Largely Typical Neural Activation During Monetary Reward Receipt in People With Psychosis-Spectrum Disorders and First-Degree Relatives

Background and Hypothesis: Schizophrenia (SZ) is associated with difficulty adapting behavior using reward-related information, but it is unclear if this deficit is associated with irregular neural responses during reward receipt. Furthermore, it is uncertain whether abnormal reward receipt neural functions are seen across psychosis-spectrum disorders or in people with genetic liability for psychosis. Study Design: We compared behavior and brain activation during reward receipt in 123 people with psychosis (PwP), 81 first-degree biological relatives of PwP, and 49 controls (CTL) using a modified Monetary Incentive Delay task during fMRI. Given inconsistencies across existing fMRI literature, 2 unique imaging preprocessing pipelines were used to analyze this dataset to determine reliability of results. Study Results: PwP exhibited poorer task performance compared to CTL and relatives, but comparable reward-related reaction times. When receiving higher rewards, PwP and relatives exhibited whole-brain activation similar to CTL. Small between-groups differences emerged but their cluster locations varied across analyses. Region of interest analyses revealed putamen hyperactivation in PwP driven by participants with SZ. Groups did not differ in parametrically modulated (pMod) brain activation or Adaptive Coding, measures that capture brain activation relative to reward, but pMod putamen activation correlated with reward earnings only in the CTL group. Conclusions: Although the current findings point to some subtle putamen differences during reward receipt, they suggest largely typical brain response in PwP and first-degree biological relatives of PwP, particularly regarding pMod brain activation or adaptive reward coding.