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Altered reward processing in the nucleus accumbens and mesial prefrontal cortex of patients with posttraumatic stress disorder
Abstract
Posttraumatic stress disorder (PTSD) is known to be associated with altered medial prefrontal activation in response to threatening stimuli and with behavioural deficits in prefrontal functions such as working memory and attention. Given the importance of these areas and processes for decision-making, this functional magnetic resonance imaging study investigated whether decision-making is altered in patients with PTSD. In particular, the neural response to gain and loss feedback was evaluated in a decision-making task in which subjects could maximise their number of points total by learning a particular response pattern. Behaviourally, controls learned the correct response pattern faster than patients. Functionally, patients and controls differed in their neural response to gains, but not in their response to losses. During the processing of gains in the late phase of learning, PTSD patients as compared to controls showed lower activation in the nucleus accumbens and the mesial PFC, critical structures in the reward pathway. This reduced activation was not due to different rates of learning, since it was similarly present in patients with unimpaired learning performance. These findings suggest that positive outcome information lost its salience for patients with PTSD. This may reflect decreasing motivation as the task progressed.
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“While early research focused on fear-related processes, a growing recognition of alterations in reward processing (115, 116) led to a reconceptualization of PTSD as an imbalance between approach (reward-related) and avoidance (fear-related) systems (117–119).”
From A transdiagnostic perspective on social anhedonia (2019) · cites this paper as [116]
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Metadata
- Authors
- Sailer, U., Robinson, S., Fischmeister, F. P. S., König, D., Oppenauer, C., Lueger-Schuster, B., Moser, E., Kryspin-Exner, I., & Bauer, H.
- Affiliations
- University of Vienna (AT)
- Medical University of Vienna (AT)
- Corresponding author
- Sailer, Uta
- ORCID
- Venue
- Neuropsychologia
- Publisher
- Elsevier BV
- Published
- 2008-09
- Volume
- 46
- Issue
- 11
- Pages
- 2836-2844
- ISSN
- 0028-3932 (ISSN-L)
- OpenAlex
- W1981443966
- Cited by
- 201
- References
- 65
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 6 · 2023: 14 · 2022: 10 · 2021: 12 · 2020: 14 · 2019: 14 · 2018: 17 · 2017: 12 · 2016: 18 · 2015: 12 · 2014: 5 · 2013: 11 · 2012: 14
- FWCI
- 8.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neuropsychologia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Oesterreichische Nationalbank
- Schuhfried
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- post-traumatic stress disorder, reward processing, nucleus accumbens, decision-making, learning, motivation, reward salience, reward pathways
- MeSH terms
- Adult, Decision Making, Feedback, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Mental Processes, Neuropsychological Tests, Nucleus Accumbens, Oxygen, Psychomotor Performance, Reward, Stress Disorders, Post-Traumatic, Case-Control Studies, Prefrontal Cortex, Statistics, Nonparametric
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