Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin & St. Hedwig Hospital, Berlin, Germany; Berlin School of Mind and Brain, Germany; Bernstein Center of Computational Neuroscience Berlin, Germany.
Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin & St. Hedwig Hospital, Berlin, Germany.
Neuroimage. 2019 Apr 15;190:133-143. doi: 10.1016/j.neuroimage.2018.05.074. Epub 2018 May 31.
Dysfunctional decision-making has been implicated in the positive and negative symptoms of schizophrenia. Decision-making can be conceptualized within the framework of hierarchical predictive coding as the result of a Bayesian inference process that uses prior beliefs to infer states of the world. According to this idea, prior beliefs encoded at higher levels in the brain are fed back as predictive signals to lower levels. Whenever these predictions are violated by the incoming sensory data, a prediction error is generated and fed forward to update beliefs encoded at higher levels. Well-documented impairments in cognitive decision-making support the view that these neural inference mechanisms are altered in schizophrenia. There is also extensive evidence relating the symptoms of schizophrenia to aberrant signaling of prediction errors, especially in the domain of reward and value-based decision-making. Moreover, the idea of altered predictive coding is supported by evidence for impaired low-level sensory mechanisms and motor processes. We review behavioral and neural findings from these research areas and provide an integrated view suggesting that schizophrenia may be related to a pervasive alteration in predictive coding at multiple hierarchical levels, including cognitive and value-based decision-making processes as well as sensory and motor systems. We relate these findings to decision-making processes and propose that varying degrees of impairment in the implicated brain areas contribute to the variety of psychotic experiences.
功能失调的决策与精神分裂症的阳性和阴性症状有关。决策可以在分层预测编码的框架内进行概念化，作为贝叶斯推理过程的结果，该过程使用先验信念来推断世界的状态。根据这个想法，大脑中更高层次编码的先验信念被反馈为预测信号，以较低的层次。每当这些预测被传入的感觉数据违反时，就会产生预测误差，并向前馈以更新更高层次编码的信念。有充分文件记录的认知决策受损支持这样一种观点，即这些神经推理机制在精神分裂症中发生了改变。也有大量证据将精神分裂症的症状与预测误差的异常信号联系起来，特别是在奖励和基于价值的决策领域。此外，改变预测编码的想法得到了证据的支持，这些证据表明，低水平的感觉机制和运动过程受到了损害。我们回顾了这些研究领域的行为和神经发现，并提供了一个综合的观点，表明精神分裂症可能与多个层次的预测编码普遍改变有关，包括认知和基于价值的决策过程以及感觉和运动系统。我们将这些发现与决策过程联系起来，并提出受影响的大脑区域的不同程度的损伤导致了各种精神病症状的出现。
