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Hernandez CM, McCuiston MA, Davis K, Halls Y, Carcamo Dal Zotto JP, Jackson NL, Dobrunz LE, King PH, McMahon LL. In a circuit necessary for cognition and emotional affect, Alzheimer's-like pathology associates with neuroinflammation, cognitive and motivational deficits in the young adult TgF344-AD rat. Brain Behav Immun Health 2024; 39:100798. [PMID: 39022628 PMCID: PMC11253229 DOI: 10.1016/j.bbih.2024.100798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 07/20/2024] Open
Abstract
In addition to extracellular amyloid plaques, intracellular neurofibrillary tau tangles, and inflammation, cognitive and emotional affect perturbations are characteristic of Alzheimer's disease (AD). The cognitive and emotional domains impaired by AD include several forms of decision making (such as intertemporal choice), blunted motivation (increased apathy), and impaired executive function (such as working memory and cognitive flexibility). However, the interaction between these domains of the mind and their supporting neurobiological substrates at prodromal stages of AD, or whether these interactions can be predictive of AD severity (individual variability), remain unclear. In this study, we employed a battery of cognitive and emotional tests in the young adult (5-7 mo) transgenic Fisher-344 AD (TgF344-AD; TgAD) rat model of AD. We also assessed whether markers of inflammation or AD-like pathology in the prelimbic cortex (PrL) of the medial prefrontal cortex (mPFC), basolateral amygdala (BLA), or nucleus accumbens (NAc), all structures that directly support the aforementioned behaviors, were predictive of behavioral deficits. We found TgAD rats displayed maladaptive decision making, greater apathy, and impaired working memory that was indeed predicted by AD-like pathology in the relevant brain structures, even at an early age. Moreover, we report that the BLA is an early epicenter of inflammation, and notably, AD-like pathology in the PrL, BLA, and NAc was predictive of BLA inflammation. These results suggest that operant-based battery testing may be sensitive enough to determine pathology trajectories, including neuroinflammation, from early stages of AD.
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Affiliation(s)
- Caesar M. Hernandez
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, USA
| | - Macy A. McCuiston
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristian Davis
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yolanda Halls
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Juan Pablo Carcamo Dal Zotto
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nateka L. Jackson
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, USA
- Department of Neuroscience, Medical University of South Carolina, USA
| | - Lynn E. Dobrunz
- Department of Neurobiology, The University of Alabama at Birmingham, USA
| | - Peter H. King
- Department of Neurology, The University of Alabama at Birmingham, USA
- Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
| | - Lori L. McMahon
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, USA
- Department of Neuroscience, Medical University of South Carolina, USA
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2
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Boutoleau-Bretonnière C, Kapogiannis D, El Haj M. The guaranteed euros: Probabilistic discounting in behavioural-variant frontotemporal dementia. J Neuropsychol 2024; 18:239-250. [PMID: 38135907 DOI: 10.1111/jnp.12357] [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: 09/14/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Financial decision-making requires trading off between guaranteed and probabilistic outcomes and between immediate and delayed ones. While research has demonstrated that patients with behavioural-variant frontotemporal dementia (bvFTD) prefer immediate rewards at the expense of future ones (i.e. temporal discounting), little is known about how patients choose between smaller, guaranteed and larger, but probabilistic, outcomes (i.e. probabilistic discounting). We thus investigated probabilistic discounting by inviting 18 patients with bvFTD and 20 control participants to choose between fixed smaller monetary amounts and a fixed larger monetary amount with a variated probability of occurrence (e.g. 'Would you rather have 40€ for sure or a 20% chance of winning 100€?'). Results demonstrated lower scores, indicating higher risk tolerance, on the probabilistic discounting task in patients with bvFTD (while impulsively choosing more immediate rewards on the temporal discounting task) compared to control participants. Probabilistic discounting was significantly correlated with a decline in general cognitive performance in patients with bvFTD. When dealing between smaller, guaranteed, and larger, but probabilistic, rewards, patients with bvFTD tend to prefer guaranteed rewards and discount the uncertain ones.
