The role of the basal ganglia in learning and memory: insight from Parkinson's disease

Training gains and transfer effects after mnemonic strategy training in mild cognitive impairment: A fMRI study

Prior work has revealed that mnemonic strategy training (MST) can enhance memory for specific content and engages regions in the frontoparietal cognitive control network. Evidence of transfer to novel content is less clear. Here, we provide secondary analysis of functional magnetic resonance imaging (fMRI) data acquired during a randomized controlled trial that compared MST to an active education control condition in patients with amnestic mild cognitive impairment (a-MCI). In the trial, thirty participants with a-MCI were randomized to the education program (EP) or MST, where they learned to apply the technique to face-name associations during four intervening hour long training sessions. Participants underwent pre- and post-training fMRI scans, during which they encoded both the trained (i.e., those used during the four training sessions) and untrained ('novel') face-name associations. The primary cognitive outcome measures revealed significantly improved memory for both trained and novel stimuli - effects supporting near transfer of MST. Relative to pre-training, there were significant and highly similar increases in activation for both trained and novel stimuli, especially in regions associated with the frontoparietal cognitive control network bilaterally, but also in temporal areas related to social cognition and emotional processing. Critically, this pattern of activation was notably different from the EP group. Thus, the changes in activation were consistent with the strategies trained and, combined with the cognitively-based near transfer effects, suggest that MST focused on face-name association enhances performance by engaging cognitive control and social/emotional processing. Finally, our data indicated that our MST is a relevant and efficient intervention to a-MCI.

Role of the striatum in incidental learning of sound categories

Humans are born as “universal listeners.” However, over the first year, infants’ perception is shaped by native speech categories. How do these categories naturally emerge without explicit training or overt feedback? Using fMRI, we examined the neural basis of incidental sound category learning as participants played a videogame in which sound category exemplars had functional utility in guiding videogame success. Even without explicit categorization of the sounds, participants learned functionally relevant sound categories that generalized to novel exemplars when exemplars had an organized distributional structure. Critically, the striatum was engaged and functionally connected to the auditory cortex during game play, and this activity and connectivity predicted the learning outcome. These findings elucidate the neural mechanism by which humans incidentally learn “real-world” categories.

Humans are born as “universal listeners” without a bias toward any particular language. However, over the first year of life, infants’ perception is shaped by learning native speech categories. Acoustically different sounds—such as the same word produced by different speakers—come to be treated as functionally equivalent. In natural environments, these categories often emerge incidentally without overt categorization or explicit feedback. However, the neural substrates of category learning have been investigated almost exclusively using overt categorization tasks with explicit feedback about categorization decisions. Here, we examined whether the striatum, previously implicated in category learning, contributes to incidental acquisition of sound categories. In the fMRI scanner, participants played a videogame in which sound category exemplars aligned with game actions and events, allowing sound categories to incidentally support successful game play. An experimental group heard nonspeech sound exemplars drawn from coherent category spaces, whereas a control group heard acoustically similar sounds drawn from a less structured space. Although the groups exhibited similar in-game performance, generalization of sound category learning and activation of the posterior striatum were significantly greater in the experimental than control group. Moreover, the experimental group showed brain–behavior relationships related to the generalization of all categories, while in the control group these relationships were restricted to the categories with structured sound distributions. Together, these results demonstrate that the striatum, through its interactions with the left superior temporal sulcus, contributes to incidental acquisition of sound category representations emerging from naturalistic learning environments.

Modulation of associative learning in the hippocampal-striatal circuit based on item-set similarity

Mounting evidence suggests that the medial temporal lobe (MTL) and striatal learning systems support different forms of learning, which can be competitive or cooperative depending on task demands. We have previously shown how activity in these regions can be modulated in a conditional visuomotor associative learning task based on the consistency of response mappings or reward feedback (Mattfeld & Stark, 2015). Here, we examined the shift in learning towards the MTL and away from the striatum by placing strong demands on pattern separation, a process of orthogonalizing similar inputs into distinct representations. Mnemonically, pattern separation processes have been shown to rely heavily on processing in the hippocampus. Therefore, we predicted modulation of hippocampal activity by pattern separation demands, but no such modulation of striatal activity. Using a variant of the conditional visuomotor associative learning task that we have used previously, we presented participants with two blocked conditions: items with high and low perceptual overlap during functional magnetic resonance imaging (fMRI). As predicted, we observed learning-related activity in the hippocampus, which was greater in the high than the low overlap condition, particularly in the dentate gyrus. In contrast, the associative striatum also showed learning related activity, but it was not modulated by overlap condition. Using functional connectivity analyses, we showed that the correlation between the hippocampus and dentate gyrus with the associative striatum was differentially modulated by high vs. low overlap, suggesting that the coordination between these regions was affected when pattern separation demands were high. These findings contribute to a growing literature that suggests that the hippocampus and striatal network both contribute to the learning of arbitrary associations that are computationally distinct and can be altered by task demands.

