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Marshall KD, Derse AR, Weiner SG, Joseph JW. Navigating Care Refusal and Noncompliance in Patients with Opioid Use Disorder. J Emerg Med 2024; 67:e233-e242. [PMID: 38849254 DOI: 10.1016/j.jemermed.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/09/2024] [Accepted: 03/06/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND For many emergency physicians (EPs), deciding whether or not to allow a patient suffering the ill effects of opioid use to refuse care is the most frequent and fraught situation in which they encounter issues of decision-making capacity, informed refusal, and autonomy. Despite the frequency of this issue and the well-known impacts of opioid use disorder on decision-making, the medical ethics community has offered little targeted analysis or guidance regarding these situations. DISCUSSION As a result, EPs demonstrate significant variability in how they evaluate and respond to them, with highly divergent understandings and application of concepts such as decision-making capacity, informed consent, autonomy, legal repercussions, and strategies to resolve the clinical dilemma. In this paper, we seek to provide more clarity to this issue for the EPs. CONCLUSIONS Successfully navigating this issue requires that EPs understand the specific effects that opioid use disorder has on decision-making, and how that in turn bears on the ethical concepts of autonomy, capacity, and informed refusal. Understanding these concepts can lead to helpful strategies to resolve these commonly-encountered dilemmas.
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Affiliation(s)
- Kenneth D Marshall
- Department of Emergency Medicine and History and Philosophy of Medicine, University of Kansas Medical Center, Kansas City, Kansas.
| | - Arthur R Derse
- Department of Emergency Medicine, Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Scott G Weiner
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joshua W Joseph
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Hrelja KM, Kawkab C, Avramidis DK, Ramaiah S, Winstanley CA. Increased risky choice during forced abstinence from fentanyl on the cued rat gambling task. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06659-w. [PMID: 39078498 DOI: 10.1007/s00213-024-06659-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 07/23/2024] [Indexed: 07/31/2024]
Abstract
RATIONALE The use of illicit opioids has arguably never been more risky; street drug potency can be dangerously high, is often unknown to the consumer, and results in multiple daily fatalities worldwide. Furthermore, substance use disorder (SUD) is associated with increased maladaptive, risky decisions in laboratory-based gambling tasks. Animal studies can help determine whether this decision-making deficit is a cause or consequence of drug use. However, most experiments have only assessed psychostimulant drugs. OBJECTIVES To assess differences in decision-making strategies both before, during, and after self-administration of fentanyl in male and female Long Evans rats. METHODS Male and female Long Evans rats were trained to perform the rat gambling task (rGT), loosely based on the Iowa Gambling Task (IGT) used clinically, and/or self-administer fentanyl. We used the cued version of the rGT, in which sound and light stimuli signal sugar pellet rewards, as cocaine self-administration has the greatest effects on decision making in this task variant. RESULTS After training on the cued rGT, female rats self-administered fentanyl more readily, an effect that was most apparent in optimal decision-makers. Contrary to previous reports using cocaine self-administration, decision-making was unaffected during fentanyl self-administration training in either sex. However, risky decision-making increased throughout forced abstinence from fentanyl in males. CONCLUSIONS These findings complement those from human subjects, in whom preference for uncertain outcomes increased before relapse. These data highlight an abstinence-induced change in cognition that is unique to opiates as compared to psychostimulants, and which may critically contribute to the maintenance of addiction and relapse.
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Affiliation(s)
- Kelly M Hrelja
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Carol Kawkab
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Dimitrios K Avramidis
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Shrishti Ramaiah
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Catharine A Winstanley
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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Marshall KD, Derse AR, Weiner SG, Joseph JW. Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:11-24. [PMID: 37220012 DOI: 10.1080/15265161.2023.2209534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient's interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation.
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Yang L, Chen Z, Qi L, Yang H, Zhang Y. Processing abnormalities in monetary outcome evaluations among male individuals with opioid use disorder: evidence from feedback-related negativity. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:207-217. [PMID: 38386811 DOI: 10.1080/00952990.2024.2304036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/07/2024] [Indexed: 02/24/2024]
Abstract
Background: Numerous studies have highlighted the pivotal role of alterations in the monetary reward system in the development and maintenance of substance use disorder (SUD). Although these alterations have been well documented in various forms of SUD, the electrophysiological mechanisms specific to opioid use disorder (OUD) remain underexplored. Understanding these mechanisms is critical for developing targeted interventions and advancing theories of addiction specific to opioid use.Objectives: To explore abnormalities in monetary reward outcome processing in males with OUD. We hypothesized that control individuals would show higher feedback-related negativity (FRN) to losses, unlike those in the OUD group, where FRN to losses and gains would not differ significantly.Methods: Fifty-seven participants (29 male individuals with OUD [heroin] and 28 male controls) were evaluated. A combination of the monetary incentive delay task (MIDT) and event-related potential (ERP) technology was used to investigate electrophysiological differences in monetary reward feedback processing between the OUD and healthy control groups.Results: We observed a significant interaction between group (control vs. OUD) and monetary outcome (loss vs. gain), indicated by p < .05 and η2p = 0.116. Specifically, control participants showed stronger negative FRN to losses than gains (p < .05), unlike the OUD group (p > .05).Conclusion: This study's FRN data indicate that males with OUD show altered processing of monetary rewards, marked by reduced sensitivity to loss. These findings offer electrophysiological insights into why males with OUD may pursue drugs despite potential economic downsides.
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Affiliation(s)
- Ling Yang
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou, China
| | - ZhiChen Chen
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou, China
| | - LiJuan Qi
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou, China
| | - HanBing Yang
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou, China
| | - Yang Zhang
- Faculty of Education, Henan Normal University, Xinxiang, China
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Zeng J, You L, Sheng H, Luo Y, Yang X. The differential neural substrates for reward choice under gain-loss contexts and risk in alcohol use disorder: Evidence from a voxel-based meta-analysis. Drug Alcohol Depend 2023; 248:109912. [PMID: 37182355 DOI: 10.1016/j.drugalcdep.2023.109912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/15/2023] [Accepted: 04/30/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Making a risky decision is a complex process that involves the evaluation of both the values of the options and the associated risk level; this process is distinct from reward processing in gain versus loss contexts. Although disrupted reward processing in mesolimbic dopamine circuitry is suggested to underlie pathological incentive processing in patients with alcohol use disorder (AUD), the differential neural processes subserving these motivational tendencies for risk situations or gain/loss choices in decision-making have not been identified. METHODS To examine the common or distinct neural mechanisms in the evaluation of risk versus outcomes for AUD, we conducted two separate coordinate-based meta-analyses of functional neuroimaging studies by using Seed-Based d Mapping software to evaluate 13 studies investigating gain and loss processing and 10 studies investigating risky decision-making. RESULTS During gain and loss processing, relative to healthy controls, AUD patients showed reduced activation in the mesocortical-limbic circuit, including the orbital prefrontal cortex (OFC), dorsal striatum, insula, hippocampus, cerebellum, cuneus cortex and superior temporal gyrus, but hyperactivation in the inferior temporal gyrus and paracentral lobule (extending to the middle cingulate cortex (MCC) and precuneus). During decision-making under risk, AUD patients exhibited hypoactivity of the prefrontal and cingulate cortices, including the posterior cingulate cortex (extending to the MCC), middle frontal gyrus, medial prefrontal cortex, dorsolateral prefrontal cortex, OFC and anterior cingulate cortex. CONCLUSIONS Our results extend existing neurological evidence by showing that a reduced response in the mesocortical-limbic circuit is found in gain versus loss processing, with decreased responsivity in cortical regions in risk decision-making. Our results implicate dissociable neural circuit responses for gain-loss processing and risk decision-making, which contribute to a better understanding of the pathophysiological mechanism underlying nondrug incentive and risk processing in individuals with AUD.
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Affiliation(s)
- Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, Chongqing, China
| | - Lantao You
- School of Economics and Business Administration, Chongqing University, Chongqing, China
| | - Haoxuan Sheng
- School of Public Policy and Administration, Chongqing University, Chongqing, China
| | - Ya Luo
- Department of Psychiatry, State Key Lab of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Xun Yang
- School of Public Policy and Administration, Chongqing University, Chongqing, China.
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Chang VN, Peters J. Neural circuits controlling choice behavior in opioid addiction. Neuropharmacology 2023; 226:109407. [PMID: 36592884 PMCID: PMC9898219 DOI: 10.1016/j.neuropharm.2022.109407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 12/31/2022]
Abstract
As the opioid epidemic presents an ever-expanding public health threat, there is a growing need to identify effective new treatments for opioid use disorder (OUD). OUD is characterized by a behavioral misallocation in choice behavior between opioids and other rewards, as opioid use leads to negative consequences, such as job loss, family neglect, and potential overdose. Preclinical models of addiction that incorporate choice behavior, as opposed to self-administration of a single drug reward, are needed to understand the neural circuits governing opioid choice. These choice models recapitulate scenarios that humans suffering from OUD encounter in their daily lives. Indeed, patients with substance use disorders (SUDs) exhibit a propensity to choose drug under certain conditions. While most preclinical addiction models have focused on relapse as the outcome measure, our data suggest that choice is an independent metric of addiction severity, perhaps relating to loss of cognitive control over choice, as opposed to excessive motivational drive to seek drugs during relapse. In this review, we examine both preclinical and clinical literature on choice behavior for drugs, with a focus on opioids, and the neural circuits that mediate drug choice versus relapse. We argue that preclinical models of opioid choice are needed to identify promising new avenues for OUD therapy that are translationally relevant. Both forward and reverse translation will be necessary to identify novel treatment interventions. This article is part of the Special Issue on "Opioid-induced changes in addiction and pain circuits".
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Affiliation(s)
- Victoria N Chang
- Department of Anesthesiology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Jamie Peters
- Department of Anesthesiology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA; Department of Pharmacology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA.
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Hüpen P, Habel U, Votinov M, Kable JW, Wagels L. A Systematic Review on Common and Distinct Neural Correlates of Risk-taking in Substance-related and Non-substance Related Addictions. Neuropsychol Rev 2022; 33:492-513. [PMID: 35906511 PMCID: PMC10148787 DOI: 10.1007/s11065-022-09552-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 05/24/2022] [Indexed: 12/01/2022]
Abstract
Both substance-related as well as non-substance-related addictions may include recurrent engagement in risky actions despite adverse outcomes. We here apply a unified approach and review task-based neuroimaging studies on substance-related (SRAs) and non-substance related addictions (NSRAs) to examine commonalities and differences in neural correlates of risk-taking in these two addiction types. To this end, we conducted a systematic review adhering to the PRISMA guidelines. Two databases were searched with predefined search terms to identify neuroimaging studies on risk-taking tasks in individuals with addiction disorders. In total, 19 studies on SRAs (comprising a total of 648 individuals with SRAs) and 10 studies on NSRAs (comprising a total of 187 individuals with NSRAs) were included. Risk-related brain activation in SRAs and NSRAs was summarized individually and subsequently compared to each other. Results suggest convergent altered risk-related neural processes, including hyperactivity in the OFC and the striatum. As characteristic for both addiction types, these brain regions may represent an underlying mechanism of suboptimal decision-making. In contrast, decreased DLPFC activity may be specific to SRAs and decreased IFG activity could only be identified for NSRAs. The precuneus and posterior cingulate show elevated activity in SRAs, while findings regarding these areas were mixed in NSRAs. Additional scarce evidence suggests decreased ventral ACC activity and increased dorsal ACC activity in both addiction types. Associations between identified activation patterns with drug use severity underpin the clinical relevance of these findings. However, this exploratory evidence should be interpreted with caution and should be regarded as preliminary. Future research is needed to evaluate the findings gathered by this review.
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Affiliation(s)
- Philippa Hüpen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany. .,JARA - Translational Brain Medicine, Aachen, Germany.