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Affiliation(s)
| | - Dimitrios Kapogiannis
- Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, Maryland, USA
| | - Mohamad El Haj
- Clinical Gerontology Department, CHU Nantes, Nantes, France
- Institut Universitaire de France, Paris, France
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3
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Ngo S, Jackson AJ, Manivannan M, Young JC, Leggins B, Cryns NG, Tran ST, Grant HE, Knudtson MV, Chiong W. Real World Financial Mismanagement in Alzheimer's Disease, Frontotemporal Dementia, and Primary Progressive Aphasia. J Alzheimers Dis 2024; 99:251-262. [PMID: 38669528 PMCID: PMC11132181 DOI: 10.3233/jad-231021] [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] [Indexed: 04/28/2024]
Abstract
Background Whereas clinical experience in dementia indicates high risk for financial mismanagement, there has been little formal study of real world financial errors in dementia. Objective We aimed to compare caregiver-reported financial mistakes among people with Alzheimer's disease, behavioral variant frontotemporal dementia (bvFTD), and primary progressive aphasia (PPA). Methods Caregivers reported whether participants with dementia had made financial mistakes within the last year; and if so, categorized these as resulting from: (a) being too trusting or gullible, (b) being wasteful or careless with money, or (c) trouble with memory. In a pre-registered analysis https://archive.org/details/osf-registrations-vupj7-v1), we examined the hypotheses that (1) financial mistakes due to impaired socioemotional function and diminished sensitivity to negative outcomes are more prevalent in bvFTD than in Alzheimer's disease, and (2) financial mistakes due to memory are more prevalent in Alzheimer's disease than in bvFTD. Exploratory analyses addressed vulnerability in PPA and brain-behavior relationships using voxel-based morphometry. Results Concordant with our first hypothesis, bvFTD was more strongly associated than Alzheimer's disease with mistakes due to being too trusting/gullible or wasteful/careless; contrary to our second hypothesis, both groups were similarly likely to make mistakes due to memory. No differences were found between Alzheimer's disease and PPA. Exploratory analyses indicated associations between financial errors and atrophy in right prefrontal and insular cortex. Conclusions Our findings cohere with documented socioemotional and valuation impairments in bvFTD, and with research indicating comparable memory impairment between bvFTD and Alzheimer's disease.
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Affiliation(s)
- Sang Ngo
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Ashley J Jackson
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | | | - J Clayton Young
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Brandon Leggins
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Noah G Cryns
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Sheila T Tran
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Harli E Grant
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Marguerite V Knudtson
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Winston Chiong
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
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4
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Ohm DT, Rhodes E, Bahena A, Capp N, Lowe M, Sabatini P, Trotman W, Olm CA, Phillips J, Prabhakaran K, Rascovsky K, Massimo L, McMillan C, Gee J, Tisdall MD, Yushkevich PA, Lee EB, Grossman M, Irwin DJ. Neuroanatomical and cellular degeneration associated with a social disorder characterized by new ritualistic belief systems in a TDP-C patient vs. a Pick patient. Front Neurol 2023; 14:1245886. [PMID: 37900607 PMCID: PMC10600461 DOI: 10.3389/fneur.2023.1245886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/15/2023] [Indexed: 10/31/2023] Open
Abstract
Frontotemporal dementia (FTD) is a spectrum of clinically and pathologically heterogenous neurodegenerative dementias. Clinical and anatomical variants of FTD have been described and associated with underlying frontotemporal lobar degeneration (FTLD) pathology, including tauopathies (FTLD-tau) or TDP-43 proteinopathies (FTLD-TDP). FTD patients with predominant degeneration of anterior temporal cortices often develop a language disorder of semantic knowledge loss and/or a social disorder often characterized by compulsive rituals and belief systems corresponding to predominant left or right hemisphere involvement, respectively. The neural substrates of these complex social disorders remain unclear. Here, we present a comparative imaging and postmortem study of two patients, one with FTLD-TDP (subtype C) and one with FTLD-tau (subtype Pick disease), who both developed new rigid belief systems. The FTLD-TDP patient developed a complex set of values centered on positivity and associated with specific physical and behavioral features of pigs, while the FTLD-tau patient developed compulsive, goal-directed behaviors related to general themes of positivity and spirituality. Neuroimaging showed left-predominant temporal atrophy in the FTLD-TDP patient and right-predominant frontotemporal atrophy in the FTLD-tau patient. Consistent with antemortem cortical atrophy, histopathologic examinations revealed severe loss of neurons and myelin predominantly in the anterior temporal lobes of both patients, but the FTLD-tau patient showed more bilateral, dorsolateral involvement featuring greater pathology and loss of projection neurons and deep white matter. These findings highlight that the regions within and connected to anterior temporal lobes may have differential vulnerability to distinct FTLD proteinopathies and serve important roles in human belief systems.