Hybrid PET-MRI Applications in Movement Disorders

Even before the success of combined positron emission tomography and computed tomography (PET/CT), the neuroimaging community was conceiving the idea to integrate the positron emission tomography (PET), with very high molecular quantitative data but low spatial resolution, and magnetic resonance imaging (MRI), with high spatial resolution. Several technical limitations have delayed the use of a hybrid scanner in neuroimaging studies, including the full integration of the PET detector ring within the MRI system, the optimization of data acquisition, and the implementation of reliable methods for PET attenuation, motion correction, and joint image reconstruction. To be valid and useful in clinical and research settings, this instrument should be able to simultaneously acquire PET and MRI, and generate quantitative parametric PET images comparable to PET-CT. While post hoc co-registration of combined PET and MRI data acquired separately became the most reliable technique for the generation of "fused" PET-MRI images, only hybrid PET-MRI approach allows merging these measurements naturally and correlating them in a temporal manner. Furthermore, hybrid PET-MRI represents the most accurate tool to investigate in vivo the interplay between molecular and functional aspects of brain pathophysiology. Hybrid PET-MRI technology is still in the early stages in the movement disorders field, due to the limited availability of scanners with integrated optimized methodological models. This technology is ideally suited to investigate interactions between resting-state functional/arterial spin labeling MRI and [¹⁸F]FDG PET glucose metabolism in the evaluation of the brain "hubs" particularly vulnerable to neurodegeneration, areas with a high degree of connectivity and associated with an efficient synaptic neurotransmission. In Parkinson's disease, hybrid PET-MRI is also the ideal instrument to deeper explore the relationship between resting-state functional MRI and dopamine release at [¹¹C]raclopride PET challenge, in the identification of early drug-naïve Parkinson's disease patients at higher risk of motor complications and in the evaluation of the efficacy of novel neuroprotective treatment able to restore at the same time the altered resting state and the release of dopamine. In this chapter, we discuss the key methodological aspects of hybrid PET-MRI; the evidence in movement disorders of the key resting-state functional and perfusion MRI; [¹⁸F]FDG PET and [¹¹C]raclopride PET challenge studies; the potential advantages of using hybrid PET-MRI to investigate the pathophysiology of movement disorders and neurodegenerative diseases. Future directions of hybrid PET-MRI will be discussed alongside with up-to-date technological innovations on hybrid systems.

Feedback Timing Modulates Probabilistic Learning in Adults with ADHD

Attention deficit hyperactivity disorder (ADHD) has been associated primarily with executive function deficits. Emerging findings suggest, however, that procedural learning may be compromised as well. To this effect, we recently showed that feedback-based procedural learning is selectively impaired in ADHD, results that coincide with dopaminergic alterations associated with ADHD. Key questions, however, remain unresolved, among which are the learning conditions that may improve procedural learning in ADHD. Here we examined feedback-based probabilistic learning during conditions that engage procedural and declarative learning systems to different degrees, depending on feedback timing. ADHD and control participants carried out a probabilistic learning task in which they were required to learn to associate between cues and outcomes, where outcomes were presented either immediately or with a short/long delays. Whereas performance in probabilistic learning in ADHD participants was comparable to controls in delayed feedback conditions, during both learning and test phases, their performance diminished when feedback was immediate. Furthermore, ADHD symptom severity was negatively correlated with the ability to learn from immediate feedback. These results suggest that feedback-based probabilistic learning can be improved in ADHD, provided appropriate conditions. By shifting the load from midbrain/striatal systems to declarative memory mechanisms, behavioral performance in ADHD populations can be remediated.

Paradoxical Decision-Making: A Framework for Understanding Cognition in Parkinson's Disease

People with Parkinson's disease (PD) show impaired decision-making when sensory and memory information must be combined. This recently identified impairment results from an inability to accumulate the proper amount of information needed to make a decision and appears to be independent of dopamine tone and reinforcement learning mechanisms. Although considerable work focuses on PD and decisions involving risk and reward, in this Opinion article we propose that the emerging findings in perceptual decision-making highlight the multisystem nature of PD, and that unraveling the neuronal circuits underlying perceptual decision-making impairment may help in understanding other cognitive impairments in people with PD. We also discuss how a decision-making framework may be extended to gain insights into mechanisms of motor impairments in PD.

Basal ganglia and beyond: The interplay between motor and cognitive aspects in Parkinson's disease rehabilitation

Parkinson's disease (PD) is characterized by motor and cognitive dysfunctions, affecting the motor behaviour. We summarize evidence that the interplay between motor and cognitive approaches is crucial in PD rehabilitation. Rehabilitation is complementary to pharmacological therapy and effective in reducing the PD disturbances, probably acting by inducing neuroplastic effects. The motor behaviour results from a complex integration between cortical and subcortical areas, underlying the motor, cognitive and motivational aspects of movement. The close interplay amongst these areas makes possible to learn, control and express habitual-automatic actions, which are dysfunctional in PD. The physiopathology of PD could be considered the base for the development of effective rehabilitation treatments. As the volitional action control is spared in early-medium stages of disease, rehabilitative approaches engaging cognition permit to achieve motor benefits and appear to be the most effective for PD. We will point out data supporting the relevance of targeting both motor and cognitive aspects in PD rehabilitation. Finally, we will discuss the role of cognitive engagement in motor rehabilitation for PD.

White-Matter Pathways for Statistical Learning of Temporal Structures

Extracting the statistics of event streams in natural environments is critical for interpreting current events and predicting future ones. The brain is known to rapidly find structure and meaning in unfamiliar streams of sensory experience, often by mere exposure to the environment (i.e., without explicit feedback). Yet, we know little about the brain pathways that support this type of statistical learning. Here, we test whether changes in white-matter (WM) connectivity due to training relate to our ability to extract temporal regularities. By combining behavioral training and diffusion tensor imaging (DTI), we demonstrate that humans adapt to the environment's statistics as they change over time from simple repetition to probabilistic combinations. In particular, we show that learning relates to the decision strategy that individuals adopt when extracting temporal statistics. We next test for learning-dependent changes in WM connectivity and ask whether they relate to individual variability in decision strategy. Our DTI results provide evidence for dissociable WM pathways that relate to individual strategy: extracting the exact sequence statistics (i.e., matching) relates to connectivity changes between caudate and hippocampus, while selecting the most probable outcomes in a given context (i.e., maximizing) relates to connectivity changes between prefrontal, cingulate and basal ganglia (caudate, putamen) regions. Thus, our findings provide evidence for distinct cortico-striatal circuits that show learning-dependent changes of WM connectivity and support individual ability to learn behaviorally-relevant statistics.

