Motivation-cognition interaction: how feedback processing changes in healthy ageing and in Parkinson's disease

Parsing the contributions of negative affect vs. aversive motivation to cognitive control: an experimental investigation

Introduction

Punishment is a powerful drive that fosters aversive motivation and increases negative affect. Previous studies have reported that this drive has the propensity to improve cognitive control, as shown by improved conflict processing when it is used. However, whether aversive motivation per se or negative affect eventually drives this change remains unclear because in previous work, the specific contribution of these two components could not be isolated.

Methods

To address this question, we conducted two experiments where we administered the confound minimized Stroop task to a large group of participants each time (N = 50 and N = 47 for Experiment 1 and 2, respectively) and manipulated punishment and feedback contingency using a factorial design. These two experiments were similar except that in the second one, we also measured awareness of feedback contingency at the subjective level. We reasoned that cognitive control would improve the most when punishment would be used, and the contingency between this motivational drive and performance would be reinforced, selectively.

Results

Both experiments consistently showed that negative affect increased at the subjective level when punishment was used and the feedback was contingent on task performance, with these two effects being additive. In Experiment 1, we found that when the feedback was contingent on task performance and punishment was activated, conflict processing did not improve. In Experiment 2, we found that conflict processing improved when punishment was contingent on task performance, and participants were aware of this contingency.

Discussion

These results suggest that aversive motivation can improve conflict processing when participants are aware of the link created between punishment and performance.

Decision making in Parkinson's disease: An analysis of the studies using the Iowa Gambling Task

In Parkinson's disease (PD) impairments in decision making can occur, in particular because of the tendency toward risky and rewarding options. The Iowa Gambling Task has been widely used to investigate decision processes involving these options. The task assesses the ability to manage risk and to learn from feedback. The present paper aims at critically examining those studies in which this task has been administered to PD patients, in order to understand possible anomalies in patients' decision processes and which variables are responsible for that. A meta‐analysis has been conducted as well. Features of the task, sociodemographic and clinical aspects (including daily drugs intake), cognitive conditions and emotional disorders of the patients have been taken into account. Neural correlates of decision‐making competences were considered. It emerged that PD patients show a trend of preference toward risky choices, probably due to an impairment in anticipating the unrewarding consequences or to an insensitiveness to punishment. The possible role played by dopamine medications in decision making under uncertain conditions, affecting basal ganglia and structures involved in the limbic loop, was discussed. Attention has been focused on some aspects that need to be investigated in further research, in order to delve into this issue and promote patients' quality of life.

Sociability-based fitness approach in Parkinson's disease: Comparison with conventional rehabilitation

BACKGROUND AND PURPOSE

The effect of a sociability-based fitness approach on parkinsonian disability in patients with Parkinson's disease (PD) was assessed.

METHODS

Eighty patients diagnosed with PD were randomly assigned to either the group-based rehabilitation (GBR) group (n = 40) or the individual-based rehabilitation (IBR) group (n = 40). The primary outcome was the difference between the two groups in the mean change from baseline to post-training in the total score on the Unified Parkinson's Disease Rating Scale (UPDRS). The secondary outcomes included the change in mental status and the difference in the mean change from baseline to month 3 and month 6 in the total score on the UPDRS.

RESULTS

The mean (±SD) UPDRS scores were 72.0 ± 21.0 in the GBR group and 72.1 ± 18.6 in the IBR group. The UPDRS scores from baseline to post-training were 22.8 ± 13.5 in the GBR group and 10.9 ± 8.8 in the IBR group (difference 11.8 points; 95% confidence interval [CI] 5.0-18.6; p = 0.001). The difference between the groups from baseline to month 3 (difference 10.06 points; 95% CI 3.3-16.8) and the difference between the groups from baseline to month 6 (difference 11.7 points; 95% CI 4.9-18.5) were also significant (p = 0.004 and p = 0.001, respectively). The scores of cognitive function and depression had not changed significantly.

CONCLUSIONS

Patients receiving GBR demonstrated significant improvements in parkinsonian symptoms, suggesting that the sociability-based fitness can be applied to clinical treatment by sustaining the motivation in PD.

