Schizophrenia in translation: the presence of absence: habenular regulation of dopamine neurons and the encoding of negative outcomes.
Many patients with schizophrenia have pronounced deficits in the use of negative feedback to guide problem solving and learning, as seen on tasks like the Wisconsin Card Sorting Test. There is now a compelling body of evidence from nonhuman primates that suggests transient decreases in dopamine cell activity may reflect the occurrence of unexpected negative outcomes, such as the absence of an expected reward, and, generalizing to the human, the occurrence of negative feedback or the absence of expected reward. We present preliminary evidence that habenula projections to the midbrain are capable of producing a transient, but nearly complete, inhibition of dopamine neurons at a population level similar to that observed in behaving primates following an unexpected negative outcome. Human functional imaging studies offer further evidence that the habenula is activated following receipt of unexpected negative feedback or the absence of expected positive feedback. We present initial evidence that patients with schizophrenia lack appropriate modulation of habenula activity in response to feedback. Collectively, these data suggest that the habenula may play a critical role in mediating the feedback-processing deficits of schizophrenia.