1
|
Dodd K, Legget KT, Cornier MA, Novick AM, McHugo M, Berman BD, Lawful BP, Tregellas JR. Relationship between functional connectivity and weight-gain risk of antipsychotics in schizophrenia. Schizophr Res 2024; 267:173-181. [PMID: 38552340 DOI: 10.1016/j.schres.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 01/19/2024] [Accepted: 03/18/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND The mechanisms by which antipsychotic medications (APs) contribute to obesity in schizophrenia are not well understood. Because AP effects on functional brain connectivity may contribute to weight effects, the current study investigated how AP-associated weight-gain risk relates to functional connectivity in schizophrenia. METHODS Fifty-five individuals with schizophrenia (final N = 54) were divided into groups based on previously reported AP weight-gain risk (no APs/low risk [N = 19]; moderate risk [N = 17]; high risk [N = 18]). Resting-state functional magnetic resonance imaging (fMRI) was completed after an overnight fast ("fasted") and post-meal ("fed"). Correlations between AP weight-gain risk and functional connectivity were assessed at the whole-brain level and in reward- and eating-related brain regions (anterior insula, caudate, nucleus accumbens). RESULTS When fasted, greater AP weight-gain risk was associated with increased connectivity between thalamus and sensorimotor cortex (pFDR = 0.021). When fed, greater AP weight-gain risk was associated with increased connectivity between left caudate and left precentral/postcentral gyri (pFDR = 0.048) and between right caudate and multiple regions, including the left precentral/postcentral gyri (pFDR = 0.001), intracalcarine/precuneal/cuneal cortices (pFDR < 0.001), and fusiform gyrus (pFDR = 0.008). When fed, greater AP weight-gain risk was also associated with decreased connectivity between right anterior insula and ventromedial prefrontal cortex (pFDR = 0.002). CONCLUSIONS APs with higher weight-gain risk were associated with greater connectivity between reward-related regions and sensorimotor regions when fasted, perhaps relating to motor anticipation for consumption. Higher weight-gain risk APs were also associated with increased connectivity between reward, salience, and visual regions when fed, potentially reflecting greater desire for consumption following satiety.
Collapse
Affiliation(s)
- Keith Dodd
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA; Department of Bioengineering, University of Colorado Denver, 12705 E Montview Blvd Suite 100, Aurora, CO 80045, USA
| | - Kristina T Legget
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA; Research Service, Rocky Mountain Regional VA Medical Center, 1700 N Wheeling St, Aurora, CO 80045, USA
| | - Marc-Andre Cornier
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Medical University of South Carolina, Clinical Sciences Building, CSB 96 Jonathan Lucas Street, Charleston, SC 29425, USA
| | - Andrew M Novick
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA
| | - Maureen McHugo
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA
| | - Brian D Berman
- Department of Neurology, Virginia Commonwealth University, 1101 E Marshall Street, Richmond, VA 23298, USA
| | - Benjamin P Lawful
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA
| | - Jason R Tregellas
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Anschutz Health Sciences Building, 1890 N Revere Ct, Aurora, CO 80045, USA; Research Service, Rocky Mountain Regional VA Medical Center, 1700 N Wheeling St, Aurora, CO 80045, USA.
| |
Collapse
|
2
|
Abstract
Anhedonia has long been considered a cardinal symptom of schizophrenia. This symptom is strongly associated with poor functional outcome, and limited treatment options are available. While originally conceptualized as an inability to experience pleasure, recent work has consistently shown that individuals with schizophrenia have an intact capacity to experience pleasure in-the-moment. Adjacent work in basic affective neuroscience has broadened the conceptualization of anhedonia to include not only the capacity to experience pleasure but highlights important temporal affective dynamics and decision-making processes that go awry in schizophrenia. Here we detail these mechanisms for emotional and motivational impairment in people with schizophrenia including: (1) initial response to reward; (2) reward anticipation; (3) reward learning; (4) effort-cost decision-making; (5) working memory and cognitive control. We will review studies that utilized various types of rewards (e.g., monetary, social), in order to draw conclusions regarding whether findings vary by reward type. We will then discuss how modern assessment methods may best incorporate each of the mechanisms, to provide a more fine-grained understanding of anhedonia in individuals with schizophrenia. We will close by providing a discussion of relevant future directions.
Collapse
Affiliation(s)
- Erin K Moran
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Adam J Culbreth
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, College Park, MD, USA
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
| |
Collapse
|
3
|
Grimm O, Nägele M, Küpper-Tetzel L, de Greck M, Plichta M, Reif A. No effect of a dopaminergic modulation fMRI task by amisulpride and L-DOPA on reward anticipation in healthy volunteers. Psychopharmacology (Berl) 2021; 238:1333-1342. [PMID: 33140215 PMCID: PMC8062334 DOI: 10.1007/s00213-020-05693-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 10/23/2020] [Indexed: 01/02/2023]
Abstract
RATIONALE Dysregulation of dopaminergic neurotransmission, specifically altered reward processing assessed via the reward anticipation in the MID task, plays a central role in the etiopathogenesis of neuropsychiatric disorders. OBJECTIVES We hypothesized to find a difference in the activity level of the reward system (measured by the proxy reward anticipation) under drug administration versus placebo, in that amisulpride reduces, and L-DOPA enhances, its activity. METHODS We studied the influence of dopamine agonist L-DOPA and the antagonist amisulpride on the reward system using functional magnetic resonance imaging (fMRI) during a monetary incentive delay (MID) task in n = 45 healthy volunteers in a randomized, blinded, cross-over study. RESULTS The MID paradigm elicits strong activation in reward-dependent structures (such as ventral striatum, putamen, caudate, anterior insula) during reward anticipation. The placebo effect demonstrated the expected significant blood oxygen level-dependent activity in reward-dependent brain regions. Neither amisulpride nor L-DOPA led to significant changes in comparison with the placebo condition. This was true for whole-brain analysis as well as analysis of a pre-defined nucleus accumbens region-of-interest mask. CONCLUSION The present results cast doubt on the sensitivity of reward anticipation contrast in the MID task for assessing dopamine-specific changes in healthy volunteers by pharmaco-fMRI. While our task was not well-suited for detailed analysis of the outcome phase, we provide reasonable arguments that the lack of effect in the anticipation phase is not due to an inefficient task but points to unexpected behavior of the reward system during pharmacological challenge. Group differences of reward anticipation should therefore not be seen as simple representatives of dopaminergic states.
