Dissociation of response and feedback negativity in schizophrenia: electrophysiological and computational evidence for a deficit in the representation of value

Dysfunctional feedback processing in male methamphetamine abusers: Evidence from neurophysiological and computational approaches

Methamphetamine use disorder (MUD) as a major public health risk is associated with dysfunctional neural feedback processing. Although dysfunctional feedback processing in people who are substance dependent has been explored in several behavioral, computational, and electrocortical studies, this mechanism in MUDs requires to be well understood. Furthermore, the current understanding of latent components of their behavior such as learning speed and exploration-exploitation dilemma is still limited. In addition, the association between the latent cognitive components and the related neural mechanisms also needs to be explored. Therefore, in this study, the underlying neurocognitive mechanisms of feedback processing of such impairment, and age/gender-matched healthy controls are evaluated within a probabilistic learning task with rewards and punishments. Mathematical modeling results based on the Q-learning paradigm suggested that MUDs show less sensitivity in distinguishing optimal options. Additionally, it may be worth noting that MUDs exhibited a slight decrease in their ability to learn from negative feedback compared to healthy controls. Also through the lens of underlying neural mechanisms, MUDs showed lower theta power at the medial-frontal areas while responding to negative feedback. However, other EEG measures of reinforcement learning including feedback-related negativity, parietal-P300, and activity flow from the medial frontal to lateral prefrontal regions, remained intact in MUDs. On the other hand, the elimination of the linkage between value sensitivity and medial-frontal theta activity in MUDs was observed. The observed dysfunction could be due to the adverse effects of methamphetamine on the cortico-striatal dopamine circuit, which is reflected in the anterior cingulate cortex activity as the most likely region responsible for efficient behavior adjustment. These findings could help us to pave the way toward tailored therapeutic approaches.

Alpha Event-Related Desynchronization During Reward Processing in Schizophrenia

BACKGROUND

Alterations in the brain's reward system may underlie motivation and pleasure deficits in schizophrenia (SZ). Neuro-oscillatory desynchronization in the alpha band is thought to direct resource allocation away from the internal state, to prioritize processing salient environmental events, including reward feedback. We hypothesized reduced reward-related alpha event-related desynchronization (ERD) in SZ, consistent with less externally focused processing during reward feedback.

METHODS

Electroencephalography was recorded while participants with SZ (n = 54) and healthy control participants (n = 54) played a simple slot machine task. Total alpha band power (8-14 Hz), a measure of neural oscillation magnitude, was extracted via principal component analysis and compared between groups and reward outcomes. The clinical relevance of hypothesized alpha power alterations was examined by testing associations with negative symptoms within the SZ group and with trait rumination, dimensionally, across groups.

RESULTS

A group × reward outcome interaction (p = .018) was explained by healthy control participants showing significant posterior-occipital alpha power suppression to wins versus losses (p < .001), in contrast to participants with SZ (p > .1). Among participants with SZ, this alpha ERD was unrelated to negative symptoms (p > .1). Across all participants, less alpha ERD to reward outcomes covaried with greater trait rumination for both win (p = .005) and loss (p = .002) outcomes, with no group differences in slope.

CONCLUSIONS

These findings demonstrate alpha ERD alterations in SZ during reward outcome processing. Additionally, higher trait rumination was associated with less alpha ERD during reward feedback, suggesting that individual differences in rumination covary with external attention to reward processing, regardless of reward outcome valence or group membership.

Using Computational Modeling to Capture Schizophrenia-Specific Reinforcement Learning Differences and Their Implications on Patient Classification

BACKGROUND

Psychiatric diagnosis and treatment have historically taken a symptom-based approach, with less attention on identifying underlying symptom-producing mechanisms. Recent efforts have illuminated the extent to which different underlying circuitry can produce phenotypically similar symptomatology (e.g., psychosis in bipolar disorder vs. schizophrenia). Computational modeling makes it possible to identify and mathematically differentiate behaviorally unobservable, specific reinforcement learning differences in patients with schizophrenia versus other disorders, likely owing to a higher reliance on prediction error-driven learning associated with basal ganglia and underreliance on explicit value representations associated with orbitofrontal cortex.

METHODS

We used a well-established probabilistic reinforcement learning task to replicate those findings in individuals with schizophrenia both on (n = 120) and off (n = 44) antipsychotic medications and included a patient comparison group of bipolar patients with psychosis (n = 60) and healthy control subjects (n = 72).

RESULTS

Using accuracy, there was a main effect of group (F3,279 = 7.87, p < .001), such that all patient groups were less accurate than control subjects. Using computationally derived parameters, both medicated and unmediated individuals with schizophrenia, but not patients with bipolar disorder, demonstrated a reduced mixing parameter (F3,295 = 13.91, p < .001), indicating less dependence on learning explicit value representations as well as greater learning decay between training and test (F1,289 = 12.81, p < .001). Unmedicated patients with schizophrenia also showed greater decision noise (F3,295 = 2.67, p = .04).

CONCLUSIONS

Both medicated and unmedicated patients showed overreliance on prediction error-driven learning as well as significantly higher noise and value-related memory decay, compared with the healthy control subjects and the patients with bipolar disorder. Additionally, the computational model parameters capturing these processes can significantly improve patient/control classification, potentially providing useful diagnosis insight.

Reward processing electrophysiology in schizophrenia: Effects of age and illness phase

BACKGROUND

Reward processing abnormalities may underlie characteristic pleasure and motivational impairments in schizophrenia. Some neural measures of reward processing show age-related modulation, highlighting the importance of considering age effects on reward sensitivity. We compared event-related potentials (ERPs) reflecting reward anticipation (stimulus-preceding negativity, SPN) and evaluation (reward positivity, RewP; late positive potential, LPP) across individuals with schizophrenia (SZ) and healthy controls (HC), with an emphasis on examining the effects of chronological age, brain age (i.e., predicted age based on neurobiological measures), and illness phase.

