Reduced activation in the ventral striatum during probabilistic decision-making in patients in an at-risk mental state

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2015
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Rausch, Franziska
Eifler, Sarah
Fenske, Sabrina
Schirmbeck, Frederike
Englisch, Susanne
Schilling, Claudia
Meyer-Lindenberg, Andreas
Kirsch, Peter
Zink, Mathias
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Journal of Psychiatry & Neuroscience. 2015, 40(3), pp. 163-173. ISSN 1180-4882. eISSN 1488-2434. Available under: doi: 10.1503/jpn.140191
Zusammenfassung

Background: Patients with schizophrenia display metacognitive impairments, such as hasty decision-making during probabilistic reasoning - the "jumping to conclusion" bias (JTC). Our recent fMRI study revealed reduced activations in the right ventral striatum (VS) and the ventral tegmental area (VTA) to be associated with decision-making in patients with schizophrenia. It is unclear whether these functional alterations occur in the at-risk mental state (ARMS).

Methods: We administered the classical beads task and fMRI among ARMS patients and healthy controls matched for age, sex, education and premorbid verbal intelligence. None of the ARMS patients was treated with antipsychotics. Both tasks request probabilistic decisions after a variable amount of stimuli. We evaluated activation during decision-making under certainty versus uncertainty and the process of final decision-making.

Results: We included 24 AMRS patients and 24 controls in our study. Compared with controls, ARMS patients tended to draw fewer beads and showed significantly more JTC bias in the classical beads task, mirroring findings in patients with schizophrenia. During fMRI, ARMS patients did not demonstrate JTC bias on the behavioural level, but showed a significant hypoactivation in the right VS during the decision stage.

Limitations: Owing to the cross-sectional design of the study, results are constrained to a better insight into the neurobiology of risk constellations, but not prepsychotic stages. Nine of the ARMS patients were treated with antidepressants and/or lorazepam.

Conclusion: As in patients with schizophrenia, a striatal hypoactivation was found in ARMS patients. Confounding effects of antipsychotic medication can be excluded. Our findings indicate that error prediction signalling and reward anticipation may be linked to striatal dysfunction during prodromal stages and should be examined for their utility in predicting transition risk.

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ISO 690RAUSCH, Franziska, Daniela MIER, Sarah EIFLER, Sabrina FENSKE, Frederike SCHIRMBECK, Susanne ENGLISCH, Claudia SCHILLING, Andreas MEYER-LINDENBERG, Peter KIRSCH, Mathias ZINK, 2015. Reduced activation in the ventral striatum during probabilistic decision-making in patients in an at-risk mental state. In: Journal of Psychiatry & Neuroscience. 2015, 40(3), pp. 163-173. ISSN 1180-4882. eISSN 1488-2434. Available under: doi: 10.1503/jpn.140191
BibTex
@article{Rausch2015-05Reduc-45602,
  year={2015},
  doi={10.1503/jpn.140191},
  title={Reduced activation in the ventral striatum during probabilistic decision-making in patients in an at-risk mental state},
  number={3},
  volume={40},
  issn={1180-4882},
  journal={Journal of Psychiatry & Neuroscience},
  pages={163--173},
  author={Rausch, Franziska and Mier, Daniela and Eifler, Sarah and Fenske, Sabrina and Schirmbeck, Frederike and Englisch, Susanne and Schilling, Claudia and Meyer-Lindenberg, Andreas and Kirsch, Peter and Zink, Mathias}
}
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    <dcterms:abstract xml:lang="eng">Background: Patients with schizophrenia display metacognitive impairments, such as hasty decision-making during probabilistic reasoning - the "jumping to conclusion" bias (JTC). Our recent fMRI study revealed reduced activations in the right ventral striatum (VS) and the ventral tegmental area (VTA) to be associated with decision-making in patients with schizophrenia. It is unclear whether these functional alterations occur in the at-risk mental state (ARMS).&lt;br /&gt;&lt;br /&gt;Methods: We administered the classical beads task and fMRI among ARMS patients and healthy controls matched for age, sex, education and premorbid verbal intelligence. None of the ARMS patients was treated with antipsychotics. Both tasks request probabilistic decisions after a variable amount of stimuli. We evaluated activation during decision-making under certainty versus uncertainty and the process of final decision-making.&lt;br /&gt;&lt;br /&gt;Results: We included 24 AMRS patients and 24 controls in our study. Compared with controls, ARMS patients tended to draw fewer beads and showed significantly more JTC bias in the classical beads task, mirroring findings in patients with schizophrenia. During fMRI, ARMS patients did not demonstrate JTC bias on the behavioural level, but showed a significant hypoactivation in the right VS during the decision stage.&lt;br /&gt;&lt;br /&gt;Limitations: Owing to the cross-sectional design of the study, results are constrained to a better insight into the neurobiology of risk constellations, but not prepsychotic stages. Nine of the ARMS patients were treated with antidepressants and/or lorazepam.&lt;br /&gt;&lt;br /&gt;Conclusion: As in patients with schizophrenia, a striatal hypoactivation was found in ARMS patients. Confounding effects of antipsychotic medication can be excluded. Our findings indicate that error prediction signalling and reward anticipation may be linked to striatal dysfunction during prodromal stages and should be examined for their utility in predicting transition risk.</dcterms:abstract>
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