Subramaniam Karuna, Hooker Christine I, Biagianti Bruno, Fisher Melissa, Nagarajan Srikantan, Vinogradov Sophia
San Francisco Department of Veterans Affairs Medical Center, Department of Psychiatry, University of California, San Francisco, CA 94121, USA.
Department of Psychology, Harvard University, Cambridge, MA 02138, USA.
Neuroimage Clin. 2015 Aug 20;9:153-63. doi: 10.1016/j.nicl.2015.08.001. eCollection 2015.
Amotivation in schizophrenia is a central predictor of poor functioning, and is thought to occur due to deficits in anticipating future rewards, suggesting that impairments in anticipating pleasure can contribute to functional disability in schizophrenia. In healthy comparison (HC) participants, reward anticipation is associated with activity in frontal-striatal networks. By contrast, schizophrenia (SZ) participants show hypoactivation within these frontal-striatal networks during this motivated anticipatory brain state. Here, we examined neural activation in SZ and HC participants during the anticipatory phase of stimuli that predicted immediate upcoming reward and punishment, and during the feedback/outcome phase, in relation to trait measures of hedonic pleasure and real-world functional capacity. SZ patients showed hypoactivation in ventral striatum during reward anticipation. Additionally, we found distinct differences between HC and SZ groups in their association between reward-related immediate anticipatory neural activity and their reported experience of pleasure. HC participants recruited reward-related regions in striatum that significantly correlated with subjective consummatory pleasure, while SZ patients revealed activation in attention-related regions, such as the IPL, which correlated with consummatory pleasure and functional capacity. These findings may suggest that SZ patients activate compensatory attention processes during anticipation of immediate upcoming rewards, which likely contribute to their functional capacity in daily life.
精神分裂症中的动机缺乏是功能不良的核心预测指标，被认为是由于对未来奖励的预期不足所致，这表明预期愉悦方面的损害可能导致精神分裂症患者的功能残疾。在健康对照（HC）参与者中，奖励预期与额叶 - 纹状体网络的活动相关。相比之下，精神分裂症（SZ）患者在这种有动机的预期脑状态下，这些额叶 - 纹状体网络内表现出激活不足。在此，我们研究了SZ患者和HC参与者在预测即将到来的即时奖励和惩罚的刺激的预期阶段以及反馈/结果阶段的神经激活情况，以及与享乐愉悦和现实世界功能能力的特质测量之间的关系。SZ患者在奖励预期期间腹侧纹状体表现出激活不足。此外，我们发现HC组和SZ组在奖励相关的即时预期神经活动与其报告的愉悦体验之间的关联存在明显差异。HC参与者在纹状体中募集了与奖励相关的区域，这些区域与主观满足愉悦显著相关，而SZ患者在与注意力相关的区域，如顶下小叶，表现出激活，这与满足愉悦和功能能力相关。这些发现可能表明，SZ患者在预期即将到来的即时奖励时会激活补偿性注意力过程，这可能有助于他们在日常生活中的功能能力。