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Affiliation(s)
- Daniel T. Ohm
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Emma Rhodes
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Alejandra Bahena
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Noah Capp
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - MaKayla Lowe
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Philip Sabatini
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Winifred Trotman
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher A. Olm
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Jeffrey Phillips
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Karthik Prabhakaran
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Lauren Massimo
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Corey McMillan
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - James Gee
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - M. Dylan Tisdall
- Center for Advanced Magnetic Resonance Imaging and Spectroscopy, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Paul A. Yushkevich
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Edward B. Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - David J. Irwin
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
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5
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Godefroy V, Sezer I, Bouzigues A, Montembeault M, Koban L, Plassmann H, Migliaccio R. Altered delay discounting in neurodegeneration: insight into the underlying mechanisms and perspectives for clinical applications. Neurosci Biobehav Rev 2023; 146:105048. [PMID: 36669749 DOI: 10.1016/j.neubiorev.2023.105048] [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: 09/23/2022] [Revised: 12/12/2022] [Accepted: 01/14/2023] [Indexed: 01/19/2023]
Abstract
Steeper delay discounting (i.e., the extent to which future rewards are perceived as less valuable than immediate ones) has been proposed as a transdiagnostic process across different health conditions, in particular psychiatric disorders. Impulsive decision-making is a hallmark of different neurodegenerative conditions but little is known about delay discounting in the domain of neurodegenerative conditions. We reviewed studies on delay discounting in patients with Parkinson's disease (PD) and in patients with dementia (Alzheimer's disease / AD or frontotemporal dementia / FTD). We proposed that delay discounting could be an early marker of the neurodegenerative process. We developed the idea that altered delay discounting is associated with overlapping but distinct neurocognitive mechanisms across neurodegenerative diseases: dopaminergic-related disorders of reward processing in PD, memory/projection deficits due to medial temporal atrophy in AD, modified reward processing due to orbitofrontal atrophy in FTD. Neurodegeneration could provide a framework to decipher the neuropsychological mechanisms of value-based decision-making. Further, delay discounting could become a marker of interest in clinical practice, in particular for differential diagnosis.
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Affiliation(s)
- Valérie Godefroy
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France; Marketing Area, INSEAD, Fontainebleau, France; Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne University, Paris, France.
| | - Idil Sezer
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France
| | - Arabella Bouzigues
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France
| | - Maxime Montembeault
- Douglas Research Centre, Montréal, Canada; Department of Psychiatry, McGill University, Montréal, Canada
| | - Leonie Koban
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, Bron, France
| | - Hilke Plassmann
- Marketing Area, INSEAD, Fontainebleau, France; Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne University, Paris, France
| | - Raffaella Migliaccio
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France; Centre de Référence des Démences Rares ou Précoces, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Institute of Memory and Alzheimer's Disease, Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
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6
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Lenglin V, Wong S, O'Callaghan C, Erzinçlioğlu S, Hornberger M, Lebouvier T, Piguet O, Bourgeois-Gironde S, Bertoux M. Zero the hero: Evidence for involvement of the ventromedial prefrontal cortex in affective bias for free items. Cortex 2023; 160:24-42. [PMID: 36680922 DOI: 10.1016/j.cortex.2022.12.009] [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: 07/28/2022] [Revised: 10/31/2022] [Accepted: 12/06/2022] [Indexed: 12/30/2022]
Abstract
Recent evidence from psycho-economics shows that when the price of an item decreases to the extent that it becomes available for free, one can observe a remarkable increase of subjective utility toward this item. This phenomenon, which is not observed for any other price but zero, has been termed the zero-price effect (ZPE). The ZPE is attributed to an affective heuristic where the positive affect elicited by the free status of an item provides a mental shortcut biasing choice towards that item. Given that the ZPE relies on affective processing, a key role of the ventromedial prefrontal cortex (vmPFC) has been proposed, yet neuroscientific studies of the ZPE remain scarce. This study aimed to explore the role of the vmPFC in the ZPE using a novel, within-subject assessment in participants with either an acquired (lesion patients) or degenerative (behavioural-variant frontotemporal dementia patients) lesion of the vmPFC, and age-matched healthy controls. All participants were asked to make a series of choices between pairs of items that varied in price. One choice trial involved an equal decrease of both item prices, such that one of the items was priced zero. In contrast to controls, patients with both vmPFC-lesion and behavioural-variant frontotemporal dementia showed marked reductions in zero-related changes of preference in pairs of gift-cards, but not for pairs of food items. Our findings suggest that affective evaluations driving the ZPE are altered in patients with focal or degenerative damage to the vmPFC. This supports the notion of a key role of the vmPFC in the ZPE and, more generally, the importance of this region in value-based affective decision-making. Our findings also highlight the potential utility of affective heuristic tasks in future clinical assessments.
