Ventral striatal activation during reward processing in subjects with ultra-high risk for schizophrenia.
BACKGROUND
Early dysfunction of the brain reward system in schizophrenia might be already recognized in the prodromal phase of this illness. We used functional magnetic resonance imaging to assess the blood oxygen level-dependent response in the ventral striatum (VS) of subjects with ultra-high risk for psychosis during the presentation of reward-indicating and loss-indicating stimuli.


METHODS
Thirteen prodromal patients (mean age: 25.5 ± 4.6 years) and 13 age-matched healthy volunteers participated in an incentive monetary delay task, in which visual cues predicted that a rapid response to a subsequent target stimulus will gain money, avoid losing money or have no consequence.


RESULTS
Compared with the neutral condition, anticipation of reward loss-avoidance elicited significant activation of the VS in both healthy subjects and subjects with ultra-high risk for psychosis, but there was only a statistical tendency for less activation during loss-avoidance anticipation in prodromal compared to healthy subjects.


CONCLUSIONS
This study provides a first weak hint, as revealed by functional magnetic resonance imaging, for impaired activation of a central area of the mesolimbic dopaminergic brain reward system, the VS, already in subjects with ultra-high risk for psychosis, which is in line with results of patients with full-blown schizophrenic psychosis. This pilot study has, however, strong limitations, and its results need to be replicated first before they can be used e.g. for early recognition of patients in the schizophrenic prodrome.
Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany. georg.juckel@wkp-lwl.org
Georg
G
Juckel
Eva
E
Friedel
Michael
M
Koslowski
Henning
H
Witthaus
Seza
S
Ozgürdal
Yehonala
Y
Gudlowski
Brian
B
Knutson
Jana
J
Wrase
Martin
M
Brüne
Andreas
A
Heinz
Florian
F
Schlagenhauf
D000328:Adult; D059031:Anticipation, Psychological; D001479:Basal Ganglia / Q000503:physiopathology*; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000503:physiopathology*; D003463:Cues; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010865:Pilot Projects; D011930:Reaction Time; D012201:Reward; D012307:Risk Factors; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology