Haloperidol 2 mg impairs inhibition but not visuospatial attention

Mindfulness and inhibitory control: Insights from the stop signal task with neutral and reward-associated stimuli

Mindfulness has been linked to enhanced inhibitory control, yet the dynamics of this relationship, especially in reward situations, are not well understood. Our cross-sectional study aimed to explore the relationship between trait mindfulness and a performance measure of inhibitory control as a function of reward context operationalized by stimuli characteristics, and temporal inhibitory demands. Thirty-six individuals aged 19 to 41 filled out the Mindful Attention Awareness Scale (MAAS) and performed a stop signal task (SST), that included both neutral (stone images) and reward-related (money images) stimuli. The SST encompassed four conditions: neutral go/neutral stop, neutral go/reward stop, reward go/neutral stop, and reward go/reward stop, requiring participants to suppress reactions either during or after encountering reward-related stimuli. The relevant index of inhibitory control is the stop signal reaction time (SSRT), a performance measure of inhibitory control. Our findings showed no notable variation in the relationship between the MAAS score and SSRT across the different conditions. However, there was an overall significant effect of MAAS score on SSRT, irrespective of condition. Results may reflect the benefit of mindfulness on inhibitory control after generalized reward exposure.

The effect of continuous theta burst stimulation on antipsychotic-induced weight gain in first-episode drug-naive individuals with schizophrenia: a double-blind, randomized, sham-controlled feasibility trial

Antipsychotic intake may induce weight gain in drug-naive individuals with schizophrenia, leading to poor compliance in clinical management. However, there is still a lack of effective approaches to treat or prevent this side-effect. Therefore, we conducted this pilot study to investigate the effect of continuous theta burst stimulation (cTBS), a non-invasive magnetic stimulation technique, on preventing olanzapine-induced weight gain. Thirty-nine first-episode drug-naive individuals with schizophrenia were randomly assigned to receive either the active or sham cTBS intervention for 25 sessions (5 times per day for 5 consecutive days). The primary outcomes were changes in body weight and body mass index (BMI). Secondary outcomes included psychiatric symptoms, eating behavior scales, behavior tasks, and metabolic measures. For the result, the body weight and BMI increased significantly in the sham group but not in the active group, with a significant group effect. The active group exhibited a selective increase in the cognitive restraint domain in the Three-Factor Eating Questionnaire (TFEQ-CR) and a decrease in stop-signal reaction time compared to the sham group. The effect of cTBS on body weight was mediated by TFEQ-CR. Our findings demonstrated the feasibility that cTBS intervention could be a potential method for preventing olanzapine-induced weight gain in drug-naive first-episode schizophrenia patients through enhancing cognitive restraint to food. Trial registration: clinical trial registered with clinicaltrials.gov (NCT05086133).

Dispositional Mindfulness and Inhibitory Control after Perceiving Neutral, Food and Money Related Stimuli

Previous studies have shown that dispositional mindfulness is positively associated with cognitive performance, including the ability to stop behavioral actions (formally called inhibitory control). However, some studies suggest that the relationship may be context dependent. The current study addressed previous limitations and focused on the role of reward context regarding the relationship between mindfulness and inhibitory control. Seventy-five participants (31 men, 44 women) between 18-50 years old (M = 30, SD = 9) were included in the final sample. Participants filled out a self-report measure of mindfulness and performed a stop signal task with three conditions that varied in terms of reward context. In the neutral condition, go stimuli (stimuli to which a response was required) were letters; in the food and money condition, these were pictures of food and money, respectively. Results showed that inhibitory control was reduced in the money condition relative to the neutral condition (p = 0.012). Mindfulness was positively correlated with inhibitory control, but only in the money condition (p = 0.001). However, results might differ when inhibitory control is required while perceiving a learned reward-related stimulus. The latter represents an open question for future research.

The relationship between reward context and inhibitory control, does it depend on BMI, maladaptive eating, and negative affect?

BACKGROUND

Recent studies suggest that higher Body Mass Index (BMI) is associated with reduced inhibitory control in contexts of palatable food. However, due to limitations of previous studies, it remained the question whether this reduction is specific to food contexts, and whether it generalizes to other contexts of reward, such as money. This main question was addressed in the current study. In addition, we explored the effect of maladaptive eating and stress regarding inhibitory control across the contexts that differed in terms of reward.

METHODS

In total, 46 participants between 19 and 50 years old (39% males and 61% females) with an average BMI of 23.5 (SD = 3.9) participated. Participants filled out questionnaires and performed a go/no-go task (indexing inhibitory control) with three conditions (neutral, food, and money condition).