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
| | - Mikhail Votinov
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
| | - Joseph W Kable
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lisa Wagels
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
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Poudel R, Tobia MJ, Riedel MC, Salo T, Flannery JS, Hill-Bowen LD, Dick AS, Laird AR, Parra CM, Sutherland MT. Risky decision-making strategies mediate the relationship between amygdala activity and real-world financial savings among individuals from lower income households: A pilot study. Behav Brain Res 2022; 428:113867. [PMID: 35385783 PMCID: PMC10739684 DOI: 10.1016/j.bbr.2022.113867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 03/06/2022] [Accepted: 03/28/2022] [Indexed: 11/19/2022]
Abstract
Lower financial savings among individuals experiencing adverse social determinants of health (SDoH) increases vulnerabilities during times of crisis. SDoH including low socioeconomic status (low-SES) influence cognitive abilities as well as health and life outcomes that may perpetuate poverty and disparities. Despite evidence suggesting a role for financial growth in minimizing SDoH-related disparities and vulnerabilities, neurobiological mechanisms linked with financial behavior remain to be elucidated. As such, we examined the relationships between brain activity during decision-making (DM), laboratory-based task performance, and money savings behavior. Participants (N = 24, 14 females) from low-SES households (income<$20,000/year) underwent fMRI scanning while performing the Balloon Analogue Risk Task (BART), a DM paradigm probing risky- and strategic-DM processes. Participants also completed self-report instruments characterizing relevant personality characteristics and then engaged in a community outreach financial program where amount of money saved was tracked over a 6-month period. Regarding BART-related brain activity, we observed expected activity in regions implicated in reward and emotional processing including the amygdala. Regarding brain-behavior relationships, we found that laboratory-based BART performance mediated the impact of amygdala activity on real-world behavior. That is, elevated amygdala activity was linked with BART strategic-DM which, in turn, was linked with more money saved after 6 months. In exploratory analyses, this mediation was moderated by emotion-related personality characteristics such that, only individuals reporting lower alexithymia demonstrated a relationship between amygdala activity and savings. These outcomes suggest that DM-related amygdala activity and/or emotion-related personality characteristics may provide utility as an endophenotypic marker of individual's financial savings behavior.
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Affiliation(s)
- Ranjita Poudel
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Michael J Tobia
- Department of Physics, Florida International University, Miami, FL, United States
| | - Michael C Riedel
- Department of Physics, Florida International University, Miami, FL, United States
| | - Taylor Salo
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Jessica S Flannery
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Lauren D Hill-Bowen
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Anthony S Dick
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, United States
| | - Carlos M Parra
- College of Business, Florida International University, Miami, FL, United States
| | - Matthew T Sutherland
- Department of Psychology, Florida International University, Miami, FL, United States.
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Studler M, Gianotti LRR, Koch K, Hausfeld J, Tarokh L, Maric A, Knoch D. Local slow-wave activity over the right prefrontal cortex reveals individual risk preferences. Neuroimage 2022; 253:119086. [PMID: 35283285 DOI: 10.1016/j.neuroimage.2022.119086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/01/2022] [Accepted: 03/09/2022] [Indexed: 11/24/2022] Open
Abstract
In everyday life, we have to make decisions under varying degrees of risk. Even though previous research has shown that the manipulation of sleep affects risky decision-making, it remains unknown whether individual, temporally stable neural sleep characteristics relate to individual differences in risk preferences. Here, we collected sleep data under normal conditions in fifty-four healthy adults using a portable high-density EEG at participants' home. Whole-brain corrected for multiple testing, we found that lower slow-wave activity (SWA, an indicator of sleep depth) in a cluster of electrodes over the right prefrontal cortex (PFC) is associated with higher individual risk propensity. Importantly, the association between local sleep depth and risk preferences remained significant when controlling for total sleep time and for time spent in deep sleep, i.e., sleep stages N2 and N3. Moreover, the association between risk preferences and SWA over the right PFC was very similar in all sleep cycles. Because the right PFC plays a central role in cognitive control functions, we speculate that local sleep depth in this area, as reflected by SWA, might serve as a dispositional indicator of self-regulatory ability, which in turn reflects risk preferences.
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Affiliation(s)
- Mirjam Studler
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Fabrikstrasse 8, Bern 3012, Switzerland
| | - Lorena R R Gianotti
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Fabrikstrasse 8, Bern 3012, Switzerland.
| | - Katharina Koch
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Fabrikstrasse 8, Bern 3012, Switzerland
| | - Jan Hausfeld
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Fabrikstrasse 8, Bern 3012, Switzerland; CREED and Amsterdam School of Economics, University of Amsterdam, Roeterstraat 11, Amsterdam 1018WB , Netherlands
| | - Leila Tarokh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Bern 3000, Switzerland; Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Bern 3000, Switzerland
| | - Angelina Maric
- Department of Neurology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 26, Zürich 8091, Switzerland
| | - Daria Knoch
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Fabrikstrasse 8, Bern 3012, Switzerland.
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McQuaid GA, Darcey VL, Patterson AE, Rose EJ, VanMeter AS, Fishbein DH. Baseline brain and behavioral factors distinguish adolescent substance initiators and non-initiators at follow-up. Front Psychiatry 2022; 13:1025259. [PMID: 36569626 PMCID: PMC9780121 DOI: 10.3389/fpsyt.2022.1025259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Background Earlier substance use (SU) initiation is associated with greater risk for the development of SU disorders (SUDs), while delays in SU initiation are associated with a diminished risk for SUDs. Thus, identifying brain and behavioral factors that are markers of enhanced risk for earlier SU has major public health import. Heightened reward-sensitivity and risk-taking are two factors that confer risk for earlier SU. Materials and methods We characterized neural and behavioral factors associated with reward-sensitivity and risk-taking in substance-naïve adolescents (N = 70; 11.1-14.0 years), examining whether these factors differed as a function of subsequent SU initiation at 18- and 36-months follow-up. Adolescents completed a reward-related decision-making task while undergoing functional MRI. Measures of reward sensitivity (Behavioral Inhibition System-Behavioral Approach System; BIS-BAS), impulsive decision-making (delay discounting task), and SUD risk [Drug Use Screening Inventory, Revised (DUSI-R)] were collected. These metrics were compared for youth who did [Substance Initiators (SI); n = 27] and did not [Substance Non-initiators (SN); n = 43] initiate SU at follow-up. Results While SI and SN youth showed similar task-based risk-taking behavior, SI youth showed more variable patterns of activation in left insular cortex during high-risk selections, and left anterior cingulate cortex in response to rewarded outcomes. Groups displayed similar discounting behavior. SI participants scored higher on the DUSI-R and the BAS sub-scale. Conclusion Activation patterns in the insula and anterior cingulate cortex may serve as a biomarker for earlier SU initiation. Importantly, these brain regions are implicated in the development and experience of SUDs, suggesting differences in these regions prior to substance exposure.
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Affiliation(s)
- Goldie A. McQuaid
- Department of Psychology, George Mason University, Fairfax, VA, United States
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, United States
- *Correspondence: Goldie A. McQuaid,
| | - Valerie L. Darcey
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, United States
- The Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, United States
| | - Amanda E. Patterson
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, United States
| | - Emma Jane Rose
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Ashley S. VanMeter
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, United States
| | - Diana H. Fishbein
- Frank Porter Graham Child Development Institute, The University of North Carolina, Chapel Hill, Chapel Hill, NC, United States
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
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Ye S, Zhu B, Zhao L, Tian X, Yang Q, Krueger F. Connectome-based model predicts individual psychopathic traits in college students. Neurosci Lett 2021; 769:136387. [PMID: 34883220 DOI: 10.1016/j.neulet.2021.136387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/26/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Psychopathic traits have been suggested to increase the risk of violations of socio-moral norms. Previous studies revealed that abnormal neural signatures are associated with elevated psychopathic traits; however, whether the intrinsic network architecture can predict psychopathic traits at the individual level remains unclear. METHODS The present study utilized connectome-based predictive modeling (CPM) to investigate whether whole-brain resting-state functional connectivity (RSFC) can predict psychopathic traits in the general population. Resting-state fMRI data were collected from 84 college students with varying psychopathic traits measured by the Levenson Self-Report Psychopathy Scale (LSRP). RESULTS Functional connections that were negatively correlated with psychopathic traits predicted individual differences in total LSRP and secondary psychopathy score but not primary score. Particularly, nodes with the most connections in the predictive connectome anchored in the prefrontal cortex (e.g., anterior prefrontal cortex and orbitofrontal cortex) and limbic system (e.g., anterior cingulate cortex and insula). In addition, the connections between the occipital network (OCCN) and cingulo-opercular network (CON) served as a significant predictive connectome for total LSRP and secondary psychopathy score. CONCLUSION CPM constituted by whole-brain RSFC significantly predicted psychopathic traits individually in the general population. The brain areas including the prefrontal cortex and limbic system and large-scale networks including the CON and OCCN play special roles in the predictive model-possibly reflecting atypical cognitive control and affective processing for individuals with elevated psychopathic traits. These findings may facilitate detection and potential intervention of individuals with maladaptive psychopathic tendency.
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Affiliation(s)
- Shuer Ye
- Department of Psychology, Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China
| | - Bing Zhu
- School of Marxism, Zhejiang Yuexiu University, Shaoxing, China
| | - Lei Zhao
- Department of Psychology, Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China; Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Xuehong Tian
- Department of Psychology, Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China
| | - Qun Yang
- Department of Psychology, Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China.
| | - Frank Krueger
- School of Systems Biology, George Mason University, Fairfax, VA, USA; Department of Psychology, University of Mannheim, Mannheim, Germany
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Leota J, Kleinert T, Tran A, Nash K. Neural signatures of heterogeneity in risk-taking and strategic consistency. Eur J Neurosci 2021; 54:7214-7230. [PMID: 34561929 PMCID: PMC9292925 DOI: 10.1111/ejn.15476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/23/2021] [Accepted: 09/20/2021] [Indexed: 12/28/2022]
Abstract
People display a high degree of heterogeneity in risk-taking behaviour, but this heterogeneity remains poorly understood. Here, we use a neural trait approach to examine if task-independent, brain-based differences can help uncover the sources of heterogeneity in risky decision-making. We extend prior research in two key ways. First, we disentangled risk-taking and strategic consistency using novel measures afforded by the Balloon Analogue Risk Task. Second, we applied a personality neuroscience framework to explore why personality traits are typically only weakly related to risk-taking behaviour. We regressed participants' (N = 104) source localized resting-state electroencephalographic activity on risk-taking and strategic consistency. Results revealed that higher levels of resting-state delta-band current density (reflecting reduced cortical activation) in the left dorsal anterior cingulate cortex and the left dorsolateral prefrontal cortex were associated with increased risk-taking and decreased strategic consistency, respectively. These results suggest that heterogeneity in risk-taking behaviour is associated with neural dispositions related to sensitivity to the risk of loss, whereas heterogeneity in strategic consistency is associated with neural dispositions related to strategic decision-making. Finally, extraversion, neuroticism, openness, and self-control were broadly associated with both of the identified neural traits, which in turn mediated indirect associations between personality traits and behavioural measures. These results provide an explanation for the weak direct relationships between personality traits and risk-taking behaviour, supporting a personality neuroscience framework of traits and decision-making.
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Affiliation(s)
- Josh Leota
- Department of Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Tobias Kleinert
- Department of Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Alex Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Kyle Nash
- Department of Psychology, University of Alberta, Edmonton, Alberta, Canada
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13
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Taberna GA, Samogin J, Marino M, Mantini D. Detection of Resting-State Functional Connectivity from High-Density Electroencephalography Data: Impact of Head Modeling Strategies. Brain Sci 2021; 11:brainsci11060741. [PMID: 34204868 PMCID: PMC8226780 DOI: 10.3390/brainsci11060741] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/23/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022] Open
Abstract
Recent technological advances have been permitted to use high-density electroencephalography (hdEEG) for the estimation of functional connectivity and the mapping of resting-state networks (RSNs). The reliable estimate of activity and connectivity from hdEEG data relies on the creation of an accurate head model, defining how neural currents propagate from the cortex to the sensors placed over the scalp. To the best of our knowledge, no study has been conducted yet to systematically test to what extent head modeling accuracy impacts on EEG-RSN reconstruction. To address this question, we used 256-channel hdEEG data collected in a group of young healthy participants at rest. We first estimated functional connectivity in EEG-RSNs by means of band-limited power envelope correlations, using neural activity estimated with an optimized analysis workflow. Then, we defined a series of head models with different levels of complexity, specifically testing the effect of different electrode positioning techniques and head tissue segmentation methods. We observed that robust EEG-RSNs can be obtained using a realistic head model, and that inaccuracies due to head tissue segmentation impact on RSN reconstruction more than those due to electrode positioning. Additionally, we found that EEG-RSN robustness to head model variations had space and frequency specificity. Overall, our results may contribute to defining a benchmark for assessing the reliability of hdEEG functional connectivity measures.