METHODS

Subjects underwent EEG while completing a slot-machine task for which rewards were not dependent on performance accuracy, speed, or response preparation. Slot-machine task EEG responses were compared between 54 SZ and 54 HC individuals, ages 19 to 65. Reward-related ERPs were analyzed with respect to chronological age, categorically-defined illness phase (early; ESZ versus chronic schizophrenia; CSZ), and were used to model brain age relative to chronological age.

RESULTS

Illness phase-focused analyses indicated there were no group differences in average SPN or RewP amplitudes. However, a group × reward outcome interaction revealed that ESZ differed from HC in later outcome processing, reflected by greater LPP responses following loss versus reward (a reversal of the HC pattern). While brain age estimates did not differ among groups, depressive symptoms in SZ were associated with older brain age estimates while controlling for negative symptoms.

CONCLUSIONS

ESZ and CSZ did not differ from HC in reward anticipation or early outcome processing during a cognitively undemanding reward task, highlighting areas of preserved functioning. However, ESZ showed altered later reward outcome evaluation, pointing to selective reward deficits during the early illness phase of schizophrenia. Further, an association between ERP-derived brain age and depressive symptoms in SZ extends prior findings linking depression with reward-related ERP blunting. Taken together, both illness phase and age may impact reward processing among SZ, and brain aging may offer a promising, novel marker of reward dysfunction that warrants further study.

Dynamic changes of brain networks during feedback-related processing of reinforcement learning in schizophrenia

Previous studies have reported that schizophrenia (SZ) patients showed selective reinforcement learning deficits and abnormal feedback-related event-related potential (ERP) components. However, how the brain networks and their topological properties evolve over time during transient feedback-related cognition processing in SZ patients has not been investigated so far. In this paper, using publicly available feedback-related ERP data which were recorded from SZ patients and healthy controls (HC) when they performed a reinforcement learning task, we carried out an event-related network analysis where topology of brain functional networks was characterized with some graph measures including clustering coefficient (C), global efficiency (E_global) and local efficiency (E_local) on a millisecond timescale. Our results showed that the brain functional networks displayed rapid rearrangements of topological properties during transient feedback-related cognition process for both two groups. More importantly, we found that SZ patients exhibited significantly reduced theta-band (time window of 170-350 ms after stimuli onset) brain functional connectivity strength, E_global, E_local and C in response to negative feedback stimuli compared to HC group. The network based statistic (NBS) analysis detected one significantly decreased theta-band subnetwork in SZ patients mainly involving in frontal-occipital and temporal-occipital connections compared to HC group. In addition, clozapine treatment seemed to greatly reduce theta-band power and topological measures of brain networks in SZ patients. Finally, the theta-band power, graph measures and functional connectivity were extracted to train a support vector machine classifier for classification of HC from SZ, or Cloz + SZ or Cloz- SZ, and a relatively good classification accuracy of 84.48%, 89.47% and 78.26% was obtained, respectively. The above results suggested a less optimal organization of theta-band brain network in SZ patients, and studying the topological parameters of brain networks evolve over time during transient feedback-related processing could be useful for understanding the pathophysiologic mechanisms underlying reinforcement learning deficits in SZ patients.

Socially Learned Attitude Change is not reduced in Medicated Patients with Schizophrenia

Schizophrenia is often associated with distinctive or odd social behaviours. Previous work suggests this could be due to a general reduction in conformity; however, this work only assessed the tendency to publicly agree with others, which may involve a number of different mechanisms. In this study, we specifically investigated whether patients display a reduced tendency to adopt other people’s opinions (socially learned attitude change). We administered a computerized conformity task, assumed to rely on reinforcement learning circuits, to 32 patients with schizophrenia or schizo-affective disorder and 39 matched controls. Each participant rated 153 faces for trustworthiness. After each rating, they were immediately shown the opinion of a group. After approximately 1 hour, participants were unexpectedly asked to rate all the faces again. We compared the degree of attitude change towards group opinion in patients and controls. Patients presented equal or more social influence on attitudes than controls. This effect may have been medication induced, as increased conformity was seen with higher antipsychotic dose. The results suggest that there is not a general decline in conformity in medicated patients with schizophrenia and that previous findings of reduced conformity are likely related to mechanisms other than reinforcement based social influence on attitudes.

ERP indices of performance monitoring and feedback processing in psychosis: A meta-analysis

BACKGROUND

Although individuals with, or at risk for, psychotic disorders often show difficulties with performance monitoring and feedback processing, findings from studies using event-related potentials (ERPs) to index these processes are not consistent. This meta-analytic review focused on studies of two different indexes of performance monitoring, the early error-related negativity (ERN; n = 25) and the later error positivity (Pe; n = 17), and one index of feedback processing, the feedback negativity (FN; n = 6).

METHODS

We evaluated whether individuals (1) with psychotic disorders, or (2) at heightened risk for these disorders differ from healthy controls in available studies of the ERN, Pe, and FN.

RESULTS

There was a significant, large ERN reduction in those with psychosis (g = -0.96) compared to controls, and a significant, moderate ERN reduction in those at-risk (g = -0.48). In contrast, there were uniformly non-significant, small between-group differences for Pe and FN (gs ≤ |0.16|).

CONCLUSIONS

The results reveal a differential pattern of impairment in psychosis. Early performance monitoring (ERN) impairments are substantial among those with psychotic disorders in general and may be a useful vulnerability indicator for these disorders. However, later performance monitoring (Pe) and basic feedback processing (FN) appear to be relatively spared in psychosis.

Evidence for a general performance-monitoring system in the human brain

Adaptive behavior relies on the ability of the brain to form predictions and monitor action outcomes. In the human brain, the same system is thought to monitor action outcomes regardless of whether the information originates from internal (e.g., proprioceptive) and external (e.g., visual) sensory channels. Neural signatures of processing motor errors and action outcomes communicated by external feedback have been studied extensively; however, the existence of such a general action‐monitoring system has not been tested directly. Here, we use concurrent EEG‐MEG measurements and a probabilistic learning task to demonstrate that event‐related responses measured by electroencephalography and magnetoencephalography display spatiotemporal patterns that allow an effective transfer of a multivariate statistical model discriminating the outcomes across the following conditions: (a) erroneous versus correct motor output, (b) negative versus positive feedback, (c) high‐ versus low‐surprise negative feedback, and (d) erroneous versus correct brain–computer‐interface output. We further show that these patterns originate from highly‐overlapping neural sources in the medial frontal and the medial parietal cortices. We conclude that information about action outcomes arriving from internal or external sensory channels converges to the same neural system in the human brain, that matches this information to the internal predictions.