RESULTS

Relatively high (above median) BMI was associated with challenged inhibitory control in the food relative to the neutral context, but not in the money relative to neutral context. Explorative analyses suggested that maladaptive eating and stress were associated with reduced inhibitory control in the food context. Only rumination was associated with reduced inhibitory control in the money context.

CONCLUSIONS

The effects of BMI, maladaptive eating behavior, and stress on inhibitory control were specific to the food context, and did not generalize to a non-intrinsic reward condition, operationalized with money pictures. Our results imply that (research on) interventions directed at improving inhibitory control in relation to overweight and obesity, should consider food-reward context.

Inhibitory Performance in Smokers Relative to Nonsmokers When Exposed to Neutral, Smoking- and Money-Related Pictures

INTRODUCTION

Smoking is associated with significant negative health consequences. It has been suggested that deficient inhibitory control may be implicated in (nicotine) addiction, but its exact role has not yet been elucidated. In the current study, our aim was to investigate the role of inhibitory control in relation to nicotine addiction in contexts that differ in terms of reward.

METHODS

Participants filled out questionnaires and performed a go/no-go task with three conditions. In one condition, the stimuli were neutral color squares, and in the reward conditions, these were smoking-related pictures and money-related pictures, respectively. In total, 43 non-abstinent individuals that smoke and 35 individuals that do not smoke were included in the sample.

RESULTS

The main results showed that individuals that smoke, relative to individuals that do not smoke, had reduced inhibitory control in both reward contexts, relative to a neutral context. The reductions in inhibitory control were mirrored by speeded responses.

CONCLUSIONS

Individuals that smoke seem to present with reduced inhibitory control, which is most pronounced in contexts of reward. Consistent with incentive sensitization theory, the reduced inhibitory control may be (at least partly) due to the heightened approach bias to reward-related stimuli as indicated by the speeded responses.

Locus coeruleus integrity and the effect of atomoxetine on response inhibition in Parkinson's disease

Cognitive decline is a common feature of Parkinson's disease, and many of these cognitive deficits fail to respond to dopaminergic therapy. Therefore, targeting other neuromodulatory systems represents an important therapeutic strategy. Among these, the locus coeruleus-noradrenaline system has been extensively implicated in response inhibition deficits. Restoring noradrenaline levels using the noradrenergic reuptake inhibitor atomoxetine can improve response inhibition in some patients with Parkinson's disease, but there is considerable heterogeneity in treatment response. Accurately predicting the patients who would benefit from therapies targeting this neurotransmitter system remains a critical goal, in order to design the necessary clinical trials with stratified patient selection to establish the therapeutic potential of atomoxetine. Here, we test the hypothesis that integrity of the noradrenergic locus coeruleus explains the variation in improvement of response inhibition following atomoxetine. In a double-blind placebo-controlled randomized crossover design, 19 patients with Parkinson's disease completed an acute psychopharmacological challenge with 40 mg of oral atomoxetine or placebo. A stop-signal task was used to measure response inhibition, with stop-signal reaction times obtained through hierarchical Bayesian estimation of an ex-Gaussian race model. Twenty-six control subjects completed the same task without undergoing the drug manipulation. In a separate session, patients and controls underwent ultra-high field 7 T imaging of the locus coeruleus using a neuromelanin-sensitive magnetization transfer sequence. The principal result was that atomoxetine improved stop-signal reaction times in those patients with lower locus coeruleus integrity. This was in the context of a general impairment in response inhibition, as patients on placebo had longer stop-signal reaction times compared to controls. We also found that the caudal portion of the locus coeruleus showed the largest neuromelanin signal decrease in the patients compared to controls. Our results highlight a link between the integrity of the noradrenergic locus coeruleus and response inhibition in patients with Parkinson's disease. Furthermore, they demonstrate the importance of baseline noradrenergic state in determining the response to atomoxetine. We suggest that locus coeruleus neuromelanin imaging offers a marker of noradrenergic capacity that could be used to stratify patients in trials of noradrenergic therapy and to ultimately inform personalized treatment approaches.

Attentional bias and disengagement as a function of Body Mass Index in conditions that differ in anticipated reward

BACKGROUND AND AIMS

Previous studies suggest that attentional bias and disengagement may vary as a function of Body Mass Index (BMI), most notably in a palatable food related context. Though this could indeed represent a food context specific effect, it could also represent a general reward related context effect. In addition, though mindfulness and stress have both been reported to affect attention, it is not yet clear whether these moderate the relationship between BMI and attention as a function of reward context. In the current study we addressed these questions. It was hypothesized that BMI would be positively associated with bias in a food context and money context relative to a neutral context. The inverse was expected for disengagement. It was expected that mindfulness would decrease these relationships and for stress the inverse was expected.

