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Webler RD, Oathes DJ, van Rooij SJH, Gewirtz JC, Nahas Z, Lissek SM, Widge AS. Causally mapping human threat extinction relevant circuits with depolarizing brain stimulation methods. Neurosci Biobehav Rev 2023; 144:105005. [PMID: 36549377 DOI: 10.1016/j.neubiorev.2022.105005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/17/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
Laboratory threat extinction paradigms and exposure-based therapy both involve repeated, safe confrontation with stimuli previously experienced as threatening. This fundamental procedural overlap supports laboratory threat extinction as a compelling analogue of exposure-based therapy. Threat extinction impairments have been detected in clinical anxiety and may contribute to exposure-based therapy non-response and relapse. However, efforts to improve exposure outcomes using techniques that boost extinction - primarily rodent extinction - have largely failed to date, potentially due to fundamental differences between rodent and human neurobiology. In this review, we articulate a comprehensive pre-clinical human research agenda designed to overcome these failures. We describe how connectivity guided depolarizing brain stimulation methods (i.e., TMS and DBS) can be applied concurrently with threat extinction and dual threat reconsolidation-extinction paradigms to causally map human extinction relevant circuits and inform the optimal integration of these methods with exposure-based therapy. We highlight candidate targets including the amygdala, hippocampus, ventromedial prefrontal cortex, dorsal anterior cingulate cortex, and mesolimbic structures, and propose hypotheses about how stimulation delivered at specific learning phases could strengthen threat extinction.
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Affiliation(s)
- Ryan D Webler
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA.
| | - Desmond J Oathes
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Jonathan C Gewirtz
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA; Department of Psychology, Arizona State University, AZ, USA
| | - Ziad Nahas
- Department of Psychology, Arizona State University, AZ, USA
| | - Shmuel M Lissek
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Alik S Widge
- Department of Psychiatry and Medical Discovery Team on Addictions, University of Minnesota Medical School, MN, USA
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Ulrich M, Niemann F, Grön G. Role of the right anterior insula for the emergence of flow-A combined task-based fMRI activation and connectivity study. Front Hum Neurosci 2022; 16:1067968. [PMID: 36569474 PMCID: PMC9772033 DOI: 10.3389/fnhum.2022.1067968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
The emergence of flow is a situation of high salience because externally oriented attention on the task and access to resources for goal-directed behavior are enhanced, while internally oriented or self-related cognition is decreased. The right anterior insula has been reported as a causal out-flow hub of the salience resting-state network, orchestrating the engagement of the central executive network (CEN) and the disengagement of the default-mode network (DMN) during a functional challenge. In the present study, we employed a combined task-based activation and connectivity analysis to investigate the role of the right anterior insula during the emergence of flow. A sample of 41 healthy male subjects was confronted with a functional challenge that permitted the emergence of flow during BOLD-based functional magnetic resonance imaging. Comparing connectivity changes in the right anterior insula during the flow condition against connectivity changes associated with control conditions of boredom and overload, relatively increased couplings were observed with the left and right dorsolateral prefrontal cortex. Activation data for these regions did, however, not show the flow-typical inverted U-shaped (invU) response pattern. Relatively decreased functional couplings encompassed ventral aspects of the striatum, but neither the amygdala nor the medial prefrontal cortex (MPFC). For the ventral striatum, activation data were consistent with the flow-typical U-shaped activation pattern, which supports the notion that under the high salience of autotelic situations, the anterior insula is much less positively coupled with the ventral striatum than under boundary conditions of boredom and overload. Taken together, present functional connectivity results were in alignment with the assumed role of the right anterior insula under conditions of different salience. However, this particular region does not appear to mediate the most typical flow-associated activation patterns.
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Affiliation(s)
- Martin Ulrich
- Section Neuropsychology and Functional Imaging, Department of Psychiatry, Ulm University, Ulm, Germany,*Correspondence: Martin Ulrich,
| | - Filip Niemann
- Cognition, Aging, and Brain Stimulation Lab, Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Georg Grön
- Section Neuropsychology and Functional Imaging, Department of Psychiatry, Ulm University, Ulm, Germany
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Janacsek K, Evans TM, Kiss M, Shah L, Blumenfeld H, Ullman MT. Subcortical Cognition: The Fruit Below the Rind. Annu Rev Neurosci 2022; 45:361-386. [PMID: 35385670 DOI: 10.1146/annurev-neuro-110920-013544] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cognitive neuroscience has highlighted the cerebral cortex while often overlooking subcortical structures. This cortical proclivity is found in basic and translational research on many aspects of cognition, especially higher cognitive domains such as language, reading, music, and math. We suggest that, for both anatomical and evolutionary reasons, multiple subcortical structures play substantial roles across higher and lower cognition. We present a comprehensive review of existing evidence, which indeed reveals extensive subcortical contributions in multiple cognitive domains. We argue that the findings are overall both real and important. Next, we advance a theoretical framework to capture the nature of (sub)cortical contributions to cognition. Finally, we propose how new subcortical cognitive roles can be identified by leveraging anatomical and evolutionary principles, and we describe specific methods that can be used to reveal subcortical cognition. Altogether, this review aims to advance cognitive neuroscience by highlighting subcortical cognition and facilitating its future investigation. Expected final online publication date for the Annual Review of Neuroscience, Volume 45 is July 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Karolina Janacsek
- Centre for Thinking and Learning, Institute for Lifecourse Development, School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, London, United Kingdom.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Tanya M Evans
- School of Education and Human Development, University of Virginia, Charlottesville, Virginia, USA
| | - Mariann Kiss
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Department of Cognitive Science, Faculty of Natural Sciences, Budapest University of Technology and Economics, Budapest, Hungary
| | - Leela Shah
- School of Education and Human Development, University of Virginia, Charlottesville, Virginia, USA
| | - Hal Blumenfeld
- Departments of Neurology, Neuroscience and Neurosurgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michael T Ullman
- Brain and Language Lab, Department of Neuroscience, Georgetown University, Washington, DC, USA;
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Johnson BP, Cohen LG. Reward and plasticity: Implications for neurorehabilitation. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:331-340. [PMID: 35034746 DOI: 10.1016/b978-0-12-819410-2.00018-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Neuroplasticity follows nervous system injury in the presence or absence of rehabilitative treatments. Rehabilitative interventions can be used to modulate adaptive neuroplasticity, reducing motor impairment and improving activities of daily living in patients with brain lesions. Learning principles guide some rehabilitative interventions. While basic science research has shown that reward combined with training enhances learning, this principle has been only recently explored in the context of neurorehabilitation. Commonly used reinforcers may be more or less rewarding depending on the individual or the context in which the task is performed. Studies in healthy humans showed that both reward and punishment can enhance within-session motor performance; but reward, and not punishment, improves consolidation and retention of motor skills. On the other hand, neurorehabilitative training after brain lesions involves complex tasks (e.g., walking and activities of daily living). The contribution of reward to neurorehabilitation is incompletely understood. Here, we discuss recent research on the role of reward in neurorehabilitation and the needed directions of future research.
