G, Du H, Li X, Cao D, Wang L, Wu X, Yang F, Chen X, He L, Ping Y, Zhou D. Genetic and functional analysis reveals TENM4 contributes to schizophrenia. iScience 2021; 24:103063. [PMID: 34568788 PMCID: PMC8449235 DOI: 10.1016/j.isci.2021.103063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/23/2021] [Accepted: 08/26/2021] [Indexed: 12/09/2022] Open
Abstract
TENM4, encoding a member of the teneurin protein family, is a risk gene shared by many types of mental diseases and is implicated in neuronal plasticity and signaling. However, the role and the mechanisms of TENM4 in schizophrenia (SCZ) remain unclear. We identified possible pathogenic mutations in the TENM4 gene through target sequencing of TENM4 in 68 SCZ families. We further demonstrated that aberrant expression of Ten-m leads to lower learning ability, sleep reduction, and increased aggressiveness in animal models. RNA sequencing showed that aberrant expression of Ten-m was related to stimulus perception and metabolic process, and Gene Ontology enrichment terms were neurogenesis and ATPase activity. This study provides strong evidence that TENM4 contributes to SCZ, and its functional mutations might be responsible for the impaired neural circuits and behaviors observed in SCZ. Possible pathogenic rare missense mutations in TENM4 gene contribute to SCZ Aberrant expression of Ten-m leads to behavioral disturbances related to SCZ symptoms Ten-m affects stimulation, metabolic process, neurogenesis, and ATPase activity
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Affiliation(s)
- Xin Yi
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China
| | - Minzhe Li
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China
| | - Guang He
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huihui Du
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China
| | - Xingwang Li
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongmei Cao
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China
| | - Lu Wang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China
| | - Xi Wu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China
| | - Fengping Yang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China
| | - Xu Chen
- Department of Neurology, Shanghai Eighth People's Hospital, Shanghai Sixth People's Hospital Xuhui Branch, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China
| | - Lin He
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Ping
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daizhan Zhou
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, 1954 Huashan Rd., Shanghai 200030, PR China
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18
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Yaple ZA, Tolomeo S, Yu R. Abnormal prediction error processing in schizophrenia and depression. Hum Brain Mapp 2021; 42:3547-3560. [PMID: 33955106 PMCID: PMC8249895 DOI: 10.1002/hbm.25453] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/01/2021] [Accepted: 04/11/2021] [Indexed: 11/19/2022] Open
Abstract
To make adaptive decisions under uncertainty, individuals need to actively monitor the discrepancy between expected outcomes and actual outcomes, known as prediction errors. Reward‐based learning deficits have been shown in both depression and schizophrenia patients. For this study, we compiled studies that investigated prediction error processing in depression and schizophrenia patients and performed a series of meta‐analyses. In both groups, positive t‐maps of prediction error tend to yield striatum activity across studies. The analysis of negative t‐maps of prediction error revealed two large clusters within the right superior and inferior frontal lobes in schizophrenia and the medial prefrontal cortex and bilateral insula in depression. The concordant posterior cingulate activity was observed in both patient groups, more prominent in the depression group and absent in the healthy control group. These findings suggest a possible role in dopamine‐rich areas associated with the encoding of prediction errors in depression and schizophrenia.
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Affiliation(s)
| | - Serenella Tolomeo
- Department of Psychology, National University of Singapore, Singapore
| | - Rongjun Yu
- Department of Management, Hong Kong Baptist University, Hong Kong, China.,Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.,Department of Physics, Hong Kong Baptist University, Hong Kong, China
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19
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Culbreth AJ, Waltz JA, Frank MJ, Gold JM. Retention of Value Representations Across Time in People With Schizophrenia and Healthy Control Subjects. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:420-428. [PMID: 32712211 PMCID: PMC7708393 DOI: 10.1016/j.bpsc.2020.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/24/2020] [Accepted: 05/18/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND The current study aimed to further etiological understanding of the psychological mechanisms underlying negative symptoms in people with schizophrenia. Specifically, we tested whether negative symptom severity is associated with reduced retention of reward-related information over time and thus a degraded ability to utilize such information to guide future action selection. METHODS Forty-four patients with a diagnosis of schizophrenia or schizoaffective disorder and 28 healthy control volunteers performed a probabilistic reinforcement-learning task involving stimulus pairs in which choices resulted in reward or in loss avoidance. Following training, participants indicated their valuation of learned stimuli in a test/transfer phase. The test/transfer phase was administered immediately following training and 1 week later. Percent retention was defined as accuracy at week-long delay divided by accuracy at immediate delay. RESULTS Healthy control subjects and people with schizophrenia showed similarly robust retention of reinforcement learning over a 1-week delay interval. However, in the schizophrenia group, negative symptom severity was associated with reduced retention of information regarding the value of actions across a week-long interval. This pattern was particularly notable for stimuli associated with reward compared with loss avoidance. CONCLUSIONS Our results show that although individuals with schizophrenia may initially learn about rewarding aspects of their environment, such learning decays at a more rapid rate in patients with severe negative symptoms. Thus, previously learned reward-related information may be more difficult to access to guide future decision making and to motivate action selection.
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Affiliation(s)
- Adam J Culbreth
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Baltimore, Maryland.
| | - James A Waltz
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Baltimore, Maryland
| | - Michael J Frank
- Department of Cognitive, Linguistics, and Psychological Sciences, Brown University, Providence, Rhode Island
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Baltimore, Maryland
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20
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Kim BH, Kim HE, Lee JS, Kim JJ. Anhedonia Relates to the Altered Global and Local Grey Matter Network Properties in Schizophrenia. J Clin Med 2021; 10:jcm10071395. [PMID: 33807226 PMCID: PMC8038049 DOI: 10.3390/jcm10071395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/22/2021] [Accepted: 03/26/2021] [Indexed: 12/19/2022] Open
Abstract
Anhedonia is one of the major negative symptoms in schizophrenia and defined as the loss of hedonic experience to various stimuli in real life. Although structural magnetic resonance imaging has provided a deeper understanding of anhedonia-related abnormalities in schizophrenia, network analysis of the grey matter focusing on this symptom is lacking. In this study, single-subject grey matter networks were constructed in 123 patients with schizophrenia and 160 healthy controls. The small-world property of the grey matter network and its correlations with the level of physical and social anhedonia were evaluated using graph theory analysis. In the global scale whole-brain analysis, the patients showed reduced small-world property of the grey matter network. The local-scale analysis further revealed reduced small-world property in the default mode network, salience/ventral attention network, and visual network. The regional-level analysis showed an altered relationship between the small-world properties and the social anhedonia scale scores in the cerebellar lobule in patients with schizophrenia. These results indicate that anhedonia in schizophrenia may be related to abnormalities in the grey matter network at both the global whole-brain scale and local-regional scale.
