Deciphering reward-based decision-making in schizophrenia: A meta-analysis and behavioral modeling of the Iowa Gambling Task

SCHIZOPHRENIA RESEARCH

卷:204

Review

Betz, Linda T.¹  Brambilla, Paolo²  Ilankovic, Andrej³  Premkumar, Preethi⁴  Kim, Myung-Sun⁵  Raffard, Stephane^6,7  Bayard, Sophie⁷  Hori, Hikaru⁸  Lee, Kyoung-Uk⁹  Lee, Seung Jae¹⁰  Koutsouleris, Nikolaos¹  Kambeitz, Joseph¹ 

[1] Ludwig Maximilian Univ Munich, Dept Psychiat, Munich, Germany

[2] Sci Inst IRCCS E Medea, Bosisio Parini, Lecco, Italy

[3] Univ Belgrade, Psychiat Clin, Clin Ctr Serbia, Belgrade, Serbia

[4] Nottingham Trent Univ, Sch Social Sci, Dept Psychol, Nottingham, England

[5] Surngshin Womens Univ, Dept Psychol, Seoul, South Korea

[6] CHRU Montpellier, Univ Dept Adult Psychiat, La Colombiere Hosp, Montpellier, France

[7] Univ Paul Valery Montpellier 3, Lab Epsylon, EA 4556, Montpellier, France

[8] Univ Occupat & Environm Hlth, Dept Psychiat, Yahatanishi Ku, 1-1 Iseigaoka, Kitakyushu, Fukuoka 8078555, Japan

[9] Catholic Univ Korea, Coll Med, Dept Psychiat, Uijeongbu St Marys Hosp, Uijongbu, South Korea

[10] Kyungpook Natl Univ, Sch Med, Dept Psychiat, Daegu, South Korea

关键词: Schizophrenia;    Decision-making;    Reward;    Iowa Gambling Task;    Meta-analysis;    Linear modeling;   

DOI  :  10.1016/j.schres.2018.09.009

来源: Elsevier

【 摘 要 】

Background: Patients with schizophrenia (SZP) have been reported to exhibit impairments in reward-based decision-making, but results are heterogeneous with multiple potential confounds such as age, intelligence level, clinical symptoms or medication, making it difficult to evaluate the robustness of these impairments. Methods: We conducted a meta-analysis of studies comparing the performance of SZP and healthy controls (HC) in the Iowa Gambling Task (IGT) as well as comprehensive analyses based on subject-level data (n = 303 SZP, = 188 HC) W investigate reward-based decision-making in SZP. To quantify differences in the influence of individual deck features (immediate gain, gain frequency, net loss) between SZP and HC, we additionally employed a least-squares model. Results: SZP showed statistically significant suboptimal decisions as indicated by disadvantageous deck choices (d from 051 to -0.62) and lower net scores (d from -0.35 to -1.03) in a meta-analysis of k = 29 samples (n = 1127 SZP, n = 1149 HC) and these results were confirmed in a complementary subject-level analysis. Moreover, decision-making in SZP was characterized by a rebtive overweighting of immediate gain and net losses and an underweighting of gain frequency. Moderator analyses revealed that in part, decision-making in the IGT was 'moderated by intelligence level, medication and general symptom scores. Conclusion: Our results indicate robust impairments in reward-based decision-making in SZP and suggest that decreased cognitive resources, such as working memory, may contribute to these alterations. (C) 2018 Elsevier B.V. All rights reserved.

【 授权许可】

Free