Journal Article

Transdiagnostic Prediction of Affective, Cognitive, and Social Function Through Brain Reward Anticipation in Schizophrenia, Bipolar Disorder, Major Depression, and Autism Spectrum Diagnoses

Banaschewski, Tobias, Meyer-Lindenberg, Andreas, Erk, Susanne, Walter, Henrik, Schweiger, Janina I, Baumeister, Sarah, Brandeis, Daniel, Plichta, Michael M, Tost, Heike, Moessnang, Carolin, Wackerhagen, Carolin, Schwarz, Kristina

2020

Overview

The relationship between transdiagnostic, dimensional, and categorical approaches to psychiatric nosology is under intense debate. To inform this discussion, we studied neural systems linked to reward anticipation across a range of disorders and behavioral dimensions. We assessed brain responses to reward expectancy in a large sample of 221 participants, including patients with schizophrenia (SZ; n = 27), bipolar disorder (BP; n = 28), major depressive disorder (MD; n = 31), autism spectrum disorder (ASD; n = 25), and healthy controls (n = 110). We also characterized all subjects with an extensive test battery from which a cognitive, affective, and social functioning factor was constructed. These factors were subsequently related to functional responses in the ventral striatum (vST) and neural networks linked to it. We found that blunted vST responses were present in SZ, BP, and ASD but not in MD. Activation within the vST predicted individual differences in affective, cognitive, and social functioning across diagnostic boundaries. Network alterations extended beyond the reward network to include regions implicated in executive control. We further confirmed the robustness of our results in various control analyses. Our findings suggest that altered brain responses during reward anticipation show transdiagnostic alterations that can be mapped onto dimensional measures of functioning. They also highlight the role of executive control of reward and salience signaling in the disorders we study and show the power of systems-level neuroscience to account for clinically relevant behaviors.

• Publisher: Oxford University Press
• Subject: Adult / Affective Symptoms - diagnostic imaging / Affective Symptoms - etiology / Affective Symptoms - physiopathology / Anticipation, Psychological - physiology / Autism / Autism Spectrum Disorder - complications / Autism Spectrum Disorder - diagnostic imaging / Autism Spectrum Disorder - physiopathology / Bipolar disorder / Bipolar Disorder - complications / Bipolar Disorder - diagnostic imaging / Bipolar Disorder - physiopathology / Cognitive Dysfunction - diagnostic imaging / Cognitive Dysfunction - etiology / Cognitive Dysfunction - physiopathology / Depressive Disorder, Major - complications / Depressive Disorder, Major - diagnostic imaging / Depressive Disorder, Major - physiopathology / Executive Function - physiology / Female / Humans / Magnetic Resonance Imaging / Male / Middle Aged / Nerve Net - diagnostic imaging / Nerve Net - physiopathology / Prospective Studies / Psychosocial Functioning / Regular / Reward / Schizophrenia / Schizophrenia - complications / Schizophrenia - diagnostic imaging / Schizophrenia - physiopathology / Ventral Striatum - diagnostic imaging / Ventral Striatum - physiopathology / Young Adult