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Affiliation(s)
- Gaia Amaranta Taberna
- Research Center for Motor Control and Neuroplasticity, KU Leuven, 3001 Leuven, Belgium; (G.A.T.); (J.S.); (M.M.)
| | - Jessica Samogin
- Research Center for Motor Control and Neuroplasticity, KU Leuven, 3001 Leuven, Belgium; (G.A.T.); (J.S.); (M.M.)
| | - Marco Marino
- Research Center for Motor Control and Neuroplasticity, KU Leuven, 3001 Leuven, Belgium; (G.A.T.); (J.S.); (M.M.)
- Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Dante Mantini
- Research Center for Motor Control and Neuroplasticity, KU Leuven, 3001 Leuven, Belgium; (G.A.T.); (J.S.); (M.M.)
- Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, 30126 Venice, Italy
- Correspondence: ; Tel.: +32-16-37-29-09
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Piantadosi PT, Halladay LR, Radke AK, Holmes A. Advances in understanding meso-cortico-limbic-striatal systems mediating risky reward seeking. J Neurochem 2021; 157:1547-1571. [PMID: 33704784 DOI: 10.1111/jnc.15342] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/04/2021] [Accepted: 03/06/2021] [Indexed: 02/06/2023]
Abstract
The risk of an aversive consequence occurring as the result of a reward-seeking action can have a profound effect on subsequent behavior. Such aversive events can be described as punishers, as they decrease the probability that the same action will be produced again in the future and increase the exploration of less risky alternatives. Punishment can involve the omission of an expected rewarding event ("negative" punishment) or the addition of an unpleasant event ("positive" punishment). Although many individuals adaptively navigate situations associated with the risk of negative or positive punishment, those suffering from substance use disorders or behavioral addictions tend to be less able to curtail addictive behaviors despite the aversive consequences associated with them. Here, we discuss the psychological processes underpinning reward seeking despite the risk of negative and positive punishment and consider how behavioral assays in animals have been employed to provide insights into the neural mechanisms underlying addictive disorders. We then review the critical contributions of dopamine signaling to punishment learning and risky reward seeking, and address the roles of interconnected ventral striatal, cortical, and amygdala regions to these processes. We conclude by discussing the ample opportunities for future study to clarify critical gaps in the literature, particularly as related to delineating neural contributions to distinct phases of the risky decision-making process.
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Affiliation(s)
- Patrick T Piantadosi
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD, USA
| | | | - Anna K Radke
- Department of Psychology and Center for Neuroscience and Behavior, Miami University, Oxford, OH, USA
| | - Andrew Holmes
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD, USA
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15
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Todesco S, Chao T, Schmid L, Thiessen KA, Schütz CG. Changes in Loss Sensitivity During Treatment in Concurrent Disorders Inpatients: A Computational Model Approach to Assessing Risky Decision-Making. Front Psychiatry 2021; 12:794014. [PMID: 35153861 PMCID: PMC8831914 DOI: 10.3389/fpsyt.2021.794014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recent studies have employed computational modeling to characterize deficits in aspects of decision-making not otherwise detected using traditional behavioral task outcomes. While prospect utility-based modeling has shown to differentiate decision-making patterns between users of different drugs, its relevance in the context of treatment has yet to be examined. This study investigated model-based decision-making as it relates to treatment outcome in inpatients with co-occurring mental health and substance use disorders. METHODS 50 patients (Mage = 38.5, SD = 11.4; 16F) completed the Cambridge Gambling Task (CGT) within 2 weeks of admission (baseline) and 6 months into treatment (follow-up), and 50 controls (Mage = 31.9, SD = 10.0; 25F) completed CGT under a single outpatient session. We evaluated 4 traditional CGT outputs and 5 decisional processes derived from the Cumulative Model. Psychiatric diagnoses and discharge data were retrieved from patient health records. RESULTS Groups were similar in age, sex, and premorbid IQ. Differences in years of education were included as covariates across all group comparisons. All patients had ≥1 mental health diagnosis, with 80% having >1 substance use disorder. On the CGT, patients showed greater Deliberation Time and Delay Aversion than controls. Estimated model parameters revealed higher Delayed Reward Discounting, and lower Probability Distortion and Loss Sensitivity in patients relative to controls. From baseline to follow-up, patients (n = 24) showed a decrease in model-derived Loss Sensitivity and Color Choice Bias. Lastly, poorer Quality of Decision-Making and Choice Consistency, and greater Color Choice Bias independently predicted higher likelihood of treatment dropout, while none were significant in relation to treatment length of stay. CONCLUSION This is the first study to assess a computational model of decision-making in the context of treatment for concurrent disorders. Patients were more impulsive and slower to deliberate choice than controls. While both traditional and computational outcomes predicted treatment adherence in patients, findings suggest computational methods are able to capture treatment-sensitive aspects of decision-making not accessible via traditional methods. Further research is needed to confirm findings as well as investigate the relationship between model-based decision-making and post-treatment outcomes.
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Affiliation(s)
- Stefanie Todesco
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada
| | - Thomas Chao
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada
| | - Laura Schmid
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada
| | - Karina A Thiessen
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada
| | - Christian G Schütz
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada.,BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority (PHSA), Vancouver, BC, Canada
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16
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Khaleghi A, Pirzad Jahromi G, Zarafshan H, Mostafavi SA, Mohammadi MR. Effects of transcranial direct current stimulation of prefrontal cortex on risk-taking behavior. Psychiatry Clin Neurosci 2020; 74:455-465. [PMID: 32415800 DOI: 10.1111/pcn.13025] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/26/2020] [Accepted: 05/10/2020] [Indexed: 01/23/2023]
Abstract
AIM Recent cognitive neuroscience research shows that noninvasive brain stimulation can modify a wide range of behaviors in healthy people. Such regulation effects on human behaviors provide new insights into the neurobiology of cognitive processes and establish causal brain-behavior relations. Here, we aimed to examine the effects of transcranial electrical stimulation (TES) of the prefrontal cortex on risk-taking. METHODS We performed a systematic search on the PubMed, Web of Science, and Cochrane databases with appropriate keywords for original studies reporting the use of TES to modulate risk-taking behavior in healthy individuals. Then, in the meta-analysis phase, a random-effects model was used to measure the pooled effect size (ES). RESULTS Twenty articles were evaluated as eligible studies, including 16 articles on transcranial direct current stimulation (tDCS), two on transcranial alternating current stimulation, one on transcranial pulsed current stimulation, and one on high-definition tDCS. A meta-analysis showed a pooled estimated standardized ES of -0.20 (95% confidence interval [CI], -0.39 to -0.01), which indicates a small ES for active tDCS over the dorsolateral prefrontal cortex (DLPFC) in comparison to sham stimulation (z = 2.31, P = 0.03) in terms of less risky behaviors. Subgroup analysis showed that there is no significant ES for bilateral DLPFC stimulation (d = -0.01; 95%CI, -0.28 to 0.26), but a significant near-medium ES for unilateral DLPFC stimulation (d = -0.41; 95%CI, -0.71 to -0.10). CONCLUSION Our findings support a significant impact of neuroregulation of the DLPFC on risk-taking behavior in healthy individuals. Unilateral noninvasive electrical stimulation of the DLPFC can result in a conservative risk-averse response style, probably through modulating plasticity of the relevant brain networks, including cortical and subcortical structures, as well as increasing subcortical dopaminergic activity.
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Affiliation(s)
- Ali Khaleghi
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Gila Pirzad Jahromi
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hadi Zarafshan
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Ali Mostafavi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Lisoni J, Miotto P, Barlati S, Calza S, Crescini A, Deste G, Sacchetti E, Vita A. Change in core symptoms of borderline personality disorder by tDCS: A pilot study. Psychiatry Res 2020; 291:113261. [PMID: 32622171 DOI: 10.1016/j.psychres.2020.113261] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 12/16/2022]
Abstract
Borderline personality disorder (BPD) recognizes several psychopathological dimensions related to prefrontal cortex impairments. Transcranial Direct Current Stimulation (tDCS) targeting the right prefrontal dorsolateral cortex (DLPFC) positively influence cognitive functions related to impulsivity in healthy subjects. A randomized double-blind study was designed to investigate whether tDCS could modulate core dimensions (impulsivity, aggression, affective dysregulation) of BPD. Also effects on decision making process and substances craving was assessed. Patients were randomized to receive active-tDCS at 2 mA versus sham-tDCS, once a day for 15 sessions. Anode was placed on the right DLPFC (F4), cathode on the left DLPFC (F3). Impulsivity and aggression measures were significantly reduced only in patients treated with active-tDCS. Decision-making process was marginally influenced by the active current. Craving intensity was reduced only in the active-tDCS sample. Both groups showed improvements in the affective dysregulation dimension and anxious and depressive symptoms. The application of bilateral tDCS targeting right DLPFC with anodal stimulation seems to improve core dimensions of BPD (mainly impulsivity and aggression) probably by restoring prefrontal activity. tDCS might be a potential tool for preventing self-harming behaviors.
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Affiliation(s)
- Jacopo Lisoni
- Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy Piazzale Spedali Civili 1, 25123, Brescia Italy.
| | - Paola Miotto
- Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy Piazzale Spedali Civili 1, 25123, Brescia Italy.
| | - Stefano Barlati
- Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy Piazzale Spedali Civili 1, 25123, Brescia Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. Viale Europa 11, 25123, Brescia Italy.
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy. Viale Europa 11, 25123, Brescia Italy.
| | - Alessandra Crescini
- Department of Mental Health, ASST Valcamonica, Esine, Italy. Via Manzoni 142, Esine, Brescia ITALY
| | - Giacomo Deste
- Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy Piazzale Spedali Civili 1, 25123, Brescia Italy.
| | - Emilio Sacchetti
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. Viale Europa 11, 25123, Brescia Italy.
| | - Antonio Vita
- Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy Piazzale Spedali Civili 1, 25123, Brescia Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. Viale Europa 11, 25123, Brescia Italy.
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18
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Risky decision-making in individuals with substance use disorder: A meta-analysis and meta-regression review. Psychopharmacology (Berl) 2020; 237:1893-1908. [PMID: 32363438 DOI: 10.1007/s00213-020-05506-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/10/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND This review aims to identify whether risky decision-making is increased in substance users, and the impact of substance type, polysubstance use status, abstinence period, and treatment status on risky decision-making. METHODS A literature search with no date restrictions was conducted to identify case-control studies or cross-sectional studies that used behavioral tasks to measure risky decision-making in substance users. A random-effects model was performed. GRADE criteria was used to assess the quality of evidence. RESULTS 52 studies were enrolled. The result showed that the difference in risky decision-making performance between user groups and control groups was significant (SMD = - 0.590; 95%CI = - 0.849 to - 0.330; p < 0.001; I2 = 93.4%; Pheterogeneity < 0.001). Subgroup analysis showed that users in the subgroups of alcohol (p < 0.001), tobacco (p < 0.01), cocaine (p < 0.001), opioid (p < 0.001), mixed group (p < 0.01), adult users (p < 0.001), small sample size (p < 0.001), large sample size (p < 0.01), low education (p < 0.001), high education (p < 0.001), short-abstinence period (p < 0.001), long-abstinence period (p < 0.001), without current polysubstance dependence (p < 0.001), and with treatment (p < 0.001) had increased risky decision-making when compared to the controls. On the other hand, elderly substance users with short-abstinence period showed increased risky decision-making. Moreover, current treatment status and polysubstance use may not influence the level of decision-making in substance users. CONCLUSIONS The results show that substance use is associated with impaired risky decision-making, indicating that interventions targeting risky decision-making in substance users should be developed for relapse prevention and rehabilitation.