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Affiliation(s)
- Byung-Hoon Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul 03722, Korea;
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.E.K.); (J.S.L.)
| | - Hesun Erin Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.E.K.); (J.S.L.)
| | - Jung Suk Lee
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.E.K.); (J.S.L.)
- Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-do 10444, Korea
| | - Jae-Jin Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul 03722, Korea;
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.E.K.); (J.S.L.)
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea
- Correspondence:
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21
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Yang ZY, Zhang RT, Wang YM, Huang J, Zhou HY, Cheung EFC, Chan RCK. Altered activation and functional connectivity in individuals with social anhedonia when envisioning positive future episodes. Psychol Med 2021; 52:1-9. [PMID: 33775271 DOI: 10.1017/s0033291721000970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Anticipatory pleasure deficits are closely correlated with negative symptoms in schizophrenia, and may be found in both clinical and subclinical populations along the psychosis continuum. Prospection, which is an important component of anticipatory pleasure, is impaired in individuals with social anhedonia (SocAnh). In this study, we examined the neural correlates of envisioning positive future events in individuals with SocAnh. METHODS Forty-nine individuals with SocAnh and 33 matched controls were recruited to undergo functional MRI scanning, during which they were instructed to simulate positive or neutral future episodes according to cue words. Two stages of prospection were distinguished: construction and elaboration. RESULTS Reduced activation at the caudate and the precuneus when prospecting positive (v. neutral) future events was observed in individuals with SocAnh. Furthermore, compared with controls, increased functional connectivity between the caudate and the inferior occipital gyrus during positive (v. neutral) prospection was found in individuals with SocAnh. Both groups exhibited a similar pattern of brain activation for the construction v. elaboration contrast, regardless of the emotional context. CONCLUSIONS Our results provide further evidence on the neural mechanism of anticipatory pleasure deficits in subclinical individuals with SocAnh and suggest that altered cortico-striatal circuit may play a role in anticipatory pleasure deficits in these individuals.
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Affiliation(s)
- Zhuo-Ya Yang
- 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
| | - Rui-Ting Zhang
- 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
| | - Yong-Ming Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Sino-Danish College, University of Chinese Academy of Sciences, Beijing100190, PR China
| | - 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
| | - Han-Yu Zhou
- 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
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administration Region, Hong Kong Special Administration Region, 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
- Sino-Danish College, University of Chinese Academy of Sciences, Beijing100190, PR China
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22
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Simon J, Rudebeck PH, Rich EL. From affective to cognitive processing: Functional organization of the medial frontal cortex. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 158:1-28. [PMID: 33785142 DOI: 10.1016/bs.irn.2020.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The medial wall of the primate frontal lobe encompasses multiple anatomical subregions. Based on distinct neurophysiological correlates and effects of lesions, individual areas are thought to play unique roles in behavior. Further, evidence suggests that dysfunction localized to specific subregions is commonly found in different neuropsychiatric disorders. The neurobiological underpinnings of these disorders, however, remain far from clear. Here, to better understand the functions of medial frontal cortex (MFC) and its role in psychiatric disease, we focus on its functional organization. We describe the emerging pattern in which more dorsal regions subserve temporally extended cognitive functions and more ventral regions predominantly subserve affective functions. We focus on two specific domains, decision-making and social cognition, that require integration across emotion and cognition. In each case, we discuss the current understanding of the functions believed to depend on subregions of MFC as a stepping-stone to speculate on how they might work in unison. We conclude with an overview of how symptoms of certain psychiatric disorders relate to our understanding of MFC functional organization and how further discovery could fuel advances in circuit-based therapies.
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Affiliation(s)
- Joseph Simon
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Peter H Rudebeck
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Erin L Rich
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
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23
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Pelletier-Baldelli A, Orr JM, Bernard JA, Mittal VA. Social reward processing: A biomarker for predicting psychosis risk? Schizophr Res 2020; 226:129-137. [PMID: 30093351 PMCID: PMC6367066 DOI: 10.1016/j.schres.2018.07.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/25/2018] [Accepted: 07/28/2018] [Indexed: 11/16/2022]
Abstract
The desire to obtain social rewards (e.g. positive feedback) features prominently in our lives and relationships, and is relevant to understanding psychopathology - where behavior is often impaired. Investigating social rewards within the psychosis-spectrum offers an especially useful opportunity, given the high rates of impaired social functioning and social isolation. The goal of this study was to investigate hedonic experience associated with social reward processing as a potential biomarker for psychosis risk. This study used a task-based functional magnetic resonance imaging (fMRI) paradigm in adolescents at clinical high-risk for the development of psychosis (CHR, n = 19) and healthy unaffected peers (healthy controls - HC, n = 20). Regional activation and connectivity of the ventromedial prefrontal cortex and ventral striatum were examined in response to receiving positive social feedback relative to an ambiguous feedback condition. Expectations of impaired hedonic processes in CHR youth were generally not supported, as there were no group differences in neural response or task-based connectivity. Although interesting relationships were found linking neural reward response and connectivity with social, anticipatory, and consummatory anhedonia in the CHR group, results are difficult to interpret in light of task limitations. We discuss potential implications for future study designs that seek to investigate social reward processing as a biomarker for psychosis risk.
