Background
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.
Methods
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.
Results
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.
Conclusion
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.
Key Words
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Article info
Publication history
Published online: March 15, 2012
Accepted:
February 3,
2012
Received in revised form:
February 3,
2012
Received:
August 4,
2011
Identification
Copyright
© 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