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Darcey VL, Serafine KM. Omega-3 Fatty Acids and Vulnerability to Addiction: Reviewing Preclinical and Clinical Evidence. Curr Pharm Des 2020; 26:2385-2401. [DOI: 10.2174/1381612826666200429094158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/06/2020] [Indexed: 01/05/2023]
Abstract
Omega-3 (N3) fatty acids are dietary nutrients that are essential for human health. Arguably, one of their most critical contributions to health is their involvement in the structure and function of the nervous system. N3 fatty acids accumulate in neuronal membranes through young adulthood, becoming particularly enriched in a brain region known to be the locus of cognitive control of behavior-the prefrontal cortex (PFC). The PFC undergoes a surge in development during adolescence, coinciding with a life stage when dietary quality and intake of N3 fatty acids tend to be suboptimal. Such low intake may impact neurodevelopment and normative development of cognitive functions suggested to be protective for the risk of subsequent substance and alcohol use disorders (UD). While multiple genetic and environmental factors contribute to risk for and resilience to substance and alcohol use disorders, mounting evidence suggests that dietary patterns early in life may also modulate cognitive and behavioral factors thought to elevate UD risk (e.g., impulsivity and reward sensitivity). This review aims to summarize the literature on dietary N3 fatty acids during childhood and adolescence and risk of executive/ cognitive or behavioral dysfunction, which may contribute to the risk of subsequent UD. We begin with a review of the effects of N3 fatty acids in the brain at the molecular to cellular levels–providing the biochemical mechanisms ostensibly supporting observed beneficial effects. We continue with a review of cognitive, behavioral and neurodevelopmental features thought to predict early substance and alcohol use in humans. This is followed by a review of the preclinical literature, largely demonstrating that dietary manipulation of N3 fatty acids contributes to behavioral changes that impact drug sensitivity. Finally, a review of the available evidence in human literature, suggesting an association between dietary N3 fatty and neurodevelopmental profiles associated with risk of adverse outcomes including UD. We conclude with a brief summary and call to action for additional research to extend the current understanding of the impact of dietary N3 fatty acids and the risk of drug and alcohol UD.
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Affiliation(s)
- Valerie L. Darcey
- Georgetown University, Interdisciplinary Program in Neuroscience, Washington DC, United States
| | - Katherine M. Serafine
- Department of Psychology, The University of Texas at El Paso, El Paso, TX 79968, United States
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Abstract
Resting-state functional connectivity provides novel insight into variations in neural networks associated with addiction to stimulant drugs in individuals with and without a family history of addiction, and both with and without personal drug use. An increased risk for addiction, either because of drug use or genetic/psychosocial vulnerability, is associated with hypoconnectivity in frontostriatal networks, which may weaken goal-directed decision-making. Resilience against addiction development, by contrast, is characterized by hyperconnectivity in two corticostriatal pathways, possibly reflecting compensatory responses in networks associated with regulatory control over habitual behaviors. It is thus conceivable that defying the risk of developing stimulant drug addiction requires increased efforts to control behavior—a hypothesis that may open up new pathways for therapeutic and preventative strategies. Regular drug use can lead to addiction, but not everyone who takes drugs makes this transition. How exactly drugs of abuse interact with individual vulnerability is not fully understood, nor is it clear how individuals defy the risks associated with drugs or addiction vulnerability. We used resting-state functional MRI (fMRI) in 162 participants to characterize risk- and resilience-related changes in corticostriatal functional circuits in individuals exposed to stimulant drugs both with and without clinically diagnosed drug addiction, siblings of addicted individuals, and control volunteers. The likelihood of developing addiction, whether due to familial vulnerability or drug use, was associated with significant hypoconnectivity in orbitofrontal and ventromedial prefrontal cortical-striatal circuits—pathways critically implicated in goal-directed decision-making. By contrast, resilience against a diagnosis of substance use disorder was associated with hyperconnectivity in two networks involving 1) the lateral prefrontal cortex and medial caudate nucleus and 2) the supplementary motor area, superior medial frontal cortex, and putamen—brain circuits respectively implicated in top-down inhibitory control and the regulation of habits. These findings point toward a predisposing vulnerability in the causation of addiction, related to impaired goal-directed actions, as well as countervailing resilience systems implicated in behavioral regulation, and may inform novel strategies for therapeutic and preventative interventions.
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21
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Common and distinct brain activity associated with risky and ambiguous decision-making. Drug Alcohol Depend 2020; 209:107884. [PMID: 32078973 PMCID: PMC7127964 DOI: 10.1016/j.drugalcdep.2020.107884] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/10/2020] [Accepted: 01/26/2020] [Indexed: 01/01/2023]
Abstract
Two often-studied forms of uncertain decision-making (DM) are risky-DM (outcome probabilities known) and ambiguous-DM (outcome probabilities unknown). While DM in general is associated with activation of several brain regions, previous neuroimaging efforts suggest a dissociation between activity linked with risky and ambiguous choices. However, the common and distinct neurobiological correlates associated with risky- and ambiguous-DM, as well as their specificity when compared to perceptual-DM (as a 'control condition'), remains to be clarified. We conducted multiple meta-analyses on neuroimaging results from 151 studies to characterize common and domain-specific brain activity during risky-, ambiguous-, and perceptual-DM. When considering all DM tasks, convergent activity was observed in brain regions considered to be consituents of the canonical salience, valuation, and executive control networks. When considering subgroups of studies, risky-DM (vs. perceptual-DM) was linked with convergent activity in the striatum and anterior cingulate cortex (ACC), regions associated with reward-related processes (determined by objective functional decoding). When considering ambiguous-DM (vs. perceptual-DM), activity convergence was observed in the lateral prefrontal cortex and insula, regions implicated in affectively-neutral mental processes (e.g., cognitive control and behavioral responding; determined by functional decoding). An exploratory meta-analysis comparing brain activity between substance users and non-users during risky-DM identified reduced convergent activity among users in the striatum, cingulate, and thalamus. Taken together, these findings suggest a dissociation of brain regions linked with risky- and ambiguous-DM reflecting possible differential functionality and highlight brain alterations potentially contributing to poor decision-making in the context of substance use disorders.
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22
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Groman SM. The Neurobiology of Impulsive Decision-Making and Reinforcement Learning in Nonhuman Animals. Curr Top Behav Neurosci 2020; 47:23-52. [PMID: 32157666 DOI: 10.1007/7854_2020_127] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Impulsive decisions are those that favor immediate over delayed rewards, involve the acceptance of undue risk or uncertainty, or fail to adapt to environmental changes. Pathological levels of impulsive decision-making have been observed in individuals with mental illness, but there may be substantial heterogeneity in the processes that drive impulsive choices. Understanding this behavioral heterogeneity may be critical for understanding associated diverseness in the neural mechanisms that give rise to impulsivity. The application of reinforcement learning algorithms in the deconstruction of impulsive decision-making phenotypes can help bridge the gap between biology and behavior and provide insights into the biobehavioral heterogeneity of impulsive choice. This chapter will review the literature on the neurobiological mechanisms of impulsive decision-making in nonhuman animals; specifically, the role of the amine neuromodulatory systems (dopamine, serotonin, norepinephrine, and acetylcholine) in impulsive decision-making and reinforcement learning processes is discussed. Ultimately, the integration of reinforcement learning algorithms with sophisticated behavioral and neuroscience techniques may be critical for advancing the understanding of the neurochemical basis of impulsive decision-making.
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van Holstein M, Floresco SB. Dissociable roles for the ventral and dorsal medial prefrontal cortex in cue-guided risk/reward decision making. Neuropsychopharmacology 2020; 45:683-693. [PMID: 31652433 PMCID: PMC7021677 DOI: 10.1038/s41386-019-0557-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/08/2019] [Accepted: 10/17/2019] [Indexed: 11/09/2022]
Abstract
Converging evidence from studies with animals and humans have implicated separate regions of the medial prefrontal cortex (mPFC) corresponding to the anterior cingulate cortex (ACC), in mediating different aspects of reward-related decisions involving uncertainty or risk. However, the dissociable contributions of subregions of the ACC remain unclear, as discrepancies exist between human neuroimaging findings and preclinical rodent studies. To clarify how ventral vs. dorsal regions of the mPFC contribute to risk/reward decision making, the present study assessed the effects of inactivation of different subregions on performance of a "Blackjack task" that measured cue-guided decision making and shares similarities with paradigms used with humans. Male, Long-Evans rats were well-trained to choose between a Small/Certain reward vs a Large/Risky reward delivered with variable probabilities (i.e., good vs. poor-odds, 50% vs. 12.5%). The odds of obtaining the larger reward was signaled by auditory cues at the start of each trial. Inactivation of the ventral, infralimbic region of the mPFC increased risky choice selectively when the odds of winning were poor. By contrast, inactivation of the prelimbic and anterior cingulate regions of the dorsal mPFC led to suboptimal reductions in risky choice on good-odds trials. The effects of prelimbic vs anterior cingulate inactivations were associated with context-dependent alterations in reward vs negative feedback, respectively. These results further clarify the distinct yet complementary manners in which separate ACC regions promote optimal risk/reward decision making and complement neuroimaging findings that activity in human ventral vs dorsal ACC promotes risk aversion or risky choices.
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Affiliation(s)
- Mieke van Holstein
- Department of Psychology and Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, V6T 1Z3, Canada.
| | - Stan B. Floresco
- 0000 0001 2288 9830grid.17091.3eDepartment of Psychology and Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, V6T 1Z3 Canada
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24
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Kitzman H, Olds DL, Knudtson MD, Cole R, Anson E, Smith JA, Fishbein D, DiClemente R, Wingood G, Caliendo AM, Hopfer C, Miller T, Conti G. Prenatal and Infancy Nurse Home Visiting and 18-Year Outcomes of a Randomized Trial. Pediatrics 2019; 144:e20183876. [PMID: 31748254 PMCID: PMC6889968 DOI: 10.1542/peds.2018-3876] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2019] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Given earlier effects found in randomized clinical trials of the Nurse-Family Partnership, we examined whether this program would improve 18-year-old first-born youths' cognition, academic achievement, and behavior and whether effects on cognitive-related outcomes would be greater for youth born to mothers with limited psychological resources (LPR) and on arrests and convictions among females. METHODS We enrolled 742 pregnant, low-income women with no previous live births and randomly assigned them to receive either free transportation for prenatal care plus child development screening and referral (control; n = 514) or prenatal and infant home nurse visit (NV) plus transportation and screening (n = 228). Assessments were completed on 629 18-year-old first-born offspring to evaluate these primary outcomes: (1) cognitive-related abilities (nonverbal intelligence, receptive language, and math achievement) and (2) behavioral health (internalizing behavioral problems, substance use and abuse, sexually transmitted infections, HIV risk, arrests, convictions, and gang membership). RESULTS Compared with control-group counterparts, NV youth born to mothers with LPR had better receptive language (effect size = 0.24; 95% confidence interval [CI]: 0.00 to 0.47; P = .05), math achievement (effect size = 0.38; 95% CI: 0.14 to 0.61; P = .002), and a number of secondary cognitive-related outcomes. NV females, as a trend, had fewer convictions (incidence ratio = 0.47; 95% CI: 0.20 to 1.11; P = .08). There were no intervention effects on other behaviors. CONCLUSIONS The program improved the cognitive-related skills of 18-year-olds born to mothers with LPR and, as a trend, reduced female convictions but produced no other effects on youth behavioral health.