Human moral decision-making through the lens of Parkinson's disease

Parkinson's disease (PD) is a neurodegenerative disorder characterized by the loss of dopaminergic neurons in the basal ganglia (BG) and thalamocortical circuitry. While defective motor control has long been considered the defining symptom of PD, mounting evidence indicates that the BG are fundamentally important for a multitude of cognitive, emotional, and motivational processes in addition to motor function. Here, we review alterations in moral decision-making in people with PD, specifically in the context of deceptive behavior. We report that PD patients exhibit two opposite behavioral patterns: hyper- and hypo-honesty. The hyper-honest subgroup engages in deception less often than matched controls, even when lying is associated with a monetary payoff. This behavioral pattern seems to be linked to dopaminergic hypo-activity, implying enhanced harm avoidance, risk aversion, non-impulsivity, and reduced reward sensitivity. On the contrary, the hypo-honest subgroup-often characterized by the additional diagnosis of impulse control disorders (ICDs) and dopamine dysregulation syndrome (DDS)-deceives more often than both PD patients without ICDs/DDS and controls. This behavioral pattern appears to be associated with dopaminergic hyperactivity, which underpins enhanced novelty-seeking, risk-proneness, impulsivity, and reward sensitivity. We posit that these two complementary behavioral patterns might be related to dysfunction of the dopaminergic reward system, leading to reduced or enhanced motivation to deceive. Only a few studies have directly investigated moral decision-making in PD and other neurodegenerative disorders affecting the BG, and further research on the causal role of subcortical structures in shaping moral behavior is needed.

The Role of Motivation and Anxiety on Error Awareness in Younger and Older Adults

Aging is associated with several changes in cognitive functions, as well as in motivational and affective processes, which in turn interact with cognitive functions. The present study aimed to investigate error awareness (EA), which declines with aging, in relation to motivation and anxiety. Adopting an experimental task, we firstly tested the hypothesis that EA could be enhanced through reward motivation. Secondly, we explored the relation between state and trait anxiety and EA, investigating the hypothesis of an association between EA and anxiety, and between anxiety and the potential benefit of motivation on EA. Thirty healthy younger (age range: 19-35 years; mean age 25.4 ± 5.1; 10 M) and 30 healthy older adults (age range: 61-83 years; mean age 69.7 ± 5.5; 12 M) took part in the study and performed both the classic Error Awareness Task (EAT) and one experimental task, called the Motivational EAT. In this new task, motivational incentives were delivered after aware correct responses and aware errors. For every participant, standard measures of state and trait anxiety and cognitive functions were collected. Confirming the presence of a significant age-related EA decline, results did not reveal any influence of reward motivation on EA, nor any relation between EA and anxiety. However, both younger and older adults had longer response times (RTs) and made more errors during the Motivational EAT, with the more anxious participants showing the greater RT slowing. Findings suggest that reward motivation might not be always beneficial for cognitive performance, as well as that anxiety does not relate to EA capacity. Results also recommend further investigation, as well as the assessment of EA in patients with either motivational deficits like apathy, and/or with anxiety disorders.

Effortful control is associated with executive attention: A computational study

INTRODUCTION

Effortful control (EC) is the self-regulatory aspect of temperament that is thought to reflect the efficiency of executive attention (EA). Findings on relationship between EC and performance on EA tasks among adults are still contradictory. This study used a computational approach to clarify whether greater self-reported EC reflects better EA.

METHODS

Four hundred twenty-seven healthy subjects completed the Adult Temperament Questionnaires and the Attention Network Task-revised, a conflict resolution task that gauges EA as the flanker effect (FE), that is, the difference in performances between incongruent and congruent trials. Here we also employed a drift-diffusion model in which parameters reflecting the actual decisional process (drift rate) and the extra-decisional time are extracted for congruent and incongruent trials.

RESULTS

EC was not correlated with the FE computed with the classic approach, but correlated positively with drift rate for the incongruent trials, even when controlling for the drift rate in the congruent condition and the extra-decisional time in the incongruent condition.

CONCLUSION

This study demonstrates an association between self-reported EC and EA among adults. Specifically, EC is not associated with overall response facilitation but specifically with a greater ability to make goal-oriented decisions when facing conflicting information.