Interactions of spatial strategies producing generalization gradient and blocking: A computational approach

We present a computational model of spatial navigation comprising different learning mechanisms in mammals, i.e., associative, cognitive mapping and parallel systems. This model is able to reproduce a large number of experimental results in different variants of the Morris water maze task, including standard associative phenomena (spatial generalization gradient and blocking), as well as navigation based on cognitive mapping. Furthermore, we show that competitive and cooperative patterns between different navigation strategies in the model allow to explain previous apparently contradictory results supporting either associative or cognitive mechanisms for spatial learning. The key computational mechanism to reconcile experimental results showing different influences of distal and proximal cues on the behavior, different learning times, and different abilities of individuals to alternatively perform spatial and response strategies, relies in the dynamic coordination of navigation strategies, whose performance is evaluated online with a common currency through a modular approach. We provide a set of concrete experimental predictions to further test the computational model. Overall, this computational work sheds new light on inter-individual differences in navigation learning, and provides a formal and mechanistic approach to test various theories of spatial cognition in mammals.

Perceptual decisions based on previously learned information are independent of dopaminergic tone

Both cognitive and motor symptoms in people with Parkinson's disease (PD) arise from either too little or too much dopamine (DA). Akinesia stems from DA neuronal cell loss, and dyskinesia often stems from an overdose of DA medication. Cognitive behaviors typically associated with frontal cortical function, such as working memory and task switching, are also affected by too little or too much DA in PD. Whether motor and cognitive circuits overlap in PD is unknown. In this article, we show that whereas motor performance improves in people with PD when on dopaminergic medication compared with off medication, perceptual decision-making based on previously learned information (priors) remains impaired whether on or off medications. To rule out effects of long-term DA treatment and dopaminergic neuronal loss such as occur in PD, we also tested a group of people with dopa-unresponsive focal dystonia, a disease that involves the basal ganglia, like PD, but has motor symptoms that are insensitive to dopamine treatment and is not thought to involve frontal cortical DA circuits, unlike PD. We found that people with focal dystonia showed intact perceptual decision-making performance but impaired use of priors in perceptual decision-making, similar to people with PD. Together, the results show a dissociation between motor and cognitive performance in people with PD and reveal a novel cognitive impairment, independent of sensory and motor impairment, in people with focal dystonia. The combined results from people with PD and people with focal dystonia provide mechanistic insights into the role of basal ganglia non-dopaminergic circuits in perceptual decision-making based on priors.

Separating the effect of reward from corrective feedback during learning in patients with Parkinson's disease

Parkinson's disease (PD) is associated with procedural learning deficits. Nonetheless, studies have demonstrated that reward-related learning is comparable between patients with PD and controls (Bódi et al., Brain, 132(9), 2385-2395, 2009; Frank, Seeberger, & O'Reilly, Science, 306(5703), 1940-1943, 2004; Palminteri et al., Proceedings of the National Academy of Sciences of the United States of America, 106(45), 19179-19184, 2009). However, because these studies do not separate the effect of reward from the effect of practice, it is difficult to determine whether the effect of reward on learning is distinct from the effect of corrective feedback on learning. Thus, it is unknown whether these group differences in learning are due to reward processing or learning in general. Here, we compared the performance of medicated PD patients to demographically matched healthy controls (HCs) on a task where the effect of reward can be examined separately from the effect of practice. We found that patients with PD showed significantly less reward-related learning improvements compared to HCs. In addition, stronger learning of rewarded associations over unrewarded associations was significantly correlated with smaller skin-conductance responses for HCs but not PD patients. These results demonstrate that when separating the effect of reward from the effect of corrective feedback, PD patients do not benefit from reward.

What Is Memory-Guided Attention? How Past Experiences Shape Selective Visuospatial Attention in the Present

What controls our attention? It is historically thought that there are two primary factors that determine selective attention: the perceptual salience of the stimuli and the goals based on the task at hand. However, this distinction doesn't neatly capture the varied ways our past experience can influence our ongoing mental processing. In this chapter, we aim to describe how past experience can be systematically characterized by different types of memory, and we outline experimental evidence suggesting how attention can then be guided by each of these different memory types. We highlight findings from human behavioral, neuroimaging, and neuropsychological work from the perspective of two related frameworks of human memory: the multiple memory systems (MMS) framework and the neural processing (NP) framework. The MMS framework underscores how memory can be separated based on consciousness (declarative and non-declarative memory), while the NP framework emphasizes different forms of memory as reflective of different brain processing modes (rapid encoding of flexible associations, slow encoding of rigid associations, and rapid encoding of single or unitized items). We describe how memory defined by these frameworks can guide our attention, even when they do not directly relate to perceptual salience or the goals concerning the current task. We close by briefly discussing theoretical implications as well as some interesting avenues for future research.

Methylphenidate enhances implicit learning in healthy adults

BACKGROUND AND PURPOSE

One limiting factor in the development of pharmacological interventions to enhance cognition is the absence of biomarkers that can be used in healthy volunteers to screen novel compounds. Drug discovery has tended to rely heavily on explicit measures of cognition, but these are typically insensitive to cognition-enhancing effects in healthy volunteers. This study investigated whether a novel battery of implicit cognition measures is sensitive to the effects of methylphenidate (Ritalin) in healthy volunteers.

EXPERIMENTAL APPROACH

Eighty healthy volunteers were randomised to receive either a single (10 mg) dose of methylphenidate or matched placebo. Participants completed a battery of tasks measuring implicit cognition (location priming, contextual cueing, implicit task switching). The effect of methylphenidate on standard, explicit measures of cognition was also assessed.

KEY RESULTS

Methylphenidate enhanced implicit learning on the location priming task and the implicit task-switching task. In line with previous work, we found that these effects were greater in male volunteers. There was no evidence for improved learning in any of the explicit measures.

CONCLUSION AND IMPLICATIONS

These results demonstrate that implicit measures of cognition are sensitive to pharmacological interventions in healthy volunteers. As such, implicit cognition measures may be a useful way of screening and tracking cognitive effects of novel agents in experimental medicine studies.