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Affiliation(s)
- Andrea Pelletier-Baldelli
- Department of Psychology and Neuroscience, University of Colorado Boulder, 1905 Colorado Ave., Boulder, CO 80309, United States of America; Center for Neuroscience, University of Colorado Boulder, 1905 Colorado Ave., Boulder, CO 80309, United States of America.
| | - Joseph M Orr
- Department of Psychological and Brain Sciences, Texas A&M University, 515 Coke St., 4235 TAMU, College Station, TX 77845, United States of America; Texas A&M Institute for Neuroscience, Texas A&M University, 515 Coke St., 4235 TAMU, College Station, TX 77845, United States of America
| | - Jessica A Bernard
- Department of Psychological and Brain Sciences, Texas A&M University, 515 Coke St., 4235 TAMU, College Station, TX 77845, United States of America; Texas A&M Institute for Neuroscience, Texas A&M University, 515 Coke St., 4235 TAMU, College Station, TX 77845, United States of America
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL 60208, United States of America; Department of Psychiatry, Northwestern University, 446 E Ontario St., Chicago, IL 60611, United States of America; Institute for Policy Research, Northwestern University, 2029 Sheridan Rd., Evanston, IL 60208, United States of America; Department of Medical Social Sciences, Northwestern University, 446 E Ontario St., Chicago, IL 60611, United States of America
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24
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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.
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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
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25
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Abram SV, Roach BJ, Holroyd CB, Paulus MP, Ford JM, Mathalon DH, Fryer SL. Reward processing electrophysiology in schizophrenia: Effects of age and illness phase. Neuroimage Clin 2020; 28:102492. [PMID: 33395983 PMCID: PMC7695886 DOI: 10.1016/j.nicl.2020.102492] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 11/01/2022]
Abstract
BACKGROUND Reward processing abnormalities may underlie characteristic pleasure and motivational impairments in schizophrenia. Some neural measures of reward processing show age-related modulation, highlighting the importance of considering age effects on reward sensitivity. We compared event-related potentials (ERPs) reflecting reward anticipation (stimulus-preceding negativity, SPN) and evaluation (reward positivity, RewP; late positive potential, LPP) across individuals with schizophrenia (SZ) and healthy controls (HC), with an emphasis on examining the effects of chronological age, brain age (i.e., predicted age based on neurobiological measures), and illness phase. METHODS Subjects underwent EEG while completing a slot-machine task for which rewards were not dependent on performance accuracy, speed, or response preparation. Slot-machine task EEG responses were compared between 54 SZ and 54 HC individuals, ages 19 to 65. Reward-related ERPs were analyzed with respect to chronological age, categorically-defined illness phase (early; ESZ versus chronic schizophrenia; CSZ), and were used to model brain age relative to chronological age. RESULTS Illness phase-focused analyses indicated there were no group differences in average SPN or RewP amplitudes. However, a group × reward outcome interaction revealed that ESZ differed from HC in later outcome processing, reflected by greater LPP responses following loss versus reward (a reversal of the HC pattern). While brain age estimates did not differ among groups, depressive symptoms in SZ were associated with older brain age estimates while controlling for negative symptoms. CONCLUSIONS ESZ and CSZ did not differ from HC in reward anticipation or early outcome processing during a cognitively undemanding reward task, highlighting areas of preserved functioning. However, ESZ showed altered later reward outcome evaluation, pointing to selective reward deficits during the early illness phase of schizophrenia. Further, an association between ERP-derived brain age and depressive symptoms in SZ extends prior findings linking depression with reward-related ERP blunting. Taken together, both illness phase and age may impact reward processing among SZ, and brain aging may offer a promising, novel marker of reward dysfunction that warrants further study.
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Affiliation(s)
- Samantha V Abram
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Medical Center, and the University of California, San Francisco, CA, USA; Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Brian J Roach
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Clay B Holroyd
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | | | - Judith M Ford
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Daniel H Mathalon
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Susanna L Fryer
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
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26
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Whitton AE, Merchant JT, Lewandowski KE. Dissociable mechanisms underpinning effort-cost decision-making across the psychosis spectrum. Schizophr Res 2020; 224:133-140. [PMID: 33046339 DOI: 10.1016/j.schres.2020.09.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 08/24/2020] [Accepted: 09/20/2020] [Indexed: 10/23/2022]
Abstract
Recent theoretical models propose that abnormal effort-cost decision-making (ECDM) likely has divergent underpinnings across mood and psychotic disorders. However, whether this same model applies to individuals across the psychosis spectrum, including individuals with affective psychosis, remains unclear. This study aimed to empirically test whether two component processes - working memory and reward learning - contribute to ECDM impairment across the psychosis spectrum. ECDM was assessed using the Effort Expenditure for Rewards Task in individuals with psychotic disorders (n = 190) and healthy controls (n = 52). Working memory was assessed using a Digit Sequencing Task and reward learning was assessed using a Probabilistic Reward Task. Relative to the control group, the psychosis group showed reduced willingness to expend effort for higher probability, higher value rewards. This effect was most pronounced in individuals with schizophrenia and schizoaffective disorder relative to individuals with psychotic bipolar disorder. Across the whole sample, better working memory but not reward learning predicted greater willingness to expend effort for higher probability rewards. However, the link between working memory and ECDM differed as a function of patient symptom profile. Specifically, working memory was only predictive of ECDM for individuals with less severe negative symptoms and minimal depressive symptoms. For individuals with more severe negative symptoms, poorer ECDM was instead predicted by deficits in reward learning. Although these findings reiterate the important link between working memory and ECDM in individuals with psychotic disorders, they also show that this link varies in accordance with the presence of prominent negative and depressive symptoms.
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Affiliation(s)
- Alexis E Whitton
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Jaisal T Merchant
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA.
| | - Kathryn E Lewandowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA.
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27
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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]
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28
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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.
