Abnormal Reward System Activation in Mania
Open accessAbstract
Transmission of reward signals is a function of dopamine, a neurotransmitter known to be involved in the mechanism of psychosis. Using functional magnetic resonance imaging (fMRI), we investigated how expectation and receipt of monetary rewards modulate brain activation in patients with bipolar mania and schizophrenia. We studied 12 acutely manic patients with a history of bipolar disorder, 12 patients with a current episode of schizoaffective disorder or schizophrenia and 12 healthy subjects. All patients were treated with dopamine antagonists at the time of the study. Subjects performed a delayed incentive paradigm with monetary reward in the scanner that allowed for investigating effects of expectation, receipt, and omission of rewards. Patients with schizophrenia and healthy control subjects showed the expected activation of dopaminergic brain areas, that is, ventral tegmentum activation upon expectation of monetary rewards and nucleus accumbens activation during receipt vs omission of rewards. In manic patients, however, we did not find a similar pattern of brain activation and the differential signal in the nucleus accumbens upon receipt vs omission of rewards was significantly lower compared to the healthy control subjects. Our findings provide evidence for abnormal function of the dopamine system during receipt or omission of expected rewards in bipolar disorder. These deficits in prediction error processing in acute mania may help to explain symptoms of disinhibition and abnormal goal pursuit regulation.
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Abler et al. reported decreased NAc activation during monetary-reward outcome in bipolar disorder, a pattern not evident in schizophrenia patients scanned using the same paradigm.
“Abler et al. [279] reported decreased NAc activation during monetary-reward outcome, a pattern that was not evident in a group of patients with schizophrenia scanned using the same paradigm.”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [279]
Striatal responses during monetary anticipation in schizophrenia are partially normalized by olanzapine but not by other antipsychotics.
“A handful of studies also suggest that striatal responses during monetary anticipation in schizophrenia are partially normalized by the antipsychotic, olanzapine [279,417,423] but not by other antipsychotics [418]”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [279]
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“Our study suggests that BD youths may have neural alterations in frontostriatal regions mediating reversal learning, especially those involved with the receipt of unexpected, spurious reward and punishment (Ramnani et al. 2004 ; Abler et al. 2008).”
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“In addition, reward dysfunction in hypomania/mania, at both the neurophysiological (Blumberg et al., 2000; Rubinsztein et al., 2001; Abler et al., 2008) and the phenomenological (increased risk taking, impulsivity) (Mason et al., 2012) levels, is also observed.”
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- Authors
- Abler, B., Greenhouse, I., Ongur, D., Walter, H., & Heckers, S.
- Affiliations
- Universität Ulm (DE)
- University of California, San Francisco (US)
- University of Bonn (DE)
- Vanderbilt University (US)
- Corresponding author
- Abler, Birgit
- Venue
- Neuropsychopharmacology
- Published
- 2007-11-07
- Volume
- 33
- Issue
- 9
- Pages
- 2217-2227
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- PMC
- PMC2574988
- OpenAlex
- W2045088017
- Cited by
- 216
- References
- 48
- Citations by year
- 2026: 2 · 2025: 11 · 2024: 3 · 2023: 6 · 2022: 8 · 2021: 31 · 2020: 11 · 2019: 9 · 2018: 8 · 2017: 15 · 2016: 9 · 2015: 15 · 2014: 14 · 2013: 15 · 2012: 16
- FWCI
- 6.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01mh070560-16)
- National Institute of Mental Health (R01-MH070560, R01MH094594)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- mania, bipolar disorder, schizophrenia, reward processing, dopaminergic system, nucleus accumbens, ventral tegmental area, prediction error, monetary rewards, dopamine antagonists, disinhibition, goal pursuit
- MeSH terms
- Adult, Bipolar Disorder, Brain, Brain Mapping, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Neural Pathways, Oxygen, Psychiatric Status Rating Scales, Psychological Tests, Reaction Time, Reward, Schizophrenia
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