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Affiliation(s)
- Harriet Kitzman
- School of Nursing, University of Rochester, Rochester, New York
| | | | | | - Robert Cole
- School of Nursing, University of Rochester, Rochester, New York
| | - Elizabeth Anson
- School of Nursing, University of Rochester, Rochester, New York
| | - Joyce A Smith
- School of Nursing, University of Rochester, Rochester, New York
| | - Diana Fishbein
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, State College, Pennsylvania
| | - Ralph DiClemente
- College of Global Public Health, New York University, New York, New York
| | - Gina Wingood
- Mailman School of Public Health, Columbia University, New York, New York
| | - Angela M Caliendo
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Christian Hopfer
- Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Ted Miller
- Pacific Institute for Research and Evaluation and School of Public Health, Curtin University, Beltsville, Maryland; and
| | - Gabriella Conti
- Departments of Economics and Social Science, University College London, London, United Kingdom
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25
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Orsini CA, Hernandez CM, Bizon JL, Setlow B. Deconstructing value-based decision making via temporally selective manipulation of neural activity: Insights from rodent models. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 19:459-476. [PMID: 30341621 PMCID: PMC6472996 DOI: 10.3758/s13415-018-00649-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The ability to choose among options that differ in their rewards and costs (value-based decision making) has long been a topic of interest for neuroscientists, psychologists, and economists alike. This is likely because this is a cognitive process in which all animals (including humans) engage on a daily basis, be it routine (which road to take to work) or consequential (which graduate school to attend). Studies of value-based decision making (particularly at the preclinical level) often treat it as a uniform process. The results of such studies have been invaluable for our understanding of the brain substrates and neurochemical systems that contribute to decision making involving a range of different rewards and costs. Value-based decision making is not a unitary process, however, but is instead composed of distinct cognitive operations that function in concert to guide choice behavior. Within this conceptual framework, it is therefore important to consider that the known neural substrates supporting decision making may contribute to temporally distinct and dissociable components of the decision process. This review will describe this approach for investigating decision making, drawing from published studies that have used techniques that allow temporal dissection of the decision process, with an emphasis on the literature in animal models. The review will conclude with a discussion of the implications of this work for understanding pathological conditions that are characterized by impaired decision making.
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Affiliation(s)
- Caitlin A Orsini
- Department of Psychiatry, University of Florida College of Medicine, P.O. Box 100256, Gainesville, FL, 32610-0256, USA.
- Center for Addiction Research and Education, University of Florida, Gainesville, FL, 32610, USA.
| | - Caesar M Hernandez
- Department of Neuroscience, University of Florida, Gainesville, FL, 32610, USA
| | - Jennifer L Bizon
- Department of Psychiatry, University of Florida College of Medicine, P.O. Box 100256, Gainesville, FL, 32610-0256, USA
- Center for Addiction Research and Education, University of Florida, Gainesville, FL, 32610, USA
- Department of Neuroscience, University of Florida, Gainesville, FL, 32610, USA
| | - Barry Setlow
- Department of Psychiatry, University of Florida College of Medicine, P.O. Box 100256, Gainesville, FL, 32610-0256, USA
- Center for Addiction Research and Education, University of Florida, Gainesville, FL, 32610, USA
- Department of Neuroscience, University of Florida, Gainesville, FL, 32610, USA
- Department of Psychology, University of Florida, Gainesville, FL, 32610, USA
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26
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Wei S, Liu Q, Harrington M, Sun J, Yu H, Han J, Hao M, Wu H, Liu X. Nonconformist tendencies related to risky choices in female methamphetamine abstainers. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 46:68-77. [PMID: 31120769 DOI: 10.1080/00952990.2019.1608554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Many experimental studies and theoretical models have tried to explain the multifaceted formation of drug addiction. In most addiction models, social factors are an important component; however, few empirical studies have investigated the social influences on the safe or risky choices of drug-addicted individuals during the abstinence stage. Objectives: To investigate the behavioral patterns of female methamphetamine abstainers under social influence. Methods: Thirty-seven female methamphetamine abstainers (average abstinence time: 8.61 ± 4.75 months) and 40 matched controls performed a gambling task in the presence of peers' choices. We applied both model-free and computational model-based analysis to examine how the decision patterns differed with social influence between the two groups. Results: 1) the choice data from the two groups showed a social influence effect such that participants made more risky choices when others made risky choices; 2) overall, the female methamphetamine abstainers made more risky choices in the social influence task; and 3) in the computational model parameters, the female methamphetamine abstainers exhibited more nonconforming attitudes (with negative other-conferred utility) with respect to peer influence, whereas controls showed higher conformity to peers. Conclusion: Our findings provide the first objective evidence that female methamphetamine abstainers show peer nonconformity. This nonconformist tendency may be a potential behavioral marker to track drug addiction and help to elucidate the mechanisms of decisions made by female methamphetamine abstainers.
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Affiliation(s)
- Shuguang Wei
- Faculty of Education, Henan Normal University, Xinxiang, Henan, China.,CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
| | - Quanying Liu
- Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA.,Molecular Neurology Program, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Michael Harrington
- Molecular Neurology Program, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Jinxiu Sun
- Department of Sports, Jishou University, Jishou, China
| | - Hao Yu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Sino Danish College, Univerisity of Chinese Academy of Sciences, Beijing, China
| | - Jie Han
- Department of Education, Hebei Female Drug Rehabilitation Center, Shijiazhuang, Hebei, China
| | - Ming Hao
- Department of Education, Hebei Female Drug Rehabilitation Center, Shijiazhuang, Hebei, China
| | - Haiyan Wu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Xun Liu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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27
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Marinho V, Pinto GR, Bandeira J, Oliveira T, Carvalho V, Rocha K, Magalhães F, de Sousa VG, Bastos VH, Gupta D, Orsini M, Teixeira S. Impaired decision-making and time perception in individuals with stroke: Behavioral and neural correlates. Rev Neurol (Paris) 2019; 175:367-376. [PMID: 30922589 DOI: 10.1016/j.neurol.2018.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/09/2018] [Accepted: 10/09/2018] [Indexed: 01/03/2023]
Abstract
Several studies have demonstrated that stroke subjects present impairment of functions related to decision-making and timing, involving the information processing in the neural circuits of the cerebellum in association with the prefrontal cortex. This review is aimed to identify the gaps, and demonstrate a better understanding of decision-making and timing functions in the patients with stroke. Electronic literature database was searched and the findings of relevant studies were used to explore the mechanisms of decision-making and timing in patients with stroke, as well as the circuit connections in timing mediated by prefrontal cortex and cerebellum. A literature review was conducted with 65 studies that synthesized findings on decision-making and time perception in individuals with stroke. Types of neurobiological modalities in this study included: Relationships among decision-making, time perception, related cognitive aspects (such as discrimination tasks, verbal estimation, bisection tasks, time production and motor reproduction), and motor control. We demonstrate that the timing processes are important for the performance in cognitive tasks and that the cerebellum and prefrontal cortex are involved in decision-making and time perception. In the context, the decision-making is impaired in stroke patients has a great impact on executive functions, and this seems to be important in determining neurobiological aspects relevant to the time interval interpretation.
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Affiliation(s)
- V Marinho
- Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil; Genetics and Molecular Biology Laboratory, Federal University of Piauí, Parnaíba-PI, Brazil; The Northeast Biotechnology Network, Federal University of Piauí, Teresina-PI, Brazil.
| | - G R Pinto
- Genetics and Molecular Biology Laboratory, Federal University of Piauí, Parnaíba-PI, Brazil; The Northeast Biotechnology Network, Federal University of Piauí, Teresina-PI, Brazil
| | - J Bandeira
- Teresina Unified Education Center - CEUT, Teresina-PI, Brazil
| | - T Oliveira
- Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil; Genetics and Molecular Biology Laboratory, Federal University of Piauí, Parnaíba-PI, Brazil; The Northeast Biotechnology Network, Federal University of Piauí, Teresina-PI, Brazil
| | - V Carvalho
- Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil; The Northeast Biotechnology Network, Federal University of Piauí, Teresina-PI, Brazil
| | - K Rocha
- Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil; The Northeast Biotechnology Network, Federal University of Piauí, Teresina-PI, Brazil
| | - F Magalhães
- Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil; The Northeast Biotechnology Network, Federal University of Piauí, Teresina-PI, Brazil
| | - V G de Sousa
- Genetics and Molecular Biology Laboratory, Federal University of Piauí, Parnaíba-PI, Brazil
| | - V H Bastos
- The Northeast Biotechnology Network, Federal University of Piauí, Teresina-PI, Brazil; Brain Mapping and Functionality Laboratory, Federal University of Piauí, Parnaíba-PI, Brazil
| | - D Gupta
- Department of Biology, Camden County College, Blackwood, NJ, USA
| | - M Orsini
- Master's Program in Local Development Program, University Center Augusto Motta - UNISUAM, Rio de Janeiro, Brazil
| | - S Teixeira
- Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil; The Northeast Biotechnology Network, Federal University of Piauí, Teresina-PI, Brazil
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28
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Rose EJ, Picci G, Fishbein DH. Neurocognitive Precursors of Substance Misuse Corresponding to Risk, Resistance, and Resilience Pathways: Implications for Prevention Science. Front Psychiatry 2019; 10:399. [PMID: 31258493 PMCID: PMC6586742 DOI: 10.3389/fpsyt.2019.00399] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/21/2019] [Indexed: 12/22/2022] Open
Abstract
Studies of substance misuse prevention generally focus on characteristics that typify risk, with the assumption that the prevalence of the problem will be optimally reduced by identifying, targeting, and reducing or eliminating risk factors. However, this risk-centered approach neglects variations in individual-level and environmental characteristics that portend differential pathways that are distinguishable by timing of substance use initiation (e.g., early versus delayed), the likelihood of use escalation versus eventual desistance, and enduring abstinence, despite exposure to significant risk factors. Considering the various underpinnings of these distinct substance use trajectories is critical to a more nuanced understanding of the effects, potency, and malleability of factors that are known to increase risk or confer protection. Here, we discuss three pathways relative to substance use patterns and predictors in the context of adversity, a well-known, highly significant influence on propensity for substance misuse. The first pathway is designated as "high risk" based on early onset of substance use, rapid escalation, and proneness to substance use disorders. Individuals who defy all odds and eventually exhibit adaptive developmental outcomes despite an initial maladaptive reaction to adversity, are referred to as "resilient." However, another categorization that has not been adequately characterized is "resistant." Resistant individuals include those who do not exhibit problematic substance use behaviors (e.g., early onset and escalation) and do not develop substance use disorders or other forms of psychopathology, despite significant exposure to factors that normally increase the propensity for such outcomes (e.g. trauma and/or adversity). In this paper, we apply this conceptualization of risk, resistance, and resilience for substance misuse to a more fine-grained analysis of substance use pathways and their corresponding patterns (e.g., non-use, initiation, escalation, desistance). The significance of the progression of neurocognitive functioning over the course of development is discussed as well as how this knowledge may be translated to make a science-based determination of intervention targets. This more encompassing theoretical model has direct implications for primary prevention and clinical approaches to disrupt risk pathways and to optimize long-term outcomes.
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Affiliation(s)
- Emma Jane Rose
- Program for Translational Research on Adversity and Neurodevelopment (P-TRAN), The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Giorgia Picci
- Program for Translational Research on Adversity and Neurodevelopment (P-TRAN), The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Diana H Fishbein
- Program for Translational Research on Adversity and Neurodevelopment (P-TRAN), The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA.,Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
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29
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Amidfar M, Ko YH, Kim YK. Neuromodulation and Cognitive Control of Emotion. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:545-564. [DOI: 10.1007/978-981-32-9721-0_27] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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30
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White R, Gatzke-Kopp LM, Ryan PJ, Lydon-Staley DM. The association between perinatal hypoxia exposure and externalizing symptoms and children's decision making in conditions of uncertainty is moderated by DRD2 genotype. Dev Psychobiol 2018; 61:56-68. [PMID: 30264459 DOI: 10.1002/dev.21785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 08/14/2018] [Accepted: 08/26/2018] [Indexed: 11/10/2022]
Abstract
Variants of the DRD2 Taq1A polymorphism, which have been shown to result in functional differences in dopamine D2 receptors (D2R), have been linked to various externalizing outcomes in adults. However, the neurobiological processes that contribute to these associations are not well understood. The current study investigates gene × environment effects on teacher-rated externalizing behaviors and probabilistic decision making in a sample of 333 children (age 9) enrolled in an ongoing longitudinal study. Findings indicate that externalizing behaviors increased as a function of hypoxic exposure only among individuals carrying the A1 (A1+) allele. Results also indicate that willingness to pursue reward under conditions of maximum uncertainty (50% probability) decreased as a function of hypoxic exposure only among A1- individuals. Among A1 carriers, no association between probability decision making and hypoxic exposure emerged. These findings suggest that hypoxia could influence neural development through different biological pathways depending on D2 receptor genotype, and provide insight into the development of individual differences in behavior and decision making.