The Neuropsychology of Movement and Movement Disorders: Neuroanatomical and Cognitive Considerations

This paper highlights major developments over the past two to three decades in the neuropsychology of movement and its disorders. We focus on studies in healthy individuals and patients, which have identified cognitive contributions to movement control and animal work that has delineated the neural circuitry that makes these interactions possible. We cover advances in three major areas: (1) the neuroanatomical aspects of the "motor" system with an emphasis on multiple parallel circuits that include cortical, corticostriate, and corticocerebellar connections; (2) behavioral paradigms that have enabled an appreciation of the cognitive influences on the preparation and execution of movement; and (3) hemispheric differences (exemplified by limb praxis, motor sequencing, and motor learning). Finally, we discuss the clinical implications of this work, and make suggestions for future research in this area. (JINS, 2017, 23, 768-777).

Decision Making and Sequential Sampling from Memory

Decisions take time, and as a rule more difficult decisions take more time. But this only raises the question of what consumes the time. For decisions informed by a sequence of samples of evidence, the answer is straightforward: more samples are available with more time. Indeed, the speed and accuracy of such decisions are explained by the accumulation of evidence to a threshold or bound. However, the same framework seems to apply to decisions that are not obviously informed by sequences of evidence samples. Here, we proffer the hypothesis that the sequential character of such tasks involves retrieval of evidence from memory. We explore this hypothesis by focusing on value-based decisions and argue that mnemonic processes can account for regularities in choice and decision time. We speculate on the neural mechanisms that link sampling of evidence from memory to circuits that represent the accumulated evidence bearing on a choice. We propose that memory processes may contribute to a wider class of decisions that conform to the regularities of choice-reaction time predicted by the sequential sampling framework.

Cognition in Parkinson's Disease

Cognitive decline is now recognized as a common nonmotor symptom of Parkinson's disease, and it has been the subject of increasing research in recent decades. Cognitive deficits in Parkinson's disease can be distinguished as dopaminergically mediated executive dysfunction seen in the milder stages vs a global dementia syndrome that can occur with disease progression. The neural basis of these deficits has been explored from the perspective of multimodal imaging techniques to measure the structural, functional, and metabolic correlates of cognitive decline in Parkinson's disease. Increasingly, changes in neurotransmitter systems beyond dopamine, including the noradrenergic, serotonergic, and cholinergic systems, are being recognized for their contribution to cognitive decline. The impact of certain genetic variations on cognitive function has also been established, including links between cognitive decline and polymorphisms affecting COMT, MAPT, APOE, and GBA genotypes. Although therapeutic options for cognitive decline are still far less established than for motor systems, both pharmacological and nonpharmacological strategies are continuing to develop.

Egocentric and allocentric visuospatial working memory in premotor Huntington's disease: A double dissociation with caudate and hippocampal volumes

Our brains represent spatial information in egocentric (self-based) or allocentric (landmark-based) coordinates. Rodent studies have demonstrated a critical role for the caudate in egocentric navigation and the hippocampus in allocentric navigation. We administered tests of egocentric and allocentric working memory to individuals with premotor Huntington's disease (pmHD), which is associated with early caudate nucleus atrophy, and controls. Each test had 80 trials during which subjects were asked to remember 2 locations over 1-sec delays. The only difference between these otherwise identical tests was that locations could only be coded in self-based or landmark-based coordinates. We applied a multiatlas-based segmentation algorithm and computed point-wise Jacobian determinants to measure regional variations in caudate and hippocampal volumes from 3T MRI. As predicted, the pmHD patients were significantly more impaired on egocentric working memory. Only egocentric accuracy correlated with caudate volumes, specifically the dorsolateral caudate head, right more than left, a region that receives dense efferents from dorsolateral prefrontal cortex. In contrast, only allocentric accuracy correlated with hippocampal volumes, specifically intermediate and posterior regions that connect strongly with parahippocampal and posterior parietal cortices. These results indicate that the distinction between egocentric and allocentric navigation applies to working memory. The dorsolateral caudate is important for egocentric working memory, which can explain the disproportionate impairment in pmHD. Allocentric working memory, in contrast, relies on the hippocampus and is relatively spared in pmHD.

Cognition and Dopamine D2 Receptor Availability in the Striatum in Older Patients with Schizophrenia

OBJECTIVES

To assess the impact of reducing the dose of antipsychotics on cognition and dopaminergic D₂ receptor availability in the whole striatum, and identify their relationship in patients with schizophrenia aged 50 years or older.

DESIGN

Open-label prospective PET [¹¹C]-raclopride study.

SETTING

A tertiary care center outpatient setting.

PARTICIPANTS

Thirty-seven clinically stable participants with schizophrenia or schizoaffective disorder, aged 50 years or greater, and having been treated with olanzapine or risperidone monotherapy at the same dose for at least 6 months.

INTERVENTION

Gradual reduction in their olanzapine or risperidone daily dose of up to 40%.

MEASUREMENTS

Clinical and cognitive assessments, and [¹¹C]-raclopride PET to determine D₂ receptor availability at baseline and after the dose reduction. Main outcome measures were overall cognition and D₂ receptor availability in whole striatum.

RESULTS

Reducing the antipsychotic dose resulted in an increase in D₂ receptor availability in the whole striatum and an association between D₂ receptor availability and overall cognition despite lack of change in the latter. There was also an association between change in D₂ receptor availability and change in overall cognition.

CONCLUSIONS

Our findings suggest that optimizing D₂ receptor availability by reducing antipsychotic dose allows this system to contribute more significantly to cognitive function in patients with schizophrenia. This uncovered association could be harnessed by cognitive-enhancing interventions.

Short-term Internet-search practicing modulates brain activity during recollection

Internet-searching behaviors may change ways in which we find, store and consider information. In this study, we tested the effect of short-term Internet-search practicing on recollection processes. Fifty-nine human subjects with valid data (Experimental group, 43; Control group, 16) completed procedures involving a pre-test, 6days of practicing, and a post-test. Behavioral and imaging results were obtained and within- and between-group comparisons were made at pre-test and post-test times. With respect to behavioral performance, six days of practicing was associated with improved behavioral performance during Internet searching: subjects in the experimental group showed shorter response times (RTs) and similar accuracy rates during recollection at post-test as compared to pre-test. During imaging and as compared to pre-test data, subjects in the experimental group showed during post-test recall relatively decreased brain activations bilaterally in the middle frontal and temporal gyri. Such findings were not observed in the control group. The findings suggest that six days of practicing Internet searching may improve the efficiency of Internet searching without influencing the accuracy of recollection, with neuroimaging results implicating cortical regions involved in long-term memory and executive processing.