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29
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Kirschner M, Rabinowitz A, Singer N, Dagher A. From apathy to addiction: Insights from neurology and psychiatry. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109926. [PMID: 32171904 DOI: 10.1016/j.pnpbp.2020.109926] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 12/21/2022]
Abstract
The tendency to engage in addictive behaviors has long been tied to the actions of the dopamine system. Early theories were based on the fact that all addictive drugs and behaviors (such as gambling) increase dopamine levels in the striatum, and the evidence that dopamine signaled reward or reward prediction error. However, with a changing emphasis of addiction away from purely pharmacological models that emphasize tolerance and withdrawal, towards one of behavioral dyscontrol, is there still a place for abnormal dopamine signaling in addiction? Here we recast the dopamine theory of addiction based on the idea that tonic dopamine may index a continuous phenotype that goes from apathy to impulsivity and compulsivity. Higher tonic dopamine signaling would make individuals vulnerable to drug reinforcement and cue-induced craving. We relate this to computational models of dopamine signaling, and review clinical and neuroimaging evidence from Parkinson's Disease, schizophrenia and bipolar disorder in support of this model.
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Affiliation(s)
- Matthias Kirschner
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - Arielle Rabinowitz
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Neomi Singer
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada.
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30
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Abstract
We report on the ongoing R21 project “Social Reward Learning in Schizophrenia”. Impairments in social cognition are a hallmark of schizophrenia. However, little work has been done on social reward learning deficits in schizophrenia. The overall goal of the project is to assess social reward learning in schizophrenia. A probabilistic reward learning (PRL) task is being used in the MRI scanner to evaluate reward learning to negative and positive social feedback. Monetary reward learning is used as a comparison to assess specificity. Behavioral outcomes and brain areas, included those involved in reward, are assessed in patients with schizophrenia or schizoaffective disorder and controls. It is also critical to determine whether decreased expected value (EV) of social stimuli and/or reward prediction error (RPE) learning underlie social reward learning deficits to inform potential treatment pathways. Our central hypothesis is that the pattern of social learning deficits is an extension of a more general reward learning impairment in schizophrenia and that social reward learning deficits critically contribute to deficits in social motivation and pleasure. We hypothesize that people with schizophrenia will show impaired behavioral social reward learning compared to controls, as well as decreased ventromedial prefrontal cortex (vmPFC) EV signaling at time of choice and decreased striatal RPE signaling at time of outcome, with potentially greater impairment to positive than negative feedback. The grant is in its second year. It is hoped that this innovative approach may lead to novel and more targeted treatment approaches for social cognitive impairments, using cognitive remediation and/or brain stimulation.
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31
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Wang LL, Yan C, Shao YX, Lv QY, Neumann D, Ettinger U, Cheung EFC, Yi ZH, Chan RCK. Revisiting anticipatory hedonic processing in patients with schizophrenia: An examination between representation activation and maintenance. Schizophr Res 2020; 216:138-146. [PMID: 31882275 DOI: 10.1016/j.schres.2019.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/01/2019] [Accepted: 12/18/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Anticipatory anhedonia is one of the key deficits found in patients with schizophrenia (SCZ). However, the underlying mechanism of this deficit remains unclear. The present study examined whether representation activation and maintenance capacity influenced anticipatory experiences in SCZ patients. METHODS We recruited 46 SCZ patients (26 males) and 45 matched healthy controls (24 males). The Reward Representation Activation and Maintenance (RRAM) Task was administrated to assess anticipatory experience and representation activation and maintenance capacity. RESULTS SCZ patients exhibited lower subjective arousal than controls in anticipation of rewards with high probability when representation activation and maintenance were difficult to accomplish. SCZ patients also tended to reduce their button presses more than HC when they were required to maintain reward representation. CONCLUSIONS Our findings suggest that representation activation and maintenance may partially account for anticipatory anhedonia observed in SCZ patients.
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Affiliation(s)
- Ling-Ling Wang
- Key Laboratory of Brain Functional Genomics (MOE&STCSM), Shanghai Changning-ECNU Mental Health Center, School of Psychology and Cognitive Science, East China Normal University, China; 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
| | - Chao Yan
- Key Laboratory of Brain Functional Genomics (MOE&STCSM), Shanghai Changning-ECNU Mental Health Center, School of Psychology and Cognitive Science, East China Normal University, China.
| | - Yu-Xin Shao
- Key Laboratory of Brain Functional Genomics (MOE&STCSM), Shanghai Changning-ECNU Mental Health Center, School of Psychology and Cognitive Science, East China Normal University, China
| | - Qin-Yu Lv
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - David Neumann
- School of Applied Psychology, Health Group, Griffith University, Brisbane, Australia
| | | | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region
| | - Zheng-Hui Yi
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 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.
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32
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Linsambarth S, Jeria A, Avirame K, Todder D, Riquelme R, Stehberg J. Deep Transcranial Magnetic Stimulation for the Treatment of Negative Symptoms in Schizophrenia: Beyond an Antidepressant Effect. J ECT 2019; 35:e46-e54. [PMID: 31764455 DOI: 10.1097/yct.0000000000000592] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Negative symptoms of schizophrenia show limited response to both typical and atypical antipsychotics. Repetitive transcranial magnetic stimulation applied over the prefrontal cortex (PFC) has been proposed as an adjuvant to pharmacological treatment of negative symptoms in schizophrenia, but whether the improvements obtained are specific to negative symptoms or attributable to antidepressant effects is still unclear. OBJECTIVE The aim of the present study is to determine to which extent the improvements in negative symptoms of schizophrenia obtained after high-frequency stimulation of the bilateral PFC using deep TMS (dTMS) are attributable to antidepressant effects. METHODS Repetitive dTMS was administered to the PFC in a cohort of 16 patients with schizophrenia under successful pharmacological control of positive symptoms and predominant negative symptoms. Patients were treated using high-frequency (18 Hz) bilateral stimulation applied over the lateral PFC bilaterally using Brainsway H-2 coil. The effects of dTMS on negative symptoms were measured using the Scale for the Assessment of Negative Symptoms and the Positive and Negative Syndrome Scales. We then compared the improvements in negative symptoms obtained in patients showing depressive symptoms (≥7 points) with those found in patients without depression (>7 points), as determined by the Calgary Scale for Depression. RESULTS Repetitive dTMS treatment induced significant improvements in negative symptoms as assessed using both Scale for the Assessment of Negative Symptoms and Positive and Negative Syndrome Scales. Comparison of the improvements obtained in patients with or without depression at the beginning of treatment revealed similar improvements in negative symptoms, irrespective of subjacent depression. CONCLUSIONS Our data suggest that the beneficial effects of high frequency dTMS of the PFC cannot be attributed solely to its antidepressant effects.