Collapse
Affiliation(s)
- Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany.
| | - Magdalena Nägele
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Lea Küpper-Tetzel
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Moritz de Greck
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Michael Plichta
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| |
Collapse
|
4
|
Stogios N, Smith E, Asgariroozbehani R, Hamel L, Gdanski A, Selby P, Sockalingam S, Graff-Guerrero A, Taylor VH, Agarwal SM, Hahn MK. Exploring Patterns of Disturbed Eating in Psychosis: A Scoping Review. Nutrients 2020; 12:E3883. [PMID: 33353080 PMCID: PMC7768542 DOI: 10.3390/nu12123883] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/03/2020] [Accepted: 12/09/2020] [Indexed: 12/19/2022] Open
Abstract
Disturbed eating behaviours have been widely reported in psychotic disorders since the early 19th century. There is also evidence that antipsychotic (AP) treatment may induce binge eating or other related compulsive eating behaviours. It is therefore possible that abnormal eating patterns may contribute to the significant weight gain and other metabolic disturbances observed in patients with psychosis. In this scoping review, we aimed to explore the underlying psychopathological and neurobiological mechanisms of disrupted eating behaviours in psychosis spectrum disorders and the role of APs in this relationship. A systematic search identified 35 studies that met our eligibility criteria and were included in our qualitative synthesis. Synthesizing evidence from self-report questionnaires and food surveys, we found that patients with psychosis exhibit increased appetite and craving for fatty food, as well as increased caloric intake and snacking, which may be associated with increased disinhibition. Limited evidence from neuroimaging studies suggested that AP-naïve first episode patients exhibit similar neural processing of food to healthy controls, while chronic AP exposure may lead to decreased activity in satiety areas and increased activity in areas associated with reward anticipation. Overall, this review supports the notion that AP use can lead to disturbed eating patterns in patients, which may contribute to AP-induced weight gain. However, intrinsic illness-related effects on eating behaviors remain less well elucidated, and many confounding factors as well as variability in study designs limits interpretation of existing literature in this field and precludes firm conclusions from being made.
Collapse
Affiliation(s)
- Nicolette Stogios
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Emily Smith
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Roshanak Asgariroozbehani
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Laurie Hamel
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
| | - Alexander Gdanski
- Department of Human Biology, University of Toronto, Toronto, ON M5S 3J6, Canada;
| | - Peter Selby
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Sanjeev Sockalingam
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Bariatric Surgery Program, University Health Network, Toronto, ON M5T 2S8, Canada
| | - Ariel Graff-Guerrero
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Valerie H. Taylor
- Department of Psychiatry, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Sri Mahavir Agarwal
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Margaret K. Hahn
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| |
Collapse
|
5
|
Shi J, Guo H, Liu S, Xue W, Fan F, Fan H, An H, Wang Z, Tan S, Yang F, Tan Y. Resting-state functional connectivity of neural circuits associated with primary and secondary rewards in patients with bipolar disorder. Soc Cogn Affect Neurosci 2020; 15:755-763. [PMID: 32734286 PMCID: PMC7511880 DOI: 10.1093/scan/nsaa100] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/08/2020] [Accepted: 07/11/2020] [Indexed: 01/27/2023] Open
Abstract
Objective We used resting-state functional connectivity (rsFC) to evaluate the integrity of the neural circuits associated with primary and secondary rewards in bipolar disorder (BD) with different mood phases. Methods Sixty patients with BD [21 patients with depressive episode of BD (BDD) and 41 patients with maniac episode of BD (BDM)] and 42 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging. rsFC was assessed using region of interest-wise analyses. Results Attenuation of rsFC at the orbitofrontal cortex (OFC) and the left ventral striatum (LVS) was observed in the secondary reward circuit of patients with BD compared to that of HCs. Among BDD, BDM and HCs, the rsFC between OFC and LVS in BDM was intermediate, while the rsFC between OFC and right ventral striatum/right amygdala in BDM was the highest; the corresponding rsFC values in BDD were the lowest. Furthermore, a positive correlation was found between rsFC and Young Mania Rating Scale scores in BDM. Conclusions This study suggests that there may be an abnormal rsFC between OFC and LVS in the second reward of patients with BD and the discrepant patterns of rsFC may exist between different mood states in patients with BD.
Collapse
Affiliation(s)
- Jing Shi
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Hua Guo
- Present Office, The Psychiatric Hospital of Zhumadian, Zhumadian, Henan 463000, China
| | - Sijia Liu
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Wei Xue
- Department of Clinical Pharmacology, Beijing Hospital of the Ministry of Health, Beijing 100730, P.R. China
| | - Fengmei Fan
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Hongzhen Fan
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Huimei An
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Zhiren Wang
- Correspondence: Zhiren Wang, Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China, 100096.
| | - Shuping Tan
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Fude Yang
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Yunlong Tan
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| |
Collapse
|
6
|
Distinct striatum pathways connected to salience network predict symptoms improvement and resilient functioning in schizophrenia following risperidone monotherapy. Schizophr Res 2020; 215:89-96. [PMID: 31759811 DOI: 10.1016/j.schres.2019.11.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 10/09/2019] [Accepted: 11/12/2019] [Indexed: 11/23/2022]
Abstract
Abnormal interactions between the striatum and salience network (SN) are considered as etiological and treatment-sensitive marker in schizophrenia. However, whether alterations in the intrinsic dynamics as reflected by resting-state functional connectivity (RSFC) between the striatum and salience network may predict treatment response to the widely used antipsychotic treatment strategies (risperidone, monotherapy) has not been examined systematically. To this end, treatment-naive first-episode schizophrenia patients (n = 41) underwent task-free resting-state fMRI assessment before (baseline) and after 8 weeks of risperidone monotherapy (n = 38). Intrinsic connectivity between striatal sub-regions and core salience processing nodes were examined and compared to carefully matched healthy controls (HC) to determine disorder-specific and treatment-predictive neural markers. Findings demonstrate hypo-connectivity of both ventral and dorsal striatal-SN pathways in patients at baseline. Importantly, specifically the dorsal striatal pathway at baseline could predict negative symptoms improvement in patients; while ventral striatal pathways could predict positive symptoms improvement. Together, results indicate that distinct striatal-SN pathways represent specific treatment-success markers for the effects of risperidone, suggesting that alterations in dorsal versus ventral striatal network markers may represent brain-based markers for specific symptomatologic improvements following risperidone mono-therapy.
