Learning-related changes in brain activity following errors and performance feedback in schizophrenia.

In previous studies of self-monitoring in schizophrenia, patients have exhibited reductions in the amplitude of the error-related negativity (ERN), a component of the event-related brain potential (ERP) elicited most prominently immediately following the execution of incorrect responses. In the current study, we examined the ERN and a related component, the feedback negativity (FBN) in 26 schizophrenia outpatients and 27 psychiatrically healthy comparison subjects during a probabilistic learning task in which participants could learn stimulus-response pairs by attending to feedback indicating response accuracy. The validity of the feedback varied in three conditions. In one condition, accuracy feedback was entirely consistent (i.e., a left response to one of the stimuli in this condition was always correct and a right response was always incorrect). In the second condition, feedback was valid on only 80% of the trials, and in the third condition, accuracy feedback was random. Changes in ERP amplitudes accompanying learning of stimulus-response pairs were examined. Schizophrenia patients exhibited reduced ERN amplitude compared to healthy subjects in all conditions. This finding extends the previously reported impairment to include disruption of self-monitoring on a task in which participants learn stimulus-response mappings by trial and error, rather than being told the mappings explicitly. Schizophrenia patients also exhibited reduced FBN amplitude compared to healthy subjects in the 100% condition during early trials when the feedback was essential for accurate performance. These findings suggest that reward-related brain activity is weakened in schizophrenia, perhaps reflecting diminished sensitivity to whether ongoing events are better or worse than expected.