Insights into psychosis risk: unveiling impaired reinforcement learning through a behavioral and functional near-infrared spectroscopy-based optical neuroimaging study

Background - Reward processing is crucial for learning, motivation and decision-making, and can be disturbed in the development of psychosis. Previous research has linked cognitive impairment and abnormalities in brain function to the clinical high risk state of psychosis (CHR-P). However, the exten...

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Hauptverfasser: Klaassen, Arndt-Lukas (VerfasserIn) , Michel, Chantal (VerfasserIn) , Stüble, Miriam (VerfasserIn) , Scholkmann, Felix (VerfasserIn) , Kaess, Michael (VerfasserIn) , Kindler, Jochen (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: April 2025
In: Journal of psychiatric research
Year: 2025, Jahrgang: 184, Pages: 187-197
ISSN:1879-1379
DOI:10.1016/j.jpsychires.2025.01.051
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.jpsychires.2025.01.051
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0022395625000597
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Verfasserangaben:Arndt-Lukas Klaassen, Chantal Michel, Miriam Stüble, Felix Scholkmann, Michael Kaess, Jochen Kindler

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520 |a Background - Reward processing is crucial for learning, motivation and decision-making, and can be disturbed in the development of psychosis. Previous research has linked cognitive impairment and abnormalities in brain function to the clinical high risk state of psychosis (CHR-P). However, the extent to which processes of cognitive flexibility in response to reward feedback are impaired in CHR-P compared to healthy control (HC) individuals is largely unknown. - Methods - To address this knowledge gap, we conducted a probabilistic reward task in 59 people with CHR-P (age: 18.89 ± 0.66 years, 54% female) from the Bern Early Recognition and Intervention Center, and 24 HC (age: 19.37 ± 1.20 years, 50% female). In addition, we recorded the prefrontal neurovascular response of the subjects using functional near-infrared spectroscopy (fNIRS) neuroimaging during task performance. - Results - Behavioral results of the probabilistic reward task showed that CHR-P subjects had a significantly lower propensity for reward feedback compared to HC subjects, especially in the later course of the task (p = 0.018, Cohen's d = 0.58). When comparing the fNIRS measurements, we found a significantly lower task-induced increase in total hemoglobin concentration ([tHb]) in CHR-P subjects compared to HC subjects (p = 0.049). - Conclusions - Our findings indicate impaired reward feedback processing in CHR-P subjects, suggesting reduced sensitivity to reward. This is reflected in decreased task-induced response in cerebrovascular [tHb], indicating lower task-relevant prefrontal activities compared to HC subjects. These findings suggest that impaired processing of reward feedback may contribute to reward learning deficits and inflexible cognition in CHR-P subjects. 
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