Collapse
|
7
|
Toward integrated understanding of salience in psychosis. Neurobiol Dis 2019; 131:104414. [DOI: 10.1016/j.nbd.2019.03.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/04/2019] [Accepted: 03/04/2019] [Indexed: 01/08/2023] Open
|
8
|
Moran EK, Culbreth AJ, Kandala S, Barch DM. From neuroimaging to daily functioning: A multimethod analysis of reward anticipation in people with schizophrenia. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 128:723-734. [PMID: 31464449 DOI: 10.1037/abn0000461] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Negative symptoms are a core clinical feature of schizophrenia that are only marginally responsive to current treatments. Recent work suggests that deficits in reinforcement learning and anticipatory responses to reward may be two mechanisms that help explain impairments in motivation in those with schizophrenia. The present study utilized a reinforcement-learning paradigm, which allowed us to examine both reward anticipation and reinforcement learning. Twenty-eight people with schizophrenia and 30 healthy controls completed a reinforcement-learning task while undergoing functional MRI. Participants with schizophrenia also completed a weeklong ecological momentary assessment protocol reporting anticipated motivation and pleasure in their daily activities. Unexpectedly, we found no significant group differences in performance or neural response in reinforcement learning. However, we found that poorer reward learning was associated with greater clinician ratings of negative symptoms and daily reports of anticipatory motivation and pleasure negative symptoms. In regards to anticipatory responses, we found that people with schizophrenia showed blunted activation in the anterior cingulate, insula, caudate, and putamen while anticipating reward. Further, blood oxygen level-dependent (BOLD) response in reward related regions during anticipation of reward was significantly related to both clinician-rated motivation and pleasure deficits as well as daily reports of motivation and pleasure. Our results provide further evidence of deficits during reward anticipation in individuals with schizophrenia, particularly for those with severe negative symptoms, and some evidence for worse reward learning among those with greater negative symptoms. Moreover, our findings suggest that these deficits show important relationships with emotional and motivational functioning in everyday life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
|
9
|
Yan C, Lui SSY, Zou LQ, Wang CY, Zhou FC, Cheung EFC, Shum DHK, Chan RCK. Anticipatory pleasure for future rewards is attenuated in patients with schizophrenia but not in individuals with schizotypal traits. Schizophr Res 2019; 206:118-126. [PMID: 30545761 DOI: 10.1016/j.schres.2018.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/11/2018] [Accepted: 12/04/2018] [Indexed: 01/02/2023]
Abstract
The anhedonia paradox is consistently observed in individuals with schizophrenia. However, the underlying mechanism of the dissociation between trait and state hedonic capacity remains unclear. In the present study, we aimed to re-examine anhedonia in patients with schizophrenia (SCZ) and individuals with high schizotypy (HS) using the Monetary Incentive Delay (MID) task to assess different dimensions of anticipatory and consummatory pleasure. We recruited 44 SCZ patients, 46 matched healthy controls (HC), 30 individuals with HS and 35 with low schizotypy (LS). The modified MID task was used to measure anticipatory and consummatory pleasure in terms of valence and arousal ratings. To measure the predictive value of anticipatory pleasure, participants were asked to predict their hedonic experience before the MID task. For SCZ patients, there was no significant Group main effect or Group × Prize interaction on consummatory pleasantness to reward received or loss avoidance. As expected, SCZ patients (particularly male patients) reported less pleasantness and arousal to future rewards in both the prediction and feeling dimensions compared with HC. Additionally, male patients reported less anticipatory and consummatory negativity than HC. Individuals with HS predicted more arousing experience to high-rewards than LS individuals. They also reported and predicted more negativity to in-the-moment and future monetary losses. Further, the negative dimension of schizotypy predicted low levels of pleasantness and arousal towards future rewards, but the positive dimension predicted increased arousing experience towards future rewards. In conclusion, the anhedonia paradox in schizophrenia could be partially accounted for by the dissociation between anticipatory and consummatory pleasure.
Collapse
Affiliation(s)
- Chao Yan
- Shanghai Key Laboratory of Brain Functional Genomics, Key Laboratory of Brain Functional Genomics, Ministry of Education, East China Normal University, China; Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | | | - Lai-Quan Zou
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Chuan-Yue Wang
- Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China; Centre of Schizophrenia, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders (Capital Medical University), Ministry of Science and Technology, Beijing, China
| | - Fu-Chun Zhou
- Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China; Centre of Schizophrenia, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders (Capital Medical University), Ministry of Science and Technology, Beijing, China
| | | | - David H K Shum
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China; Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
| |
Collapse
|
10
|
Borgan F, O’Daly O, Hoang K, Veronese M, Withers D, Batterham R, Howes O. Neural Responsivity to Food Cues in Patients With Unmedicated First-Episode Psychosis. JAMA Netw Open 2019; 2:e186893. [PMID: 30646204 PMCID: PMC6420094 DOI: 10.1001/jamanetworkopen.2018.6893] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
IMPORTANCE Schizophrenia is associated with a reduced life expectancy of 15 to 20 years owing to a high prevalence of cardiometabolic disorders. Obesity, a key risk factor for the development of cardiometabolic alterations, is more prevalent in individuals with schizophrenia. Although obesity is linked to the altered reward processing of food cues, no studies have investigated this link in schizophrenia without the confounds of antipsychotics and illness chronicity. OBJECTIVE To investigate neural responsivity to food cues in first-episode psychosis without the confounds of antipsychotic medication or illness chronicity. DESIGN, SETTING, AND PARTICIPANTS A case-control study was conducted from January 31, 2015, to September 30, 2018, in London, United Kingdom, of 29 patients with first-episode psychosis who were not taking antipsychotic medication and 28 matched controls. MAIN OUTCOMES AND MEASURES Participants completed a food cue paradigm while undergoing a functional magnetic resonance imaging scan. Neural activation was indexed using the blood oxygen level-dependent hemodynamic response. The Dietary Instrument for Nutrition Education was used to measure diet, and the International Physical Activity Questionnaire was used to measure exercise. RESULTS There were no significant differences in age, sex, or body mass index between the 29 patients (25 men and 4 women; mean [SD] age, 26.1 [4.8] years) and 28 controls (22 men and 6 women; mean [SD] age, 26.4 [5.5] years). Relative to controls, patients consumed more saturated fat (t46 = -3.046; P = .004) and undertook less high-intensity (U = 304.0; P = .01) and low-intensity (U = 299.5; P = .005) weekly exercise. There were no group differences in neural responses to food vs nonfood cues in whole-brain or region-of-interest analyses of the nucleus accumbens, insula, or hypothalamus. Body mass index was inversely correlated with the mean blood oxygen level-dependent signal in the nucleus accumbens in response to food vs nonfood cues in controls (R = -0.499; P = .01) but not patients (R = 0.082; P = .70). CONCLUSIONS AND RELEVANCE Relative to controls, patients with first-episode psychosis who were not taking antipsychotic medication consumed more saturated fat and showed an altered association between body mass index and neural response to food cues in the absence of differences in neural responses to food cues. These findings highlight how maladaptive eating patterns and alterations in the association between body mass index and neural responses to food cues are established early in the course of schizophrenia.