METHODS

In the current online study, eighty-seven participants (24 males and 63 females; age: M = 30.1, SD = 8.3; BMI: M = 24.2, SD = 4.67), filled out questionnaires and completed a visuospatial cueing task measuring attention and disengagement of attention in a neutral, food-related, and money-related condition.

RESULTS

There was no association between BMI and attentional bias. Higher BMI was associated with faster responses to money pictures presented opposite to a cued location as compared to money pictures that did not follow a predictive cue. Our results do not support a clear moderating role of mindfulness and stress.

DISCUSSION AND CONCLUSION

Our results imply faster processing and associated quicker responding to unanticipated reward-related stimuli in individuals with overweight or obesity.

Ropinirole, a dopamine agonist with high D3 affinity, reduces proactive inhibition: A double-blind, placebo-controlled study in healthy adults

Response inhibition describes the cognitive processes mediating the suppression of unwanted actions. A network involving the basal ganglia mediates two forms of response inhibition: reactive and proactive inhibition. Reactive inhibition serves to abruptly stop motor activity, whereas proactive inhibition is goal-orientated and results in slowing of motor activity in anticipation of stopping. Due to its impairment in several psychiatric disorders, the neurochemistry of response inhibition has become of recent interest. Dopamine has been posed as a candidate mediator of response inhibition due to its role in functioning of the basal ganglia and the observation that patients with Parkinson's disease on dopamine agonists develop impulse control disorders. Although the effects of dopamine on reactive inhibition have been studied, substantial literature on the role of dopamine on proactive inhibition is lacking. To fill this gap, we devised a double-blind, placebo-controlled study of 1 mg ropinirole (a dopamine agonist) on response inhibition in healthy volunteers. We found that whilst reactive inhibition was unchanged, proactive inhibition was impaired when participants were on ropinirole relative to when on placebo. To investigate how ropinirole mediated this effect on proactive inhibition, we used hierarchical drift-diffusion modelling. We found that ropinirole impaired the ability to raise the decision threshold when proactive inhibition was called upon. Our results provide novel evidence that an acute dose of ropinirole selectively reduces proactive inhibition in healthy participants. These results may help explain how ropinirole induces impulse control disorders in susceptible patients with Parkinson's disease.

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Proactive but not reactive inhibition is impaired under the influence of ropinirole vs placebo.

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Ropinirole impairs the ability to raise the decision threshold when proactive inhibition is called upon.

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We provide novel evidence that an acute dose of ropinirole selectively reduces proactive inhibition in healthy participants.

Dopaminergic and noradrenergic manipulation of anticipatory reward and probability event-related potentials

Predicting what will happen in the future in terms of potential reward is essential in daily life. The aim of the current study was to investigate the neurotransmitter systems involved in the anticipation of reward value and probability. We hypothesized that dopaminergic and noradrenergic antagonism would affect anticipation of reward value and probability, respectively. Twenty-three healthy participants were included in a haloperidol (2 mg) × clonidine (0.150 mg) × placebo cross-over design and subjected to a Go/NoGo experimental task during which cues signaled the probability of subsequent target appearance. Reward value (amount of money that could be won for correct and fast responding to the target) as well as probability of target appearance was orthogonally manipulated across four task blocks. Cue-elicited EEG event-related potentials were recorded to assess anticipation of value and probability, respectively. The processing of reward value was affected by dopaminergic antagonism (haloperidol), as evidenced by reduction of the reward-related positivity and P300 to reward cues. This reduction was specifically significant for subjects with high baseline dopamine levels for the P300 and most pronounced for these subjects for the reward-related positivity. In contrast, the processing of reward probability was affected by noradrenergic antagonism (clonidine). In addition, both drugs reduced overall performance (omission rate, response speed variability). We conclude that at least anticipation of reward value and probability, respectively, is specifically affected by dopaminergic versus noradrenergic antagonism.

Dopamine D2 receptor stimulation modulates the balance between ignoring and updating according to baseline working memory ability

BACKGROUND

Working memory (WM) deficits in neuropsychiatric disorders have often been attributed to altered dopaminergic signalling. Specifically, D₂ receptor stimulation is thought to affect the ease with which items can be gated into and out of WM. In addition, this effect has been hypothesised to vary according to baseline WM ability, a putative index of dopamine synthesis levels. Moreover, whether D₂ stimulation affects WM vicariously through modulating relatively WM-free cognitive control processes has not been explored.

AIMS

We examined the effect of administering a dopamine agonist on the ability to ignore or update information in WM.

METHOD

A single dose of cabergoline (1 mg) was administered to healthy older adult humans in a within-subject, double-blind, placebo-controlled study. In addition, we obtained measures of baseline WM ability and relatively WM-free cognitive control (overcoming response conflict).

