Reward processing in schizophrenia: A deficit in the representation of value
Reward processing in schizophrenia: A deficit in the representation of value
复制标题
DOI：
10.1093/schbul/sbn068
复制
发表时间：
2008-09-01
影响因子：
6.6
通讯作者：
Heerey, Erin A.
中科院分区：
文献类型：
--
作者：
Gold, James M.;Waltz, James A.;Heerey, Erin A.
精神分裂症患者在动机和学习方面表现出缺陷，这表明奖励系统的不同方面受到损害。在这篇文章中，我们提出了8个收敛实验的结果，这些实验涉及主观奖励体验，奖励对决策的影响，以及奖励在指导快速和长期学习中的作用。所有实验都比较了稳定治疗的门诊精神分裂症患者和人口统计学匹配的健康志愿者的表现。迄今为止的结果表明：（1）当呈现唤起刺激时，患者具有令人惊讶的正常积极情绪体验;（2）与对照组相比，患者对刺激的主观评价与行动选择之间的相关性降低;（3）患者的决策似乎受到充分代表不同选择和反应选项的价值的能力缺陷的影响，（4）基于试验到试验反馈的快速学习受到严重损害，而在许多范例中，更渐进的学习可能令人惊讶地被保留下来。研究结果的总体模式表明，眼眶和背侧前额叶结构的妥协，在代表结果和计划的价值的能力中发挥着关键作用。相比之下，患者通常（但不总是）在许多试验中通过整合强化信号实现的缓慢学习中接近正常的表现水平，被认为是由基底神经节介导的。
Patients with schizophrenia demonstrate deficits in motivation and learning that suggest impairment in different aspects of the reward system. In this article, we present the results of 8 converging experiments that address subjective reward experience, the impact of rewards on decision making, and the role of rewards in guiding both rapid and long-term learning. All experiments compared the performance of stably treated outpatients with schizophrenia and demographically matched healthy volunteers. Results to date suggest (1) that patients have surprisingly normal experiences of positive emotion when presented with evocative stimuli, (2) that patients show reduced correlation, compared with controls, between their own subjective valuation of stimuli and action selection, (3) that decision making in patients appears to be compromised by deficits in the ability to fully represent the value of different choices and response options, and (4) that rapid learning on the basis of trial-to-trial feedback is severely impaired whereas more gradual learning may be surprisingly preserved in many paradigms. The overall pattern of findings suggests compromises in the orbital and dorsal prefrontal structures that play a critical role in the ability to represent the value of outcomes and plans. In contrast, patients often (but not always) approach normal performance levels on the slow learning achieved by the integration of reinforcement signals over many trials, thought to be mediated by the basal ganglia.