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Article: Mild Reinforcement Learning Deficits in Patients With First-Episode Psychosis

TitleMild Reinforcement Learning Deficits in Patients With First-Episode Psychosis
Authors
Issue Date2016
PublisherOxford University Press. The Journal's web site is located at http://schizophreniabulletin.oxfordjournals.org/
Citation
Schizophrenia Bulletin, 2016, v. 42 n. 6, p. 1476-1485 How to Cite?
AbstractNumerous studies have identified reinforcement learning (RL) deficits in schizophrenia. Most have focused on chronic patients with longstanding antipsychotic treatment, however, and studies of RL in early-illness patients have produced mixed results, particularly regarding gradual/procedural learning. No study has directly contrasted both rapid and gradual RL in first-episode psychosis (FEP) samples. We examined probabilistic RL in 34 FEP patients and 36 controls, using Go/NoGo (GNG) and Gain vs Loss-Avoidance (GLA) paradigms. Our results were mixed, with FEP patients exhibiting greater impairment in the ability to use positive, as opposed to negative, feedback to drive rapid RL on the GLA, but not the GNG. By contrast, patients and controls showed similar improvement across the acquisition. Finally, we found no significant between-group differences in the postacquisition expression of value-based preference in both tasks. Negative symptoms were modestly associated with RL measures, while the overall bias to engage in Go-responding correlated significantly with psychosis severity in FEP patients, consistent with striatal hyperdopaminergia. Taken together, FEP patients demonstrated more circumscribed RL impairments than previous studies have documented in chronic samples, possibly reflecting differential symptom profiles between first-episode and chronic samples. Our finding of relatively preserved gradual/procedural RL, in briefly medicated FEP patients, might suggest spared or restored basal ganglia function. Our findings of preserved abilities to use representations of expected value to guide decision making, and our mixed results regarding rapid RL, may reflect a lesser degree of prefrontal cortical functional impairment in FEP than in chronic samples. Further longitudinal research, in larger samples, is required.
Persistent Identifierhttp://hdl.handle.net/10722/225670
ISSN
2015 Impact Factor: 7.757
2015 SCImago Journal Rankings: 4.051

 

DC FieldValueLanguage
dc.contributor.authorChang, WC-
dc.contributor.authorWaltz, JA-
dc.contributor.authorGold, JM-
dc.contributor.authorChan, TCW-
dc.contributor.authorChen, EYH-
dc.date.accessioned2016-05-20T08:09:56Z-
dc.date.available2016-05-20T08:09:56Z-
dc.date.issued2016-
dc.identifier.citationSchizophrenia Bulletin, 2016, v. 42 n. 6, p. 1476-1485-
dc.identifier.issn0586-7614-
dc.identifier.urihttp://hdl.handle.net/10722/225670-
dc.description.abstractNumerous studies have identified reinforcement learning (RL) deficits in schizophrenia. Most have focused on chronic patients with longstanding antipsychotic treatment, however, and studies of RL in early-illness patients have produced mixed results, particularly regarding gradual/procedural learning. No study has directly contrasted both rapid and gradual RL in first-episode psychosis (FEP) samples. We examined probabilistic RL in 34 FEP patients and 36 controls, using Go/NoGo (GNG) and Gain vs Loss-Avoidance (GLA) paradigms. Our results were mixed, with FEP patients exhibiting greater impairment in the ability to use positive, as opposed to negative, feedback to drive rapid RL on the GLA, but not the GNG. By contrast, patients and controls showed similar improvement across the acquisition. Finally, we found no significant between-group differences in the postacquisition expression of value-based preference in both tasks. Negative symptoms were modestly associated with RL measures, while the overall bias to engage in Go-responding correlated significantly with psychosis severity in FEP patients, consistent with striatal hyperdopaminergia. Taken together, FEP patients demonstrated more circumscribed RL impairments than previous studies have documented in chronic samples, possibly reflecting differential symptom profiles between first-episode and chronic samples. Our finding of relatively preserved gradual/procedural RL, in briefly medicated FEP patients, might suggest spared or restored basal ganglia function. Our findings of preserved abilities to use representations of expected value to guide decision making, and our mixed results regarding rapid RL, may reflect a lesser degree of prefrontal cortical functional impairment in FEP than in chronic samples. Further longitudinal research, in larger samples, is required.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://schizophreniabulletin.oxfordjournals.org/-
dc.relation.ispartofSchizophrenia Bulletin-
dc.rightsThis is a pre-copy-editing, author-produced PDF of an article accepted for publication in Schizophrenia Bulletin following peer review. The definitive publisher-authenticated version Schizophrenia Bulletin, 2016, v. 42 n. 6, p. 1476-1485 is available online at: https://academic.oup.com/schizophreniabulletin/article-lookup/doi/10.1093/schbul/sbw060-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleMild Reinforcement Learning Deficits in Patients With First-Episode Psychosis-
dc.typeArticle-
dc.identifier.emailChang, WC: changwc@hku.hk-
dc.identifier.emailChen, EYH: eyhchen@hku.hk-
dc.identifier.authorityChang, WC=rp01465-
dc.identifier.authorityChen, EYH=rp00392-
dc.description.naturepostprint-
dc.identifier.doi10.1093/schbul/sbw060-
dc.identifier.hkuros258109-
dc.identifier.volume42-
dc.identifier.issue6-
dc.identifier.spage1476-
dc.identifier.epage1485-
dc.publisher.placeUnited Kingdom-

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