Increased conflict-induced slowing, but no differences in conflict-induced positive or negative prediction error learning in patients with schizophrenia

People with schizophrenia (PSZ) often fail to pursue rewarding activities despite largely intact in-the-moment hedonic experiences. Deficits in effort-based decision making in PSZ may be related to enhanced effects of cost or reduced reward, i.e., through the amplification of negative prediction errors or by dampened positive prediction errors (here, positive and negative prediction errors refer to outcomes that are better or worse than expected respectively). We administered a modified Simon task to people with schizophrenia (PSZ; N = 46) and healthy controls (N = 32). The modification included a reinforcement learning component, where positive and negative prediction errors are dampened or boosted through the use of cognitively-effortful response conflict. EEG was recorded concurrently to investigate potential differences in conflict enhanced mid-frontal theta power between PSZ and controls. We found an enhanced effect of response conflict on response time in people with schizophrenia, but no discernible difference in conflict processing as reflected by the lack of a difference in theta-power enhancement to conflict in mid-frontal regions. Using the reinforcement learning transfer phase of the modified Simon task, PSZ also showed clear deficits in selecting the most rewarding stimulus during the 'easy' (most discriminable in terms of value) stimulus contrasts. However, we failed to find a difference between patients and controls in their gain or avoidance learning bias, nor did these biases correlate with negative symptoms. Previous studies had failed to find significant conflict effects on the Simon task likely due to its modest effect size. Our results show that PSZ do indeed possess subtle impairments in response-conflict, suggesting an increase in cognitive effort required for appropriate responding. In addition, while the lack of an overt positive or negative prediction error bias (i.e., a bias towards punishment or reward learning) was unexpected, it is consistent with recent work showing intact estimation of value when the reinforcement learning system is isolated from other contributors to value learning.

Informationally administered reward enhances intrinsic motivation in schizophrenia

Even when individuals with schizophrenia have an intact ability to enjoy rewarding moments, the means to assist them to translate rewarding experiences into goal-directed behaviors is unclear. The present study sought to determine whether informationally administered rewards enhance intrinsic motivation to foster goal-directed behaviors in individuals with schizophrenia (SZ) and healthy controls (HCs). Eighty-four participants (SZ=43, HCs=41) were randomly assigned to conditions involving either a performance-contingent reward with an informationally administered reward or a task-contingent reward with no feedback. Participants were asked to play two cognitive games of equalized difficulty. Accuracy, self-reported intrinsic motivation, free-choice intrinsic motivation (i.e., game play during a free-choice observation period), and perceived competency were measured. Intrinsic motivation and perceived competency in the cognitive games were similar between the two participant groups. The informationally administered reward significantly enhanced self-reported intrinsic motivation and perceived competency in both the groups. The likelihood that individuals with schizophrenia would play the game during the free-choice observation period was four times greater in the informationally administered reward condition than that in the no-feedback condition. Our findings suggest that, in the context of cognitive remediation, individuals with schizophrenia would benefit from informationally administered rewards.

Event-related potentials reflect impaired temporal interval learning following haloperidol administration

BACKGROUND

Signals carried by the mesencephalic dopamine system and conveyed to anterior cingulate cortex are critically implicated in probabilistic reward learning and performance monitoring. A common evaluative mechanism purportedly subserves both functions, giving rise to homologous medial frontal negativities in feedback- and response-locked event-related brain potentials (the feedback-related negativity (FRN) and the error-related negativity (ERN), respectively), reflecting dopamine-dependent prediction error signals to unexpectedly negative events. Consistent with this model, the dopamine receptor antagonist, haloperidol, attenuates the ERN, but effects on FRN have not yet been evaluated.

METHODS

ERN and FRN were recorded during a temporal interval learning task (TILT) following randomized, double-blind administration of haloperidol (3 mg; n = 18), diphenhydramine (an active control for haloperidol; 25 mg; n = 20), or placebo (n = 21) to healthy controls. Centroparietal positivities, the Pe and feedback-locked P300, were also measured and correlations between ERP measures and behavioral indices of learning, overall accuracy, and post-error compensatory behavior were evaluated. We hypothesized that haloperidol would reduce ERN and FRN, but that ERN would uniquely track automatic, error-related performance adjustments, while FRN would be associated with learning and overall accuracy.

RESULTS

As predicted, ERN was reduced by haloperidol and in those exhibiting less adaptive post-error performance; however, these effects were limited to ERNs following fast timing errors. In contrast, the FRN was not affected by drug condition, although increased FRN amplitude was associated with improved accuracy. Significant drug effects on centroparietal positivities were also absent.

CONCLUSIONS

Our results support a functional and neurobiological dissociation between the ERN and FRN.

A trans-diagnostic perspective on obsessive-compulsive disorder

Progress in understanding the underlying neurobiology of obsessive-compulsive disorder (OCD) has stalled in part because of the considerable problem of heterogeneity within this diagnostic category, and homogeneity across other putatively discrete, diagnostic categories. As psychiatry begins to recognize the shortcomings of a purely symptom-based psychiatric nosology, new data-driven approaches have begun to be utilized with the goal of solving these problems: specifically, identifying trans-diagnostic aspects of clinical phenomenology based on their association with neurobiological processes. In this review, we describe key methodological approaches to understanding OCD from this perspective and highlight the candidate traits that have already been identified as a result of these early endeavours. We discuss how important inferences can be made from pre-existing case-control studies as well as showcasing newer methods that rely on large general population datasets to refine and validate psychiatric phenotypes. As exemplars, we take 'compulsivity' and 'anxiety', putatively trans-diagnostic symptom dimensions that are linked to well-defined neurobiological mechanisms, goal-directed learning and error-related negativity, respectively. We argue that the identification of biologically valid, more homogeneous, dimensions such as these provides renewed optimism for identifying reliable genetic contributions to OCD and other disorders, improving animal models and critically, provides a path towards a future of more targeted psychiatric treatments.