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Affiliation(s)
- Sergio Linsambarth
- From the Laboratorio de Neurobiología, Institute of Biomedical Sciences, Faculty of Medicine and Faculty of Life Sciences, Universidad Andres Bello
| | - Alvaro Jeria
- NeuroMagnetics, Las Condes
- Departamento de Psiquiatría, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Doron Todder
- Neuroclinic Health Center, Ramat Gan
- Zlotovsky Center for Neuroscience, Ben-Gurion University, Beersheva, Israel
| | | | - Jimmy Stehberg
- From the Laboratorio de Neurobiología, Institute of Biomedical Sciences, Faculty of Medicine and Faculty of Life Sciences, Universidad Andres Bello
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Moran EK, Culbreth AJ, Kandala S, Barch DM. From neuroimaging to daily functioning: A multimethod analysis of reward anticipation in people with schizophrenia. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 128:723-734. [PMID: 31464449 DOI: 10.1037/abn0000461] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Negative symptoms are a core clinical feature of schizophrenia that are only marginally responsive to current treatments. Recent work suggests that deficits in reinforcement learning and anticipatory responses to reward may be two mechanisms that help explain impairments in motivation in those with schizophrenia. The present study utilized a reinforcement-learning paradigm, which allowed us to examine both reward anticipation and reinforcement learning. Twenty-eight people with schizophrenia and 30 healthy controls completed a reinforcement-learning task while undergoing functional MRI. Participants with schizophrenia also completed a weeklong ecological momentary assessment protocol reporting anticipated motivation and pleasure in their daily activities. Unexpectedly, we found no significant group differences in performance or neural response in reinforcement learning. However, we found that poorer reward learning was associated with greater clinician ratings of negative symptoms and daily reports of anticipatory motivation and pleasure negative symptoms. In regards to anticipatory responses, we found that people with schizophrenia showed blunted activation in the anterior cingulate, insula, caudate, and putamen while anticipating reward. Further, blood oxygen level-dependent (BOLD) response in reward related regions during anticipation of reward was significantly related to both clinician-rated motivation and pleasure deficits as well as daily reports of motivation and pleasure. Our results provide further evidence of deficits during reward anticipation in individuals with schizophrenia, particularly for those with severe negative symptoms, and some evidence for worse reward learning among those with greater negative symptoms. Moreover, our findings suggest that these deficits show important relationships with emotional and motivational functioning in everyday life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Cooper JA, Barch DM, Reddy LF, Horan WP, Green MF, Treadway MT. Effortful goal-directed behavior in schizophrenia: Computational subtypes and associations with cognition. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 128:710-722. [PMID: 31282687 DOI: 10.1037/abn0000443] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Schizophrenia is associated with amotivation and reduced goal-directed behavior, which have been linked to poor functional outcomes. Motivational deficits in schizophrenia are often measured using effort-based decision-making (EBDM) paradigms, revealing consistent alterations in effort expenditure relative to controls. Although these results have generally been interpreted in terms of decreased motivation, the ability to use trial-by-trial changes in reward magnitude or probability of receipt to guide effort allocation may also be affected by cognitive deficits. To date, it remains unclear whether altered performance in EBDM primarily reflects deficits in motivation, cognitive functioning, or both. We applied a newly developed computational modeling approach to the analysis of EBDM data from two previously collected samples comprising 153 patients and 105 controls to determine the extent to which individuals did or did not use available information about reward and probability to guide effort allocation. Half of the participants with schizophrenia failed to incorporate information about reward and probability when making effort-expenditure decisions. The subset of patients who exhibited difficulties using reward and probability information were characterized by greater impairments across measures of cognitive functioning. Interestingly, even within the subset of patients who successfully used reward and probability information to guide effort expenditure, higher levels of negative symptoms related to motivation and avolition were associated with greater effort aversion during the task. Taken together, these data suggest that prior reports of aberrant EBDM in schizophrenia patients are related to both cognitive function and individual differences in negative symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Szczepanik JE, Reed JL, Nugent AC, Ballard ED, Evans JW, Lejuez CW, Zarate CA. Mapping anticipatory anhedonia: an fMRI study. Brain Imaging Behav 2019; 13:1624-1634. [PMID: 31030316 DOI: 10.1007/s11682-019-00084-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Anhedonia-broadly defined as loss of interest and/or an inability to experience pleasure-is an important feature of several psychiatric disorders. Research into the clinical presentation and neurobiology of this symptom has identified components related to motivation, learning, anticipation, and experience of pleasure as important constructs that inform therapeutic interventions. The experimental study of anhedonia is largely based on incentive processing paradigms, most often with monetary rewards, though studies have also used pleasantness ratings of various stimuli. However, linking an individual's own system of reinforcers and ability to enjoy them with anhedonia and neural activity remains comparatively under-explored. A previous study of participants with major depressive disorder (MDD) and healthy controls found that activity word ratings correlated with measures of anhedonia, depression, and motivation. The present study collected functional magnetic resonance imaging (fMRI) images in healthy controls while they rated activity words and pictures showing activities in order to identify networks differentially responsive to subjective decisions about the appetitive value of activities. The study sought to measure individually-relevant hedonic capacity as demonstrated by correlations between task measures and anticipatory anhedonia ratings. Ratings of potential pleasure were associated with neural activity in areas previously identified as relevant to pleasure and reward processing, such as anterior and posterior cingulate, middle frontal areas, and dorsal and ventral striatum. Although the study included only healthy controls, the results demonstrate a link between anhedonia measures, behavior, and brain responses and also test a paradigm that could be used to study anhedonia in clinical populations.