Collapse
Affiliation(s)
- Faith Borgan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Psychiatric Imaging Group, Faculty of Medicine, Medical Research Council London Institute of Medical Sciences, Imperial College London, London, United Kingdom
| | - Owen O’Daly
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Karen Hoang
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Mattia Veronese
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Dominic Withers
- Metabolic Signalling Group, Medical Research Council London Institute of Medical Sciences, Imperial College London, London, United Kingdom
- Institute of Clinical Sciences, Imperial College London, London, United Kingdom
| | - Rachel Batterham
- Centre for Obesity Research, University College London, London, United Kingdom
- University College London Hospitals Bariatric Centre for Weight Management and Metabolic Surgery, London, United Kingdom
- National Institute of Health Research University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Psychiatric Imaging Group, Faculty of Medicine, Medical Research Council London Institute of Medical Sciences, Imperial College London, London, United Kingdom
| |
Collapse
|
11
|
Zhang B, Lin P, Shi H, Öngür D, Auerbach RP, Wang X, Yao S, Wang X. Mapping anhedonia-specific dysfunction in a transdiagnostic approach: an ALE meta-analysis. Brain Imaging Behav 2017; 10:920-39. [PMID: 26487590 PMCID: PMC4838562 DOI: 10.1007/s11682-015-9457-6] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Anhedonia is a prominent symptom in neuropsychiatric disorders, most markedly in major depressive disorder (MDD) and schizophrenia (SZ). Emerging evidence indicates an overlap in the neural substrates of anhedonia between MDD and SZ, which supported a transdiagnostic approach. Therefore, we used activation likelihood estimation (ALE) meta-analysis of functional magnetic resonance imaging studies in MDD and SZ to examine the neural bases of three subdomains of anhedonia: consummatory anhedonia, anticipatory anhedonia and emotional processing. ALE analysis focused specifically on MDD or SZ was used later to dissociate specific anhedonia-related neurobiological impairments from potential disease general impairments. ALE results revealed that consummatory anhedonia was associated with decreased activation in ventral basal ganglia areas, while anticipatory anhedonia was associated with more substrates in frontal-striatal networks except the ventral striatum, which included the dorsal anterior cingulate, middle frontal gyrus and medial frontal gyrus. MDD and SZ patients showed similar neurobiological impairments in anticipatory and consummatory anhedonia, but differences in the emotional experience task, which may also involve affective/mood general processing. These results support that anhedonia is characterized by alterations in reward processing and relies on frontal-striatal brain circuitry. The transdiagnostic approach is a promising way to reveal the overall neurobiological framework that contributes to anhedonia and could help to improve targeted treatment strategies.
Collapse
Affiliation(s)
- Bei Zhang
- Medical Psychological Institute, The Second Xiangya Hospital of Central South University, 139 Renmin (M) Road, Changsha, Hunan, 410011, People's Republic of China
| | - Pan Lin
- Key Laboratory of Biomedical Information Engineering of Education Ministry, Institute of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shanxi, 710049, People's Republic of China
| | - Huqing Shi
- Department of Psychology, Shanghai Normal University, Shanghai, 200234, People's Republic of China
| | - Dost Öngür
- Harvard Medical School and McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA
| | - Randy P Auerbach
- Harvard Medical School and McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA
| | - Xiaosheng Wang
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China
| | - Shuqiao Yao
- Medical Psychological Institute, The Second Xiangya Hospital of Central South University, 139 Renmin (M) Road, Changsha, Hunan, 410011, People's Republic of China
| | - Xiang Wang
- Medical Psychological Institute, The Second Xiangya Hospital of Central South University, 139 Renmin (M) Road, Changsha, Hunan, 410011, People's Republic of China.
| |
Collapse
|
12
|
Abstract
Years of research and clinical practice have demonstrated that individuals with certain mental health conditions are at an increased risk of obesity. However, no identified research has examined associations between multiple comorbid psychiatric disorders and body mass index (BMI). This study uses a secondary analysis to examine associations between a large number of combinations of various mental health conditions and BMI. Surprisingly, the results of this study indicate that the most comorbid psychiatric disorders are not associated with an increased risk of elevated BMI. However, bipolar disorder, agoraphobia, attention-deficit hyperactivity disorder, and panic disorder had the greatest number of comorbid disorder associations linked with elevated BMI. The effect sizes ranged from a significant but relatively small Cohen's d of 0.3 to a more notable effect size of 0.7. The results of this study indicate that practitioners should be especially vigilant in helping their patients to avoid weight gain when they have one of the four identified disorders in combination with at least one other disorder. Future research is needed to understand the mechanisms underlying this increased risk and evaluate targeted interventions that would be the most effective for people with these diagnoses.
Collapse
Affiliation(s)
- Nicholas Guenzel
- a University of Nebraska Medical Center , College of Nursing , Omaha , Nebraska , USA
| | - Daniel J Schober
- a University of Nebraska Medical Center , College of Nursing , Omaha , Nebraska , USA
| |
Collapse
|
13
|
Grimm O, Kaiser S, Plichta MM, Tobler PN. Altered reward anticipation: Potential explanation for weight gain in schizophrenia? Neurosci Biobehav Rev 2017; 75:91-103. [DOI: 10.1016/j.neubiorev.2017.01.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/19/2017] [Accepted: 01/23/2017] [Indexed: 01/19/2023]
|
14
|
Anticevic A, Schleifer C, Youngsun TC. Emotional and cognitive dysregulation in schizophrenia and depression: understanding common and distinct behavioral and neural mechanisms. DIALOGUES IN CLINICAL NEUROSCIENCE 2016. [PMID: 26869843 PMCID: PMC4734880 DOI: 10.31887/dcns.2015.17.4/aanticevic] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Emerging behavioral and neuroimaging studies in schizophrenia (SCZ) and major depressive disorder (MD) are mapping mechanisms of co-occurring and distinct affective disturbances across these disorders. This constitutes a critical goal towards developing rationally guided therapies for upstream neural pathways that contribute to comorbid symptoms across disorders. We highlight the current state of the art in our understanding of emotional dysregulation in SCZ versus MD by focusing on broad domains of behavioral function that can map onto underlying neural systems, namely deficits in hedonics, anticipatory behaviors, computations underlying value and effort, and effortful goal-directed behaviors needed to pursue rewarding outcomes. We highlight unique disturbances in each disorder that may involve dissociable neural systems, but also possible interactions between affect and cognition in MD versus SCZ. Finally, we review computational and translational approaches that offer mechanistic insight into how cellular-level disruptions can lead to complex affective disturbances, informing development of therapies across MD and SCZ.