Early neuroimaging markers of FOXP2 intragenic deletion

FOXP2 is the major gene associated with severe, persistent, developmental speech and language disorders. While studies in the original family in which a FOXP2 mutation was found showed volume reduction and reduced activation in core language and speech networks, there have been no imaging studies of different FOXP2 mutations. We conducted a multimodal MRI study in an eight-year-old boy (A-II) with a de novo FOXP2 intragenic deletion. A-II showed marked bilateral volume reductions in the hippocampus, thalamus, globus pallidus, and caudate nucleus compared with 26 control males (effect sizes from −1 to −3). He showed no detectable functional MRI activity when repeating nonsense words. The hippocampus is implicated for the first time in FOXP2 diseases. We conclude that FOXP2 anomaly is either directly or indirectly associated with atypical development of widespread subcortical networks early in life.

Contributions of the hippocampus to feedback learning

Humans learn about the world in a variety of manners, including by observation, by associating cues in the environment, and via feedback. Across species, two brain structures have been predominantly involved in these learning processes: the hippocampus--supporting learning via observation and paired association--and the striatum--critical for feedback learning. This simple dichotomy, however, has recently been challenged by reports of hippocampal engagement in feedback learning, although the role of the hippocampus is not fully understood. The purpose of this experiment was to characterize the hippocampal response during feedback learning by manipulating varying levels of memory interference. Consistent with prior reports, feedback learning recruited the striatum and midbrain. Notably, feedback learning also engaged the hippocampus. The level of activity in these regions was modulated by the degree of memory interference, such that the greatest activation occurred during the highest level of memory interference. Importantly, the accuracy of information learned via feedback correlated with hippocampal activation and was reduced by the presence of high memory interference. Taken together, these findings provide evidence of hippocampal involvement in feedback learning by demonstrating both its relevance for the accuracy of information learned via feedback and its susceptibility to interference.

Cortisol alters reward processing in the human brain

Dysfunctional reward processing is known to play a central role for the development of psychiatric disorders. Glucocorticoids that are secreted in response to stress have been shown to attenuate reward sensitivity and thereby might promote the onset of psychopathology. However, the underlying neurobiological mechanisms mediating stress hormone effects on reward processing as well as potential sex differences remain elusive. In this neuroimaging study, we administered 30mg cortisol or a placebo to 30 men and 30 women and subsequently tested them in the Monetary Incentive Delay Task. Cortisol attenuated anticipatory neural responses to a verbal and a monetary reward in the left pallidum and the right anterior parahippocampal gyrus. Furthermore, in men, activation in the amygdala, the precuneus, the anterior cingulate, and in hippocampal regions was reduced under cortisol, whereas in cortisol-treated women a signal increase was observed in these regions. Behavioral performance also indicated that reward learning in men is impaired under high cortisol concentrations, while it is augmented in women. These findings illustrate that the stress hormone cortisol substantially diminishes reward anticipation and provide first evidence that cortisol effects on the neural reward system are sensitive to sex differences, which might translate into different vulnerabilities for psychiatric disorders.

Patients with Parkinson's Disease Show Impaired Use of Priors in Conditions of Sensory Uncertainty

Perceptual decisions arise after considering the available sensory evidence [1]. When sensory information is unreliable, a good strategy is to rely on previous experience in similar situations to guide decisions [2-6]. It is well known that patients with Parkinson's disease (PD) are impaired at value-based decision-making [7-11]. How patients combine past experience and sensory information to make perceptual decisions is unknown. We developed a novel, perceptual decision-making task and manipulated the statistics of the sensory stimuli presented to patients with PD and healthy participants to determine the influence of past experience on decision-making. We show that patients with PD are impaired at combining previously learned information with current sensory information to guide decisions. We modeled the results using the drift-diffusion model (DDM) and found that the impairment corresponds to a failure in adjusting the amount of sensory evidence needed to make a decision. Our modeling results also show that two complementary mechanisms operate to implement a bias when two sets of priors are learned concurrently. Asymmetric decision threshold adjustments, as reflected by changes in the starting point of evidence accumulation, are responsible for a general choice bias, whereas the adjustment of a dynamic bias that develops over the course of a trial, as reflected by a drift-rate offset, provides the stimulus-specific component of the prior. A proper interplay between these two processes is required to implement a bias based on concurrent, stimulus-specific priors in decision-making. We show here that patients with PD are impaired in these across-trial decision threshold adjustments.

Learning to live without the cerebellum

The near-total absence of the cerebellum is a rare congenital condition with a wide phenotypic heterogeneity ranging from a severe to mild impairment of motor, cognitive, and behavioral functions. In this study, the case of a 48-year-old right-handed man with a near-total absence of the cerebellum was examined with the aim of understanding the long-term reorganization of a brain developed without a cerebellum. Clinical, neuropsychological evaluation and a neuroimaging study on a 3-T scanner were carried out. Both conventional structural diffusion tensor imaging (DTI) and functional (resting-state fMRI) data were acquired. A severe neuropsychomotor delay in infancy and adolescence involving motor skills, cognitive, and affective competencies was observed, which improved over the years. Conventional MRI findings confirmed the complete absence of the cerebellum. Analysis of DTI and resting-state fMRI data showed an impairment of the executive-control network, involving areas strongly connected with the cerebellum through the frontopontine fibers. The neuroimaging findings excluded the involvement of the extracerebellar structure. In conclusion, our data support the vascular genesis hypothesis for this rare pathology, consistent with an acquired embryonic cerebellar insult. This case also shows that it is possible to learn to live without the cerebellum over time.

