Associations of neural processing of reward with posttraumatic stress disorder and secondary psychotic symptoms in trauma-affected refugees. Issue 1 (31st December 2020)

• Record Type: Journal Article
• Authors: Uldall, Sigurd Wiingaard; Nielsen, Mette Ødegaard; Carlsson, Jessica; Glenthøj, Birte; Siebner, Hartwig Roman; Madsen, Kristoffer Hougaard; Madsen, Camilla Gøbel; Leffers, Anne-Mette; Nejad, Ayna Baladi; Rostrup, Egill
• Is Part Of: European journal of psychotraumatology. Volume 11:Issue 1(2020)
• Publication Date: 2020-12-31
• Subjects: PTSD -- psychotic symptoms -- reward -- salience -- refugees -- anhedonia; TEPT -- síntomas psicóticos -- recompensa -- saliencia -- refugiados -- anhedonia; PTSD -- 精神病症状 -- 奖赏 -- 显著 -- 难民 -- 快感缺失; Functional Magnetic Resonance study of 70 trauma-affected refugees. PTSD (n=39) was associated with decreased activity in the medial prefrontal cortex (mPFC) when winning 7 Euro suggesting that the mPFC is important in anhedonia for non-social rewards in PTSD. PTSD with secondary psychotic symptoms was associated with abnormal reward processing in associative striatum suggesting that the abnormal signals in the basal ganglia facilitates psychotic symptoms across psychiatric conditions.; Post-traumatic stress disorder -- Periodicals; Stress Disorders, Post-Traumatic; Post-traumatic stress disorder; Electronic journals; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.8521
• DOI: 10.1080/20008198.2020.1730091
• Languages: English
• ISSNs: 2000-8198

Abstract

ABSTRACT: Background : Psychological traumatic experiences can lead to posttraumatic stress disorder (PTSD). Secondary psychotic symptoms are not common but may occur. Objectives : Since psychotic symptoms of schizophrenia have been related to aberrant reward processing in the striatum, using the same paradigm we investigate whether the same finding extends to psychotic and anhedonic symptoms in PTSD. Methods : A total of 70 male refugees: 18 PTSD patients with no secondary psychotic symptoms (PTSD-NSP), 21 PTSD patients with secondary psychotic symptoms (PTSD-SP), and 31 healthy controls (RHC) were interviewed and scanned with functional magnetic resonance imaging (fMRI) during a monetary incentive delay task. Using region of interest analysis of the prefrontal cortex and ventral striatum, we investigated reward-related activity. Results : Compared to RHC, participants with PTSD had decreased neural activity during monetary reward. Also, participants with PTSD-SP exhibited decreased activity in the associative striatum relative to participants with PTSD-NSP during processing of motivational reward anticipation which correlated with severity of psychotic symptoms. However, the difference between the two PTSD groups disappeared when PTSD severity and trauma exposure were accounted for. Conclusions : Anhedonia and secondary psychotic symptoms in PTSD are characterized by dysfunctional reward consumption and anticipation processing, respectively. The latter may reflect a mechanism by which abnormal reward signals in the basal ganglia facilitates psychotic symptoms across psychiatric conditions.