title: Attenuated prefrontal activation during decision-making under uncertainty in schizophrenia: a multi-center fMRI study.
abstract: Decisions are called decisions under uncertainty when either prior information is incomplete or the outcomes of the decision are unclear. Alterations in these processes related to decisions under uncertainty have been linked to delusions. In patients with schizophrenia, the underlying neural networks have only rarely been studied. We aimed to disentangle the neural correlates of decision-making and relate them to neuropsychological and psychopathological parameters in a large sample of patients with schizophrenia and healthy subjects. Fifty-seven patients and fifty-seven healthy volunteers from six centers had to either indicate via button-press from which of two bottles red or blue balls were drawn (decision-making under uncertainty condition), or indicate whether eight red balls had been presented (baseline condition) while BOLD signal was measured with fMRI. Patients based their decisions on less conclusive evidence and had decreased activations in the underlying neural network, comprising of medial and lateral frontal as well as parietal areas, as compared to healthy subjects. While current psychopathology was not correlated with brain activation, positive symptoms led to longer decision latencies in patients. These results suggest that decision-making under uncertainty in schizophrenia is affected by a complex interplay of aberrant neural activation. Furthermore, reduced neuropsychological functioning in patients was related to impaired decision-making and task performance was modulated by distinct positive symptoms.
authors: Department of Psychiatry and Psychotherapy, Philipps University, Marburg, Germany. Electronic address: kruga@med.uni-marburg.de.
authors: A
authors: A
authors: Krug
authors: Department of Psychiatry and Psychotherapy, Philipps University, Marburg, Germany.
authors: M
authors: M
authors: Cabanis
authors: Department of Psychiatry and Psychotherapy, Philipps University, Marburg, Germany.
authors: M
authors: M
authors: Pyka
authors: Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Medical School, RWTH Aachen University, Aachen, Germany.
authors: K
authors: K
authors: Pauly
authors: Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Medical School, RWTH Aachen University, Aachen, Germany.
authors: T
authors: T
authors: Kellermann
authors: Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany.
authors: H
authors: H
authors: Walter
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
authors: M
authors: M
authors: Wagner
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
authors: M
authors: M
authors: Landsberg
authors: Institute of Neuroscience and Medicine, Medical Imaging Physics (INM4), Research Centre Juelich, Germany; Department of Neurology, Faculty of Medicine, JARA, RWTH Aachen University, Aachen, Germany.
authors: N J
authors: NJ
authors: Shah
authors: Cologne Center for Genomics, University of Cologne, Köln, Germany.
authors: G
authors: G
authors: Winterer
authors: Department of Psychiatry and Psychotherapy, Heinrich Heine University, Rhineland State Clinics for Psychiatry, Düsseldorf, Germany.
authors: W
authors: W
authors: Wölwer
authors: Department of Psychiatry and Psychotherapy, Heinrich Heine University, Rhineland State Clinics for Psychiatry, Düsseldorf, Germany.
authors: J
authors: J
authors: Brinkmeyer
authors: LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, Rhineland State Clinics for Psychiatry, Essen, Germany.
authors: B W
authors: BW
authors: Müller
authors: LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, Rhineland State Clinics for Psychiatry, Essen, Germany.
authors: C
authors: C
authors: Kärgel
authors: Clinic of Psychiatry and Psychotherapy, Clinical Center, Fulda, Germany.
authors: G
authors: G
authors: Wiedemann
authors: Department of Psychiatry and Psychotherapy, Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
authors: J
authors: J
authors: Herrlich
authors: Department of Psychiatry and Psychotherapy, University of Cologne, Köln, Germany; Institute for Neurosciences and Medicine, Cognitive Neuroscience (INM3), Research Center Juelich, Germany.
authors: K
authors: K
authors: Vogeley
authors: Department of Psychiatry and Psychotherapy, University of Cologne, Köln, Germany.
authors: L
authors: L
authors: Schilbach
authors: Department of Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany.
authors: A
authors: A
authors: Rapp
authors: Department of Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany.
authors: S
authors: S
authors: Klingberg
authors: Department of Psychiatry and Psychotherapy, Philipps University, Marburg, Germany.
authors: T
authors: T
authors: Kircher
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003657:Decision Making; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D010259:Paranoid Disorders / Q000473:pathology; D017397:Prefrontal Cortex / Q000098:blood supply*; D012559:Schizophrenia / Q000473:pathology*; D013223:Statistics as Topic; D035501:Uncertainty
chemical_list: D010100:Oxygen
keywords: Decision making; Jumping to conclusions; Psychopathology; Schizophrenia; fMRI