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Affiliation(s)
- Joanna E Szczepanik
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
- Division of Translational Research, Extramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
| | - Jessica L Reed
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Allison C Nugent
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth D Ballard
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Jennifer W Evans
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Carl W Lejuez
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Carlos A Zarate
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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Szczypiński JJ, Gola M. Dopamine dysregulation hypothesis: the common basis for motivational anhedonia in major depressive disorder and schizophrenia? Rev Neurosci 2018; 29:727-744. [PMID: 29573379 DOI: 10.1515/revneuro-2017-0091] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/30/2018] [Indexed: 12/12/2022]
Abstract
Abnormalities in reward processing are crucial symptoms of major depressive disorder (MDD) and schizophrenia (SCH). Recent neuroscientific findings regarding MDD have led to conclusions about two different symptoms related to reward processing: motivational and consummatory anhedonia, corresponding, respectively, to impaired motivation to obtain rewards ('wanting'), and diminished satisfaction from consuming them ('liking'). One can ask: which of these is common for MDD and SCH. In our review of the latest neuroscientific studies, we show that MDD and SCH do not share consummatory anhedonia, as SCH patients usually have unaltered liking. Therefore, we investigated whether motivational anhedonia is the common symptom across MDD and SCH. With regard to the similarities and differences between the neural mechanisms of MDD and SCH, here we expand the current knowledge of motivation deficits and present the common underlying mechanism of motivational anhedonia - the dopamine dysregulation hypothesis - stating that any prolonged dysregulation in tonic dopamine signaling that exceeds the given equilibrium can lead to striatal dysfunction and motivational anhedonia. The implications for further research and treatment of MDD and SCH are also discussed.
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Affiliation(s)
- Jan Józef Szczypiński
- Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Sciences, 3 Pasteur Street, 02-093Warsaw, Poland.,Medical University of Warsaw, Chair of Psychiatry, Nowowiejska 27, 00-665Warsaw, Poland.,Center for Modern Interdisciplinary Technologies, Neurocognitive Laboratory, Wileńska 4, 87-100 Torun, Poland
| | - Mateusz Gola
- Swartz Center for Computational Neuroscience, Institute of Neural Computations, University of California San Diego, 9500 Gilman Drive, #0559, La Jolla, CA 92093-0559, USA.,Institute of Psychology, Polish Academy of Sciences, Clinical Neuroscience Lab, Jaracza 1, 00-001, Warsaw, Poland
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37
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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]
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Giordano GM, Koenig T, Mucci A, Vignapiano A, Amodio A, Di Lorenzo G, Siracusano A, Bellomo A, Altamura M, Monteleone P, Pompili M, Galderisi S, Maj M. Neurophysiological correlates of Avolition-apathy in schizophrenia: A resting-EEG microstates study. NEUROIMAGE-CLINICAL 2018; 20:627-636. [PMID: 30202724 PMCID: PMC6128100 DOI: 10.1016/j.nicl.2018.08.031] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 07/12/2018] [Accepted: 08/31/2018] [Indexed: 12/23/2022]
Abstract
Background The “Avolition-apathy” domain of the negative symptoms was found to include different symptoms by factor analytic studies on ratings derived by different scales. In particular, the relationship of anhedonia with this domain is controversial. Recently introduced negative symptom rating scales provide a better assessment of anhedonia, allowing the distinction of anticipatory and consummatory aspects, which might be related to different psychopathological dimensions. The study of associations with external validators, such as electrophysiological, brain imaging or cognitive indices, might shed further light on the status of anhedonia within the Avolition-apathy domain. Objectives We used brain electrical microstates (MSs), which represent subsecond periods of quasi-stable scalp electrical field, associated with resting-state neural networks (and thus with global patterns of functional connectivity), to test whether the component symptoms of Avolition-apathy share the same correlates. Method We analyzed multichannel resting EEGs in 142 individuals with schizophrenia (SCZ) and in 64 healthy controls (HC), recruited within the add-on EEG study of the Italian Network for Research on Psychoses. Relative time contribution, duration and occurrence of four MS classes (MS-A/-B/-C/−D) were calculated. Group differences on MS parameters (contribution and duration) and their associations with negative symptom domains (assessed using the Brief Negative Symptoms Scale) were investigated. Results SCZ, in comparison to HC, showed increased contribution and duration of MS-C. The contribution of MS-A positively correlated with Avolition-apathy, but not with Expressive deficit. Within the Avolition-apathy domain, anticipatory anhedonia, avolition and asociality, but not consummatory anhedonia, showed the same correlations with MS-A contribution. Conclusion Our findings support the existence of distinct electrophysiological correlates of Avolition-apathy with respect to Expressive deficit, and lend support to the hypothesis that only the anticipatory component of anhedonia shares the same pathophysiological underpinnings of the Avolition-apathy domain. Microstate C contribution and duration were increased in SCZ compared to HC. Avolition-apathy was correlated with the contribution of microstate A. Avolition-apathy might be associated with sensory processing deficit.
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Affiliation(s)
- Giulia M Giordano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Thomas Koenig
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Armida Mucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Annarita Vignapiano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonella Amodio
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Mario Altamura
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Neurosciences, University of Salerno, Salerno, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant' Andrea Hospital, Sapienza University of Rome, Rome
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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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.