Collapse
Affiliation(s)
- Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine; Interdepartmental Neuroscience Program, Yale University; NIAAA Center for the Translational Neuroscience of Alcoholism; Department of Psychology, Yale University; Division of Neurocognition, Neurogenetics & Neurocomputation, Yale University School of Medicine (Alan Anticevic) - New Haven, Connecticut, USA
| | | | | |
Collapse
|
15
|
Walter A, Suenderhauf C, Smieskova R, Lenz C, Harrisberger F, Schmidt A, Vogel T, Lang UE, Riecher-Rössler A, Eckert A, Borgwardt S. Altered Insular Function during Aberrant Salience Processing in Relation to the Severity of Psychotic Symptoms. Front Psychiatry 2016; 7:189. [PMID: 27933003 PMCID: PMC5120113 DOI: 10.3389/fpsyt.2016.00189] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 11/09/2016] [Indexed: 12/31/2022] Open
Abstract
There is strong evidence for abnormal salience processing in patients with psychotic experiences. In particular, there are indications that the degree of aberrant salience processing increases with the severity of positive symptoms. The aim of the present study was to elucidate this relationship by means of brain imaging. Functional magnetic resonance imaging was acquired to assess hemodynamic responses during the Salience Attribution Test, a paradigm for reaction time that measures aberrant salience to irrelevant stimulus features. We included 42 patients who were diagnosed as having a psychotic disorder and divided them into two groups according to the severity of their positive symptoms. Whole brain analysis was performed using Statistical Parametric Mapping. We found no significant behavioral differences with respect to task performance. Patients with more positive symptoms showed increased hemodynamic responses in the left insula corresponding to aberrant salience than in patients with less positive symptoms. In addition, left insula activation correlated negatively with cumulative antipsychotic medication. Aberrant salience processing in the insula may be increased in psychosis, depending on the severity of positive symptoms. This study indicates that clinically similar psychosis manifestations share the same functional characteristics. In addition, our results suggest that antipsychotic medication can modulate insular function.
Collapse
Affiliation(s)
- Anna Walter
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | | | - Renata Smieskova
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Claudia Lenz
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | | | - André Schmidt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Tobias Vogel
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Undine E. Lang
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | | | - Anne Eckert
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| |
Collapse
|
16
|
Abstract
Psychiatric disorders can affect our ability to successfully and enjoyably interact with others. Conversely, having difficulties in social relations is known to increase the risk of developing a psychiatric disorder. In this article, the assumption that psychiatric disorders can be construed as disorders of social interaction is reviewed from a clinical point of view. Furthermore, it is argued that a psychiatrically motivated focus on the dynamics of social interaction may help to provide new perspectives for the field of social neuroscience. Such progress may be crucial to realize social neuroscience's translational potential and to advance the transdiagnostic investigation of the neurobiology of psychiatric disorders.
Collapse
Affiliation(s)
- Leonhard Schilbach
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Kraepelinstrasse 2-10, München-Schwabing 80804, Germany Department of Psychiatry, University Hospital Cologne, Kerpener Strasse 62, Cologne 50924, Germany
| |
Collapse
|
17
|
van Duin EDA, Goossens L, Hernaus D, da Silva Alves F, Schmitz N, Schruers K, van Amelsvoort T. Neural correlates of reward processing in adults with 22q11 deletion syndrome. J Neurodev Disord 2016; 8:25. [PMID: 27429661 PMCID: PMC4946156 DOI: 10.1186/s11689-016-9158-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 07/05/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11DS) is caused by a microdeletion on chromosome 22q11.2 and associated with an increased risk to develop psychosis. The gene coding for catechol-O-methyl-transferase (COMT) is located at the deleted region, resulting in disrupted dopaminergic neurotransmission in 22q11DS, which may contribute to the increased vulnerability for psychosis. A dysfunctional motivational reward system is considered one of the salient features in psychosis and thought to be related to abnormal dopaminergic neurotransmission. The functional anatomy of the brain reward circuitry has not yet been investigated in 22q11DS. METHODS This study aims to investigate neural activity during anticipation of reward and loss in adult patients with 22q11DS. We measured blood-oxygen-level dependent (BOLD) activity in 16 patients with 22q11DS and 12 healthy controls during a monetary incentive delay task using a 3T Philips Intera MRI system. Data were analysed using SPM8. RESULTS During anticipation of reward, the 22q11DS group alone displayed significant activation in bilateral middle frontal and temporal brain regions. Compared to healthy controls, significantly less activation in bilateral cingulate gyrus extending to premotor, primary motor and somatosensory areas was found. During anticipation of loss, the 22q11DS group displayed activity in the left middle frontal gyrus and anterior cingulate cortex, and relative to controls, they showed reduced brain activation in bilateral (pre)cuneus and left posterior cingulate. Within the 22q11DS group, COMT Val hemizygotes displayed more activation compared to Met hemizygotes in right posterior cingulate and bilateral parietal regions during anticipation of reward. During anticipation of loss, COMT Met hemizygotes compared to Val hemizygotes showed more activation in bilateral insula, striatum and left anterior cingulate. CONCLUSIONS This is the first study to investigate reward processing in 22q11DS. Our preliminary results suggest that people with 22q11DS engage a fronto-temporal neural network. Compared to healthy controls, people with 22q11DS primarily displayed reduced activity in medial frontal regions during reward anticipation. COMT hemizygosity affects responsivity of the reward system in this condition. Alterations in reward processing partly underlain by the dopamine system may play a role in susceptibility for psychosis in 22q11DS.
