This title appears in the Scientific Report : 2014 

Striatal response to reward anticipation: Evidence for a systems-level intermediate phenotype for schizophrenia
Grimm, Oliver (Corresponding author)
Heinz, Andreas / Walter, Henrik / Kirsch, Peter / Erk, Susanne / Haddad, Leila / Plichta, Michael M / Romanczuk-Seiferth, Nina / Pöhland, Lydia / Mohnke, Sebastian / Mühleisen, Thomas / Mattheisen, Manuel / Witt, Stephanie H / Schäfer, Axel / Cichon, Sven / Nöthen, Markus / Rietschel, Marcella / Tost, Heike / Meyer-Lindenberg, Andreas
Strukturelle und funktionelle Organisation des Gehirns; INM-1
JAMA psychiatry, 71 (2014) 5, S. 531-539
Chicago, Ill. AMA 2014
10.1001/jamapsychiatry.2014.9
24622944
Journal Article
Connectivity and Activity
Pathophysiological Mechanisms of Neurological and Psychiatric Diseases
Please use the identifier: http://dx.doi.org/10.1001/jamapsychiatry.2014.9 in citations.
IMPORTANCE Attenuated ventral striatal response during reward anticipation is a core feature of schizophrenia that is seen in prodromal, drug-naive, and chronic schizophrenic patients. Schizophrenia is highly heritable, raising the possibility that this phenotype is related to the genetic risk for the disorder. OBJECTIVE To examine a large sample of healthy first-degree relatives of schizophrenic patients and compare their neural responses to reward anticipation with those of carefully matched controls without a family psychiatric history. To further support the utility of this phenotype, we studied its test-retest reliability, its potential brain structural contributions, and the effects of a protective missense variant in neuregulin 1 (NRG1) linked to schizophrenia by meta-analysis (ie, rs10503929). DESIGN, SETTING, AND PARTICIPANTS Examination of a well-established monetary reward anticipation paradigm during functional magnetic resonance imaging at a university hospital; voxel-based morphometry; test-retest reliability analysis of striatal activations in an independent sample of 25 healthy participants scanned twice with the same task; and imaging genetics analysis of the control group. A total of 54 healthy first-degree relatives of schizophrenic patients and 80 controls matched for demographic, psychological, clinical, and task performance characteristics were studied. MAIN OUTCOMES AND MEASURES Blood oxygen level-dependent response during reward anticipation, analysis of intraclass correlations of functional contrasts, and associations between striatal gray matter volume and NRG1 genotype. RESULTS Compared with controls, healthy first-degree relatives showed a highly significant decrease in ventral striatal activation during reward anticipation (familywise error-corrected P < .03 for multiple comparisons across the whole brain). Supplemental analyses confirmed that the identified systems-level functional phenotype is reliable (with intraclass correlation coefficients of 0.59-0.73), independent of local gray matter volume (with no corresponding group differences and no correlation to function, and with all uncorrected P values >.05), and affected by the NRG1 genotype (higher striatal responses in controls with the protective rs10503929 C allele; familywise error-corrected P < .03 for ventral striatal response). CONCLUSIONS AND RELEVANCE Healthy first-degree relatives of schizophrenic patients show altered striatal activation during reward anticipation in a directionality and localization consistent with prior patient findings. This provides evidence for a functional neural system mechanism related to familial risk. The phenotype can be assessed reliably, is independent of alterations in striatal structure, and is influenced by a schizophrenia candidate gene variant in NRG1. These data encourage us to further investigate the genetic and molecular contributions to this phenotype.