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Transl Psychiatry. 2018 Sep 21;8(1):196. doi: 10.1038/s41398-018-0250-3.

Brain responses to different types of salience in antipsychotic naïve first episode psychosis: An fMRI study.

Author information

1
Department of Psychiatry, University of Cambridge, Cambridge, UK. fk291@cam.ac.uk.
2
Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK. fk291@cam.ac.uk.
3
Unit for Social & Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, East London NHS Foundation Trust, Cambridge, UK.
4
IMIM (Hospital del Mar Medical Research Institute)., Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
5
Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
6
Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
7
Institute of Psychology, University of Lübeck, Lübeck, Germany.
8
Otto-von-Guericke University Magdeburg, Institute of Cognitive Neurology and Dementia Research, Magdeburg, Germany.
9
German Centre for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
10
Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.

Abstract

Abnormal salience processing has been suggested to contribute to the formation of positive psychotic symptoms in schizophrenia and related conditions. Previous research utilising reward learning or anticipation paradigms has demonstrated cortical and subcortical abnormalities in people with psychosis, specifically in the prefrontal cortex, the dopaminergic midbrain and the striatum. In these paradigms, reward prediction errors attribute motivational salience to stimuli. However, little is known about possible abnormalities across different forms of salience processing in psychosis patients, and whether any such abnormalities involve the dopaminergic midbrain. The aim of our study was, therefore, to investigate possible alterations in psychosis in neural activity in response to various forms of salience: novelty, negative emotion, targetness (task-driven salience) and rareness/deviance. We studied 14 antipsychotic naïve participants with first episode psychosis, and 37 healthy volunteers. During fMRI scanning, participants performed a visual oddball task containing these four forms of salience. Psychosis patients showed abnormally reduced signalling in the substantia nigra/ventral tegmental area (SN/VTA) for novelty, negative emotional salience and targetness; reduced striatal and occipital (lingual gyrus) signalling to novelty and negative emotional salience, reduced signalling in the amygdala, anterior cingulate cortex and parahippocamal gyrus to negative emotional salience, and reduced cerebellar signalling to novelty and negative emotional salience. Our results indicate alterations of several forms of salience processing in patients with psychosis in the midbrain SN/VTA, with additional subcortical and cortical regions also showing alterations in salience signalling, the exact pattern of alterations depending on the form of salience in question.

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