Collapse
Affiliation(s)
- Esther D. A. van Duin
- />Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Liesbet Goossens
- />Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Dennis Hernaus
- />Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Fabiana da Silva Alves
- />Department of Psychiatry, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Nicole Schmitz
- />Department of Psychiatry, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Koen Schruers
- />Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Therese van Amelsvoort
- />Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
18
|
Culbreth A, Westbrook A, Barch D. Negative symptoms are associated with an increased subjective cost of cognitive effort. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 125:528-536. [PMID: 26999282 PMCID: PMC4850096 DOI: 10.1037/abn0000153] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Motivational deficits in schizophrenia are proposed to be attributable in part to abnormal effort-cost computations. Inflated subjective cognitive effort costs may explain diminished functioning in schizophrenia to the extent that they drive avoidance of complex decision-making and planning. Although previous data support inflated subjective physical effort costs for individuals with schizophrenia, evidence on cognitive effort is mixed. We exploited the methodological advantages of a recently developed cognitive effort-discounting paradigm (Westbrook, Kester, & Braver, 2013) to examine effort-cost computations in schizophrenia. The paradigm quantifies subjective costs in terms of explicit, continuous discounting of monetary rewards based on parametrically varied demands (levels N of the N-back working memory task), holding objective features of task duration and reward likelihood constant. Both healthy participants (N = 25) and schizophrenia patients (N = 25) showed systematic influences of reward and task demands on choice patterns. Critically, however, participants with schizophrenia discounted rewards more steeply as a function of effort, indicating that effort was more costly for this group. Moreover, discounting varied robustly with symptomatology, such that schizophrenia patients with greater clinically rated negative symptom severity discounted rewards more steeply. These findings extend the current literature on abnormal-effort cost computations in schizophrenia by establishing a clear relationship between the costliness of cognitive effort and negative symptoms. (PsycINFO Database Record
Collapse
Affiliation(s)
- Adam Culbreth
- Department of Psychology, Washington University in Saint Louis
| | | | - Deanna Barch
- Department of Psychology, Washington University in Saint Louis
- Department of Psychiatry & Radiology, Washington University in Saint Louis
| |
Collapse
|
19
|
Ketamine Suppresses the Ventral Striatal Response to Reward Anticipation: A Cross-Species Translational Neuroimaging Study. Neuropsychopharmacology 2016; 41:1386-94. [PMID: 26388147 PMCID: PMC4793123 DOI: 10.1038/npp.2015.291] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 07/22/2015] [Accepted: 07/24/2015] [Indexed: 11/09/2022]
Abstract
Convergent evidence implicates regional neural responses to reward anticipation in the pathogenesis of several psychiatric disorders, such as schizophrenia, where blunted ventral striatal responses to positive reward are observed in patients and at-risk populations. In vivo oxygen amperometry measurements in the ventral striatum in awake, behaving rats reveal reward-related tissue oxygen changes that closely parallel blood oxygen level dependent (BOLD) signal changes observed in human functional magnetic resonance imaging (fMRI), suggesting that a cross-species approach targeting this mechanism might be feasible in psychopharmacology. The present study explored modulatory effects of acute, subanaesthetic doses of ketamine-a pharmacological model widely used in psychopharmacological research, both preclinically and clinically-on ventral striatum activity during performance of a reward anticipation task in both species, using fMRI in humans and in vivo oxygen amperometry in rats. In a region-of-interest analysis conducted following a cross-over placebo and ketamine study in human subjects, an attenuated ventral striatal response during reward anticipation was observed following ketamine relative to placebo during performance of a monetary incentive delay task. In rats, a comparable attenuation of ventral striatal signal was found after ketamine challenge, relative to vehicle, in response to a conditioned stimulus that predicted delivery of reward. This study provides the first data in both species demonstrating an attenuating effect of acute ketamine on reward-related ventral striatal (O2) and fMRI signals. These findings may help elucidate a deeper mechanistic understanding of the potential role of ketamine as a model for psychosis, show that cross-species pharmacological experiments targeting reward signaling are feasible, and suggest this phenotype as a promising translational biomarker for the development of novel compounds, assessment of disease status, and treatment efficacy.
Collapse
|
20
|
Smieskova R, Roiser JP, Chaddock CA, Schmidt A, Harrisberger F, Bendfeldt K, Simon A, Walter A, Fusar-Poli P, McGuire PK, Lang UE, Riecher-Rössler A, Borgwardt S. Modulation of motivational salience processing during the early stages of psychosis. Schizophr Res 2015; 166:17-23. [PMID: 25999039 DOI: 10.1016/j.schres.2015.04.036] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 04/15/2015] [Accepted: 04/27/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Deficits in motivational salience processing have been related to psychotic symptoms and disturbances in dopaminergic neurotransmission. We aimed at exploring changes in salience processing and brain activity during different stages of psychosis and antipsychotic medication effect. METHODS We used fMRI during the Salience Attribution Task to investigate hemodynamic differences between 19 healthy controls (HCs), 34 at-risk mental state (ARMS) individuals and 29 individuals with first-episode psychosis (FEP), including a subgroup of 17 FEP without antipsychotic medication (FEP-UM) and 12 FEP with antipsychotic medication (FEP-M). Motivational salience processing was operationalized by brain activity in response to high-probability rewarding cues (adaptive salience) and in response to low-probability rewarding cues (aberrant salience). RESULTS Behaviorally, adaptive salience response was not accelerated in FEP, although they correctly distinguished between trials with low and high reward probability. In comparison to HC, ARMS exhibited a lower hemodynamic response during adaptive salience in the right inferior parietal lobule and FEP-UM in the left dorsal cingulate gyrus. The FEP-M group exhibited a lower adaptive salience response than HC in the right insula and than ARMS in the anterior cingulate gyrus. In unmedicated individuals, the severity of hallucinations and delusions correlated negatively with the insular- and anterior cingulate hemodynamic response during adaptive salience. We found no differences in aberrant salience processing associated with behavior or medication. CONCLUSION The changes in adaptive motivational salience processing during psychosis development reveal neurofunctional abnormalities in the somatosensory and premotor cortex. Antipsychotic medication seems to modify hemodynamic responses in the anterior cingulate and insula.
Collapse
Affiliation(s)
- Renata Smieskova
- Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland; Medical Image Analysis Center, University Hospital Basel, Switzerland
| | | | | | - André Schmidt
- Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland; Medical Image Analysis Center, University Hospital Basel, Switzerland
| | - Fabienne Harrisberger
- Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland; Medical Image Analysis Center, University Hospital Basel, Switzerland
| | - Kerstin Bendfeldt
- Medical Image Analysis Center, University Hospital Basel, Switzerland
| | - Andor Simon
- Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry, Bruderholz, Switzerland
| | - Anna Walter
- Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - Philip K McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - Undine E Lang
- Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland
| | - Anita Riecher-Rössler
- Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland
| | - Stefan Borgwardt
- Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland; Medical Image Analysis Center, University Hospital Basel, Switzerland; Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| |
Collapse
|
21
|
Morris RW, Quail S, Griffiths KR, Green MJ, Balleine BW. Corticostriatal control of goal-directed action is impaired in schizophrenia. Biol Psychiatry 2015; 77:187-95. [PMID: 25062683 DOI: 10.1016/j.biopsych.2014.06.005] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 06/06/2014] [Accepted: 06/06/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Goal-directed actions depend on our capacity to integrate the anticipated consequences of an action with the value of those consequences, with the latter derived from direct experience or inferred from predictive stimuli. Schizophrenia is associated with poor goal-directed performance, but whether this reflects a deficit in experienced or predicted value or in integrating these values with action-outcome information is unknown, as is the locus of any associated neuropathology. METHODS We assessed the contribution of these sources of value to goal-directed actions in people with schizophrenia (SZ) (n = 18) and healthy adults (n = 18). Participants learned to use specific actions to liberate snack foods from a vending machine. They also learned about the reward value of the foods, changes in reward value, and the relationship between various predictive stimuli and food delivery. We then evaluated the ability of subjects to use experienced or predicted value to guide goal-directed actions while undergoing functional magnetic resonance imaging. RESULTS Acquisition and sensitivity to experienced changes in outcome value did not differ in SZ and healthy adults. The SZ were, however, deficient in their ability to integrate action-outcome learning with outcome values to guide choice, more so when actions were guided by experienced than by predicted values. These effects were differentially associated with reductions in activity in caudate and limbic structures, respectively. CONCLUSIONS This novel assessment of goal-directed learning revealed dysfunction in corticostriatal control associated with a profound deficit in integrating changes in experienced value with the action-outcome association in schizophrenia.
