Jumping to Conclusion and striatal dysfunctions: An early feature in the course of psychosis?

Presentation First Author: 
Franziska Rausch

Background: Schizophrenia patients display deficits in monitoring and controlling their own thoughts. One aspect of these metacognitive impairments is a tendency to hasty decision-making during probabilistic reasoning – the Jumping To Conclusion-bias (JTC). In a recent fMRI study we found reduced activations in the right ventral striatum (VS) and the ventral tegmental area (VTA) to be associated with decision-making in schizophrenia patients. It is unclear, whether these functional alterations already occur in the at-risk mental state (ARMS). Methods: The classical beads task and an fMRI-version were applied to 24 ARMS-patients and 24 healthy controls matched for age, gender and education. Both tasks request a probabilistic decision after a variable amount of stimuli. Activation patterns during decision-making under conditions of certainty versus uncertainty and the process of final decision-making were evaluated. Results: Compared to controls ARMS-patients tended to draw less beads in the classical beads task, and showed JTC significantly more often, mirroring findings in schizophrenia. In fMRI, ARMS-patients showed a significant hypo-activation in the right VS during the decision stage. Conclusions: As in schizophrenia patients, a hypo-activation in right VS was found in ARMS-patients. Here, confounding effects of antipsychotic medication and duration of illness can be excluded. We interpret our findings regarding disrupted error prediction signalling and reward anticipation. Striatal dysfunctions already present during the ARMS might represent an early feature of psychosis. Future studies should assess, if combining ARMS-criteria and JTC might define a subgroup within the ARMS regarding transitions to psychosis or responsiveness to CBT-interventions.

Conference Name: 
Presentation Date: 
January, 2015
Additional Authors: 
Daniela Mier - Sarah Eifler - Sabrina Fenske - Frederike Schirmbeck - Susanne Englisch - Claudia Schilling - Andreas Meyer-Lindenberg - Peter Kirsch - Mathias Zink
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