Neural mechanisms of reward processing associated with depression-related personality traits

OBJECTIVE

Although impaired reward processing in depression has been well-documented, the exact nature of that deficit remains poorly understood. To investigate the link between depression and the neural mechanisms of reward processing, we examined individual differences in personality.

METHODS

We recorded the electroencephalogram from healthy college students engaged in a probabilistic reinforcement learning task. Participants also completed several personality questionnaires that assessed traits related to reward sensitivity, motivation, and depression. We examined whether behavioral measures of reward learning and event-related potential components related to outcome processing and reward anticipation-namely, the cue and feedback-related reward positivity (RewP) and the stimulus preceding negativity (SPN)-would link these personality traits to depression.

RESULTS

Participants who scored high in reward sensitivity produced a relatively larger feedback-RewP. By contrast, participants who scored high in depression learned the contingencies for infrequently rewarded cue-response combinations relatively poorly, exhibited a larger SPN, and produced a smaller feedback-RewP, especially to outcomes following cue-response combinations that were frequently rewarded.

CONCLUSION

These results point to a primary deficit in reward valuation in individuals who score high in depression, with secondary consequences that impact reward learning and anticipation.

SIGNIFICANCE

Despite recent evidence arguing for an anticipatory deficit in depression, impaired reward valuation as a primary deficit should be further examined in clinical samples.

Neural Activities Underlying the Feedback Express Salience Prediction Errors for Appetitive and Aversive Stimuli

Feedback information is essential for us to adapt appropriately to the environment. The feedback-related negativity (FRN), a frontocentral negative deflection after the delivery of feedback, has been found to be larger for outcomes that are worse than expected, and it reflects a reward prediction error derived from the midbrain dopaminergic projections to the anterior cingulate cortex (ACC), as stated in reinforcement learning theory. In contrast, the prediction of response-outcome (PRO) model claims that the neural activity in the mediofrontal cortex (mPFC), especially the ACC, is sensitive to the violation of expectancy, irrespective of the valence of feedback. Additionally, increasing evidence has demonstrated significant activities in the striatum, anterior insula and occipital lobe for unexpected outcomes independently of their valence. Thus, the neural mechanism of the feedback remains under dispute. Here, we investigated the feedback with monetary reward and electrical pain shock in one task via functional magnetic resonance imaging. The results revealed significant prediction-error-related activities in the bilateral fusiform gyrus, right middle frontal gyrus and left cingulate gyrus for both money and pain. This implies that some regions underlying the feedback may signal a salience prediction error rather than a reward prediction error.

Abnormal Frontostriatal Activity During Unexpected Reward Receipt in Depression and Schizophrenia: Relationship to Anhedonia

Alterations in reward processes may underlie motivational and anhedonic symptoms in depression and schizophrenia. However it remains unclear whether these alterations are disorder-specific or shared, and whether they clearly relate to symptom generation or not. We studied brain responses to unexpected rewards during a simulated slot-machine game in 24 patients with depression, 21 patients with schizophrenia, and 21 healthy controls using functional magnetic resonance imaging. We investigated relationships between brain activation, task-related motivation, and questionnaire rated anhedonia. There was reduced activation in the orbitofrontal cortex, ventral striatum, inferior temporal gyrus, and occipital cortex in both depression and schizophrenia in comparison with healthy participants during receipt of unexpected reward. In the medial prefrontal cortex both patient groups showed reduced activation, with activation significantly more abnormal in schizophrenia than depression. Anterior cingulate and medial frontal cortical activation predicted task-related motivation, which in turn predicted anhedonia severity in schizophrenia. Our findings provide evidence for overlapping hypofunction in ventral striatal and orbitofrontal regions in depression and schizophrenia during unexpected reward receipt, and for a relationship between unexpected reward processing in the medial prefrontal cortex and the generation of motivational states.

Transdiagnostic Psychiatric Symptoms and Event-Related Potentials following Rewarding and Aversive Outcomes

There is a need for a better understanding of transdiagnostic psychiatric symptoms that relate to neurophysiological abnormalities following rewarding and aversive feedback in order to inform development of novel targeted treatments. To address this need, we examined a transdiagnostic sample of 44 adults (mean age: 35.52; 57% female), which consisted of individuals with broadly-defined schizophrenia-spectrum disorders (n = 16), bipolar disorders (n = 10), other mood and anxiety disorders (n = 5), and no history of a psychiatric disorder (n = 13). Participants completed a Pavlovian monetary reward prediction task during 32-channel electroencephalogram recording. We assessed the event-related potentials (ERPs) of feedback-related negativity (FRN), feedback-related positivity (FRP), and the late positive potential (LPP), following better and worse than expected outcomes. Examination of symptom relationships using stepwise regressions across the entire sample revealed that an increase in the clinician-rated Negative Symptoms factor score from the Positive and Negative Syndrome Scale, was related to a decreased LPP amplitude during better than expected (i.e., rewarding) outcomes. We also found that increased self-reported scores on the Schizotypal Personality Questionnaire (Brief-Revised) Disorganized factor related to an increased FRN amplitude during worse than expected (i.e., aversive) outcomes. Across the entire sample, the FRP component amplitudes did not show significant relationships to any of the symptoms examined. Analyses of the three diagnostic groups of schizophrenia-spectrum disorders, bipolar disorders, and nonpsychiatric controls did not reveal any statistically significant differences across the ERP amplitudes and conditions. These findings suggest relationships between specific neurophysiological abnormalities following rewarding and aversive outcomes and particular transdiagnostic psychiatric symptoms.