Apathy and noradrenaline: silent partners to mild cognitive impairment in Parkinson's disease?

PURPOSE OF REVIEW

Mild cognitive impairment (MCI) is a comorbid factor in Parkinson's disease. The aim of this review is to examine the recent neuroimaging findings in the search for Parkinson's disease MCI (PD-MCI) biomarkers to gain insight on whether MCI and specific cognitive deficits in Parkinson's disease implicate striatal dopamine or another system.

RECENT FINDINGS

The evidence implicates a diffuse pathophysiology in PD-MCI rather than acute dopaminergic involvement. On the one hand, performance in specific cognitive domains, notably in set-shifting and learning, appears to vary with dopaminergic status. On the other hand, motivational states in Parkinson's disease along with their behavioral and physiological indices suggest a noradrenergic contribution to cognitive deficits in Parkinson's disease. Finally, Parkinson's disease's pattern of neurodegeneration offers an avenue for continued research in nigrostriatal dopamine's role in distinct behaviors, as well as the specification of dorsal and ventral striatal functions.

SUMMARY

The search for PD-MCI biomarkers has employed an array of neuroimaging techniques, but still yields divergent findings. This may be due in part to MCI's broad definition, encompassing heterogeneous cognitive domains, only some of which are affected in Parkinson's disease. Most domains falling under the MCI umbrella include fronto-dependent executive functions, whereas others, notably learning, rely on the basal ganglia. Given the deterioration of the nigrostriatal dopaminergic system in Parkinson's disease, it has been the prime target of PD-MCI investigation. By testing well defined cognitive deficits in Parkinson's disease, distinct functions can be attributed to specific neural systems, overcoming conflicting results on PD-MCI. Apart from dopamine, other systems such as the neurovascular or noradrenergic systems are affected in Parkinson's disease. These factors may be at the basis of specific facets of PD-MCI for which dopaminergic involvement has not been conclusive. Finally, the impact of both dopaminergic and noradrenergic deficiency on motivational states in Parkinson's disease is examined in light of a plausible link between apathy and cognitive deficits.

Memory dysfunction

PURPOSE OF REVIEW

This article highlights the dissociable human memory systems of episodic, semantic, and procedural memory in the context of neurologic illnesses known to adversely affect specific neuroanatomic structures relevant to each memory system.

RECENT FINDINGS

Advances in functional neuroimaging and refinement of neuropsychological and bedside assessment tools continue to support a model of multiple memory systems that are distinct yet complementary and to support the potential for one system to be engaged as a compensatory strategy when a counterpart system fails.

SUMMARY

Episodic memory, the ability to recall personal episodes, is the subtype of memory most often perceived as dysfunctional by patients and informants. Medial temporal lobe structures, especially the hippocampal formation and associated cortical and subcortical structures, are most often associated with episodic memory loss. Episodic memory dysfunction may present acutely, as in concussion; transiently, as in transient global amnesia (TGA); subacutely, as in thiamine deficiency; or chronically, as in Alzheimer disease. Semantic memory refers to acquired knowledge about the world. Anterior and inferior temporal lobe structures are most often associated with semantic memory loss. The semantic variant of primary progressive aphasia (svPPA) is the paradigmatic disorder resulting in predominant semantic memory dysfunction. Working memory, associated with frontal lobe function, is the active maintenance of information in the mind that can be potentially manipulated to complete goal-directed tasks. Procedural memory, the ability to learn skills that become automatic, involves the basal ganglia, cerebellum, and supplementary motor cortex. Parkinson disease and related disorders result in procedural memory deficits. Most memory concerns warrant bedside cognitive or neuropsychological evaluation and neuroimaging to assess for specific neuropathologies and guide treatment.

Habit Formation and the Striatum

Data from experimental animals and human subjects has provided convergent evidence for the key role of the striatum in the formation of stimulus-response habits. Habits can be distinguished from associative memories that support goal-directed actions based on their insensitivity to reward devaluation and contingency degradation. Behavior on many instrumental learning tasks can be supported by both declarative knowledge and habits, and these contributions shift with the amount of training. This shift appears to be accompanied by the involvement of different cortico-striatal loops in controlling behavior. Factors that encourage the shift toward and maintenance of habits include learning under conditions of stress, distraction, and interval or probabilistic schedules of reinforcement.

How the risky features of previous selection affect subsequent decision-making: evidence from behavioral and fMRI measures

Human decision making is rarely conducted in temporal isolation. It is often biased and affected by environmental variables, particularly prior selections. In this study, we used a task that simulates a real gambling process to explore the effect of the risky features of a previous selection on subsequent decision making. Compared with decision making after an advantageous risk-taking situation (Risk_Adv), that after a disadvantageous risk-taking situation (Risk_Disadv) is associated with a longer response time (RT, the time spent in making decisions) and higher brain activations in the caudate and the dorsolateral prefrontal cortex (DLPFC). Compared with decisions after Risk_Adv, those after Risk_Disadv in loss trials are associated with higher brain activations in the left superior temporal gyrus (STG) and the precuneus. Brain activity and relevant RTs significantly correlated. Overall, people who experience disadvantageous risk-taking selections tend to focus on current decision making and engage cognitive endeavors in value evaluation and in the regulation of their risk-taking behaviors during decision making.