Collapse
Affiliation(s)
- Richard W Morris
- Brain & Mind Research Institute, University of Sydney, Camperdown; Schizophrenia Research Institute, Darlinghurst, Australia
| | - Stephanie Quail
- Brain & Mind Research Institute, University of Sydney, Camperdown
| | | | - Melissa J Green
- Schizophrenia Research Institute, Darlinghurst, Australia; School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia
| | | |
Collapse
|
22
|
Mechanisms Underlying Motivational Deficits in Psychopathology: Similarities and Differences in Depression and Schizophrenia. Curr Top Behav Neurosci 2015; 27:411-49. [PMID: 26026289 DOI: 10.1007/7854_2015_376] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Motivational and hedonic impairments are core aspects of a variety of types of psychopathology. These impairments cut across diagnostic categories and may be critical to understanding major aspects of the functional impairments accompanying psychopathology. Given the centrality of motivational and hedonic systems to psychopathology, the Research Domain Criteria (RDoC) initiative includes a "positive valence" systems domain that outlines a number of constructs that may be key to understanding the nature and mechanisms of motivational and hedonic impairments in psychopathology. These component constructs include initial responsiveness to reward, reward anticipation or expectancy, incentive or reinforcement learning, effort valuation, and action selection. Here, we review behavioral and neuroimaging studies providing evidence for impairments in these constructs in individuals with psychosis versus in individuals with depressive pathology. There are important differences in the nature of reward-related and hedonic deficits associated with psychosis versus depression that have major implications for our understanding of etiology and treatment development. In particular, the literature strongly suggests the presence of impairments in in-the-moment hedonics or "liking" in individuals with depressive pathology, particularly among those who experience anhedonia. Such deficits may propagate forward and contribute to impairments in other constructs that are dependent on hedonic responses, such as anticipation, learning, effort, and action selection. Such hedonic impairments could reflect alterations in dopamine and/or opioid signaling in the striatum related to depression or specifically to anhedonia in depressed populations. In contrast, the literature points to relatively intact in-the-moment hedonic processing in psychosis, but provides much evidence for impairments in other components involved in translating reward to action selection. Particularly, individuals with schizophrenia exhibit altered reward prediction and associated striatal and prefrontal activation, impaired reward learning, and impaired reward-modulated action selection.
Collapse
|
23
|
Koch K, Rus OG, Reeß TJ, Schachtzabel C, Wagner G, Schultz CC, Sorg C, Schlösser RGM. Functional connectivity and grey matter volume of the striatum in schizophrenia. Br J Psychiatry 2014; 205:204-13. [PMID: 25012683 DOI: 10.1192/bjp.bp.113.138099] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Alterations in the dopaminergic reward system, predominantly the striatum, constitute core characteristics of schizophrenia. AIMS Functional connectivity of the dorsal striatum during reward-related trial-and-error learning was investigated in 17 people with schizophrenia and 18 healthy volunteers and related to striatal grey matter volume and psychopathology. METHOD We used voxel-based morphometry and psychophysiological interaction to examine striatal volume and connectivity. RESULTS A reduced functional connectivity between left striatum and temporo-occipital areas, precuneus and insula could be detected in the schizophrenia group. The positive correlation between grey matter volume and functional connectivity of the left striatum yielded significant results in a very similar network. Connectivity of the left striatum was negatively correlated with negative symptoms. CONCLUSIONS Present results suggest a disruption in striatal functional connectivity that is closely linked to grey matter morphometry of the striatum. Decreased connectivity between the striatum and psychopathologically relevant networks may explain the emergence of negative symptoms.
Collapse
Affiliation(s)
- Kathrin Koch
- Kathrin Koch, PhD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Oana Georgiana Rus, MA, Tim Jonas Reeß, MA, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Claudia Schachtzabel, MA, Gerd Wagner, PhD, C. Christoph Schultz, MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena; Christian Sorg, MD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich; Ralf G. M. Schlösser, Prof. MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Oana Georgiana Rus
- Kathrin Koch, PhD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Oana Georgiana Rus, MA, Tim Jonas Reeß, MA, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Claudia Schachtzabel, MA, Gerd Wagner, PhD, C. Christoph Schultz, MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena; Christian Sorg, MD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich; Ralf G. M. Schlösser, Prof. MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Tim Jonas Reeß
- Kathrin Koch, PhD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Oana Georgiana Rus, MA, Tim Jonas Reeß, MA, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Claudia Schachtzabel, MA, Gerd Wagner, PhD, C. Christoph Schultz, MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena; Christian Sorg, MD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich; Ralf G. M. Schlösser, Prof. MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Claudia Schachtzabel
- Kathrin Koch, PhD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Oana Georgiana Rus, MA, Tim Jonas Reeß, MA, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Claudia Schachtzabel, MA, Gerd Wagner, PhD, C. Christoph Schultz, MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena; Christian Sorg, MD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich; Ralf G. M. Schlösser, Prof. MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Gerd Wagner
- Kathrin Koch, PhD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Oana Georgiana Rus, MA, Tim Jonas Reeß, MA, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Claudia Schachtzabel, MA, Gerd Wagner, PhD, C. Christoph Schultz, MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena; Christian Sorg, MD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich; Ralf G. M. Schlösser, Prof. MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - C Christoph Schultz
- Kathrin Koch, PhD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Oana Georgiana Rus, MA, Tim Jonas Reeß, MA, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Claudia Schachtzabel, MA, Gerd Wagner, PhD, C. Christoph Schultz, MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena; Christian Sorg, MD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich; Ralf G. M. Schlösser, Prof. MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Christian Sorg
- Kathrin Koch, PhD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Oana Georgiana Rus, MA, Tim Jonas Reeß, MA, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Claudia Schachtzabel, MA, Gerd Wagner, PhD, C. Christoph Schultz, MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena; Christian Sorg, MD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich; Ralf G. M. Schlösser, Prof. MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Ralf G M Schlösser
- Kathrin Koch, PhD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Oana Georgiana Rus, MA, Tim Jonas Reeß, MA, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München TUM, Munich and Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich; Claudia Schachtzabel, MA, Gerd Wagner, PhD, C. Christoph Schultz, MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena; Christian Sorg, MD, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich; Ralf G. M. Schlösser, Prof. MD, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| |
Collapse
|
24
|
The motivation and pleasure dimension of negative symptoms: neural substrates and behavioral outputs. Eur Neuropsychopharmacol 2014; 24:725-36. [PMID: 24461724 PMCID: PMC4020953 DOI: 10.1016/j.euroneuro.2013.06.007] [Citation(s) in RCA: 234] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 06/13/2013] [Accepted: 06/23/2013] [Indexed: 12/17/2022]
Abstract
A range of emotional and motivation impairments have long been clinically documented in people with schizophrenia, and there has been a resurgence of interest in understanding the psychological and neural mechanisms of the so-called "negative symptoms" in schizophrenia, given their lack of treatment responsiveness and their role in constraining function and life satisfaction in this illness. Negative symptoms comprise two domains, with the first covering diminished motivation and pleasure across a range of life domains and the second covering diminished verbal and non-verbal expression and communicative output. In this review, we focus on four aspects of the motivation/pleasure domain, providing a brief review of the behavioral and neural underpinnings of this domain. First, we cover liking or in-the-moment pleasure: immediate responses to pleasurable stimuli. Second, we cover anticipatory pleasure or wanting, which involves prediction of a forthcoming enjoyable outcome (reward) and feeling pleasure in anticipation of that outcome. Third, we address motivation, which comprises effort computation, which involves figuring out how much effort is needed to achieve a desired outcome, planning, and behavioral response. Finally, we cover the maintenance emotional states and behavioral responses. Throughout, we consider the behavioral manifestations and brain representations of these four aspects of motivation/pleasure deficits in schizophrenia. We conclude with directions for future research as well as implications for treatment.
