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

Abstract：

BACKGROUND:Bipolar 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. METHODS:We first assessed the severity of NS in 25 euthymic BD-I patients compared with 25 healthy controls (HC) and 27 patients with schizophrenia (SZ). Then, we investigated ventral (VS) and dorsal striatal (DS) activation during reward anticipation in a Monetary Incentive Delayed Task and its association with NS. RESULTS:In 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 VS and DS 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 with HC and an association between reduced activation of the inferior frontal gyrus and apathy. CONCLUSION:This study found that in BD-I patients apathy is present to an extent comparable to SZ, 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.

journal_name

Psychol Med

journal_title

Psychological medicine

authors

Kirschner M,Cathomas F,Manoliu A,Habermeyer B,Simon JJ,Seifritz E,Tobler PN,Kaiser S

doi

10.1017/S0033291719000801

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

936-947

issue

6

eissn

0033-2917

issn

1469-8978

pii

S0033291719000801

journal_volume

50

pub_type

杂志文章

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