Revisiting reward impairments in schizophrenia spectrum disorders: a systematic review and meta-analysis for neuroimaging findings

Abstract

Background Abnormal reward functioning is central to anhedonia and amotivation symptoms of schizophrenia (SCZ). Reward processing encompasses a series of psychological components. This systematic review and meta-analysis examined the brain dysfunction related to reward processing of individuals with SCZ spectrum disorders and risks, covering multiple reward components. Methods After a systematic literature search, 37 neuroimaging studies were identified and divided into four groups based on their target psychology components (i.e. reward anticipation, reward consumption, reward learning, effort computation). Whole-brain Seed-based d Mapping (SDM) meta-analyses were conducted for all included studies and each component. Results The meta-analysis for all reward-related studies revealed reduced functional activation across the SCZ spectrum in the striatum, orbital frontal cortex, cingulate cortex, and cerebellar areas. Meanwhile, distinct abnormal patterns were found for reward anticipation (decreased activation of the cingulate cortex and striatum), reward consumption (decreased activation of cerebellum IV/V areas, insula and inferior frontal gyri), and reward learning processing (decreased activation of the striatum, thalamus, cerebellar Crus I, cingulate cortex, orbitofrontal cortex, and parietal and occipital areas). Lastly, our qualitative review suggested that decreased activation of the ventral striatum and anterior cingulate cortex was also involved in effort computation. Conclusions These results provide deep insights on the component-based neuro-psychopathological mechanisms for anhedonia and amotivation symptoms of the SCZ spectrum.

Blunted ventral striatal reactivity to social reward is associated with more severe motivation and pleasure deficits in psychosis.

“…As a precursor to hypothesis testing, we used whole-brain voxelwise GLMs to determine whether the SID and MID paradigms had the expected neurophysiological consequences, as indexed by the cardinal High Reward vs. No-Reward contrast (hit trials). Consistent with work in healthy 82 , 83 and psychotic 21 , 23 samples, results confirmed that social and monetary incentives recruited an overlapping network of subcortical and cortical regions, including bilateral ventral striatum, thalamus, cingulate (subgenual, pregenual, and midcingulate), anterior insula, orbitofrontal cortex (posterior orbital gyrus), superior parietal lobule, and ventral visual cortex (p<0.05, whole-brain FWE corrected; Figure 2 ; Supplementary Tables S2-S5).…”

“…MAP deficits are often conceptualized in terms of blunted reactivity to social rewards, including reduced motivation to seek out and engage in social interactions (amotivation/avolition) and diminished hedonic pleasure when interactions do occur (anhedonia) 3 , 12 , 18 – 22 . Recent meta-analyses of the psychosis neuroimaging literature provide some neurobiological support for these hypotheses, but modest sample sizes (median n Cases =19) and a near-exclusive focus on monetary reward and other non-social incentives precludes decisive inferences 21 , 23 …”

Neural Correlates of Positive Outcome Expectancy for Aggression: Evidence from Voxel-Based Morphometry and Resting-State Functional Connectivity Analysis

“…PCC and aMPFC, as core hubs of the DMN, are involved in both remembering past and imagining future personal events [30,38]. Both regions are also involved in reward anticipation [50,51], representing the subjective value and personal significance of anticipated events [29,36,67], which may underlie the brain basis of the motivational function of aggressive POE. On the other hand, the PCC may be implicated in the formation of beliefs about aggressive POE.…”

“…Moreover, the core hubs of the DMN are involved in the valuation and emotional representation of anticipated events, indicating the motivational salience and personal significance of these events [29,36]. For example, during reward anticipation [50,51] and imagining goal achievement [52], activation of the PCC and aMPFC is significantly increased. Taken together, the DMN may be the brain correlate for imagining or inferring the potential positive outcomes of aggressive responses based on prior "aggression-positive outcome" schema.…”