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Affiliation(s)
- Roisin White
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Lisa M Gatzke-Kopp
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Patrick J Ryan
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - David M Lydon-Staley
- Department of Bioengineering, The University of Pennsylvania, University Park, Pennsylvania
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31
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Lopez-Guzman S, Konova AB, Louie K, Glimcher PW. Risk preferences impose a hidden distortion on measures of choice impulsivity. PLoS One 2018; 13:e0191357. [PMID: 29373590 PMCID: PMC5786295 DOI: 10.1371/journal.pone.0191357] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 01/03/2018] [Indexed: 12/31/2022] Open
Abstract
Measuring temporal discounting through the use of intertemporal choice tasks is now the gold standard method for quantifying human choice impulsivity (impatience) in neuroscience, psychology, behavioral economics, public health and computational psychiatry. A recent area of growing interest is individual differences in discounting levels, as these may predispose to (or protect from) mental health disorders, addictive behaviors, and other diseases. At the same time, more and more studies have been dedicated to the quantification of individual attitudes towards risk, which have been measured in many clinical and non-clinical populations using closely related techniques. Economists have pointed to interactions between measurements of time preferences and risk preferences that may distort estimations of the discount rate. However, although becoming standard practice in economics, discount rates and risk preferences are rarely measured simultaneously in the same subjects in other fields, and the magnitude of the imposed distortion is unknown in the assessment of individual differences. Here, we show that standard models of temporal discounting —such as a hyperbolic discounting model widely present in the literature which fails to account for risk attitudes in the estimation of discount rates— result in a large and systematic pattern of bias in estimated discounting parameters. This can lead to the spurious attribution of differences in impulsivity between individuals when in fact differences in risk attitudes account for observed behavioral differences. We advance a model which, when applied to standard choice tasks typically used in psychology and neuroscience, provides both a better fit to the data and successfully de-correlates risk and impulsivity parameters. This results in measures that are more accurate and thus of greater utility to the many fields interested in individual differences in impulsivity.
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Affiliation(s)
- Silvia Lopez-Guzman
- Center for Neural Science, New York University, New York, United States of America
- * E-mail:
| | - Anna B. Konova
- Center for Neural Science, New York University, New York, United States of America
| | - Kenway Louie
- Center for Neural Science, New York University, New York, United States of America
| | - Paul W. Glimcher
- Center for Neural Science, New York University, New York, United States of America
- Institute for the Study of Decision Making, New York University, New York, United States of America
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32
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Sutherland MT, Fishbein DH. Higher Trait Psychopathy Is Associated with Increased Risky Decision-Making and Less Coincident Insula and Striatal Activity. Front Behav Neurosci 2018; 11:245. [PMID: 29311863 PMCID: PMC5732997 DOI: 10.3389/fnbeh.2017.00245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 11/27/2017] [Indexed: 01/05/2023] Open
Abstract
Higher trait levels of psychopathy have been associated with both a tendency to maintain disadvantageous decision-making strategies and aberrant cortico-limbic neural activity. To explore the neural mechanisms associated with the psychopathy-related propensity to continue selecting risky choices, a non-forensic sample of participants completed a self-report psychopathy questionnaire and two runs of a risky decision-making task during H215O positron emission tomography (PET) scanning. In this secondary data analysis study, we leveraged data previously collected to examine the impact of previous drug use on risky decision-making to explore the relations between self-reported psychopathy and behavioral and brain metrics during performance of the Cambridge Decision-Making Task (CDMT), in which volunteers chose between small/likely or large/unlikely potential reward outcomes. Behaviorally, we observed that psychopathy scores were differentially correlated with the percent of risky decisions made in run 1 vs. run 2 of the task. Specifically, higher levels of psychopathy, above and beyond that attributable to drug use or sex, were associated with greater tendencies to make risky selections only in the second half (run 2) of the task. In parallel, psychopathy scores negatively correlated with regional cerebral blood flow (rCBF) in the right insula and right ventral striatum during run 2 of the CDMT. These exploratory outcomes suggest that greater levels of psychopathy may be associated with an inability to translate experience with negative outcomes into behavioral adaptations possibly due to decreased neural efficiency in regions related to somatic and/or reward feedback processes.
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Affiliation(s)
- Matthew T Sutherland
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Diana H Fishbein
- Translational Research on Adversity and Neurodevelopment, Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
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33
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Rachid F. Neurostimulation techniques in the treatment of cocaine dependence: A review of the literature. Addict Behav 2018; 76:145-155. [PMID: 28822321 DOI: 10.1016/j.addbeh.2017.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/06/2017] [Accepted: 08/08/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Cocaine use disorder is a very common condition that represents a substantial public health problem, and no effective pharmacological or psychological therapies have been identified to date. Urgent therapeutic alternatives are therefore needed such as neurostimulation techniques. The purpose of this review is to describe and discuss studies that have evaluated the safety and efficacy of these techniques for the treatment of cocaine dependence. METHODS The electronic literature on repetitive transcranial magnetic stimulation, theta-burst stimulation, deep transcranial magnetic stimulation, transcranial direct current stimulation, magnetic seizure therapy, electroconvulsive therapy, cranial electro-stimulation, and deep brain stimulation in the treatment of cocaine addiction were reviewed. RESULTS Most of these studies which are few in numbers and with limited sample sizes found that some of these neurostimulation techniques, particularly transcranial magnetic stimulation, and transcranial direct current stimulation are safe and potentially effective in the reduction of craving to cocaine. Although deep brain stimulation showed some good results in one patient, no conclusion can be drawn so far concerning the efficacy and safety of this approach. CONCLUSION Given the somewhat promising results of some of the studies, future controlled studies with larger samples, and optimal stimulus parameters should be designed to confirm the short- and long-term safety and efficacy of neurostimulation techniques to treat cocaine addiction.
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34
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Guttman Z, Moeller SJ, London ED. Neural underpinnings of maladaptive decision-making in addictions. Pharmacol Biochem Behav 2018; 164:84-98. [PMID: 28666893 PMCID: PMC5745312 DOI: 10.1016/j.pbb.2017.06.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/07/2017] [Accepted: 06/26/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Zoe Guttman
- Neuroscience Interdepartmental Program, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Scott J Moeller
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Edythe D London
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States; Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States; Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States.
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35
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Zhao Q, Li H, Hu B, Wu H, Liu Q. Abstinent Heroin Addicts Tend to Take Risks: ERP and Source Localization. Front Neurosci 2017; 11:681. [PMID: 29270107 PMCID: PMC5723666 DOI: 10.3389/fnins.2017.00681] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 11/21/2017] [Indexed: 11/13/2022] Open
Abstract
Abnormal decision making is a behavioral characteristic of drug addiction. Indeed, drug addicts prefer immediate rewards at the expense of future interests. Assessing the neurocognitive basis of decision-making related to drug dependence, combining event-related potential (ERP) analysis and source localization techniques, may provide new insights into understanding decision-making deficits in drug addicts and further guide withdrawal treatment. In this study, EEG was performed in 20 abstinent heroin addicts (AHAs) and 20 age-, education- and gender-matched healthy controls (HCs) while they participated in a simple two-choice gambling task (99 vs. 9). Our behavioral results showed that AHAs tend to select higher-risk choices compared with HCs (i.e., more "99" choices than "9"). ERP results showed that right hemisphere preponderance of stimulus-preceding negativity was disrupted in AHAs, but not in HCs. Feedback-related negativity of difference wave was higher in AHAs than HCs, with the P300 amplitude associated with risk magnitude and valence. Using source localization that allows identification of abnormal brain activity in consequential cognitive stages, including the reward expectation and outcome evaluation stages, we found abnormalities in both behavioral and neural responses on gambling in AHAs. Taken together, our findings suggest AHAs have risk-prone tendency and dysfunction in adaptive decision making, since they continue to choose risky options even after accruing considerable negative scores, and fail to shift to a safer strategy to avoid risk. Such abnormal decision-making bias to risk and immediate reward seeking may be accompanied by abnormal reward expectation and evaluation in AHAs, which explains their high risk-seeking and impulsivity.
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Affiliation(s)
- Qinglin Zhao
- Ubiquitous Awareness and Intelligent Solutions Lab, Lanzhou University, Lanzhou, China
| | - Hongqian Li
- Ubiquitous Awareness and Intelligent Solutions Lab, Lanzhou University, Lanzhou, China
| | - Bin Hu
- Ubiquitous Awareness and Intelligent Solutions Lab, Lanzhou University, Lanzhou, China
| | - Haiyan Wu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Quanying Liu
- Movement Control & Neuroplasticity Research Group, KU Leuven, Leuven, Belgium.,Neural Control of Movement Laboratory, ETH Zurich, Zurich, Switzerland
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36
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Fishbein DH, Novak SP, Ridenour TA, Thornburg V, Hammond J, Brown J. Neurocognitive Characteristics of Early Marijuana Use Initiation in Adolescents: A Signature Mapping Analysis. J Stud Alcohol Drugs 2017; 77:431-40. [PMID: 27172575 DOI: 10.15288/jsad.2016.77.431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Prior studies of the association between neurocognitive functions and marijuana use among adolescents are mostly cross-sectional and conducted in adolescents who have already initiated marijuana use. The current study used a longitudinal design on a preadolescent, substance-naive sample. We sought to identify demographic factors associated with neurocognitive functions and the complement of neurocognitive function characteristics that predict marijuana initiation in adolescents. METHOD Substance-naive adolescents (n = 465) ages 10-12 years (51% male) were recruited from a community with high levels of adolescent marijuana use and prospectively followed to ages 12-15. Tasks measuring neurocognitive functions were administered and audio-assisted interviews were conducted. Two types of models were estimated for each outcome: forced-entry models and another using stepwise selection via bidirectional elimination with varying tolerance levels to account for selection misspecification. RESULTS About 10% (n = 49) initiated marijuana use over the study period. Child's age, academic achievement, and parental education were associated with baseline neurocognitive functions; namely, positive emotion attributions and lower impulsivity. Facial recognition-particularly misattribution of sad faces-was the strongest predictor of marijuana initiation, including in the stepwise model (partial OR = 1.3, 95% CI [1.03, 1.63], p < .05) that resulted in the best-fitting model. CONCLUSIONS Prediction of marijuana initiation was improved in stepwise models compared with forced-entry models. Emotion perception appears to be an early developmental risk factor that is prospectively associated with marijuana initiation; as expected, other neurocognitive functions did not play an interactive role. Future studies of the interrelationships between emotion perception and the myriad other factors implicated in marijuana initiation, including neurocognitive functions not measured here, will provide a more comprehensive understanding of risk for marijuana initiation.
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Affiliation(s)
- Diana H Fishbein
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania
| | - Scott P Novak
- RTI International, Research Triangle Park, North Carolina
| | - Ty A Ridenour
- RTI International, Research Triangle Park, North Carolina
| | | | - Jane Hammond
- RTI International, Research Triangle Park, North Carolina
| | - Jaki Brown
- RTI International, Research Triangle Park, North Carolina
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Heilbronner SR. Modeling risky decision-making in nonhuman animals: shared core features. Curr Opin Behav Sci 2017; 16:23-29. [PMID: 28523287 DOI: 10.1016/j.cobeha.2017.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Understanding the neural mechanisms of risky decision-making is critical to developing appropriate treatments for psychiatric disorders, problem gambling, and addiction to drugs of abuse. Probing neurobiological mechanisms requires the use of nonhuman animal models (particularly rhesus macaques, rats, and mice). However, there is considerable variation across species in risk preferences. Nevertheless, there are shared core features of risky decision-making present across species. As demonstrated with a wide variety of behavioral paradigms, modulators of risk preference observed in humans are readily replicated in model species. Thus, risky decision-making represents an important implementation of reward-guided decision-making that is feasibly modeled across species.