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Affiliation(s)
- V Lenglin
- Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, LiCEND & DistALZ, Lille, France; ETHICS EA7446, Lille Catholic University, Lille, France
| | - S Wong
- The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia; Flinders University, College of Education, Psychology & Social Work, Adelaide, Australia
| | - C O'Callaghan
- The University of Sydney, Brain & Mind Centre and School of Medical Sciences, Faculty of Medicine and Health, Sydney, Australia
| | - S Erzinçlioğlu
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge UK
| | - M Hornberger
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK; Norwich Medical School, University of East Anglia, Norwich, UK
| | - T Lebouvier
- Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, LiCEND & DistALZ, Lille, France
| | - O Piguet
- The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia
| | - S Bourgeois-Gironde
- Department of Economics, Université Paris 2 - Panthéon-Assas, Paris, France; Institut Jean-Nicod, Ecole Normale Supérieure, PSL Research University, Paris, France.
| | - M Bertoux
- Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, LiCEND & DistALZ, Lille, France; Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK.
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Le Bouc R, Borderies N, Carle G, Robriquet C, Vinckier F, Daunizeau J, Azuar C, Levy R, Pessiglione M. Effort avoidance as a core mechanism of apathy in frontotemporal dementia. Brain 2023; 146:712-726. [PMID: 36401873 DOI: 10.1093/brain/awac427] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/21/2022] Open
Abstract
Apathy is a core symptom in patients with behavioural variant frontotemporal dementia (bvFTD). It is defined by the observable reduction in goal-directed behaviour, but the underlying mechanisms are poorly understood. According to decision theory, engagement in goal-directed behaviour depends on a cost-benefit optimization trading off the estimated effort (related to the behaviour) against the expected reward (related to the goal). In this framework, apathy would thus result from either a decreased appetence for reward, or from an increased aversion to effort. Here, we phenotyped the motivational state of 21 patients with bvFTD and 40 matched healthy controls using computational analyses of behavioural responses in a comprehensive series of behavioural tasks, involving both expression of preference (comparing reward value and effort cost) and optimization of performance (adjusting effort production to the reward at stake). The primary finding was an elevated aversion to effort, consistent across preference and performance tasks in patients with bvFTD compared to controls. Within the bvFTD group, effort avoidance was correlated to cortical atrophy in the dorsal anterior cingulate cortex and to apathy score measured on a clinical scale. Thus, our results highlight elevated effort aversion (not reduced reward appetence) as a core dysfunction that might generate apathy in patients with bvFTD. More broadly, they provide novel behavioural tests and computational tools to identify the dysfunctional mechanisms producing motivation deficits in patients with brain damage.
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Affiliation(s)
- Raphaël Le Bouc
- Motivation, Brain and Behavior Laboratory (MBB), Paris Brain Institute (ICM), Sorbonne University, INSERM UMRS 1127, CNRS UMR 7225, Pitié Salpêtrière Hospital, F-75013 Paris, France.,Department of Neurology, Pitié Salpêtrière Hospital, Sorbonne University, Assistance Publique-Hôpitaux de Paris (AP-HP), F75013 Paris, France
| | - Nicolas Borderies
- Motivation, Brain and Behavior Laboratory (MBB), Paris Brain Institute (ICM), Sorbonne University, INSERM UMRS 1127, CNRS UMR 7225, Pitié Salpêtrière Hospital, F-75013 Paris, France
| | - Guilhem Carle
- Department of Neurology, Pitié Salpêtrière Hospital, Sorbonne University, Assistance Publique-Hôpitaux de Paris (AP-HP), F75013 Paris, France.,FrontLab, Paris Brain Institute (ICM), Sorbonne University, INSERM UMRS 1127, CNRS UMR 7225, Pitié Salpêtrière Hospital, F-75013 Paris, France
| | - Chloé Robriquet
- Motivation, Brain and Behavior Laboratory (MBB), Paris Brain Institute (ICM), Sorbonne University, INSERM UMRS 1127, CNRS UMR 7225, Pitié Salpêtrière Hospital, F-75013 Paris, France
| | - Fabien Vinckier
- Motivation, Brain and Behavior Laboratory (MBB), Paris Brain Institute (ICM), Sorbonne University, INSERM UMRS 1127, CNRS UMR 7225, Pitié Salpêtrière Hospital, F-75013 Paris, France.,Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie and Neurosciences, University of Paris, F-75014 Paris, France
| | - Jean Daunizeau
- Motivation, Brain and Behavior Laboratory (MBB), Paris Brain Institute (ICM), Sorbonne University, INSERM UMRS 1127, CNRS UMR 7225, Pitié Salpêtrière Hospital, F-75013 Paris, France
| | - Carole Azuar
