Abnormal Responses to Monetary Outcomes in Cortex, but not in the Basal Ganglia, in Schizophrenia
Open accessAbstract
Psychosis has been associated with aberrant brain activity concurrent with both the anticipation and integration of monetary outcomes. The extent to which abnormal reward-related neural signals can be observed in chronic, medicated patients with schizophrenia (SZ), however, is not clear. In an fMRI study involving 17 chronic outpatients with SZ and 17 matched controls, we used a monetary incentive delay (MID) task, in which different-colored shapes predicted gains, losses, or neutral outcomes. Subjects needed to respond to a target within a time window in order to receive the indicated gain or avoid the indicated loss. Group differences in blood-oxygen-level-dependent responses to cues and outcomes were assessed through voxel-wise whole-brain analyses and regions-of-interest analyses in the neostriatum and prefrontal cortex (PFC). Significant group by outcome valence interactions were observed in the medial and lateral PFC, lateral temporal cortex, and amygdalae, such that controls, but not patients, showed greater activation for gains, relative to losses. In the striatum, neural activity was modulated by outcome magnitude in both groups. Additionally, we found that ratings of negative symptoms in patients correlated with sensitivity to obtained losses in medial PFC, obtained gains in lateral PFC, and anticipated gains in left ventral striatum. Sensitivity to obtained gains in lateral PFC also correlated with positive symptom scores in patients. Our findings of systematic relationships between clinical symptoms and neural responses to stimuli associated with rewards and punishments offer promise that reward-related neural responses may provide sensitive probes of the effectiveness of treatments for negative symptoms.
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A large number of fMRI studies indicate that midbrain and striatal responses to rewarding and to neutral outcomes are altered in patients with psychosis and that these alterations are associated with positive and negative symptoms.
“A large number of fMRI studies indicate that midbrain and striatal responses to rewarding and to neutral outcomes are altered in patients with psychosis (29-42) and that these alterations are associated with positive and negative symptoms.”
From Aberrant Salience, Information Processing, and Dopaminergic Signaling in People at Clinical High Risk for Psychosis (2020) · cites this paper as [37]
The Discussion (Behavior and neural activity associated with outcome anticipation) reports an association between ventral-striatal responses to gain-predicting versus neutral cues and negative symptoms. The Abstract reports positive-symptom correlations in lateral prefrontal cortex, not the striatum. The paper does not establish altered midbrain responses, and its Results (Levels of outcome: Whole-brain analyses) report no group difference in striatal responses to outcome magnitude. (LLM, conf=0.88)
Experimental — accuracy not yet measuredTask-related frontal and striatal activation and fronto-striatal connectivity have been repeatedly shown to be altered across the psychosis continuum, suggesting that high-level priors have greater influence on perception in psychosis.
“task-related frontal and striatal activation and fronto-striatal connectivity have been repeatedly shown to be altered across the psychosis continuum, suggesting that high-level priors have greater influence on perception in psychosis (33, 34, 36-38, 82, 127-130).”
From Aberrant Salience, Information Processing, and Dopaminergic Signaling in People at Clinical High Risk for Psychosis (2020) · cites this paper as [37]
The Results (Levels of outcome: Whole-brain analyses; page not provided) report altered outcome-related prefrontal activation in patients with schizophrenia. The study does not establish altered fronto-striatal connectivity or findings across the psychosis continuum; its Discussion (Behavior and neural activity associated with outcome anticipation; page not provided) reports no significant group interactions in the striatal regions of interest. It also does not link these findings to a greater influence of high-level priors on perception. (LLM, conf=0.86)
Experimental — accuracy not yet measuredNeuroimaging studies generally suggest decreased NAc activation during monetary-reward anticipation in schizophrenia in both medicated and unmedicated patients.
“Neuroimaging studies of responses to rewards in schizophrenia generally suggest decreased NAc activation during monetary-reward anticipation (but see [416]for an exception) in both patients taking medication and patients not taking medication [417-420].”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [420]
There is evidence of inverse relations between negative symptoms and NAc activation during reward anticipation and between lateral PFC activation during reward outcomes in schizophrenia.
“There is also evidence of inverse relations between negative symptoms and NAc activation during reward anticipation [416,420,422] and between lateral PFC activation during reward outcomes [420].”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [420]
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- Authors
- Waltz, J. A., Schweitzer, J. B., Ross, T. J., Kurup, P. K., Salmeron, B. J., Rose, E. J., Gold, J. M., & Stein, E. A.
- Affiliations
- University of Maryland, Baltimore (US)
- University of California Davis Medical Center (US)
- National Institutes of Health (US)
- Corresponding author
- Waltz, James A
- ORCID
- Venue
- Neuropsychopharmacology
- Published
- 2010-08-18
- Volume
- 35
- Issue
- 12
- Pages
- 2427-2439
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- PMC
- PMC2955756
- OpenAlex
- W1991367158
- Cited by
- 151
- References
- 62
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 4 · 2023: 8 · 2022: 7 · 2021: 4 · 2020: 10 · 2019: 5 · 2018: 8 · 2017: 11 · 2016: 22 · 2015: 24 · 2014: 16 · 2013: 12 · 2012: 9
- FWCI
- 5.25
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neuropsychopharmacology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p30mh068580-03, 5k12rr023250-05)
- National Institute of Mental Health (P30 MH-068580, 1R24 MH72647-01A1, R24MH072647)
- National Institute on Drug Abuse
- National Center for Research Resources (1K12 RR 023250-01, K12-RR023250)
- 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
- schizophrenia, monetary incentive delay task, reward processing, punishment sensitivity, outcome valence, prefrontal cortex, ventral striatum, basal ganglia, negative symptoms, positive symptoms, outcome magnitude
- MeSH terms
- Adult, Basal Ganglia, Brain Mapping, Cerebral Cortex, Cues, Female, Humans, Magnetic Resonance Imaging, Male, Reinforcement, Psychology, Schizophrenia, Schizophrenic Psychology, Self Report
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