Losing Money and Motivation: Effects of Loss Incentives on Motivation and Metacognition in Younger and Older Adults

Incentives are usually expected to increase motivation and cognitive control and to thereby improve performance. A small but growing number of studies have begun to investigate whether the effects of incentive on cognitive performance differ for younger vs. older adults. Most have used attention and cognitive control paradigms, trial-wise implementation of incentive condition, and gain incentives (reward), with only a very few investigating the effects of loss incentives. The present study takes a complementary approach: We tested younger and older adults in a working memory paradigm with loss incentives implemented session-wide (between subjects). We also included self-report measures to ask how loss incentive affected participants’ perceptions of the mental demand of the task, as well as their perceived effort, frustration, motivation, distraction, and metacognitive judgments of how well they had performed. This allowed us to test the disparate predictions of different theoretical views: the intuitive hypothesis that incentive should increase motivation and performance, the motivational shift proposal that older adults are especially motivated to avoid losses (Freund and Ebner, 2005), a heuristic “positivity effect” perspective that older adults ignore losses (Brassen et al., 2012; Williams et al., 2017), and a more nuanced view that suggests that when negative information is unavoidable and increases perceived costs, older adults may instead disengage from the situation (Charles, 2010; Hess, 2014). The results seemed most consistent with the more nuanced view of the positivity effect. While neither group showed incentive-related performance differences, both younger and older adults reported greater perceived demand and frustration under loss incentive, especially in the most challenging conditions. Loss incentive increased the accuracy of immediate metacognitive judgments, but reduced the accuracy of later, more global judgments of competency for older adults. Self-report measures suggested that the loss incentive manipulation was distracting to young adults and demotivating for older adults. The results suggest a need for caution in generalizing from existing studies to everyday life, and that additional studies parameterizing critical aspects of task design and incentive manipulation are needed to fully understand how incentives affect cognition and motivation in younger and older adults.

The effects of age on reward magnitude processing in the monetary incentive delay task

Previous studies have suggested age-related differences in reward-directed behavior and cerebral processes in support of the age effects. However, it remains unclear how age may influence the processing of reward magnitude. Here, with 54 volunteers (22-74 years of age) participating in the Monetary Incentive Delay Task (MIDT) with explicit cues ($1, ¢1, or nil) and timed response to win, we characterized brain activations during anticipation and feedback and the effects of age on these regional activations. Behaviorally, age was associated with less reaction time (RT) difference between dollar and cent trials, as a result of slower response to the dollar trials; i.e., age was positively correlated with RT dollar - RT cent, with RT nil as a covariate. Both age and the RT difference ($1 - ¢1) were correlated with diminished activation of the right caudate head, right anterior insula, supplementary motor area (SMA)/pre-SMA, visual cortex, parahippocampal gyrus, right superior/middle frontal gyri, and left primary motor cortex during anticipation of $1 vs. ¢1 reward. Further, these regional activities mediated the age effects on RT differences. In responses to outcomes, age was associated with decreases in regional activations to dollar vs. cent loss but only because of higher age-related responses to cent losses. Together, these findings suggest age-related differences in sensitivity to the magnitude of reward. With lower cerebral responses during anticipation to win large rewards and higher responses to outcomes of small loss, aging incurs a constricted sensitivity to the magnitude of reward.

Reward motivation and neurostimulation interact to improve working memory performance in healthy older adults: A simultaneous tDCS-fNIRS study

