Combining actigraphy, ecological momentary assessment and neuroimaging to study apathy in patients with schizophrenia

Kluge, Agne; Kirschner, Matthias; Hager, Oliver M.; Bischof, Martin; Habermeyer, Benedikt; Seifritz, Erich; Walther, Sebastian; Kaiser, Stefan

doi:10.1016/j.schres.2017.09.034

Cited by 66 publications

(70 citation statements)

References 45 publications

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“…In other words, extraction and average calculation was not restricted to the significant voxels but to all voxels of the ROIs. In addition, we performed an extra-striatal ROI analysis in the prefrontal cortex, which was based on previous findings showing an association between a behavioural measure of apathy and reduced inferior frontal gyrus (IFG) activation (Kluge et al , 2018). Structural masks of the left and right IFG were derived from the IBASPM 71 atlas implemented in the Wake Forest University Toolbox in SPM8 (Maldjian et al, 2003).…”

Section: Methodsmentioning

confidence: 99%

Shared and dissociable features of apathy and reward system dysfunction in bipolar I disorder and schizophrenia

Kirschner

Cathomas

Manoliu

et al. 2019

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BackgroundBipolar disorder I (BD-I) is defined by episodes of mania, depression, and euthymic states. These episodes are among other symptoms characterized by altered reward processing and negative symptoms (NS), in particular apathy. However, the neural correlates of these deficits are not well understood.MethodsWe first assessed the severity of negative symptoms in 25 euthymic BD-I patients compared to 25 healthy controls (HC) and 27 patients with schizophrenia (SZ). Then, we investigated ventral and dorsal striatal activation during reward anticipation in a Monetary Incentive Delayed Task and its association with NS.ResultsIn BD-I patients NS were clearly present and the severity of apathy was comparable to SZ patients. Apathy scores in the BD-I group but not in the SZ group correlated with sub-syndromal depression scores. At the neural level, we found significant ventral and dorsal striatal activation in BD-I patients and no group differences with HC or SZ patients. In contrast to patients with SZ, apathy did not correlate with striatal activation during reward anticipation. Explorative whole brain analyses revealed reduced extra-striatal activation in BD-I patients compared to HC and an association between reduced activation of the inferior frontal gyrus and apathy.ConclusionThis study found that in BD-I patients apathy is present to an extent comparable to schizophrenia, but is more strongly related to sub-syndromal depressive symptoms. The findings support the view of different pathophysiological mechanisms underlying apathy in the two disorders and suggest that extra-striatal dysfunction may contribute to impaired reward processing and apathy in BD-I.

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Section: Methodsmentioning

confidence: 99%

Shared and dissociable features of apathy and reward system dysfunction in bipolar I disorder and schizophrenia

Kirschner

Cathomas

Manoliu

et al. 2019

Preprint

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“…reward anticipation, prediction error coding, receipt of reward), with most evidence for a relationship to blunted reward anticipation ( Fig. 1) (Arrondo et al, 2015;Barch, 2010, 2012;Dowd et al, 2016;Kirschner et al, 2016;Kluge et al, 2018;Moran et al, 2019;Morris et al, 2015;Mucci et al, 2015;Simon et al, 2010;Simon et al, 2015;Stepien et al, 2018;Waltz et al, 2009;Waltz et al, 2010;Waltz et al, 2018;Wolf et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…While most studies in schizophrenia found reduced blood-oxygen-level-dependent (BOLD) activity related to apathy in the ventral striatum (VS), some studies have identified a specific involvement of the dorsal striatum (DS) (Morris et al, 2015;Mucci et al, 2015), or dysfunctions including both VS and DS (Dowd et al, 2016;Moran et al, 2019;Stepien et al, 2018). apathy/diminished motivation and pleasure and striatal activity during processing of reward and salient stimuli (Arrondo et al, 2015;Barch, 2010, 2012;Dowd et al, 2016;Kirschner et al, 2016;Kluge et al, 2018;Moran et al, 2019;Morris et al, 2015;Mucci et al, 2015;Simon et al, 2010;Simon et al, 2015;Stepien et al, 2018;Waltz et al, 2009;Waltz et al, 2010;Waltz et al, 2018;Wolf et al, 2014). (b) 2 studies (n=64) reported an association between apathy/diminished motivation and pleasure and striatal volume (Caravaggio et al, 2018a;Roth et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Apathy is not associated with reduced ventral striatal volume in patients with schizophrenia

