Neural Circuitry of Salience and Reward Processing in Psychosis
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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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Decision-making and learning impairments are core characteristics of a wide range of psychiatric disorders, including MDD, OCD, and schizophrenia, and are linked to their specific symptoms.
“Decision-making and learning impairments are core characteristics of a wide range of psychiatric disorders — such as major depressive disorder (MDD), obsessive–compulsive disorder (OCD), and schizophrenia — and are linked to their specific symptoms.1–9”
From Investigating disorder-specific and transdiagnostic alterations in model-based and model-free decision-making (2024) · cites this paper as [8]
Our findings are in line with previous literature that these patients generally possess an impairment in reward anticipation and effort-based decision-making.
“Thus, our findings are in line with previous literature elucidating that these patients generally possess an impairment in reward anticipation and effort-based decision-making.8,61”
From Investigating disorder-specific and transdiagnostic alterations in model-based and model-free decision-making (2024) · cites this paper as [8]
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Targeting disrupted networks in schizophrenia: Can muscarinic drugs make a fundamental difference?
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Applications of Behavioral Economics and Neuroeconomics in Mental Health
Abdullaeva, B. S., Àbdullaev, D., Djuraeva, L., Sagdullaeva, D. K., & Kholikov, A. (2024) · Iranian Journal of Psychiatry · doi:10.18502/ijps.v20i1.17404 · Cited by 6 · see citing works
The Translational Utility of Circuit-Based Manipulations in Preclinical Models
Kesby, J. P., & Turner, K. M. (2024) · Biological Psychiatry Global Open Science · doi:10.1016/j.bpsgos.2023.11.004 · Cited by 2 · see citing works
Self-citationThe Salience of Psychotic Experiences: Neural Correlates in the General Population
Neidhart, M., Henze, G., Vogel, B. O., Mohnke, S., Banaschewski, T., & Walter, H. (2025) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaf115 · Cited by 1 · see citing works
Inner speech and the neurobiology of psychosis
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A cortical insula–orbitofrontal circuit drives stress-induced dopamine system dysfunction
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Linking Substance Use and Schizophrenia
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Self-citationSubcortical Origin of Salience Processing Deficits in Schizophrenia
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Linking Substance Use and Schizophrenia
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- Authors
- Kesby, J. P., Murray, G. K., & Knolle, F.
- Affiliations
- The University of Queensland (AU)
- University of Cambridge (GB)
- Corresponding author
- Kesby, James P.
- Knolle, Franziska
- Venue
- Biological Psychiatry Global Open Science
- Publisher
- Elsevier BV
- Published
- 2023-01
- Volume
- 3
- Issue
- 1
- Pages
- 33-46
- ISSN
- 2667-1743 (ISSN-L)
- PMC
- PMC9874126
- OpenAlex
- W4200378437
- Cited by
- 55
- References
- 158
- Citations by year
- 2026: 11 · 2025: 16 · 2024: 6 · 2023: 13 · 2022: 9
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Biological Psychiatry Global Open Science (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Apollo
- Funders
- European Commission
- Brain and Behavior Research Foundation
- National Health and Medical Research Council (APP1139960)
- Horizon 2020 Framework Programme
- Horizon 2020 (754462)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- psychosis, schizophrenia, salience processing, reward processing, prediction error, neural circuits, subcortical dysfunction, cortical abnormalities, decision-making, functional neuroimaging, early psychosis, symptom onset
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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