title: Neural substrates underlying effort computation in schizophrenia.
abstract: The lack of initiative, drive or effort in patients with schizophrenia is linked to marked functional impairments. However, our assessment of effort and motivation is crude, relying on clinical rating scales based largely on patient recall. In order to better understand the neurobiology of effort in schizophrenia, we need more rigorous measurements of this construct. In the behavioural neuroscience literature, decades of work has been carried out developing various paradigms to examine the neural underpinnings of an animal's willingness to expend effort for a reward. Here, we shall review this literature on the nature of paradigms used in rodents to assess effort, as well as those used in humans. Next, the neurobiology of these effort-based decisions will be discussed. We shall then review what is known about effort in schizophrenia, and what might be inferred from experiments done in other human populations. Lastly, we shall discuss future directions of research that may assist in shedding light on the neurobiology of effort cost computations in schizophrenia.
authors.affiliation: Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada. Electronic address: gagan.fervaha@utoronto.ca.
authors.forename: Gagan
authors.initials: G
authors.lastname: Fervaha
authors.forename: George
authors.initials: G
authors.lastname: Foussias
authors.forename: Ofer
authors.initials: O
authors.lastname: Agid
authors.forename: Gary
authors.initials: G
authors.lastname: Remington
mesh_terms: D000818:Animals; D003073:Cognitive Dissonance; D003657:Decision Making / Q000502:physiology*; D006040:Goals; D006801:Humans; D009042:Motivation / Q000502:physiology*; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications*; D057170:Translational Research, Biomedical
keywords: Amotivation; Anterior cingulate cortex; Apathy; Avolition; Cost-benefit decision making; Dopamine; Effort; Motivation; Negative symptoms; Reward; Schizophrenia