Alterations of the Brain Reward System in Antipsychotic Naïve Schizophrenia Patients

Various schizophrenic symptoms are suggested to be linked to a dysfunction of the brain reward system. Several studies have found alterations in the reward processing in patients with schizophrenia; however, most previous findings might be confounded by medication effects. Thirty-one antipsychotic-n...

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Vydáno v:Biological psychiatry (1969) Ročník 71; číslo 10; s. 898 - 905
Hlavní autoři: Nielsen, Mette Ødegaard, Rostrup, Egill, Wulff, Sanne, Bak, Nikolaj, Lublin, Henrik, Kapur, Shitij, Glenthøj, Birte
Médium: Journal Article
Jazyk:angličtina
Vydáno: New York, NY Elsevier Inc 15.05.2012
Elsevier
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ISSN:0006-3223, 1873-2402, 1873-2402
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Abstract Various schizophrenic symptoms are suggested to be linked to a dysfunction of the brain reward system. Several studies have found alterations in the reward processing in patients with schizophrenia; however, most previous findings might be confounded by medication effects. Thirty-one antipsychotic-naïve schizophrenia patients and 31 age- and gender-matched healthy control subjects were examined with functional magnetic resonance imaging while playing a variant of the monetary incentive delay task. The task variant made it possible to separate overall salience (defined as arousing events) into behavioral salience (events where a predicted reward requires performance) and valence anticipation (the anticipation of a monetarily significant outcome). Furthermore, the evaluation of monetary gain and loss was assessed. During reward anticipation, patients had a significant attenuation of the activation in ventral tegmentum, ventral striatum, and anterior cingulate cortex during presentation of salient cues. This signal attenuation in ventral striatum was correlated with the degree of positive symptoms. Signal attenuation was most pronounced for behavioral salience and nonsignificant for value anticipation. Furthermore, patients showed a changed activation pattern during outcome evaluation in right prefrontal cortex. Our results suggest that changes during reward anticipation in schizophrenia are present from the beginning of the disease. This supports a possible involvement of reward disturbances in the pathophysiology of schizophrenia. The most pronounced changes were seen in relation to overall salience. In ventral striatum these changes were associated with the degree of positive symptoms.
AbstractList Various schizophrenic symptoms are suggested to be linked to a dysfunction of the brain reward system. Several studies have found alterations in the reward processing in patients with schizophrenia; however, most previous findings might be confounded by medication effects.BACKGROUNDVarious schizophrenic symptoms are suggested to be linked to a dysfunction of the brain reward system. Several studies have found alterations in the reward processing in patients with schizophrenia; however, most previous findings might be confounded by medication effects.Thirty-one antipsychotic-naïve schizophrenia patients and 31 age- and gender-matched healthy control subjects were examined with functional magnetic resonance imaging while playing a variant of the monetary incentive delay task. The task variant made it possible to separate overall salience (defined as arousing events) into behavioral salience (events where a predicted reward requires performance) and valence anticipation (the anticipation of a monetarily significant outcome). Furthermore, the evaluation of monetary gain and loss was assessed.METHODSThirty-one antipsychotic-naïve schizophrenia patients and 31 age- and gender-matched healthy control subjects were examined with functional magnetic resonance imaging while playing a variant of the monetary incentive delay task. The task variant made it possible to separate overall salience (defined as arousing events) into behavioral salience (events where a predicted reward requires performance) and valence anticipation (the anticipation of a monetarily significant outcome). Furthermore, the evaluation of monetary gain and loss was assessed.During reward anticipation, patients had a significant attenuation of the activation in ventral tegmentum, ventral striatum, and anterior cingulate cortex during presentation of salient cues. This signal attenuation in ventral striatum was correlated with the degree of positive symptoms. Signal attenuation was most pronounced for behavioral salience and nonsignificant for value anticipation. Furthermore, patients showed a changed activation pattern during outcome evaluation in right prefrontal cortex.RESULTSDuring reward anticipation, patients had a significant attenuation of the activation in ventral tegmentum, ventral striatum, and anterior cingulate cortex during presentation of salient cues. This signal attenuation in ventral striatum was correlated with the degree of positive symptoms. Signal attenuation was most pronounced for behavioral salience and nonsignificant for value anticipation. Furthermore, patients showed a changed activation pattern during outcome evaluation in right prefrontal cortex.Our results suggest that changes during reward anticipation in schizophrenia are present from the beginning of the disease. This supports a possible involvement of reward disturbances in the pathophysiology of schizophrenia. The most pronounced changes were seen in relation to overall salience. In ventral striatum these changes were associated with the degree of positive symptoms.CONCLUSIONOur results suggest that changes during reward anticipation in schizophrenia are present from the beginning of the disease. This supports a possible involvement of reward disturbances in the pathophysiology of schizophrenia. The most pronounced changes were seen in relation to overall salience. In ventral striatum these changes were associated with the degree of positive symptoms.
BackgroundVarious schizophrenic symptoms are suggested to be linked to a dysfunction of the brain reward system. Several studies have found alterations in the reward processing in patients with schizophrenia; however, most previous findings might be confounded by medication effects. MethodsThirty-one antipsychotic-naïve schizophrenia patients and 31 age- and gender-matched healthy control subjects were examined with functional magnetic resonance imaging while playing a variant of the monetary incentive delay task. The task variant made it possible to separate overall salience (defined as arousing events) into behavioral salience (events where a predicted reward requires performance) and valence anticipation (the anticipation of a monetarily significant outcome) . Furthermore, the evaluation of monetary gain and loss was assessed. ResultsDuring reward anticipation, patients had a significant attenuation of the activation in ventral tegmentum, ventral striatum, and anterior cingulate cortex during presentation of salient cues. This signal attenuation in ventral striatum was correlated with the degree of positive symptoms. Signal attenuation was most pronounced for behavioral salience and nonsignificant for value anticipation. Furthermore, patients showed a changed activation pattern during outcome evaluation in right prefrontal cortex. ConclusionOur results suggest that changes during reward anticipation in schizophrenia are present from the beginning of the disease. This supports a possible involvement of reward disturbances in the pathophysiology of schizophrenia. The most pronounced changes were seen in relation to overall salience. In ventral striatum these changes were associated with the degree of positive symptoms.
Various schizophrenic symptoms are suggested to be linked to a dysfunction of the brain reward system. Several studies have found alterations in the reward processing in patients with schizophrenia; however, most previous findings might be confounded by medication effects. Thirty-one antipsychotic-naïve schizophrenia patients and 31 age- and gender-matched healthy control subjects were examined with functional magnetic resonance imaging while playing a variant of the monetary incentive delay task. The task variant made it possible to separate overall salience (defined as arousing events) into behavioral salience (events where a predicted reward requires performance) and valence anticipation (the anticipation of a monetarily significant outcome). Furthermore, the evaluation of monetary gain and loss was assessed. During reward anticipation, patients had a significant attenuation of the activation in ventral tegmentum, ventral striatum, and anterior cingulate cortex during presentation of salient cues. This signal attenuation in ventral striatum was correlated with the degree of positive symptoms. Signal attenuation was most pronounced for behavioral salience and nonsignificant for value anticipation. Furthermore, patients showed a changed activation pattern during outcome evaluation in right prefrontal cortex. Our results suggest that changes during reward anticipation in schizophrenia are present from the beginning of the disease. This supports a possible involvement of reward disturbances in the pathophysiology of schizophrenia. The most pronounced changes were seen in relation to overall salience. In ventral striatum these changes were associated with the degree of positive symptoms.
Author Rostrup, Egill
Glenthøj, Birte
Lublin, Henrik
Nielsen, Mette Ødegaard
Wulff, Sanne
Bak, Nikolaj
Kapur, Shitij
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  givenname: Mette Ødegaard
  surname: Nielsen
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  organization: Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Center for Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Glostrup, Denmark
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  givenname: Egill
  surname: Rostrup
  fullname: Rostrup, Egill
  organization: Functional Imaging Unit, Copenhagen University Hospital, Glostrup, Denmark
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  givenname: Sanne
  surname: Wulff
  fullname: Wulff, Sanne
  organization: Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Center for Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Glostrup, Denmark
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  givenname: Nikolaj
  surname: Bak
  fullname: Bak, Nikolaj
  organization: Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Center for Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Glostrup, Denmark
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  givenname: Henrik
  surname: Lublin
  fullname: Lublin, Henrik
  organization: Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Center for Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Glostrup, Denmark
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  givenname: Shitij
  surname: Kapur
  fullname: Kapur, Shitij
  organization: Institute of Psychiatry, Kings College London, United Kingdom
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  givenname: Birte
  surname: Glenthøj
  fullname: Glenthøj, Birte
  organization: Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Center for Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Glostrup, Denmark
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ISSN 0006-3223
1873-2402
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IsPeerReviewed true
IsScholarly true
Issue 10
Keywords reward
Functional magnetic resonance imaging
positive symptoms
schizophrenia
ventral striatum
negative symptoms
Human
Central nervous system
Schizophrenia
Basal ganglion
Corpus striatum
Encephalon
Psychosis
Negative symptom
Reward
Positive symptom
Language English
License CC BY 4.0
Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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Snippet Various schizophrenic symptoms are suggested to be linked to a dysfunction of the brain reward system. Several studies have found alterations in the reward...
BackgroundVarious schizophrenic symptoms are suggested to be linked to a dysfunction of the brain reward system. Several studies have found alterations in the...
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SubjectTerms Adult
Adult and adolescent clinical studies
Basal Ganglia - physiopathology
Biological and medical sciences
Case-Control Studies
Female
Functional magnetic resonance imaging
Functional Neuroimaging
Gyrus Cinguli - physiopathology
Humans
Magnetic Resonance Imaging
Male
Medical sciences
Motivation
negative symptoms
positive symptoms
Prefrontal Cortex - physiopathology
Psychiatric/Mental Health
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Reward
Schizophrenia
Schizophrenia - physiopathology
Schizophrenic Psychology
ventral striatum
Ventral Tegmental Area - physiopathology
Title Alterations of the Brain Reward System in Antipsychotic Naïve Schizophrenia Patients
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