Apathy But Not Diminished Expression in Schizophrenia Is Associated With Discounting of Monetary Rewards by Physical Effort

Hartmann, Matthias; Hager, Oliver M.; Reimann, Anna V.; Chumbley, Justin R.; Kirschner, Matthias; Seifritz, Erich; Tobler, Philippe N.; Kaiser, Stefan

doi:10.1093/schbul/sbu102

Cited by 177 publications

(201 citation statements)

References 47 publications

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“…With amotivation, evidence suggests that motivational deficits may be an important determinant of functional disability (Konstantakopoulos et al, 2011;Reddy et al, 2015), possibly attributable to difficulties in perceiving reward outcomes (Gard et al, 2014), and effort-based decision making . This argument is supported by the recent finding that amotivation, but not expressive deficits, have been found to be associated with impairments in integrating rewards with effortful behaviour during decision making (Hartmann et al, 2015). Asociality is likely to result in a larger degree of isolation from others, and impair their ability to adequately function in their social context.…”

Section: Comparison With the Literaturementioning

confidence: 85%

The relationship between experiential deficits of negative symptoms and subjective quality of life in schizophrenia

Savill

Orfanos

Reininghaus

et al. 2016

Schizophrenia Research

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Section: Comparison With the Literaturementioning

confidence: 85%

The relationship between experiential deficits of negative symptoms and subjective quality of life in schizophrenia

Savill

Orfanos

Reininghaus

et al. 2016

Schizophrenia Research

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“…Several psychiatric disorders, including schizophrenia, express effortrelated deficits (e.g., [28][29][30]. A long-standing hypothesis assumes an imbalance between striatal and cortical dopamine (26,60,61), involving excess dopamine release in striatal (62, 63) but deficient dopamine release in cortical areas (64).…”

Section: Simultaneous Representations Of Effort and Reward Pes In Dopmentioning

confidence: 99%

“…A long-standing hypothesis assumes an imbalance between striatal and cortical dopamine (26,60,61), involving excess dopamine release in striatal (62, 63) but deficient dopamine release in cortical areas (64). While the former is linked to positive symptoms, such as hallucinations, the latter is considered relevant to negative symptoms, such as apathy (26,28,29). Given the striatal-cortical double dissociation, we examined whether apathy scores in our subjects, as assessed using the Apathy Evaluation Scale [AES (65)], were better predicted by dmPFC or VS activation.…”

Section: Simultaneous Representations Of Effort and Reward Pes In Dopmentioning

confidence: 99%

“…For example, selective lesioning of this region engenders a preference for loweffort choices (15,(20)(21)(22)(23), while receiving effort feedback elicits responses in this same region (24,25). The importance of dopamine to effort learning is also hinted at in disorders with putative aberrant dopamine function, such as schizophrenia (26), where a symptom profile ("negative symptoms") often includes a lack of effort expenditure and apathy (27)(28)(29)(30).…”

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confidence: 99%

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Separate mesocortical and mesolimbic pathways encode effort and reward learning signals

Hauser

Eldar

Dolan

2017

Proc. Natl. Acad. Sci. U.S.A.

