Incentive processing in congenital adrenal hyperplasia (CAH): A reward-based antisaccade study

Sven C. Mueller, Teresa Daniele, Jessica MacIntyre, Katherine Korelitz, Christina Carlisi, Michael G. Hardin, Carol Van Ryzin, Deborah P. Merke, Monique Ernst

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Little is known about how steroid hormones contribute to the beneficial effect of incentives on cognitive control during adolescent development. In this study, 27 adolescents with Congenital Adrenal Hyperplasia (CAH, mean age 15.6 years, 12 female), a disorder of cortisol deficiency and androgen excess, and 36 healthy participants (mean age 16.3 years, 18 female) completed a reward-based antisaccade task. In this mixed-saccade task, participants performed eye movements towards (prosaccades) or away (antisaccades) from a peripherally occuring stimulus. On incentive trials, monetary reward was provided for correct performance, while no such reward was provided on no-incentive trials. Consistent with the hypothesis, the results showed that healthy, but not CAH adolescents, significantly improved their inhibitory control (antisaccade accuracy) during incentive trials relative to no-incentive trials. These findings were not driven by severity of CAH (salt wasters vs. simple virilizers), individual hormone levels, sex, age-at-diagnosis, or medication type (dexamethasone vs. hydrocortisone). In addition, no significant differences between groups were found on orienting responses (prosaccades). Additional analyses revealed an impact of glucocorticoid (GC) dosage, such that higher GC dose predicted better antisaccade performance. However, this effect did not impact incentive processing. The data are discussed within the context of steroid hormone mediated effects on cognitive control and reward processing.

Original languageEnglish (US)
Pages (from-to)716-721
Number of pages6
Issue number5
StatePublished - May 2013
Externally publishedYes


  • Adolescence
  • Androgen
  • Cortisol
  • Development
  • Inhibitory control
  • Sex steroids
  • Testosterone

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Endocrine and Autonomic Systems
  • Psychiatry and Mental health
  • Biological Psychiatry


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