Several studies have evaluated the effect of anodal transcranial direct current stimulation (tDCS) over the prefrontal cortex (PFC) for the enhancement of working memory (WM) performance in healthy older adults. However, the mixed results obtained so far suggest the need for concurrent brain imaging, in order to more directly examine tDCS effects. The present study adopted a continuous multimodal approach utilizing functional near-infrared spectroscopy (fNIRS) to examine the interactive effects of tDCS combined with manipulations of reward motivation. Twenty-one older adults (mean age = 69.7 years; SD = 5.05) performed an experimental visuo-spatial WM task before, during and after the delivery of 1.5 mA anodal tDCS/sham over the left prefrontal cortex (PFC). During stimulation, participants received performance-contingent reward for every fast and correct response during the WM task. In both sessions, hemodynamic activity of the bilateral frontal, motor and parietal areas was recorded across the entire duration of the WM task. Cognitive functions and reward sensitivity were also assessed with standard measures. Results demonstrated a significant impact of tDCS on both WM performance and hemodynamic activity. Specifically, faster responses in the WM task were observed both during and after anodal tDCS, while no differences were found under sham control conditions. However, these effects emerged only when taking into account individual visuo-spatial WM capacity. Additionally, during and after the anodal tDCS, increased hemodynamic activity relative to sham was observed in the bilateral PFC, while no effects of tDCS were detected in the motor and parietal areas. These results provide the first evidence of tDCS-dependent functional changes in PFC activity in healthy older adults during the execution of a WM task. Moreover, they highlight the utility of combining reward motivation with prefrontal anodal tDCS, as a potential strategy to improve WM efficiency in low performing healthy older adults.

Age-Related Differences in Motivational Integration and Cognitive Control

Motivational incentives play an influential role in value-based decision-making and cognitive control. A compelling hypothesis in the literature suggests that the motivational value of diverse incentives are integrated in the brain into a common currency value signal that influences decision-making and behavior. To investigate whether motivational integration processes change during healthy aging, we tested older (N = 44) and younger (N = 54) adults in an innovative incentive integration task paradigm that establishes dissociable and additive effects of liquid (e.g., juice, neutral, saltwater) and monetary incentives on cognitive task performance. The results reveal that motivational incentives improve cognitive task performance in both older and younger adults, providing novel evidence demonstrating that age-related cognitive control deficits can be ameliorated with sufficient incentive motivation. Additional analyses revealed clear age-related differences in motivational integration. Younger adult task performance was modulated by both monetary and liquid incentives, whereas monetary reward effects were more gradual in older adults and more strongly impacted by trial-by-trial performance feedback. A surprising discovery was that older adults shifted attention from liquid valence toward monetary reward throughout task performance, but younger adults shifted attention from monetary reward toward integrating both monetary reward and liquid valence by the end of the task, suggesting differential strategic utilization of incentives. These data suggest that older adults may have impairments in incentive integration and employ different motivational strategies to improve cognitive task performance. The findings suggest potential candidate neural mechanisms that may serve as the locus of age-related change, providing targets for future cognitive neuroscience investigations.

Motivational Influences on Performance Monitoring and Cognitive Control Across the Adult Lifespan

Cognitive control refers to the ability to regulate cognitive processing according to the tasks at hand, especially when these are demanding. It includes maintaining and updating relevant information in working memory, inhibiting irrelevant information, and flexibly switching between tasks. Performance monitoring denotes the processing of feedback from the environment and the detection of errors or other unexpected events and signals when cognitive control needs to be exerted. These two aspects of behavioral adaptation critically rely on the integrity of the frontal lobes, which are known to show pronounced age-related performance decrements. By contrast, there is evidence that processing of rewards remains relatively intact across the adult lifespan. Hence, motivation may play an important role in modulating or even counteracting age-related changes in cognitive control functions. To answer this question, neuroscientific data can be particularly useful to uncover potential underlying mechanisms beyond behavioral outcome. The aims of this article are twofold: First, to review and systematize the extant literature on how motivational incentives can modulate performance monitoring and cognitive control in young and older adults. Second, to demonstrate that important pieces of empirical data are currently missing for the evaluation of this central question, specifically in old age. Hence, we would like to stimulate further research uncovering potential mechanisms underlying motivation-cognition interactions in young and in particular in older adults and investigating whether or not those can help to ameliorate age-related impairments.