Collapse
|
25
|
Wada J, Yajima T, Imamatsu T, Okawai H. A New Definition of BMI Scale by Relationship between Respiration and Unconscious Behavior during Sleep with Body Motion Wave. INTERNATIONAL JOURNAL OF SYSTEM DYNAMICS APPLICATIONS 2014. [DOI: 10.4018/ijsda.2014040104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recently, health problems due to overwork, apparent suicide produced by the progress of the social stress and lifestyle diseases and lifestyle diseases like hyperpiesia or obesity have been reported. From this, it has become of interest to avoid these problems and to keep the health. However, the indicators for health control and physical condition haven't been defined. Body Mass Index (BMI) has traditionally been used as an indicator of health. But, there are many unclear points left in the criteria of BMI to utilize. Sleep would be an important theme to know and to keep health. During sleep, the biological information related to health state would be appeared because of predominant activity of autonomic nervous system under the state of unconsciousness. From these, the authors investigated the relationship between BMI and autonomic nervous activity. Nineteen healthy young adults participated in this study and performed sleep experiment by adopting a pressure sensor named “dynamic air-pressure sensor” and a pressure sensor array. As a result, the authors found some relationships among respiration state, motions of muscles and unconscious behavior depending on BMI. This result about sleep behavior would suggest a new definition for BMI. For example, large value of BMI brings influences, maybe bad, to respiratory behavior during sleep.
Collapse
Affiliation(s)
- Jun'ya Wada
- Graduate School of Engineering, Iwate University, Morioka, Japan
| | - Tadashi Yajima
- Graduate School of Engineering, Iwate University, Morioka, Japan
| | | | - Hiroaki Okawai
- Graduate School of Engineering, Iwate University, Morioka, Japan
| |
Collapse
|
26
|
Neural substrates underlying effort computation in schizophrenia. Neurosci Biobehav Rev 2013; 37:2649-65. [PMID: 24035741 DOI: 10.1016/j.neubiorev.2013.09.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 08/16/2013] [Accepted: 09/03/2013] [Indexed: 11/23/2022]
Abstract
The lack of initiative, drive or effort in patients with schizophrenia is linked to marked functional impairments. However, our assessment of effort and motivation is crude, relying on clinical rating scales based largely on patient recall. In order to better understand the neurobiology of effort in schizophrenia, we need more rigorous measurements of this construct. In the behavioural neuroscience literature, decades of work has been carried out developing various paradigms to examine the neural underpinnings of an animal's willingness to expend effort for a reward. Here, we shall review this literature on the nature of paradigms used in rodents to assess effort, as well as those used in humans. Next, the neurobiology of these effort-based decisions will be discussed. We shall then review what is known about effort in schizophrenia, and what might be inferred from experiments done in other human populations. Lastly, we shall discuss future directions of research that may assist in shedding light on the neurobiology of effort cost computations in schizophrenia.
Collapse
|
27
|
Deng C. Effects of antipsychotic medications on appetite, weight, and insulin resistance. Endocrinol Metab Clin North Am 2013; 42:545-63. [PMID: 24011886 DOI: 10.1016/j.ecl.2013.05.006] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although clozapine, olanzapine, and other atypical antipsychotic drugs (APDs) have fewer extrapyramidal side effects, they have serious metabolic side effects such as substantial weight gain, intra-abdominal obesity, and type 2 diabetes mellitus. Given that most patients with mental disorders face chronic, even life-long, treatment with APDs, the risks of weight gain/obesity and other metabolic symptoms are major considerations for APD maintenance treatment. This review focuses on the effects of APDs on weight gain, appetite, insulin resistance, and glucose dysregulation, and the relevant underlying mechanisms that may be help to prevent and treat metabolic side effects caused by APD therapy.
Collapse
Affiliation(s)
- Chao Deng
- Antipsychotic Research Laboratory, School of Health Sciences, Illawarra Health and Medical Research Institute, University of Wollongong, Northfields Avenue, Wollongong, New South Wales 2522, Australia.
| |
Collapse
|
28
|
Abstract
AbstractDespite 50 years of pharmacological and psychosocial interventions schizophrenia remains one of the leading causes of disability. The inability to function in everyday settings includes deficits in performance of social, occupational, and independent living activities. Schizophrenia is also a life-shortening illness, caused mainly by poor physical health and its complications. Dysfunctional lifestyles including sedentary behavior and lack of physical activity prevail, while treatment with adipogenic antipsychotic medication interacts with poor performance in screening, monitoring, and intervention that result in shortening of life expectancies by 25–30 years. Disability interferes with self-care and medical care, further worsening physical health to produce a vicious cycle of disability. Further, the neurobiological impact of obesity on brain functioning is substantial and relevant to schizophrenia. Decision making deficits that lead to choices resulting in obesity themselves have neurobiological determinants. Simultaneous treatment of cognitive deficits and related deficits in functional skills, ubiquitous determinants of everyday functioning in schizophrenia, and targeted interventions aimed at poor physical health, especially obesity and associated comorbidities, may lead to additive or even interactive gains in everyday functioning in patients with schizophrenia not previously realized with other interventions.
Collapse
|