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Nielsen MØ, Rostrup E, Wulff S, Bak N, Lublin H, Kapur S, Glenthøj B. Alterations of the brain reward system in antipsychotic naïve schizophrenia patients. Biol Psychiatry . 2012 May 15 ; 71(10):898-905. PubMed Abstract

Comments on Paper and Primary News
Comment by:  James A. Waltz
Submitted 16 April 2012 Posted 16 April 2012

A new paper in Biological Psychiatry by Nielsen and colleagues at Copenhagen University Hospital and University College London helps to clear up a confusing literature on reward processing in patients with psychotic illness. The authors report on data from an impressively large sample of 31 neuroleptic-naïve schizophrenia patients and 31 demographically matched controls who were administered a Monetary Incentive Delay (MID) task. Variants of this task have been used for over a decade, in conjunction with neuroimaging, to examine the neural substrates underlying the anticipation and integration of rewards and punishments in human subjects. Results of multiple studies using MID tasks point to phasic activation of the human ventral striatum (VS) during the anticipation of rewards, leading some to draw a connection between these neural activity patterns and evidence of nucleus accumbens involvement in what Berridge and Robinson have termed, "incentive salience."

In schizophrenia, in particular, researchers have used MID paradigms to test the idea (  Read more

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Comment by:  Stefan KaiserJoe J. Simon
Submitted 1 May 2012 Posted 1 May 2012

This new paper by Nielsen and colleagues can be considered a true landmark study on reward processing in patients with schizophrenia. It has long been suggested that dopamine dysregulation leads to a reduced response to rewarding or salient cues. A number of previous studies have used functional magnetic resonance imaging (fMRI) with the monetary incentive delay (MID) task to provide empirical evidence for this hypothesis. These studies have suggested that the BOLD response to rewarding cues is indeed reduced in unmedicated patients, but not in patients treated with atypical antipsychotics (Juckel et al., 2006; Schlagenhauf et al., 2008; Simon et al., 2010; Walter et al., 2009; Waltz et al., 2010). However, these studies had small sample sizes and could not account for possible effects of illness chronicity. These problems have now been...  Read more

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