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Affiliation(s)
- Sarah R Heilbronner
- Department of Pharmacology and Physiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Box 711, Rochester, NY 14642
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Verdejo-Garcia A, Chong TTJ, Stout JC, Yücel M, London ED. Stages of dysfunctional decision-making in addiction. Pharmacol Biochem Behav 2017; 164:99-105. [PMID: 28216068 DOI: 10.1016/j.pbb.2017.02.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/27/2017] [Accepted: 02/03/2017] [Indexed: 01/26/2023]
Abstract
Drug use is a choice with immediate positive outcomes, but long-term negative consequences. Thus, the repeated use of drugs in the face of negative consequences suggests dysfunction in the cognitive mechanisms underpinning decision-making. This cognitive dysfunction can be mapped into three stages: the formation of preferences involving valuation of decision options; choice implementation including motivation, self-regulation and inhibitory processes; and feedback processing implicating reinforcement learning. This article reviews behavioral studies that have examined alterations in these three stages of decision-making in people with substance use disorders. Relative to healthy individuals, those with alcohol, cannabis, stimulant and opioid use disorders value risky options more highly during the formation of preferences; have a greater appetite for superficially attractive rewards during choice implementation; and are both more efficient in learning from rewards and less efficient in learning from losses during feedback processing. These observed decision-making deficits are most likely due to both premorbid factors and drug-induced effects. Because decision-making deficits have been prospectively associated with a greater risk of drug relapse, we advocate for greater research on modulating the component stages that give rise to dysfunctional decision-making in disorders of addiction.
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Affiliation(s)
- Antonio Verdejo-Garcia
- Monash Institute of Cognitive & Clinical Neuroscience (MICCN), Monash University, Australia; School of Psychological Sciences, Monash University, Australia.
| | - Trevor T-J Chong
- Monash Institute of Cognitive & Clinical Neuroscience (MICCN), Monash University, Australia; School of Psychological Sciences, Monash University, Australia
| | - Julie C Stout
- Monash Institute of Cognitive & Clinical Neuroscience (MICCN), Monash University, Australia; School of Psychological Sciences, Monash University, Australia
| | - Murat Yücel
- Monash Institute of Cognitive & Clinical Neuroscience (MICCN), Monash University, Australia; School of Psychological Sciences, Monash University, Australia
| | - Edythe D London
- Semel Institute of Neuroscience, University of California Los Angeles, United States
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Suckling J, Nestor LJ. The neurobiology of addiction: the perspective from magnetic resonance imaging present and future. Addiction 2017; 112:360-369. [PMID: 27452960 PMCID: PMC5244682 DOI: 10.1111/add.13474] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 11/19/2015] [Accepted: 05/20/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Addiction is associated with severe economic and social consequences and personal tragedies, the scientific exploration of which draws upon investigations at the molecular, cellular and systems levels with a wide variety of technologies. Magnetic resonance imaging (MRI) has been key to mapping effects observed at the microscopic and mesoscopic scales. The range of measurements from this apparatus has opened new avenues linking neurobiology to behaviour. This review considers the role of MRI in addiction research, and what future technological improvements might offer. METHODS A hermeneutic strategy supplemented by an expansive, systematic search of PubMed, Scopus and Web of Science databases, covering from database inception to October 2015, with a conjunction of search terms relevant to addiction and MRI. Formal meta-analyses were prioritized. RESULTS Results from methods that probe brain structure and function suggest frontostriatal circuitry disturbances within specific cognitive domains, some of which predict drug relapse and treatment response. New methods of processing imaging data are opening opportunities for understanding the role of cerebral vasculature, a global view of brain communication and the complex topology of the cortical surface and drug action. Future technological advances include increases in MRI field strength, with concomitant improvements in image quality. CONCLUSIONS The magnetic resonance imaging literature provides a limited but convergent picture of the neurobiology of addiction as global changes to brain structure and functional disturbances to frontostriatal circuitry, accompanied by changes in anterior white matter.
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Affiliation(s)
- John Suckling
- Department of Psychiatry and Behavioural and Clinical Neuroscience InstituteUniversity of CambridgeCambridgeUK,Cambridge and Peterborough Foundation NHS TrustCambridgeUK
| | - Liam J. Nestor
- Department of Psychiatry and Behavioural and Clinical Neuroscience InstituteUniversity of CambridgeCambridgeUK,Centre for Neuropsychopharmacology, Division of Brain SciencesImperial College LondonLondonUK
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Phillips JG, Ogeil RP. Cannabis, alcohol use, psychological distress, and decision-making style. J Clin Exp Neuropsychol 2016; 39:670-681. [PMID: 27876440 DOI: 10.1080/13803395.2016.1255311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION There have been suggestions of hypofrontality in cannabis users. To understand cannabis-related differences in decisional processes, Janis and Mann's conflict model of decision making was applied to recreational cannabis smokers who varied in their alcohol use and level of psychological distress. METHOD An online sample of recreational substance users (114 male, 119 female) completed the Melbourne Decision Making Questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), Kessler's Psychological Distress Scale (K10), and the Severity of Dependence Scale (SDS) for cannabis. RESULTS Multivariate analysis of variance examined self-reported decision-making styles as a function of gender, recent cannabis use, risky alcohol consumption, and levels of psychological distress. Psychological distress was associated with lower decisional self-esteem and higher levels of procrastination and buck-passing. There were gender differences associated with cannabis use. Female cannabis users reported higher levels of hypervigilance, while male cannabis users reported lower levels of buck-passing. CONCLUSIONS Although there was little indication of an avoidant decisional style in cannabis users, the results suggest that cannabis affects decisional processes, contributing to panic in females and impulsivity in males.
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Affiliation(s)
- James G Phillips
- a Psychology Department , Auckland University of Technology , Auckland , New Zealand
| | - Rowan P Ogeil
- b Eastern Health Clinical School , Monash University, and Turning Point, Eastern Health , Clayton , Australia
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Park SH, Park HS, Kim SE. Regional Cerebral Glucose Metabolism in Novelty Seeking and Antisocial Personality: A Positron Emission Tomography Study. Exp Neurobiol 2016; 25:185-90. [PMID: 27574485 PMCID: PMC4999424 DOI: 10.5607/en.2016.25.4.185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/08/2016] [Accepted: 07/08/2016] [Indexed: 12/31/2022] Open
Abstract
Novelty seeking (NS) and antisocial personality (ASP) are commonly exhibited by those who suffer from addictions, such as substance abuse. NS has been suggested to be a fundamental aspect of ASP. To investigate the neurobiological substrate of NS and ASP, we tested the relationship between regional cerebral glucose metabolism and the level of NS, determining the differences between individuals with and without ASP. Seventy-two healthy adults (43 males, mean age±SD=38.8±16.6 years, range=20~70 years; 29 females, 44.2±20.1 years, range=19~72 years) underwent resting-state brain positron emission tomography (PET) 40 minutes after (18)F-fluorodeoxyglucose (FDG) injection. Within 10 days of the FDG PET study, participants completed Cloninger's 240-item Temperament and Character Inventory (TCI) to determine NS scores. Participants with and without ASP were grouped according to their TCI profiles. Statistical parametric mapping analysis was performed using the FDG PET and TCI profile data. NS scores positively correlated with metabolism in the left anterior cingulate gyrus and the insula on both sides of the brain and negatively correlated with metabolism in the right pallidum and putamen. Participants with ASP showed differences in cerebral glucose metabolism across various cortical and subcortical regions, mainly in the frontal and prefrontal areas. These data demonstrate altered regional cerebral glucose metabolism in individuals with NS and ASP and inform our understanding of the neurobiological substrates of problematic behaviors and personality disorders.
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Affiliation(s)
- So Hyeon Park
- Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 16229, Korea.; Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Korea
| | - Hyun Soo Park
- Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 16229, Korea.; Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Korea.; Advanced Institutes of Convergence Technology, Suwon 16229, Korea
| | - Sang Eun Kim
- Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 16229, Korea.; Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Korea.; Advanced Institutes of Convergence Technology, Suwon 16229, Korea
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Campbell LF, Wilmoth K, Mason M. Association of exposure to neighborhood drug activity, neurobehavioral traits, and marijuana use among at-risk African American females. Addict Behav 2015; 50:45-50. [PMID: 26101077 PMCID: PMC10176802 DOI: 10.1016/j.addbeh.2015.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 04/29/2015] [Accepted: 06/02/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Theories of relative deprivation suggest African Americans in disadvantaged communities are at increased risk for drug use. This increased risk may be due, in part, to exposure to drugs and drug subcultures. Given the significance of the prefrontal cortex (PFC) functioning in yielding behavior that is strategically guided rather than reactive to environmental demands, it is important to examine the relationship between PFC functioning, neighborhood drug activity and substance use among African Americans residing in high risk communities. METHODS A sample of 120 young adult African American females was recruited from high-risk neighborhoods. Each completed the modified version of the neighborhood environment scale, a neurobehavioral assessment designed to measure apathy, behavioral disinhibition and executive dysfunction, and provided a urine sample that was tested for the presence of psychoactive drugs. RESULTS Logistic regression analyses indicated that females with higher scores on behavioral disinhibition were 2.6 times more likely to test positive for marijuana (95%CI = 1.02, 6.57). Neither apathy nor executive dysfunction was related to marijuana use. No relationship emerged between neighborhood drug activity and marijuana use. CONCLUSIONS Among the neurobehavioral traits considered only behavioral disinhibition was associated with marijuana use, suggesting that different neurobehavioral domains may be uniquely related to marijuana use. For females living in high risk environments, the extent to which they are able to control impulses may provide some protection against marijuana use. Future studies focused on the moderating effects of behavioral disinhibition on the association of exposure to risk environments and marijuana use may prove beneficial. Further, the study adds to the small base of literature supporting the Frontal Systems Behavior Scale as a brief assessment to evaluate frontally-mediated neurobehavioral traits relevant to substance use. However, future studies aimed at examining the influence of neighborhood drug activity might benefit from more precise measures of exposure to neighborhood drug activity. More research to replicate and expand on the present findings is warranted.
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Affiliation(s)
- Leah Floyd Campbell
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States; Commonwealth Institute for Child & Family Studies, Virginia Commonwealth University, PO Box 980489, Richmond, VA 23298-0489, United States.
| | - Kristin Wilmoth
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9044, United States
| | - Michael Mason
- Commonwealth Institute for Child & Family Studies, Virginia Commonwealth University, PO Box 980489, Richmond, VA 23298-0489, United States
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Reske M, Stewart JL, Flagan TM, Paulus MP. Attenuated Neural Processing of Risk in Young Adults at Risk for Stimulant Dependence. PLoS One 2015; 10:e0127010. [PMID: 26076493 PMCID: PMC4468216 DOI: 10.1371/journal.pone.0127010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/09/2015] [Indexed: 12/04/2022] Open
Abstract
Objective Approximately 10% of young adults report non-medical use of stimulants (cocaine, amphetamine, methylphenidate), which puts them at risk for the development of dependence. This fMRI study investigates whether subjects at early stages of stimulant use show altered decision making processing. Methods 158 occasional stimulants users (OSU) and 50 comparison subjects (CS) performed a “risky gains” decision making task during which they could select safe options (cash in 20 cents) or gamble them for double or nothing in two consecutive gambles (win or lose 40 or 80 cents, “risky decisions”). The primary analysis focused on risky versus safe decisions. Three secondary analyses were conducted: First, a robust regression examined the effect of lifetime exposure to stimulants and marijuana; second, subgroups of OSU with >1000 (n = 42), or <50 lifetime marijuana uses (n = 32), were compared to CS with <50 lifetime uses (n = 46) to examine potential marijuana effects; third, brain activation associated with behavioral adjustment following monetary losses was probed. Results There were no behavioral differences between groups. OSU showed attenuated activation across risky and safe decisions in prefrontal cortex, insula, and dorsal striatum, exhibited lower anterior cingulate cortex (ACC) and dorsal striatum activation for risky decisions and greater inferior frontal gyrus activation for safe decisions. Those OSU with relatively more stimulant use showed greater dorsal ACC and posterior insula attenuation. In comparison, greater lifetime marijuana use was associated with less neural differentiation between risky and safe decisions. OSU who chose more safe responses after losses exhibited similarities with CS relative to those preferring risky options. Discussion Individuals at risk for the development of stimulant use disorders presented less differentiated neural processing of risky and safe options. Specifically, OSU show attenuated brain response in regions critical for performance monitoring, reward processing and interoceptive awareness. Marijuana had additive effects by diminishing neural risk differentiation.