122

127

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Optimal decision making mandates organisms learn the relevant features of choice options. Likewise, knowing how much effort we should expend can assume paramount importance. A mesolimbic network supports reward learning, but it is unclear whether other choice features, such as effort learning, rely on this same network. Using computational fMRI, we show parallel encoding of effort and reward prediction errors (PEs) within distinct brain regions, with effort PEs expressed in dorsomedial prefrontal cortex and reward PEs in ventral striatum. We show a common mesencephalic origin for these signals evident in overlapping, but spatially dissociable, dopaminergic midbrain regions expressing both types of PE. During action anticipation, reward and effort expectations were integrated in ventral striatum, consistent with a computation of an overall net benefit of a stimulus. Thus, we show that motivationally relevant stimulus features are learned in parallel dopaminergic pathways, with formation of an integrated utility signal at choice. effort prediction errors | reward prediction errors | apathy | substantia nigra/ventral tegmental area | dorsomedial prefrontal cortex O rganisms need to make energy-efficient decisions to maximize benefits and minimize costs, a tradeoff exemplified in effort expenditure (1-3). A key example occurs during foraging, where an overestimation of effort can lead to inaction and starvation (4), whereas underestimation of effort can result in persistent failure, as exemplified in the myth of Sisyphus (5).In a naturalistic environment, we often simultaneously learn about success in expending sufficient effort into an action as well as the reward we obtain from this same action. The reward outcomes that signal success and failure of an action are usually clear, although the effort necessary to attain success is often less transparent. Only by repeatedly experiencing success and failure is it possible to acquire an estimate of an optimal level of effort needed to succeed, without unnecessary waste of energy. This type of learning is important in contexts as diverse as foraging, hunting, and harvesting (6-8). Hull in his "law of less work" proposed that organisms "gradually learn" how to minimize effort expenditure (9). Surprisingly, we know little regarding the neurocognitive mechanisms that guide this form of simultaneous learning about reward and effort.A mesolimbic dopamine system encodes a teaching signal tethered to prediction of reward outcomes (10, 11). These reward prediction errors (PEs) arise from dopaminergic neurons in substantia nigra and ventral tegmental area (SN/VTA) and are broadcast to ventral striatum (VS) to mediate reward-related adaptation and learning (12, 13). Dopamine is also thought to provide a motivational signal (14-18), while dopaminergic deficits in rodents impair how effort and reward are arbitrated (1, 4, 19). The dorsomedial prefrontal cortex (dmPFC; spanning presupplementary motor area [pre-SMA] and dorsal anterior cingulate cortex [dACC]) is a candidate substrate...

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“…40 To thoroughly assess negative symptoms with regard to the 2 symptom dimensions of apathy (deficits in motivation and pleasure) and diminished expression (blunted affect, alogia), we applied the previously used German version of the Brief Negative Symptom Scale (BNSS). 25,[41][42][43] Additionally, we used the Calgary Depression Scale for Schizophrenia (CDSS) 44 to identify depressive symptoms. For details on clinical and neuropsychological assessment see supplementary methods.…”

Section: Psychopathological Assessmentmentioning

confidence: 99%

Ventral Striatal Dysfunction and Symptom Expression in Individuals With Schizotypal Personality Traits and Early Psychosis

Kirschner

Hager

Muff

et al. 2016

SCHBUL

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Striatal abnormalities play a crucial role in the pathophysiology of schizophrenia. Growing evidence suggests an association between aberrant striatal activity during reward anticipation and symptom dimensions in schizophrenia. However, it is not clear whether this holds across the psychosis continuum. The aim of the present study was to investigate alterations of ventral striatal activation during reward anticipation and its relationship to symptom expression in persons with schizotypal personality traits (SPT) and first-episode psychosis. Twenty-six individuals with high SPT, 26 patients with non-affective first-episode psychosis (including 13 with brief psychotic disorder (FEP-BPD) and 13 with first-episode schizophrenia [FEP-SZ]) and 25 healthy controls underwent event-related functional magnetic resonance imaging while performing a variant of the Monetary Incentive Delay task. Ventral striatal activation was positively correlated with total symptom severity, in particular with levels of positive symptoms. This association was observed across the psychosis continuum and within each subgroup. Patients with FEP-SZ showed the strongest elevation of striatal activation during reward anticipation, although symptom levels did not differ between groups in the psychosis continuum. While our results provide evidence that variance in striatal activation is mainly explained by dimensional symptom expression, patients with schizophrenia show an additional dysregulation of striatal activation. Trans-diagnostic approaches are promising in order to disentangle dimensional and categorical neural mechanisms in the psychosis continuum.

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Apathy But Not Diminished Expression in Schizophrenia Is Associated With Discounting of Monetary Rewards by Physical Effort

Cited by 177 publications

References 47 publications

The relationship between experiential deficits of negative symptoms and subjective quality of life in schizophrenia

The relationship between experiential deficits of negative symptoms and subjective quality of life in schizophrenia

Separate mesocortical and mesolimbic pathways encode effort and reward learning signals

Ventral Striatal Dysfunction and Symptom Expression in Individuals With Schizotypal Personality Traits and Early Psychosis

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