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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
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40
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Abnormal reward prediction-error signalling in antipsychotic naive individuals with first-episode psychosis or clinical risk for psychosis. Neuropsychopharmacology 2018; 43:1691-1699. [PMID: 29748629 PMCID: PMC6006166 DOI: 10.1038/s41386-018-0056-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 12/20/2022]
Abstract
Ongoing research suggests preliminary, though not entirely consistent, evidence of neural abnormalities in signalling prediction errors in schizophrenia. Supporting theories suggest mechanistic links between the disruption of these processes and the generation of psychotic symptoms. However, it is unknown at what stage in the pathogenesis of psychosis these impairments in prediction-error signalling develop. One major confound in prior studies is the use of medicated patients with strongly varying disease durations. Our study aims to investigate the involvement of the meso-cortico-striatal circuitry during reward prediction-error signalling in earliest stages of psychosis. We studied patients with first-episode psychosis (FEP) and help-seeking individuals at-risk for psychosis due to sub-threshold prodromal psychotic symptoms. Patients with either FEP (n = 14), or at-risk for developing psychosis (n = 30), and healthy volunteers (n = 39) performed a reinforcement learning task during fMRI scanning. ANOVA revealed significant (p < 0.05 family-wise error corrected) prediction-error signalling differences between groups in the dopaminergic midbrain and right middle frontal gyrus (dorsolateral prefrontal cortex, DLPFC). FEP patients showed disrupted reward prediction-error signalling compared to controls in both regions. At-risk patients showed intermediate activation in the midbrain that significantly differed from controls and from FEP patients, but DLPFC activation that did not differ from controls. Our study confirms that FEP patients have abnormal meso-cortical signalling of reward-prediction errors, whereas reward-prediction-error dysfunction in the at-risk patients appears to show a more nuanced pattern of activation with a degree of midbrain impairment but preserved cortical function.
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41
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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.
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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:
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Bansal S, Robinson BM, Geng JJ, Leonard CJ, Hahn B, Luck SJ, Gold JM. The impact of reward on attention in schizophrenia. Schizophr Res Cogn 2018; 12:66-73. [PMID: 29928599 PMCID: PMC6007043 DOI: 10.1016/j.scog.2018.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/18/2018] [Accepted: 05/19/2018] [Indexed: 01/21/2023]
Abstract
Traditionally, attention was thought to be directed by either top-down goals or bottom-up salience. Recent studies have shown that the reward history of a stimulus feature also acts as a powerful attentional cue. This is particularly relevant in schizophrenia, which is characterized by motivational and attentional deficits. Here, we examine the impact of reward on selective attention. Forty-eight people with schizophrenia (PSZ) and 34 non-psychiatric control subject (NCS) discriminated the location of a target dot appearing inside a left circle or right circle. The circles were different colors, one of which was associated with reward via pre-training. In the first 2 blocks, targets were equally likely to appear in the left or right circle. In the last 4 blocks, the target was 75% likely on one side, thus allowing us to separately examine how attention was impacted by reward (color) and probability (location). PSZ had slower overall reaction times (RTs) than NCS. Both groups showed robust effects of spatial probability and reward history, with faster RTs for the rewarded color and for the more probable location. These effects were similar in PSZ and NCS. Negative symptom severity correlated with overall RT slowing, but there were no correlations between symptoms and reward-associated biasing of attention. PSZ demonstrated RT slowing but normal reward history and spatial probability-driven RT facilitation. These results are conceptually similar to prior findings showing intact implicit reward effects on response bias, and suggest that implicit processing of reward and probability is intact in PSZ.
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Affiliation(s)
- Sonia Bansal
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, 55 Wade Avenue, Catonsville, MD 21228, United States
| | - Benjamin M. Robinson
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, 55 Wade Avenue, Catonsville, MD 21228, United States
| | - Joy J. Geng
- Center for Mind & Brain and Department of Psychology, University of California, 1 Shields Avenue, Davis, CA 95616, United States
| | - Carly J. Leonard
- Department of Psychology, University of Colorado, 1200 Larimer Street, Denver, CO 80217-3364, United States
| | - Britta Hahn
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, 55 Wade Avenue, Catonsville, MD 21228, United States
| | - Steven J. Luck
- Center for Mind & Brain and Department of Psychology, University of California, 1 Shields Avenue, Davis, CA 95616, United States
| | - James M. Gold
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, 55 Wade Avenue, Catonsville, MD 21228, United States
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43
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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.
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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
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44
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Chase HW, Loriemi P, Wensing T, Eickhoff SB, Nickl-Jockschat T. Meta-analytic evidence for altered mesolimbic responses to reward in schizophrenia. Hum Brain Mapp 2018; 39:2917-2928. [PMID: 29573046 DOI: 10.1002/hbm.24049] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 01/25/2018] [Accepted: 03/08/2018] [Indexed: 11/08/2022] Open
Abstract
Dysfunction of reward-related neural circuitry in schizophrenia (SCZ) has been widely reported, and may provide insight into the motivational and cognitive disturbances that characterize the disorder. Although previous meta-analyses of reward learning paradigms in SCZ have been performed, a meta-analysis of whole-brain coordinate maps in SCZ alone has not been conducted. In this study, we performed an activation likelihood estimate (ALE) meta-analysis, and performed a follow-up analysis of functional connectivity and functional decoding of identified regions. We report several salient findings that extend prior work in this area. First, an alteration in reward-related activation was observed in the right ventral striatum, but this was not solely driven by hypoactivation in the SCZ group compared to healthy controls. Second, the region was characterized by functional connectivity primarily with the lateral prefrontal cortex and pre-supplementary motor area (preSMA), as well as subcortical regions such as the thalamus which show structural deficits in SCZ. Finally, although the meta-analysis showed no regions outside the ventral striatum to be significantly altered, regions with higher functional connectivity with the ventral striatum showed a greater number of subthreshold foci. Together, these findings confirm the alteration of ventral striatal function in SCZ, but suggest that a network-based approach may assist future analysis of the functional underpinnings of the disorder.
