Associations of neural processing of reward with posttraumatic stress disorder and secondary psychotic symptoms in trauma-affected refugees

Sigurd Wiingaard Uldall*, Mette Ødegaard Nielsen, Jessica Carlsson, Birte Glenthøj, Hartwig Roman Siebner, Kristoffer Hougaard Madsen, Camilla Gøbel Madsen, Anne Mette Leffers, Ayna Baladi Nejad, Egill Rostrup

*Corresponding author for this work

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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.

Original languageEnglish
Article number1730091
JournalEuropean Journal of Psychotraumatology
Volume11
Issue number1
Number of pages12
ISSN2000-8198
DOIs
Publication statusPublished - 31 Dec 2020

Keywords

  • Anhedonia
  • Psychotic symptoms
  • PTSD
  • Refugees
  • Reward
  • Salience

Cite this

Uldall, S. W., Nielsen, M. Ø., Carlsson, J., Glenthøj, B., Siebner, H. R., Madsen, K. H., Madsen, C. G., Leffers, A. M., Nejad, A. B., & Rostrup, E. (2020). Associations of neural processing of reward with posttraumatic stress disorder and secondary psychotic symptoms in trauma-affected refugees. European Journal of Psychotraumatology, 11(1), [1730091]. https://doi.org/10.1080/20008198.2020.1730091