RESULTS

Consistent with predictions, baseline WM ability significantly modulated the effect that drug administration had on the proficiency of ignoring and updating. High-WM individuals were relatively better at ignoring compared to updating after drug administration. Whereas the opposite occurred in low-WM individuals. Although the ability to overcome response conflict was not affected by cabergoline, a negative relationship between the effect the drug had on response conflict performance and ignoring was observed. Thus, both response conflict and ignoring are coupled to dopaminergic stimulation levels.

CONCLUSIONS

Cumulatively, these results provide evidence that dopamine affects subcomponents of cognitive control in a diverse, antagonistic fashion and that the direction of these effects is dependent upon baseline WM.

Dopamine guides competition for cognitive control: Common effects of haloperidol on working memory and response conflict

Several lines of evidence suggest that dopamine modulates working memory (the ability to faithfully maintain and efficiently manipulate information over time) but its specific role has not been fully defined. Nor is it clear whether any effects of dopamine are specific to memory processes or whether they reflect more general cognitive mechanisms that extend beyond the working memory domain. Here, we examine the effect of haloperidol, principally a dopamine D₂ receptor antagonist, on the ability of humans to ignore distracting information or update working memory contents. We compare these effects to performance on an independent measure of cognitive control (response conflict) which has minimal memory requirements. Haloperidol did not selectively affect the ability to ignore or update, but instead reduced the overall quality of recall. In addition, it impaired the ability to overcome response conflict. The deleterious effect of haloperidol on response conflict was selectively associated with the negative effect of the drug on ignoring - but not updating - suggesting that dopamine affects protection of working memory contents and inhibition in response conflict through a common mechanism. These findings provide new insights into the role of dopamine D₂ receptors on human cognition. They suggest that D₂ receptor effects on protecting the memory contents from distraction might be related to a more general process that supports inhibitory control in contexts that do not require working memory.

Parkinson's Disease Subtypes Show Distinct Tradeoffs Between Response Initiation and Inhibition Latencies

OBJECTIVES

In unpredictable situations, individuals often show tradeoffs between response initiation and inhibition speeds. We tested the hypothesis that Parkinson's disease (PD) motor subtypes differentially impact tradeoffs between these two action-oriented processes. We predicted that, compared to tremor dominant (TD) patients, predominant postural instability and gait dysfunction (PIGD) patients would show exacerbated tradeoffs between response initiation and inhibition in situations requiring the sudden potential need to interrupt an action.

METHODS

Fifty-one PD patients (subdivided into PIGD [n=27] and TD [n=24]) and 21 healthy controls (HCs) completed a choice reaction task to establish baseline response initiation speed between groups. Subsequently, participants completed a stop-signal task which introduced an occasional, unpredictable stop stimulus. We measured changes in initiation speed in preparation of an unpredictable stop (i.e., proactive slowing) and inhibition latency (i.e., stop-signal reaction time).

RESULTS

Compared to HCs, PD patients showed slower response initiation speeds in the choice reaction task. All groups showed proactive slowing in the stop-signal task but the magnitude was considerably larger in PIGD patients, almost twice as large as TD patients. PD patients, irrespective of motor subtype, showed longer inhibition latencies than HCs.

CONCLUSIONS

PIGD and TD subtypes both showed exacerbated response inhibition deficits. However, PIGD patients showed much more pronounced proactive slowing in situations with an expected yet unpredictable need to stop action abruptly. This suggests that PIGD is accompanied by exaggerated tradeoffs between response initiation and inhibition processes to meet situational action demands. We discuss putative neural mechanisms and clinical implications of these findings. (JINS, 2017, 23, 665-674).

The clinical and prognostic value of motor abnormalities in psychosis, and the importance of instrumental assessment

Motor abnormalities comprise several clinical signs intrinsic to psychosis. Critically, these features are of prognostic value in individuals at-risk for psychosis, and for those in early stages of psychotic disorders. Motor abnormalities such as tremor, rigidity, and neurological soft signs often go unrecognized. Currently, advances in this area are limited by a paucity of theoretical conceptions categorizing or linking these behaviours to underlying neurobiology affected in psychosis. However, emerging technological advances have significantly improved the ability to detect and assess motor abnormalities with objective instruments in a timely and reliable manner. Further, converging evidence has laid the groundwork for theoretically and empirically derived categorization and conceptualization. This review summarizes these advances, stressing the importance of motor abnormalities for understanding vulnerability across different stages of psychosis and introducing these innovative instrumental approaches. Patients, researchers and clinicians will benefit from these new developments, as better assessment aids the development of targeted interventions to ultimately improve the care for individuals experiencing psychosis.