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Affiliation(s)
- Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Polina Loriemi
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany.,Juelich Aachen Research Alliance - Translational Brain Medicine, Aachen, Germany
| | - Tobias Wensing
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany.,Juelich Aachen Research Alliance - Translational Brain Medicine, Aachen, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Center Jülich, Jülich, Germany.,Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Thomas Nickl-Jockschat
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany.,Juelich Aachen Research Alliance - Translational Brain Medicine, Aachen, Germany.,Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA.,Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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45
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Bismark AW, Thomas ML, Tarasenko M, Shiluk AL, Rackelmann SY, Young JW, Light GA. Relationship between effortful motivation and neurocognition in schizophrenia. Schizophr Res 2018; 193:69-76. [PMID: 28673753 PMCID: PMC5754266 DOI: 10.1016/j.schres.2017.06.042] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/21/2017] [Accepted: 06/22/2017] [Indexed: 12/21/2022]
Abstract
Effortful motivation and reward valuation learning deficits are associated with negative symptoms and impaired cognition in schizophrenia (SZ) patients. Whereas clinical assessments of motivation and reward value typically rely upon clinician ratings or self-report scales, behavioral measures often confound these constructs. Simple reverse-translated behavioral tasks that independently quantify motivation and reward valuation-which could then be linked to cognition-may facilitate the development of pro-cognitive therapeutics by bridging the "preclinical-to-clinical" gap. This study determined whether novel behavioral measures of effortful motivation and reward valuation are associated with impaired cognition in SZ patients (n=36). Patients completed the Progressive Ratio Breakpoint task (PRBT; physical effort motivation) and the Probabilistic Learning Task (PLT; reward learning/valuation) in conjunction with the MATRICS Consensus Cognitive Battery (MCCB). SZ patients exhibited statistically significant deficits in global cognition and all individual MCCB subdomains. Significant correlations were observed between PRBT and MCCB global cognition (r=0.52), speed of processing (r=0.56) and attention vigilance (r=0.48) subdomains, but not with PLT or clinical symptoms. Results indicate that effort and reward learning deficits are dissociable targets that can improve our understanding of cognitive impairments associated among patients with SZ. More importantly, the results support the long-standing notion that the measurement of cognitive impairments in SZ is highly linked to a willingness to expend effort. The availability of a PRBT designed for use in both rodents and humans could improve our understanding of the nature of cognitive impairments in neuropsychiatric disorders and accelerate the development of novel pro-cognitive therapeutics.
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Affiliation(s)
- Andrew W Bismark
- Research Service, VA San Diego Healthcare System, United States; Department of Psychiatry, University of California, San Diego, United States
| | - Michael L Thomas
- Department of Psychiatry, University of California, San Diego, United States
| | | | - Alexandra L Shiluk
- Department of Psychiatry, University of California, San Diego, United States
| | - Sonia Y Rackelmann
- Department of Psychiatry, University of California, San Diego, United States
| | - Jared W Young
- Research Service, VA San Diego Healthcare System, United States; Department of Psychiatry, University of California, San Diego, United States.
| | - Gregory A Light
- Research Service, VA San Diego Healthcare System, United States; Department of Psychiatry, University of California, San Diego, United States
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46
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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.
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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.
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47
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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.
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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
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48
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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.
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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
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49
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Luking KR, Neiman JS, Luby JL, Barch DM. Reduced Hedonic Capacity/Approach Motivation Relates to Blunted Responsivity to Gain and Loss Feedback in Children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2017; 46:450-462. [PMID: 25749348 PMCID: PMC4561215 DOI: 10.1080/15374416.2015.1012721] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Adolescents and adults with major depressive disorder or elevated depressive symptoms show reduced reward responses and tend to show enhanced responses to negative stimuli. However, reward-related behaviors and adaptive responses to negative feedback undergo dramatic changes across puberty. Thus, key questions remain regarding how altered incentive processing relates to depressive and anhedonic symptoms in prepubertal child populations. Twenty-four nonclinical prepubertal children 7-10 years of age (15 male; 16 Caucasian) completed two signal detection tasks that assessed behavioral responsivity to candy gain and loss feedback, respectively. These tasks were based on Pizzagalli's probabilistic reward task where asymmetric feedback leads to greater bias toward the more frequently rewarded response in more hedonic or nondepressed adults. We further modified the task to create a version where incorrect responses could result in losses from an original allotment of candy. Children and parents/guardians also completed individual difference questionnaires to assess the child's depressive symptoms, general affect, and hedonic capacity/approach motivation. Regressions indicated a relation between hedonic capacity/approach motivation (child self-report) and response bias in both gain and loss tasks. No significant relations were observed between depressive (child self-report), internalizing (parent report), or externalizing symptoms (parent report) and bias in either the gain or loss task in this small sample. These results suggest that reduced hedonic capacity/approach motivation is associated with blunted responses to both gain and loss feedback in prepubertal children.
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Affiliation(s)
- Katherine R Luking
- a Department of Biology and Biomedical Sciences , Washington University in St. Louis
| | - Jamie S Neiman
- b Department of Psychology , Washington University in St. Louis
| | - Joan L Luby
- c Department of Psychiatry , Washington University in St. Louis
| | - Deanna M Barch
- d Departments of Psychology, Psychiatry, and Radiology , Washington University in St. Louis
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50
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Hélie S, Shamloo F, Novak K, Foti D. The roles of valuation and reward processing in cognitive function and psychiatric disorders. Ann N Y Acad Sci 2017; 1395:33-48. [PMID: 28415138 DOI: 10.1111/nyas.13327] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In neuroeconomics, valuation refers to the process of assigning values to states and actions on the basis of the animal's current representation of the environment, while reward processing corresponds to processing the feedback received from the environment to update the values of states and actions. In this article, we review the brain circuits associated with valuation and reward processing and argue that these are fundamental processes critical to many cognitive functions. Specifically, we focus on the role of valuation and reward processing in attention, memory, decision making, and learning. Next, the extant neuroimaging literature on a number of psychiatric disorders is reviewed (i.e., addiction, pathological gambling, schizophrenia, and mood disorders), and an argument is made that associated deficits in cognitive functions can be explained in terms of abnormal valuation and reward processing. The review concludes with the impact of this framework in clinical settings and prescriptions for future research, in particular with regard to the conversions of qualitatively different valuation systems into a system of common currency.
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Affiliation(s)
- Sébastien Hélie
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana
| | - Farzin Shamloo
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana
| | - Keisha Novak
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana
| | - Dan Foti
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana
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