Decision Making under Ambiguity and Objective Risk in Higher Age - A Review on Cognitive and Emotional Contributions

The ability of decision making plays a highly relevant role in our survival, but is adversely affected during the process of aging. The present review aims to provide a better understanding of age-related differences in decision making and the role of cognitive and emotional factors in this context. We reviewed the literature about age-effects on decision-making performance, focusing on decision making under ambiguous and objective risk. In decisions under ambiguous risks, as measured by the Iowa Gambling Task, decisions are based on the experiences with consequences. In this case, many articles have attributed age-related impairments in decision making to changes in emotional and somatic reward- and punishment processing. In decisions under objective risks, as measured for example by the Game of Dice Task, decisions can be based on explicit information about risks and consequences. In this case, age-related changes have been attributed mainly to a cognitive decline, particularly impaired executive functions. However, recent findings challenge these conclusions. The present review summarizes neuropsychological and neurophysiological findings of age-related differences in decision making under ambiguous and objective risk. In this context, the relevance of learning, but also of cognitive and emotional contributors – responsible for age-related differences in decision making – are additionally pointed out.

Risky decision-making and affective features of impulse control disorders in Parkinson's disease

Impulse control disorders (ICDs) in Parkinson’s disease (PD) are considered dopaminergic treatment side effects. Cognitive and affective factors may increase the risk of ICD in PD. The aim is to investigate risky decision-making and associated cognitive processes in PD patients with ICDs within a four-stage conceptual framework. Relationship between ICDs and affective factors was explored. Thirteen PD patients with ICD (ICD+), 12 PD patients without ICD (ICD−), and 17 healthy controls were recruited. Overall risky decision-making and negative feedback effect were examined with the Balloon Analogue Risk Task (BART). A cognitive battery dissected decision-making processes according to the four-stage conceptual framework. Affective and motivational factors were measured. ANOVA showed no effect of group on overall risky decision-making. However, there was a group × feedback interaction [F (2, 39) = 3.31, p = 0.047]. ICD+, unlike ICD− and healthy controls, failed to reduce risky behaviour following negative feedback. A main effect of group was found for anxiety and depression [F(2, 38) = 8.31, p = 0.001], with higher symptoms in ICD+ vs. healthy controls. Groups did not differ in cognitive outcomes or affective and motivational metrics. ICD+ may show relatively preserved cognitive function, but reduced sensitivity to negative feedback during risky decision-making and higher symptoms of depression and anxiety.

Influence of subthalamic deep-brain stimulation on cognitive action control in incentive context

Subthalamic nucleus deep-brain stimulation (STN-DBS) is an effective treatment in Parkinson's disease (PD), but can have cognitive side effects, such as increasing the difficulty of producing appropriate responses when a habitual but inappropriate responses represent strong alternatives. STN-DBS also appears to modulate representations of incentives such as monetary rewards. Furthermore, conflict resolution can be modulated by incentive context. We therefore used a rewarded Simon Task to assess the influence of promised rewards on cognitive action control in 50 patients with PD, half of whom were being treated with STN-DBS. Results were analyzed according to the activation-suppression model. We showed that STN-DBS (i) favored the expression of motor impulsivity, as measured with the Barratt Impulsiveness Scale, (ii) facilitated the expression of incentive actions as observed with a greater increase in speed according to promised reward in patients with versus without DBS and (iii) may increase impulsive action selection in an incentive context. In addition, analysis of subgroups of implanted patients suggested that those who exhibited the most impulsive action selection had the least severe disease. This may indicate that patients with less marked disease are more at risk of developing impulsivity postoperatively. Finally, in these patients, incentive context increased the difficulty of resolving conflict situations. As a whole, the current study revealed that in patients with PD, STN-DBS affects the cognitive processes involved in conflict resolution, reward processing and the influence of promised rewards on conflict resolution.

Noradrenergic modulation of emotional memory in aging

Interest in the role of the noradrenergic system in the modulation of emotional memories has recently increased. This study briefly reviews this timely line of research with a specific focus on aging. After having identified surprisingly few studies that investigated emotional memory in older adults from a neurobiological perspective, we found a significant interaction between noradrenergic activity and emotional memory enhancement in older adults. This pattern of data are explained both in terms of a top-down modulation of behavioral processes (e.g., changes in priority and individual goals) and in terms of greater activity of noradrenergic system during aging. Altogether, both behavioral and genetic variations studies (e.g., Alpha 2 B Adrenoceptor genotype) have shown that healthy older adults are able to circumvent or minimize the experience of negative emotions and stabilize or even enhance positive emotional experiences. Future studies are highly warranted to better clarify the relationship between noradrenaline and emotional memories in the aging brain.