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Affiliation(s)
- Brian P Johnson
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Leonardo G Cohen
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States.
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Abstract
Despite the prevalence of anhedonia across multiple psychiatric disorders, its relevance to treatment selection and prognostication can be unclear (Davey et al., Psychol Med 42(10):2071-81, 2012). Given the challenges in pharmacological and psychosocial treatment, there has been increasing attention devoted to neuroanatomically-targeted treatments. This chapter will present a brief introduction to circuit-targeted therapeutics in psychiatry (Sect. 1), an overview of brain mapping as it relates to anhedonia (Sect. 2), a review of existing studies on brain stimulation for anhedonia (Sect. 3), and a description of emerging approaches to circuit-based neuromodulation for anhedonia (Sect. 4).
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Affiliation(s)
- Shan H Siddiqi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Center for Brain Circuit Therapeutics, Brigham & Women's Hospital, Boston, MA, USA.
| | - Nichola Haddad
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Center for Brain Circuit Therapeutics, Brigham & Women's Hospital, Boston, MA, USA
| | - Michael D Fox
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Center for Brain Circuit Therapeutics, Brigham & Women's Hospital, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Spano MC, Lorusso M, Pettorruso M, Zoratto F, Di Giuda D, Martinotti G, di Giannantonio M. Anhedonia across borders: Transdiagnostic relevance of reward dysfunction for noninvasive brain stimulation endophenotypes. CNS Neurosci Ther 2019; 25:1229-1236. [PMID: 31638332 PMCID: PMC6834920 DOI: 10.1111/cns.13230] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 09/15/2019] [Accepted: 09/29/2019] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Anhedonia is a transdiagnostic psychopathological dimension, consisting in the impaired ability to experience pleasure. In order to further our understanding of its neural correlates and to explore its potential relevance as a predictor of treatment response, in this article we systematically reviewed studies involving anhedonia and neuromodulation interventions, across different disorders. METHODS We included seven studies fulfilling inclusion/exclusion criteria and involving different measures of anticipatory and consummatory anhedonia, as well as different noninvasive brain stimulation interventions (transcranial magnetic stimulation and transcranial direct current stimulation). Studies not exploring hedonic measures or not involving neuromodulation intervention were excluded. RESULTS All the included studies entailed the use of rTMS protocols in one of the diverse prefrontal targets. The limited amount of studies and the heterogeneity of stimulation protocols did not allow to draw any conclusion with regard to the efficacy of rTMS in the treatment of transnosographic anhedonia. A potential for anhedonia in dissecting possible endophenotypes of different psychopathological conditions preliminarily emerged. CONCLUSIONS Anhedonia is an underexplored condition in neuromodulation trials. It may represent a valuable transdiagnostic dimension that requires further examination in order to discover new clinical predictors for treatment response.
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Affiliation(s)
- Maria Chiara Spano
- Department of Neuroscience, Imaging and Clinical SciencesUniversity “G. d’Annunzio” of Chieti‐PescaraChietiItaly
| | - Marco Lorusso
- Department of Neuroscience, Imaging and Clinical SciencesUniversity “G. d’Annunzio” of Chieti‐PescaraChietiItaly
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical SciencesUniversity “G. d’Annunzio” of Chieti‐PescaraChietiItaly
| | - Francesca Zoratto
- Reference Centre for Behavioural Sciences and Mental HealthIstituto Superiore di SanitàRomeItaly
| | - Daniela Di Giuda
- Fondazione Policlinico Universitario A. Gemelli IRCCSRomaItaly
- Università Cattolica del Sacro CuoreRomaItaly
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical SciencesUniversity “G. d’Annunzio” of Chieti‐PescaraChietiItaly
- Department of Pharmacy, Pharmacology and Clinical ScienceUniversity of HertfordshireHertsUK
| | - Massimo di Giannantonio
- Department of Neuroscience, Imaging and Clinical SciencesUniversity “G. d’Annunzio” of Chieti‐PescaraChietiItaly
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