title: Neuronal correlates of reward and loss in Cluster B personality disorders: a functional magnetic resonance imaging study.
abstract: Decision making is guided by the likely consequences of behavioural choices. Neuronal correlates of financial reward have been described in a number of functional imaging studies in humans. Areas implicated in reward include ventral striatum, dopaminergic midbrain, amygdala and orbitofrontal cortex. Response to loss has not been as extensively studied but may involve prefrontal and medial temporal cortices. It has been proposed that increased sensitivity to reward and reduced sensitivity to punishment underlie some of the psychopathology in impulsive personality disordered individuals. However, few imaging studies using reinforcement tasks have been conducted in this group. In this fMRI study, we investigate the effects of positive (monetary reward) and negative (monetary loss) outcomes on BOLD responses in two target selection tasks. The experimental group comprised eight people with Cluster B (antisocial and borderline) personality disorder, whilst the control group contained fourteen healthy participants. A key finding was the absence of prefrontal responses and reduced BOLD signal in the subcortical reward system in the PD group during positive reinforcement. Impulsivity scores correlated negatively with prefrontal responses in the PD but not the control group during both, reward and loss. Our results suggest dysfunctional responses to rewarding and aversive stimuli in Cluster B personality disordered individuals but do not support the notion of hypersensitivity to reward and hyposensitivity to loss.
authors.affiliation: Neuroscience and Psychiatry Unit, University of Manchester, Stopford Building, Oxford Rd, Manchester M13 9PT, UK. birgit.vollm@manchester.ac.uk
authors.forename: Birgit
authors.initials: B
authors.lastname: Völlm
authors.forename: Paul
authors.initials: P
authors.lastname: Richardson
authors.forename: Shane
authors.initials: S
authors.lastname: McKie
authors.forename: Rebecca
authors.initials: R
authors.lastname: Elliott
authors.forename: Mairead
authors.initials: M
authors.lastname: Dolan
authors.forename: Bill
authors.initials: B
authors.lastname: Deakin
mesh_terms: D000328:Adult; D000679:Amygdala / Q000503:physiopathology; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D001931:Brain Mapping; D003342:Corpus Striatum / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007175:Impulsive Behavior / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000503:physiopathology; D010101:Oxygen Consumption / Q000502:physiology; D020534:Parahippocampal Gyrus / Q000503:physiopathology; D010554:Personality Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D017397:Prefrontal Cortex / Q000503:physiopathology*; D011678:Punishment; D012201:Reward