Neurophysiological evidence of impaired self-monitoring in schizotypal personality disorder and its reversal by dopaminergic antagonism

Background

Schizotypal personality disorder (SPD) is a schizophrenia-spectrum disorder characterized by odd or bizarre behavior, strange speech, magical thinking, unusual perceptual experiences, and social anhedonia. Schizophrenia proper has been associated with anomalies in dopaminergic neurotransmission and deficits in neurophysiological markers of self-monitoring, such as low amplitude in cognitive event-related brain potentials (ERPs) like the error-related negativity (ERN), and the error positivity (Pe). These components occur after performance errors, rely on adequate fronto-striatal function, and are sensitive to dopaminergic modulation. Here we postulated that analogous to observations in schizophrenia, SPD individuals would show deficits in self-monitoring, as measured by the ERN and the Pe. We also assessed the capacity of dopaminergic antagonists to reverse these postulated deficits.

Methods

We recorded the electroencephalogram (EEG) from 9 SPD individuals and 12 healthy controls in two separate experimental sessions while they performed the Eriksen Flanker Task, a classical task recruiting behavioral monitoring. Participants received a placebo or 1 mg risperidone according to a double-blind randomized design.

Results

After placebo, SPD individuals showed slower reaction times to hits, longer correction times following errors and reduced ERN and Pe amplitudes. While risperidone impaired performance and decreased ERN and Pe in the control group, it led to behavioral improvements and ERN amplitude increases in the SPD individuals.

Conclusions

These results indicate that SPD individuals show deficits in self-monitoring analogous to those in schizophrenia. These deficits can be evidenced by neurophysiological measures, suggest a dopaminergic imbalance, and can be reverted by dopaminergic antagonists.

Reduction of Pavlovian Bias in Schizophrenia: Enhanced Effects in Clozapine-Administered Patients

The negative symptoms of schizophrenia (SZ) are associated with a pattern of reinforcement learning (RL) deficits likely related to degraded representations of reward values. However, the RL tasks used to date have required active responses to both reward and punishing stimuli. Pavlovian biases have been shown to affect performance on these tasks through invigoration of action to reward and inhibition of action to punishment, and may be partially responsible for the effects found in patients. Forty-five patients with schizophrenia and 30 demographically-matched controls completed a four-stimulus reinforcement learning task that crossed action ("Go" or "NoGo") and the valence of the optimal outcome (reward or punishment-avoidance), such that all combinations of action and outcome valence were tested. Behaviour was modelled using a six-parameter RL model and EEG was simultaneously recorded. Patients demonstrated a reduction in Pavlovian performance bias that was evident in a reduced Go bias across the full group. In a subset of patients administered clozapine, the reduction in Pavlovian bias was enhanced. The reduction in Pavlovian bias in SZ patients was accompanied by feedback processing differences at the time of the P3a component. The reduced Pavlovian bias in patients is suggested to be due to reduced fidelity in the communication between striatal regions and frontal cortex. It may also partially account for previous findings of poorer "Go-learning" in schizophrenia where "Go" responses or Pavlovian consistent responses are required for optimal performance. An attenuated P3a component dynamic in patients is consistent with a view that deficits in operant learning are due to impairments in adaptively using feedback to update representations of stimulus value.

Neurophysiological evidence for diminished monitoring of own, but intact monitoring of other's errors in schizophrenia

Schizophrenia is characterized by social deficits. Correctly monitoring own and others' performance is crucial for efficient social behavior. Deficits in monitoring own performance as reflected in reduced error-related negativity (rERN) amplitudes, have been demonstrated repeatedly in schizophrenia. A similar ERP component (observed ERN; oERN) is elicited when observing others' mistakes. However, possible deficits in monitoring others' performance have never been investigated in schizophrenia. The current ERP-study compared a group of schizophrenia patients (N=22) and healthy controls (N=21) while performing a Simon task and the social Simon task, enabling the investigation of own (rERN) and others' (oERN) performance monitoring. Patients showed slower reaction times, but comparable accuracy and compatibility effects in both tasks. As expected, patients' rERN amplitudes were reduced. Importantly however, oERN amplitudes were comparable between both groups. While monitoring own performance is compromised in schizophrenia, monitoring others' performance seems intact. This divergence between internal and external performance monitoring in patients is in line with studies showing normal neurophysiological responses to negative feedback. The presently found dissociation may improve our understanding of cognitive and neural mechanisms underlying monitoring of own and others' performance and may stimulate treatment development aimed at learning from external rather than internal error information in schizophrenia.

Medial-Frontal Stimulation Enhances Learning in Schizophrenia by Restoring Prediction Error Signaling

Posterror learning, associated with medial-frontal cortical recruitment in healthy subjects, is compromised in neuropsychiatric disorders. Here we report novel evidence for the mechanisms underlying learning dysfunctions in schizophrenia. We show that, by noninvasively passing direct current through human medial-frontal cortex, we could enhance the event-related potential related to learning from mistakes (i.e., the error-related negativity), a putative index of prediction error signaling in the brain. Following this causal manipulation of brain activity, the patients learned a new task at a rate that was indistinguishable from healthy individuals. Moreover, the severity of delusions interacted with the efficacy of the stimulation to improve learning. Our results demonstrate a causal link between disrupted prediction error signaling and inefficient learning in schizophrenia. These findings also demonstrate the feasibility of nonpharmacological interventions to address cognitive deficits in neuropsychiatric disorders.

SIGNIFICANCE STATEMENT

When there is a difference between what we expect to happen and what we actually experience, our brains generate a prediction error signal, so that we can map stimuli to responses and predict outcomes accurately. Theories of schizophrenia implicate abnormal prediction error signaling in the cognitive deficits of the disorder. Here, we combine noninvasive brain stimulation with large-scale electrophysiological recordings to establish a causal link between faulty prediction error signaling and learning deficits in schizophrenia. We show that it is possible to improve learning rate, as well as the neural signature of prediction error signaling, in patients to a level quantitatively indistinguishable from that of healthy subjects. The results provide mechanistic insight into schizophrenia pathophysiology and suggest a future therapy for this condition.