Burrer

Caravaggio

Manoliu

et al. 2020

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Background: A growing body of neuroimaging research has revealed a relationship between blunted activation of the ventral striatum (VS) and apathy in schizophrenia. In contrast, the association between reduced striatal volume and apathy is less well established, while the relationship between VS function and structure in patients with schizophrenia remains an open question. Here, we aimed to replicate previous structural findings in a larger independent sample and to investigate the relationship between VS hypoactivation and VS volume. Methods: We included brain structural magnetic resonance imaging (MRI) data from 60 patients with schizophrenia (SZ) that had shown an association of VS hypoactivation with apathy during reward anticipation and 58 healthy controls (HC). To improve replicability, we applied analytical methods developed in two previously published studies: Voxel-based morphometry and the Multiple Automatically Generated Templates (MAGeT) algorithm. VS and dorsal striatum (DS) volume were correlated with apathy correcting for age, gender and total brain volume. Additionally, left VS activity was correlated with left VS volume. Results: We failed to replicate the association between apathy and reduced VS volume and did not find a correlation with DS volume. Functional and structural left VS measures exhibited a trend-level correlation (rs=0.248, p=0.067, r2=0.06). Conclusions: Our present data suggests that functional and structural striatal neuroimaging correlates of apathy can occur independently. Replication of previous findings may have been limited by other factors (medication, illness duration, age) potentially related to striatal volume changes in SZ. Finally, associations between reward-related VS function and structure should be further explored.

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“…The first aim of this study was to evaluate the efficacy of a shorter version of the Switch intervention in individuals with schizophrenia and schizoaffective disorder. We expected (1) an improvement on motivation/apathy, quality of life and functional outcomes (primary outcomes), after the intervention and/or at follow-up; (2) an improvement on the various cognitive, emotional and behavioural processes identified in our model and targeted in the intervention (ESM variables), during the intervention and/or at follow-up; (3) an increase in step count as this has been shown to be an objective proxy measure of negative symptoms [23], during the intervention and/or at follow-up. Second, we aimed to explore the dynamics of the processes associated with motivation (ESM variables) before the intervention, during the intervention and at follow-up.…”

Section: Introductionmentioning

confidence: 99%

Idiographic analyses of motivation and related processes in participants with schizophrenia following a therapeutic intervention for negative symptoms

Thonon

Aubel

Lafit

et al. 2020

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Background Motivational negative symptoms hinder quality of life and daily functioning of individuals with schizophrenia spectrum disorders. A recently developed intervention, Switch, has shown promising effects on negative symptoms and functional outcomes. Switch targets multiple cognitive, emotional and behavioural processes associated with motivation and goal directed behaviours. We aimed to investigate its effects on motivation and associated processes and explore the dynamics between the processes. Methods We used a single case approach (n = 3), with a pre-post and follow-up assessment design, which also included ambulatory assessments (experience sampling method, ESM; and step count). We computed autoregressive lag 1 models to evaluate the effects of the intervention on daily motivation levels and related processes, descriptive pie-charts, and vector autoregressive modelling to reveal the dynamics of the processes over time. Results The intervention was beneficial for each participant according to traditional evaluations of motivational negative symptoms, apathy, daily functioning and quality of life. The effects on the ESM variables revealed distinct outcomes for each individual. The dynamics between the various processes differed between participants, and fluctuated within participants (when comparing baseline, intervention phase, and follow-up). Conclusions This study used an innovative approach to look at the efficacy of an intervention. The intervention seems to lead to significant improvements. The mechanisms of change need to be further investigated. Trial registration number: ClinicalTrials.gov, NCT04325100. Registered 27 March 27, 2020 -retrospectively registered, https://www.clinicaltrials.gov/ct2/show/NCT04325100 Reporting: Guidelines from the Transparent Reporting of Evaluations with Non-randomized Designs (TREND) statement [1] were followed.

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Combining actigraphy, ecological momentary assessment and neuroimaging to study apathy in patients with schizophrenia

Cited by 66 publications

References 45 publications

Shared and dissociable features of apathy and reward system dysfunction in bipolar I disorder and schizophrenia

Shared and dissociable features of apathy and reward system dysfunction in bipolar I disorder and schizophrenia

Apathy is not associated with reduced ventral striatal volume in patients with schizophrenia

Idiographic analyses of motivation and related processes in participants with schizophrenia following a therapeutic intervention for negative symptoms

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