Dopamine and Consolidation of Episodic Memory: Timing is Everything

Memory consolidation underpins adaptive behavior and dopaminergic networks may be critical for prolonged, selective information storage. To understand the time course of the dopaminergic contribution to memory consolidation in humans, here we investigate the effect of dopaminergic medication on recall and recognition in the short and longer term in Parkinson disease (PD). Fifteen people with PD were each tested on or off dopaminergic medication during learning/early consolidation (Day 1) and/or late consolidation (Day 2). Fifteen age-matched healthy participants were tested only once. On Day 1 participants learned new information, and early episodic memory was tested after 30 min. Then on Day 2, recall and recognition were retested after a 24-hr delay. Participants on medication on Day 1 recalled less information at 30 min and 24 hr. In contrast, patients on medication on Day 2 (8-24 hr after learning) recalled more information at 24 hr than those off medication. Although recognition sensitivity was unaffected by medication, response bias was dependent on dopaminergic state: Medication during learning induced a more liberal bias 24 hr later, whereas patients off medication during learning were more conservative responders 24 hr later. We use computational modeling to propose possible mechanisms for this change in response bias. In summary, dopaminergic medication in PD patients during learning impairs early consolidation of episodic memory and makes delayed responses more liberal, but enhances late memory consolidation presumably through a dopamine-dependent consolidation pathway that may be active during sleep.

Cortical and subcortical contributions to sequence retrieval: Schematic coding of temporal context in the neocortical recollection network

Episodic memory entails the ability to remember what happened when. Although the available evidence indicates that the hippocampus plays a role in structuring serial order information during retrieval of event sequences, information processed in the hippocampus must be conveyed to other cortical and subcortical areas in order to guide behavior. However, the extent to which other brain regions contribute to the temporal organization of episodic memory remains unclear. Here, we examined multivoxel activity pattern changes during retrieval of learned and random object sequences, focusing on a neocortical "core recollection network" that includes the medial prefrontal cortex, retrosplenial cortex, and angular gyrus, as well as on striatal areas including the caudate nucleus and putamen that have been implicated in processing of sequence information. The results demonstrate that regions of the core recollection network carry information about temporal positions within object sequences, irrespective of object information. This schematic coding of temporal information is in contrast to the putamen, which carried information specific to objects in learned sequences, and the caudate, which carried information about objects, irrespective of sequence context. Our results suggest a role for the cortical recollection network in the representation of temporal structure of events during episodic retrieval, and highlight the possible mechanisms by which the striatal areas may contribute to this process. More broadly, the results indicate that temporal sequence retrieval is a useful paradigm for dissecting the contributions of specific brain regions to episodic memory.

Neuropsychological assessment and differential diagnosis in young-onset dementias

Although Alzheimer's disease is the most common cause of dementia in the elderly, there are several conditions (ie, frontotemporal dementia or Huntington's disease) associated with a relatively earlier onset. This article provides arguments in favor of a comprehensive neuropsychological assessment in the differential diagnosis of young-onset dementia, as episodic memory impairment is not observed early in the course of most types of young-onset dementia that predominantly affect the domains of behavior, executive, language, and/or motor function.

Chew the Pain Away: Oral Habits to Cope with Pain and Stress and to Stimulate Cognition

The acute effects of chewing gum on cognitive performance, stress, and pain have been intensively studied in the last decade. The results have been contradicting, and replication studies proved challenging. Here, we review some of the recent findings of this topic and explore possible explanations for these discrepancies by incorporating knowledge derived from studies into oral habits and bruxism. Both stress and cerebral functional specialization (i.e., the involvement of specific brain structures in distinctive cognitive processes) are hypothesized to play a major role in the underlying physiological mechanisms of the diverse effects of chewing gum on cognition, stress, and pain.

Decision-making impairments in Parkinson's disease as a by-product of defective cost-benefit analysis and feedback processing

Studies examining decision-making in people with Parkinson's disease (PD) show impaired performance on a variety of tasks. However, there are also demonstrations that patients with PD can make optimal decisions just like healthy age-matched controls. We propose that the reason for these mixed findings is that PD does not produce a generalized impairment of decision-making, but rather affects sub-components of this process. In this review we evaluate this hypothesis by considering the empirical evidence examining decision-making in PD. We suggest that of the various stages of the decision-making process, the most affected in PD are (1) the cost-benefit analysis stage and (2) the outcome evaluation stage. We consider the implications of this proposal for research in this area.

Closed-loop training of attention with real-time brain imaging

Lapses of attention can have negative consequences, including accidents and lost productivity. Here we used closed-loop neurofeedback to improve sustained attention abilities and reduce the frequency of lapses. During a sustained attention task, the focus of attention was monitored in real time with multivariate pattern analysis of whole-brain neuroimaging data. When indicators of an attentional lapse were detected in the brain, we gave human participants feedback by making the task more difficult. Behavioral performance improved after one training session, relative to control participants who received feedback from other participants’ brains. This improvement was largest when feedback carried information from a frontoparietal attention network. A neural consequence of training was that the basal ganglia and ventral temporal cortex came to represent attentional states more distinctively. These findings suggest that attentional failures do not reflect an upper limit on cognitive potential and that attention can be trained with appropriate feedback about neural signals.

Gestures make memories, but what kind? Patients with impaired procedural memory display disruptions in gesture production and comprehension

Hand gesture, a ubiquitous feature of human interaction, facilitates communication. Gesture also facilitates new learning, benefiting speakers and listeners alike. Thus, gestures must impact cognition beyond simply supporting the expression of already-formed ideas. However, the cognitive and neural mechanisms supporting the effects of gesture on learning and memory are largely unknown. We hypothesized that gesture's ability to drive new learning is supported by procedural memory and that procedural memory deficits will disrupt gesture production and comprehension. We tested this proposal in patients with intact declarative memory, but impaired procedural memory as a consequence of Parkinson's disease (PD), and healthy comparison participants with intact declarative and procedural memory. In separate experiments, we manipulated the gestures participants saw and produced in a Tower of Hanoi (TOH) paradigm. In the first experiment, participants solved the task either on a physical board, requiring high arching movements to manipulate the discs from peg to peg, or on a computer, requiring only flat, sideways movements of the mouse. When explaining the task, healthy participants with intact procedural memory displayed evidence of their previous experience in their gestures, producing higher, more arching hand gestures after solving on a physical board, and smaller, flatter gestures after solving on a computer. In the second experiment, healthy participants who saw high arching hand gestures in an explanation prior to solving the task subsequently moved the mouse with significantly higher curvature than those who saw smaller, flatter gestures prior to solving the task. These patterns were absent in both gesture production and comprehension experiments in patients with procedural memory impairment. These findings suggest that the procedural memory system supports the ability of gesture to drive new learning.