Cognitive effort avoidance and detection in people with schizophrenia

Many people with schizophrenia exhibit avolition, a difficulty initiating and maintaining goal-directed behavior, considered to be a key negative symptom of the disorder. Recent evidence indicates that patients with higher levels of negative symptoms differ from healthy controls in showing an exaggerated cost of the physical effort needed to obtain a potential reward. We examined whether patients show an exaggerated avoidance of cognitive effort, using the demand selection task developed by Kool, McGuire, Rosen, and Botvinick (Journal of Experimental Psychology. General, 139, 665-682, 2010). A total of 83 people with schizophrenia or schizoaffective disorder and 71 healthy volunteers participated in three experiments where instructions varied. In the standard task (Experiment 1), neither controls nor patients showed expected cognitive demand avoidance. With enhanced instructions (Experiment 2), controls demonstrated greater demand avoidance than patients. In Experiment 3, patients showed nonsignificant reductions in demand avoidance, relative to controls. In a control experiment, patients showed significantly reduced ability to detect the effort demands associated with different response alternatives. In both groups, the ability to detect effort demands was associated with increased effort avoidance. In both groups, increased cognitive effort avoidance was associated with higher IQ and general neuropsychological ability. No significant correlations between demand avoidance and negative symptom severity were observed. Thus, it appears that individual differences in general intellectual ability and effort detection are related to cognitive effort avoidance and likely account for the subtle reduction in effort avoidance observed in schizophrenia.

A new computational account of cognitive control over reinforcement-based decision-making: Modeling of a probabilistic learning task

Recent work on decision-making field offers an account of dual-system theory for decision-making process. This theory holds that this process is conducted by two main controllers: a goal-directed system and a habitual system. In the reinforcement learning (RL) domain, the habitual behaviors are connected with model-free methods, in which appropriate actions are learned through trial-and-error experiences. However, goal-directed behaviors are associated with model-based methods of RL, in which actions are selected using a model of the environment. Studies on cognitive control also suggest that during processes like decision-making, some cortical and subcortical structures work in concert to monitor the consequences of decisions and to adjust control according to current task demands. Here a computational model is presented based on dual system theory and cognitive control perspective of decision-making. The proposed model is used to simulate human performance on a variant of probabilistic learning task. The basic proposal is that the brain implements a dual controller, while an accompanying monitoring system detects some kinds of conflict including a hypothetical cost-conflict one. The simulation results address existing theories about two event-related potentials, namely error related negativity (ERN) and feedback related negativity (FRN), and explore the best account of them. Based on the results, some testable predictions are also presented.

Working memory contributions to reinforcement learning impairments in schizophrenia

Previous research has shown that patients with schizophrenia are impaired in reinforcement learning tasks. However, behavioral learning curves in such tasks originate from the interaction of multiple neural processes, including the basal ganglia- and dopamine-dependent reinforcement learning (RL) system, but also prefrontal cortex-dependent cognitive strategies involving working memory (WM). Thus, it is unclear which specific system induces impairments in schizophrenia. We recently developed a task and computational model allowing us to separately assess the roles of RL (slow, cumulative learning) mechanisms versus WM (fast but capacity-limited) mechanisms in healthy adult human subjects. Here, we used this task to assess patients' specific sources of impairments in learning. In 15 separate blocks, subjects learned to pick one of three actions for stimuli. The number of stimuli to learn in each block varied from two to six, allowing us to separate influences of capacity-limited WM from the incremental RL system. As expected, both patients (n = 49) and healthy controls (n = 36) showed effects of set size and delay between stimulus repetitions, confirming the presence of working memory effects. Patients performed significantly worse than controls overall, but computational model fits and behavioral analyses indicate that these deficits could be entirely accounted for by changes in WM parameters (capacity and reliability), whereas RL processes were spared. These results suggest that the working memory system contributes strongly to learning impairments in schizophrenia.

Drift diffusion model of reward and punishment learning in schizophrenia: Modeling and experimental data

In this study, we tested reward- and punishment learning performance using a probabilistic classification learning task in patients with schizophrenia (n=37) and healthy controls (n=48). We also fit subjects' data using a Drift Diffusion Model (DDM) of simple decisions to investigate which components of the decision process differ between patients and controls. Modeling results show between-group differences in multiple components of the decision process. Specifically, patients had slower motor/encoding time, higher response caution (favoring accuracy over speed), and a deficit in classification learning for punishment, but not reward, trials. The results suggest that patients with schizophrenia adopt a compensatory strategy of favoring accuracy over speed to improve performance, yet still show signs of a deficit in learning based on negative feedback. Our data highlights the importance of applying fitting models (particularly drift diffusion models) to behavioral data. The implications of these findings are discussed relative to theories of schizophrenia and cognitive processing.

Bridging Levels of Understanding in Schizophrenia Through Computational Modeling

Schizophrenia is an illness with a remarkably complex symptom presentation that has thus far been out of reach of neuroscientific explanation. This presents a fundamental problem for developing better treatments that target specific symptoms or root causes. One promising path forward is the incorporation of computational neuroscience, which provides a way to formalize experimental observations and, in turn, make theoretical predictions for subsequent studies. We review three complementary approaches: (a) biophysically based models developed to test cellular-level and synaptic hypotheses, (b) connectionist models that give insight into large-scale neural-system-level disturbances in schizophrenia, and (c) models that provide a formalism for observations of complex behavioral deficits, such as negative symptoms. We argue that harnessing all of these modeling approaches represents a productive approach for better understanding schizophrenia. We discuss how blending these approaches can allow the field to progress toward a more comprehensive understanding of schizophrenia and its treatment.

Mechanisms Underlying Motivational Deficits in Psychopathology: Similarities and Differences in Depression and Schizophrenia

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.

Feedback-related negativity observed in rodent anterior cingulate cortex

The feedback-related negativity (FRN) refers to a difference in the human event-related potential (ERP) elicited by feedback indicating success versus failure: the difference appears negative when subtracting the success ERP from the failure ERP (Miltner et al., 1997). Although source localization techniques (e.g., BESA) suggest that the FRN is produced in the ACC, the inverse problem (that any given scalp distribution can be produced by an infinite number of possible dipole configurations) limits the certainty of this conclusion. The inverse problem can be circumvented by directly recording from the ACC in animal models. Although a non-human primate homologue of the FRN has been observed in the macaque monkey (e.g. Emeric et al., 2008), a homologue of the FRN has yet to be identified in rodents. We recorded local field potentials (LFPs) directly from the ACC in 6 rodents in a task based on the FRN paradigm. The animals were trained to poke their nose into a lighted port and received a feedback smell indicating whether or not a reward pellet would drop 1.5s later. We observed a FRN-like effect time-locked to the feedback scent whereby the LFP to feedback predicting no-reward was significantly more negative than the LFP to feedback predicting reward. This deflection began on average 130ms before behavioral changes in response to the feedback. Thus, we provide the first evidence of the existence of a rodent homologue of the FRN.

