Abnormal cognitive effort allocation and its association with amotivation in first-episode psychosis

Chang, Wing Chung; Westbrook, Andrew; Strauss, Gregory P.; Chu, Angel On Ki; Chong, Catherine Shiu‐yin; Siu, Clara Man Wah; Chan, Sherry K.W.; Lee, E H M; Hui, Christy Lai Ming; Suen, Yi Nam; Lo, Tak Lam; Chen, E Y H

doi:10.1017/s0033291719002769

Cited by 32 publications

(43 citation statements)

References 69 publications

(108 reference statements)

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“…The first psychotic episode (FEP) is the earliest stage of the disease, in which patients exhibit motivation deficits and impaired decision making related to cognitive impairment. The decreased desire to put more effort into cognitive functions is caused by the inability to appreciate the reward or overestimating the amount of effort that should be put into a given activity [20]. Patients with FEP also have reduced adaptability due to the brain defects in the hippocampus [21].…”

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confidence: 99%

Oxidative-Antioxidant Imbalance and Impaired Glucose Metabolism in Schizophrenia

et al. 2020

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Schizophrenia is a neurodevelopmental disorder featuring chronic, complex neuropsychiatric features. The etiology and pathogenesis of schizophrenia are not fully understood. Oxidative-antioxidant imbalance is a potential determinant of schizophrenia. Oxidative, nitrosative, or sulfuric damage to enzymes of glycolysis and tricarboxylic acid cycle, as well as calcium transport and ATP biosynthesis might cause impaired bioenergetics function in the brain. This could explain the initial symptoms, such as the first psychotic episode and mild cognitive impairment. Another concept of the etiopathogenesis of schizophrenia is associated with impaired glucose metabolism and insulin resistance with the activation of the mTOR mitochondrial pathway, which may contribute to impaired neuronal development. Consequently, cognitive processes requiring ATP are compromised and dysfunctions in synaptic transmission lead to neuronal death, preceding changes in key brain areas. This review summarizes the role and mutual interactions of oxidative damage and impaired glucose metabolism as key factors affecting metabolic complications in schizophrenia. These observations may be a premise for novel potential therapeutic targets that will delay not only the onset of first symptoms but also the progression of schizophrenia and its complications.

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confidence: 99%

Oxidative-Antioxidant Imbalance and Impaired Glucose Metabolism in Schizophrenia

et al. 2020

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“…This contrasts previous findings of impaired probabilistic learning and increased switching behavior in patients with schizophrenia and first-episode psychosis (Culbreth et al, 2016a;Deserno et al, 2020;Murray et al, 2008;Waltz et al, 2013) and may in part reflect task paradigm differences. In studies where a monetary reward is implemented, group differences may emerge due to differences in valuation processes (Chang et al, 2019;Culbreth et al, 2016b). Importantly, average accuracy was above chance level for all task conditions, indicating successful learning and effort investment even in the absence of an external reward.…”

Section: Discussionmentioning

confidence: 89%

Spared performance but increased uncertainty in schizophrenia: evidence from a probabilistic decision-making task

Kreis¹,

Zhang²,

Moritz³

et al. 2020

Preprint

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Aberrant attribution of salience to in fact little informative events might explain the emergence of positive symptoms in schizophrenia and has been linked to belief uncertainty. Uncertainty is thought to be encoded by neuromodulators, including norepinephrine. However, norepinephrinergic encoding of uncertainty, measured as task-related pupil dilation, has rarely been explored in schizophrenia. Here, we addressed this question by comparing individuals with a disorder from the schizophrenia spectrum to a non-psychiatric control group on behavioral and pupillometric measures in a probabilistic prediction task, where different levels of uncertainty were introduced. Behaviorally, patients performed similar to controls, but their belief uncertainty was higher, particularly when instability of the task environment was high, suggesting an increased sensitivity to this instability. Furthermore, while pupil dilation scaled positively with uncertainty in the control group, this was not the case for patients, suggesting aberrant neuromodulatory regulation of neural gain, which may hinder the reduction of uncertainty in the long run. Together, the findings point to abnormal uncertainty processing and norepinephrinergic signaling in schizophrenia, potentially informing future development of both psychopharmacological therapies and psychotherapeutic approaches that deal with the processing of uncertain information.

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“…The last decade has seen a significant rise in EBDM studies in schizophrenia spanning several of these components of decision making (Gold et al, 2013;Barch et al, 2014;Albrecht et al, 2019;Chang et al, 2019Chang et al, , 2020Cooper et al, 2019;Culbreth et al, 2021). The investigations that have been performed aimed to probe cognitive mechanisms underlying behavioural deficits, including negative symptoms.…”

Section: Effort-based Decision Making Framework For Motivation Deficitsmentioning

confidence: 99%

Mechanisms Underlying Motivational Dysfunction in Schizophrenia

Saleh

Jarratt-Barnham

Fernández-Egea

2021

Front. Behav. Neurosci.

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Negative symptoms are a debilitating feature of schizophrenia which are often resistant to pharmacological intervention. The mechanisms underlying them remain poorly understood, and diagnostic methods rely on phenotyping through validated questionnaires. Deeper endo-phenotyping is likely to be necessary in order to improve current understanding. In the last decade, valuable behavioural insights have been gained through the use of effort-based decision making (EBDM) tasks. These have highlighted impairments in reward-related processing in schizophrenia, particularly associated with negative symptom severity. Neuroimaging investigations have related these changes to dysfunction within specific brain networks including the ventral striatum (VS) and frontal brain regions. Here, we review the behavioural and neural evidence associated with negative symptoms, shedding light on potential underlying mechanisms and future therapeutic possibilities. Findings in the literature suggest that schizophrenia is characterised by impaired reward based learning and action selection, despite preserved hedonic responses. Associations between amotivation and reward-processing deficits have not always been clear, and may be mediated by factors including cognitive dysfunction or dysfunctional or self-defeatist beliefs. Successful endo-phenotyping of negative symptoms as a function of objective behavioural and neural measurements is crucial in advancing our understanding of this complex syndrome. Additionally, transdiagnostic research–leveraging findings from other brain disorders, including neurological ones–can shed valuable light on the possible common origins of motivation disorders across diseases and has important implications for future treatment development.

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Abnormal cognitive effort allocation and its association with amotivation in first-episode psychosis

Cited by 32 publications

References 69 publications

Oxidative-Antioxidant Imbalance and Impaired Glucose Metabolism in Schizophrenia

Oxidative-Antioxidant Imbalance and Impaired Glucose Metabolism in Schizophrenia

Spared performance but increased uncertainty in schizophrenia: evidence from a probabilistic decision-making task

Mechanisms Underlying Motivational Dysfunction in Schizophrenia

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