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Affiliation(s)
- Martina Reske
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America
- Institute of Neuroscience and Medicine (INM-6), Computational and Systems Neuroscience and Institute for Advanced Simulation (IAS-6), Theoretical Neuroscience, Forschungszentrum Jülich GmbH, Jülich, Germany
- JARA BRAIN Institute I, Jülich, Germany
| | - Jennifer L. Stewart
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America
- CUNY Queens College, Queens, New York, United States of America
| | - Taru M. Flagan
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America
- University of Texas, Austin, Texas, United States of America
| | - Martin P. Paulus
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America
- Psychiatry Service, VA San Diego Healthcare System, La Jolla, California, United States of America
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, Oklahoma, United States of America
- * E-mail:
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Orsini CA, Moorman DE, Young JW, Setlow B, Floresco SB. Neural mechanisms regulating different forms of risk-related decision-making: Insights from animal models. Neurosci Biobehav Rev 2015; 58:147-67. [PMID: 26072028 DOI: 10.1016/j.neubiorev.2015.04.009] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 02/13/2015] [Accepted: 04/24/2015] [Indexed: 11/18/2022]
Abstract
Over the past 20 years there has been a growing interest in the neural underpinnings of cost/benefit decision-making. Recent studies with animal models have made considerable advances in our understanding of how different prefrontal, striatal, limbic and monoaminergic circuits interact to promote efficient risk/reward decision-making, and how dysfunction in these circuits underlies aberrant decision-making observed in numerous psychiatric disorders. This review will highlight recent findings from studies exploring these questions using a variety of behavioral assays, as well as molecular, pharmacological, neurophysiological, and translational approaches. We begin with a discussion of how neural systems related to decision subcomponents may interact to generate more complex decisions involving risk and uncertainty. This is followed by an overview of interactions between prefrontal-amygdala-dopamine and habenular circuits in regulating choice between certain and uncertain rewards and how different modes of dopamine transmission may contribute to these processes. These data will be compared with results from other studies investigating the contribution of some of these systems to guiding decision-making related to rewards vs. punishment. Lastly, we provide a brief summary of impairments in risk-related decision-making associated with psychiatric disorders, highlighting recent translational studies in laboratory animals.
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Affiliation(s)
- Caitlin A Orsini
- Department of Psychiatry and Center for Addiction Research and Education, University of Florida College of Medicine, Gainesville, FL, United States
| | - David E Moorman
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, United States
| | - Jared W Young
- Department of Psychiatry, University of California San Diego, United States; VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
| | - Barry Setlow
- Department of Psychiatry and Center for Addiction Research and Education, University of Florida College of Medicine, Gainesville, FL, United States
| | - Stan B Floresco
- Department of Psychology and Brain Research Center, University of British Columbia, Vancouver, BC, Canada.
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Modulating activity in the prefrontal cortex changes decision-making for risky gains and losses: A transcranial direct current stimulation study. Behav Brain Res 2015; 286:17-21. [DOI: 10.1016/j.bbr.2015.02.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 02/14/2015] [Accepted: 02/17/2015] [Indexed: 10/24/2022]
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Ye H, Chen S, Huang D, Wang S, Jia Y, Luo J. Transcranial direct current stimulation over prefrontal cortex diminishes degree of risk aversion. Neurosci Lett 2015; 598:18-22. [DOI: 10.1016/j.neulet.2015.04.050] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/25/2015] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
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Gilman JM, Smith AR, Bjork JM, Ramchandani VA, Momenan R, Hommer DW. Cumulative gains enhance striatal response to reward opportunities in alcohol-dependent patients. Addict Biol 2015; 20:580-93. [PMID: 24754451 DOI: 10.1111/adb.12147] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Substance use disorder is characterized by a transition from volitional to compulsive responding for drug reward. A possible explanation for this transition may be that alcohol-dependent patients (ADP) show a general propensity for a history of rewarded instrumental responses, and these rewarded responses may boost the activation of motivational neurocircuitry for additional reward. Brain imaging studies of decision-making have demonstrated that ADP relative to controls (CON) often show altered neural activation in response to anticipating and receiving rewards, but the majority of studies have not investigated how past performance affects activation. A potential exists for ADP to show increased sensitivity to reward as a function of reward delivery history. In the current study, we used functional magnetic resonance imaging to investigate the neural correlates of risky decision-making in ADP (n = 18) and CON (n = 18) while they played a two-choice monetary risk-taking game. In addition to investigating general neural recruitment by risky decision-making, we also modeled each participant's running total of monetary earnings in order to determine areas of activation that correlated with cumulative reward. We found that ADP and CON showed few differences in behavior or in mesolimbic activation by choice for, and receipt of, risky gains. However, when including a cumulative-earnings covariate, ADP exhibited heightened striatal activation that correlated with total earnings during the choice event in the task. The heightened contextual sensitivity of striatal responses to cumulative earnings in ADP may represent a general neurobiological affective substrate for development of automatized instrumental behavior.
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Affiliation(s)
- Jodi M. Gilman
- Center for Addiction Medicine; Massachusetts General Hospital; Boston MA USA
| | - Ashley R. Smith
- Department of Psychology; Neurocognition Laboratory; Temple University; Philadelphia PA USA
| | - James M. Bjork
- Clinical Neuroscience Branch; Division of Clinical Neuroscience and Behavioral Research; National Institute on Drug Abuse; Bethesda MD USA
| | - Vijay A. Ramchandani
- Section on Human Psychopharmacology; Laboratory of Clinical and Translational Studies; National Institute on Alcohol Abuse and Alcoholism; National Institutes of Health; Bethesda MD USA
| | - Reza Momenan
- Section of Brain Electrophysiology and Imaging; Laboratory of Clinical and Translational Studies; National Institute on Alcohol Abuse and Alcoholism; National Institutes of Health; Bethesda MD USA
| | - Daniel W. Hommer
- Section of Brain Electrophysiology and Imaging; Laboratory of Clinical and Translational Studies; National Institute on Alcohol Abuse and Alcoholism; National Institutes of Health; Bethesda MD USA
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Alexander WH, Fukunaga R, Finn P, Brown JW. Reward salience and risk aversion underlie differential ACC activity in substance dependence. NEUROIMAGE-CLINICAL 2015; 8:59-71. [PMID: 26106528 PMCID: PMC4473292 DOI: 10.1016/j.nicl.2015.02.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 01/28/2015] [Accepted: 02/22/2015] [Indexed: 12/17/2022]
Abstract
The medial prefrontal cortex, especially the dorsal anterior cingulate cortex (ACC), has long been implicated in cognitive control and error processing. Although the association between ACC and behavior has been established, it is less clear how ACC contributes to dysfunctional behavior such as substance dependence. Evidence from neuroimaging studies investigating ACC function in substance users is mixed, with some studies showing disengagement of ACC in substance dependent individuals (SDs), while others show increased ACC activity related to substance use. In this study, we investigate ACC function in SDs and healthy individuals performing a change signal task for monetary rewards. Using a priori predictions derived from a recent computational model of ACC, we find that ACC activity differs between SDs and controls in factors related to reward salience and risk aversion between SDs and healthy individuals. Quantitative fits of a computational model to fMRI data reveal significant differences in best fit parameters for reward salience and risk preferences. Specifically, the ACC in SDs shows greater risk aversion, defined as concavity in the utility function, and greater attention to rewards relative to reward omission. Furthermore, across participants risk aversion and reward salience are positively correlated. The results clarify the role that ACC plays in both the reduced sensitivity to omitted rewards and greater reward valuation in SDs. Clinical implications of applying computational modeling in psychiatry are also discussed.
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Affiliation(s)
- William H Alexander
- Department of Psychological & Brain Sciences, Indiana University, 1101 E 10th St., Bloomington, IN 47405, USA ; Department of Experimental Psychology, Ghent University, Henri Dunantlaan 2, Ghent B-9000, Belgium
| | - Rena Fukunaga
- Department of Psychological & Brain Sciences, Indiana University, 1101 E 10th St., Bloomington, IN 47405, USA
| | - Peter Finn
- Department of Psychological & Brain Sciences, Indiana University, 1101 E 10th St., Bloomington, IN 47405, USA
| | - Joshua W Brown
- Department of Psychological & Brain Sciences, Indiana University, 1101 E 10th St., Bloomington, IN 47405, USA
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Johnson BP, Pinar A, Fornito A, Nandam LS, Hester R, Bellgrove MA. Left anterior cingulate activity predicts intra-individual reaction time variability in healthy adults. Neuropsychologia 2015; 72:22-6. [PMID: 25791710 DOI: 10.1016/j.neuropsychologia.2015.03.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 03/13/2015] [Accepted: 03/16/2015] [Indexed: 11/17/2022]
Abstract
Within-subject, or intra-individual, variability in reaction time (RT) is increasingly recognised as an important indicator of the efficiency of attentional control, yet there have been few investigations of the neural correlates of trial-to-trial RT variability in healthy adults. We sought to determine the neural correlates of intra-individual RT variability during a go/no-go response inhibition task in 27 healthy, male participants. We found that reduced trial-to-trial RT variability (i.e. greater response stability) was significantly associated with greater activation in the left pregenual anterior cingulate. These results support the role of the left anterior cingulate in the dynamic control of attention and efficient response selection. Greater understanding of intra-individual RT variability and top-down attentional control in healthy adults may help to inform disorders that impact executive/attentional control, such as attention deficit hyperactivity disorder and schizophrenia.
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Affiliation(s)
- Beth P Johnson
- School of Psychological Sciences, Monash University, Building 17, Clayton Campus, Wellington Road, VIC 3800, Australia.
| | - Ari Pinar
- School of Psychological Sciences, Monash University, Building 17, Clayton Campus, Wellington Road, VIC 3800, Australia
| | - Alex Fornito
- School of Psychological Sciences, Monash University, Building 17, Clayton Campus, Wellington Road, VIC 3800, Australia
| | - L Sanjay Nandam
- School of Psychological Sciences, Monash University, Building 17, Clayton Campus, Wellington Road, VIC 3800, Australia; Queensland Brain Institute, The University of Queensland, Brisbane 4072, Australia
| | - Robert Hester
- Melbourne School of Psychological Sciences, University of Melbourne, Redmond Barry Building, Parkville, VIC 3010, Australia
| | - Mark A Bellgrove
- School of Psychological Sciences, Monash University, Building 17, Clayton Campus, Wellington Road, VIC 3800, Australia
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Gilman JM, Calderon V, Curran MT, Evins AE. Young adult cannabis users report greater propensity for risk-taking only in non-monetary domains. Drug Alcohol Depend 2015; 147:26-31. [PMID: 25577478 PMCID: PMC4297698 DOI: 10.1016/j.drugalcdep.2014.12.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/09/2014] [Accepted: 12/13/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Though substance use is often associated with elevated risk-taking in real-world scenarios, many risk-taking tasks in experimental psychology using financial gambles fail to find significant differences between individuals with substance use disorders and healthy controls. We assessed whether participants using marijuana would show a greater propensity for risk-taking in distinct domains including, but not limited to, financial risk-taking. METHODS In the current study, we assessed risk-taking in young adult (age 18-25) regular marijuana users and in non-using control participants using a domain-specific risk-taking self-report scale (DOSPERT) encompassing five domains of risk-taking (social, financial, recreational, health/safety, and ethical). We also measured behavioral risk-taking using a laboratory monetary risk-taking task. RESULTS Marijuana users and controls reported significant differences on the social, health/safety, and ethical risk-taking scales, but no differences in the propensity to take recreational or financial risks. Complementing the self-report finding, there were no differences between marijuana users and controls in their performance on the laboratory risk-taking task. CONCLUSIONS These findings suggest that financial risk-taking may be less sensitive than other domains of risk-taking in assessing differences in risky behavior between those who use marijuana and those who do not. In order to more consistently determine whether increased risk-taking is a factor in substance use, it may be necessary to use both monetary risk-taking tasks and complementary assessments of non-monetary-based risk-taking measures.
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