Goal-directed EEG activity evoked by discriminative stimuli in reinforcement learning

In reinforcement learning (RL), discriminative stimuli (S) allow agents to anticipate the value of a future outcome, and the response that will produce that outcome. We examined this processing by recording EEG locked to S during RL. Incentive value of outcomes and predictive value of S were manipulated, allowing us to discriminate between outcome-related and response-related activity. S predicting the correct response differed from nonpredictive S in the P2. S paired with high-value outcomes differed from those paired with low-value outcomes in a frontocentral positivity and in the P3b. A slow negativity then distinguished between predictive and nonpredictive S. These results suggest that, first, attention prioritizes detection of informative S. Activation of mental representations of these informative S then retrieves representations of outcomes, which in turn retrieve representations of responses that previously produced those outcomes.

Disrupted action monitoring in recent-onset psychosis patients with schizophrenia and bipolar disorder

Schizophrenia patients experience cognitive control disturbances, manifest in altered neural signatures during action monitoring. It remains unclear whether error- and conflict-monitoring disturbances co-occur, and whether they are observed in recent-onset psychosis patients with schizophrenia or bipolar disorder. We tested electrophysiological measures of action monitoring in these patients. Seventy-three schizophrenia patients (SZ), 26 bipolar disorder type I patients (BP), each within one year of psychosis onset, and 54 healthy control subjects (HC) underwent EEG during Stroop task performance. In the trial-averaged EEG at three midline scalp electrodes, the error-related negativity (ERN), error positivity (Pe) and conflict-related N450 were measured. Compared to HC (1) SZ exhibited an attenuated ERN and N450, and Pe unchanged and (2) BP exhibited an attenuated ERN but normal Pe and N450. Between patient groups, SZ showed an attenuated N450; ERN and Pe were not significantly different. A small (n=10) SZ subgroup that was not receiving antipsychotic medication showed normal ERPs. Altered error- and conflict-monitoring occur together in the first-episode schizophrenia patients, and these measures are comparable in patients with the first-episode bipolar disorder. Antipsychotic medication may be associated with altered measures of error-monitoring in schizophrenia.

Blocked versus randomized presentation modes differentially modulate feedback-related negativity and P3b amplitudes

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ERP responses to feedback stimuli with explicit or assigned valence information were investigated with blocked or randomized trial presentation modes.

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Only P3b, but not feedback-related negativity amplitudes were affected by feedback type for both presentation modes.

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Results suggest using blocked design when using different types of feedback stimuli.

Objective

Electrophysiological studies on feedback processing typically use a wide range of feedback stimuli which might not always be comparable. The current study investigated whether two indicators of feedback processing – feedback-related negativity (FRN) and P3b – differ for feedback stimuli with explicit (facial expressions) or assigned valence information (symbols). In addition, we assessed whether presenting feedback in either a trial-by-trial or a block-wise fashion affected these ERPs.

Methods

EEG was recorded in three experiments while participants performed a time estimation task and received two different types of performance feedback.

Results

Only P3b amplitudes varied consistently in response to feedback type for both presentation types. Moreover, the blocked feedback type presentation yielded more distinct FRN peaks, higher effect sizes, and a significant relation between FRN amplitudes and behavioral task performance measures.

Conclusion

Both stimulus type and presentation mode may provoke systematic changes in feedback-related ERPs. The current findings point at important potential confounds that need to be controlled for when designing FRN or P3b studies.

Significance

Studies investigating P3b amplitudes using mixed types of stimuli have to be interpreted with caution. Furthermore, we suggest implementing a blocked presentation format when presenting different feedback types within the same experiment.

Conflict and error processing in an extended cingulo-opercular and cerebellar network in schizophrenia

The loss of cognitive control is a prominent feature of schizophrenia. Relevant for adaptive control, individuals with schizophrenia often show impairments in their ability to monitor their ongoing behavior, and to adjust their responses based on advance information or feedback. By conducting a systematic examination of the behavioral adjustments after error and conflict and of activity within and between brain regions sensitive to the need to increase control (i.e. error commission, conflict presentation) in individuals with schizophrenia (n = 38) compared to healthy controls, we aimed to 1) shed light on the role of diverse brain regions previously associated with adaptive cognitive control, and 2) contribute to our understanding of the nature of the cognitive deficits present in individuals with schizophrenia. Our results show that error- and conflict-related behavioral adjustments are relatively intact during the performance of a change-signal task. Similarly, individuals with schizophrenia demonstrated intact error- and conflict-related effects in the dorsal anterior cingulate cortex, as well as in a number of other key regions including the bilateral anterior prefrontal cortex (PFC), bilateral insula, right inferior parietal lobule during error processing, and bilateral inferior parietal lobule and thalamus, right anterior PFC, left insula, and left lateral and inferior cerebellum during conflict processing. Given that a critical characteristic of our experimental design was the use of tasks that explicitly provide information about errors and conflict, we interpret our results as suggesting that the error- and conflict-detection systems are still somewhat functional in individuals with schizophrenia, but that a compromise in the ability to represent task relevant information that allow for the generation of an error representation may lead to the alterations in error- and conflict-processing documented in the schizophrenia literature.

Feedback processing in schizophrenia: effects of affective value and remedial action

Error-monitoring deficits in schizophrenia have been found, but results with respect to feedback processing and remedial action were unclear. The present study examined the role of emotion in feedback processing in medication-free patients with recent-onset schizophrenia. Patients and controls performed a time-estimation task, and brain activation was measured with functional magnetic resonance imaging (fMRI). Participants had to estimate a 1-s interval and received feedback about their performance in the form of words or facial expressions. Patients performed the task at the same level as the controls and used the feedback to improve performance. Brain activation following the feedback stimuli in the rostral cingulate zone differed between groups, but this effect depended on the modality of the feedback stimulus. Patients showed a differential response to verbal and facial feedback in the rostral cingulate zone, whereas healthy controls did not differ between modalities. Furthermore, activation in the rostral cingulate zone following facial feedback was negatively related to severity of the disease as expressed by the scores on positive symptom subscale of the Positive and Negative Syndrome Scale. Both findings point in the direction of a specific deficit in patients which is related to the emotional impact of external feedback.

