Reduced activation in ventral striatum and ventral tegmental area during probabilistic decision-making in schizophrenia.
Patients with schizophrenia suffer from deficits in monitoring and controlling their own thoughts. Within these so-called metacognitive impairments, alterations in probabilistic reasoning might be one cognitive phenomenon disposing to delusions. However, so far little is known about alterations in associated brain functionality. A previously established task for functional magnetic resonance imaging (fMRI), which requires a probabilistic decision after a variable amount of stimuli, was applied to 23 schizophrenia patients and 28 healthy controls matched for age, gender and educational levels. We compared activation patterns during decision-making under conditions of certainty versus uncertainty and evaluated the process of final decision-making in ventral striatum (VS) and ventral tegmental area (VTA). We replicated a pre-described extended cortical activation pattern during probabilistic reasoning. During final decision-making, activations in several fronto- and parietocortical areas, as well as in VS and VTA became apparent. In both of these regions schizophrenia patients showed a significantly reduced activation. These results further define the network underlying probabilistic decision-making. The observed hypo-activation in regions commonly associated with dopaminergic neurotransmission fits into current concepts of disrupted prediction error signaling in schizophrenia and suggests functional links to reward anticipation. Forthcoming studies with patients at risk for psychosis and drug-naive first episode patients are necessary to elucidate the development of these findings over time and the interplay with associated clinical symptoms.
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
Franziska
F
Rausch
Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
Daniela
D
Mier
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
Sarah
S
Eifler
MVZ Neurology, Magdeburg, Germany.
Christine
C
Esslinger
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
Claudia
C
Schilling
Academic Medical Centre, Amsterdam University, Netherlands.
Frederike
F
Schirmbeck
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
Susanne
S
Englisch
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
Andreas
A
Meyer-Lindenberg
Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
Peter
P
Kirsch
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany. Electronic address: mathias.zink@zi-mannheim.de.
Mathias
M
Zink
D000328:Adult; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D003657:Decision Making / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000503:physiopathology; D009483:Neuropsychological Tests; D011336:Probability; D011594:Psychometrics; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D013850:Thinking / Q000502:physiology; D035501:Uncertainty; D066328:Ventral Striatum / Q000503:physiopathology*; D017557:Ventral Tegmental Area / Q000503:physiopathology*
Dopamine; Functional magnetic resonance imaging; Metacognition; Probabilistic reasoning; Schizophrenia; Ventral striatum