Disconnection of the hippocampus and amygdala associated with lesion load in relapsing-remitting multiple sclerosis: a structural and functional connectivity study

BACKGROUND AND PURPOSE

Little is known about the functional and structural connectivity (FC and SC) of the hippocampus and amygdala, which are two important structures involved in cognitive processes, or their involvement in relapsing-remitting multiple sclerosis (RRMS). In this study, we aimed to examine the connectivity of white-matter (WM) tracts and the synchrony of intrinsic neuronal activity in outer regions connected with the hippocampus or amygdala in RRMS patients.

PATIENTS AND METHODS

Twenty-three RRMS patients and 23 healthy subjects participated in this study. Diffusion tensor probabilistic tractography was used to examine the SC, the FC correlation coefficient (FC-CC) and combined FC strength (FCS), which was derived from the resting-state functional magnetic resonance imaging used to examine the FC, of the connection between the hippocampus or the amygdala and other regions, and the correlations of these connections with clinical markers.

RESULTS

Compared with healthy subjects, the RRMS patients showed significantly decreased SC and increased FCS of the bilateral hippocampus, and left amygdala. Their slightly increased FC-CC was positively correlated with WM tract damage in the right hippocampus (ρ=0.57, P=0.005); an increased FCS was also positively correlated with WM tract damage in the right amygdala. A relationship was observed between the WM lesion load and SC alterations, including the lg(N tracts) of the right hippocampus (ρ=-0.68, P<0.05), lg(N tracts) (ρ=-0.69, P<0.05), and fractional anisotropy (ρ=-0.68, P<0.05) and radial diffusivity of the left hippocampus (ρ=0.45, P<0.05). A relationship between WM lesion load and FCS of the left amygdale was also observed.

CONCLUSION

The concurrent increased functional connections and demyelination-related structural disconnectivity between the hippocampus or amygdala and other regions in RRMS suggest that the functional-structural relationships require further investigation.

Common and distinct neural effects of risperidone and olanzapine during procedural learning in schizophrenia: a randomised longitudinal fMRI study

RATIONALE

Most cognitive domains show only minimal improvement following typical or atypical antipsychotic treatments in schizophrenia, and some may even worsen. One domain that may worsen is procedural learning, an implicit memory function relying mainly on the integrity of the fronto-striatal system.

OBJECTIVES

We investigated whether switching to atypical antipsychotics would improve procedural learning and task-related neural activation in patients on typical antipsychotics. Furthermore, we explored the differential effects of the atypical antipsychotics risperidone and olanzapine.

METHODS

Thirty schizophrenia patients underwent functional magnetic resonance imaging during a 5-min procedural (sequence) learning task on two occasions: at baseline and 7-8 weeks later. Of 30 patients, 10 remained on typical antipsychotics, and 20 were switched randomly in equal numbers to receive either olanzapine (10-20 mg) or risperidone (4-8 mg) for 7-8 weeks.

RESULTS

At baseline, patients (all on typical antipsychotics) showed no procedural learning. At follow-up, patients who remained on typical antipsychotics continued to show a lack of procedural learning, whereas those switched to atypical antipsychotics displayed significant procedural learning (p = 0.001) and increased activation in the superior-middle frontal gyrus, anterior cingulate and striatum (cluster-corrected p < 0.05). These neural effects were present as a linear increase over five successive 30-s blocks of sequenced trials. A switch to either risperidone or olanzapine resulted in comparable performance but with both overlapping and distinct task-related activations.

CONCLUSIONS

Atypical antipsychotics restore procedural learning deficits and associated neural activity in schizophrenia. Furthermore, different atypical antipsychotics produce idiosyncratic task-related neural activations, and this specificity may contribute to their differential long-term clinical profiles.

Motivational modes and learning in Parkinson's disease

Learning and motivation are intrinsically related, and both have been linked to dopamine. Parkinson's disease results from a progressive loss of dopaminergic inputs to the striatum and leads to impairments in motivation and learning from feedback. However, the link between motivation and learning in Parkinson's disease is not well understood. To address this gap, we leverage a well-established psychological theory of motivation, regulatory mode theory, which distinguishes between two functionally independent motivational concerns in regulating behavior: a concern with having an effect by initiating and maintaining movement (Locomotion) and a concern with establishing what is correct by critically evaluating goal pursuit means and outcomes (Assessment). We examined Locomotion and Assessment in patients with Parkinson's disease and age-matched controls. Parkinson's disease patients demonstrated a selective decrease in Assessment motivation but no change in Locomotion motivation, suggesting that Parkinson's disease leads to a reduced tendency to evaluate and monitor outcomes. Moreover, weaker Assessment motivation was correlated with poorer performance on a feedback-based learning task previously shown to depend on the striatum. Together, these findings link a questionnaire-based personality inventory with performance on a well-characterized experimental task, advancing our understanding of how Parkinson's disease affects motivation with implications for well-being and treatment outcomes.

Cognitive deficits in Parkinson's disease: a cognitive neuroscience perspective

Progress in characterization of the nature, neural basis, and treatment of cognitive deficits in Parkinson's disease is reviewed from the perspective of cognitive neuroscience. An initial emphasis on fronto-striatal executive deficits is surveyed along with the discoveries of disruption as well as remediation of certain impairments by dopaminergic mediation and their association with theories of reinforcement learning. Subsequent focus on large cohorts has revealed considerable heterogeneity in the cognitive impairments as well as a suggestion of at least two distinct syndromes, with the dopamine-dependent fronto-striatal deficits being somewhat independent of other signs commonly associated with Parkinson's disease dementia. The utility is proposed of a new, integrated cognitive neuroscience approach based on combining genetic and neuroimaging methodologies with neuropsychological and, ultimately, psychopharmacological approaches.