The feedback-related negativity signals salience prediction errors, not reward prediction errors

Modulations of the feedback-related negativity (FRN) event-related potential (ERP) have been suggested as a potential biomarker in psychopathology. A dominant theory about this signal contends that it reflects the operation of the neural system underlying reinforcement learning in humans. The theory suggests that this frontocentral negative deflection in the ERP 230-270 ms after the delivery of a probabilistic reward expresses a prediction error signal derived from midbrain dopaminergic projections to the anterior cingulate cortex. We tested this theory by investigating whether FRN will also be observed for an inherently aversive outcome: physical pain. In another session, the outcome was monetary reward instead of pain. As predicted, unexpected reward omissions (a negative reward prediction error) yielded a more negative deflection relative to unexpected reward delivery. Surprisingly, unexpected pain omission (a positive reward prediction error) also yielded a negative deflection relative to unexpected pain delivery. Our data challenge the theory by showing that the FRN expresses aversive prediction errors with the same sign as reward prediction errors. Both FRNs were spatiotemporally and functionally equivalent. We suggest that FRN expresses salience prediction errors rather than reward prediction errors.

Unaffected control of distractor interference in schizophrenia: a meta-analysis of incompatibility slowing in flanker tasks

In schizophrenia research executive functions have been frequently reported to be impaired on a global level, largely ignoring the fact that the term executive functions refers to a collection of cognitive functions, which may be affected independently of each other. In the present meta-analysis we were able to show that an aspect of interference control, the ability to resist to distracting information, is not substantially affected in schizophrenia. Summarizing the results of 21 studies using a flanker task, we did not find an increased incompatibility slowing (relative to a compatible flanker condition). The mean effect size, integrating the data of 1029 schizophrenia and 848 controls, was with M(g) = 0.037 (95% confidence interval: -0.05 to 0.13) small and the test power was with 1-β = 0.991 sufficiently high to exclude even small population effects. A similar result was obtained when analyzing the incompatibility slowing relative to a neutral flanker condition (8 studies, M(g) = -0.032, 95% confidence interval: -0.16 to 0.09). In not being substantially affected in schizophrenia, the ability to resist distractor interference could serve as "scaffold function", which used by cognitive remediation programs, would allow to build up general functions, such as vigilance and attention, before the affected executive abilities would be addressed.

Systems biology, bioinformatics, and biomarkers in neuropsychiatry

Although neuropsychiatric (NP) disorders are among the top causes of disability worldwide with enormous financial costs, they can still be viewed as part of the most complex disorders that are of unknown etiology and incomprehensible pathophysiology. The complexity of NP disorders arises from their etiologic heterogeneity and the concurrent influence of environmental and genetic factors. In addition, the absence of rigid boundaries between the normal and diseased state, the remarkable overlap of symptoms among conditions, the high inter-individual and inter-population variations, and the absence of discriminative molecular and/or imaging biomarkers for these diseases makes difficult an accurate diagnosis. Along with the complexity of NP disorders, the practice of psychiatry suffers from a "top-down" method that relied on symptom checklists. Although checklist diagnoses cost less in terms of time and money, they are less accurate than a comprehensive assessment. Thus, reliable and objective diagnostic tools such as biomarkers are needed that can detect and discriminate among NP disorders. The real promise in understanding the pathophysiology of NP disorders lies in bringing back psychiatry to its biological basis in a systemic approach which is needed given the NP disorders' complexity to understand their normal functioning and response to perturbation. This approach is implemented in the systems biology discipline that enables the discovery of disease-specific NP biomarkers for diagnosis and therapeutics. Systems biology involves the use of sophisticated computer software "omics"-based discovery tools and advanced performance computational techniques in order to understand the behavior of biological systems and identify diagnostic and prognostic biomarkers specific for NP disorders together with new targets of therapeutics. In this review, we try to shed light on the need of systems biology, bioinformatics, and biomarkers in neuropsychiatry, and illustrate how the knowledge gained through these methodologies can be translated into clinical use providing clinicians with improved ability to diagnose, manage, and treat NP patients.

Neurobiology of schizophrenia: search for the elusive correlation with symptoms

In the last half-century, human neuroscience methods provided a way to study schizophrenia in vivo, and established that it is associated with subtle abnormalities in brain structure and function. However, efforts to understand the neurobiological bases of the clinical symptoms that the diagnosis is based on have been largely unsuccessful. In this paper, we provide an overview of the conceptual and methodological obstacles that undermine efforts to link the severity of specific symptoms to specific neurobiological measures. These obstacles include small samples, questionable reliability and validity of measurements, medication confounds, failure to distinguish state and trait effects, correlation-causation ambiguity, and the absence of compelling animal models of specific symptoms to test mechanistic hypotheses derived from brain-symptom correlations. We conclude with recommendations to promote progress in establishing brain-symptom relationships.

Response activation impairments in schizophrenia: evidence from the lateralized readiness potential

Previous research has demonstrated deficits in preresponse motor activity in schizophrenia, as evidenced by a reduced lateralized readiness potential (LRP). The LRP deficit could be due to increased activation of the incorrect response (e.g., failure to suppress competition) or to reduced activation of the correct response (e.g., a low-level impairment in response preparation). To distinguish these possibilities, we asked whether the LRP impairment is increased under conditions of strong response competition. We manipulated the compatibility of stimulus-response mappings (Experiment 1) and the compatibility of the target with flankers (Experiment 2). In both experiments, the patient LRP was reduced as much under conditions of low response competition as under high competition. These results are incompatible with a failure of patients to suppress competition and are instead consistent with a deficit in activating the correct response.