- Department of Neurology, Pitié Salpêtrière Hospital, Sorbonne University, Assistance Publique-Hôpitaux de Paris (AP-HP), F75013 Paris, France.,FrontLab, Paris Brain Institute (ICM), Sorbonne University, INSERM UMRS 1127, CNRS UMR 7225, Pitié Salpêtrière Hospital, F-75013 Paris, France
| | - Richard Levy
- Department of Neurology, Pitié Salpêtrière Hospital, Sorbonne University, Assistance Publique-Hôpitaux de Paris (AP-HP), F75013 Paris, France.,FrontLab, Paris Brain Institute (ICM), Sorbonne University, INSERM UMRS 1127, CNRS UMR 7225, Pitié Salpêtrière Hospital, F-75013 Paris, France
| | - Mathias Pessiglione
- Motivation, Brain and Behavior Laboratory (MBB), Paris Brain Institute (ICM), Sorbonne University, INSERM UMRS 1127, CNRS UMR 7225, Pitié Salpêtrière Hospital, F-75013 Paris, France
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8
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Ge X, Yao T, Zhang C, Wang Q, Wang X, Xu LC. Human microRNA-4433 (hsa-miR-4443) Targets 18 Genes to be a Risk Factor of Neurodegenerative Diseases. Curr Alzheimer Res 2022; 19:511-522. [PMID: 35929619 PMCID: PMC9906632 DOI: 10.2174/1567205019666220805120303] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Neurodegenerative diseases, such as Alzheimer's disease patients (AD), Huntington's disease (HD) and Parkinson's disease (PD), are common causes of morbidity, mortality, and cognitive impairment in older adults. OBJECTIVE We aimed to understand the transcriptome characteristics of the cortex of neurodegenerative diseases and to provide an insight into the target genes of differently expressed microRNAs in the occurrence and development of neurodegenerative diseases. METHODS The Limma package of R software was used to analyze GSE33000, GSE157239, GSE64977 and GSE72962 datasets to identify the differentially expressed genes (DEGs) and microRNAs in the cortex of neurodegenerative diseases. Bioinformatics methods, such as GO enrichment analysis, KEGG enrichment analysis and gene interaction network analysis, were used to explore the biological functions of DEGs. Weighted gene co-expression network analysis (WGCNA) was used to cluster DEGs into modules. RNA22, miRDB, miRNet 2.0 and TargetScan7 databases were performed to predict the target genes of microRNAs. RESULTS Among 310 Alzheimer's disease (AD) patients, 157 Huntington's disease (HD) patients and 157 non-demented control (Con) individuals, 214 co-DEGs were identified. Those co-DEGs were filtered into 2 different interaction network complexes, representing immune-related genes and synapserelated genes. The WGCNA results identified five modules: yellow, blue, green, turquoise, and brown. Most of the co-DEGs were clustered into the turquoise module and blue module, which respectively regulated synapse-related function and immune-related function. In addition, human microRNA-4433 (hsa-miR-4443), which targets 18 co-DEGs, was the only 1 co-up-regulated microRNA identified in the cortex of neurodegenerative diseases. CONCLUSION 214 DEGs and 5 modules regulate the immune-related and synapse-related function of the cortex in neurodegenerative diseases. Hsa-miR-4443 targets 18 co-DEGs and may be a potential molecular mechanism in neurodegenerative diseases' occurrence and development.
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Affiliation(s)
- Xing Ge
- Department of Pathogen Biology and Immunology, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China;
| | - Tingting Yao
- School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China;
| | - Chaoran Zhang
- School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China;
| | - Qingqing Wang
- Department of Nephrology, Xuzhou Children’s Hospital, Xuzhou, Jiangsu 221000, China
| | - Xuxu Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China;
| | - Li-Chun Xu
- School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China; ,Address correspondence to this author at the School of Public Health, Xuzhou Medical University, Xuzhou, 209 Tong-Shan Road, Xuzhou, Jiangsu, 221002, China; Tel: +86-516-83262650; Fax: +86-516-83262650; E-mail:
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9
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Sun W, Matsuoka T, Narumoto J. Decision-Making Support for People With Alzheimer's Disease: A Narrative Review. Front Psychol 2021; 12:750803. [PMID: 34867639 PMCID: PMC8633444 DOI: 10.3389/fpsyg.2021.750803] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/25/2021] [Indexed: 01/01/2023] Open
Abstract
The proportion of people with dementia has been increasing yearly, and the decision-making capacity of these people has become a major concern in fields such as the financial industry and in medical settings. In this narrative review, we discuss decision-making in people with Alzheimer’s disease (AD), and we propose the support for decision-making in people with AD, especially financial and medical decision-making. We summarize several hypotheses and theories on the decision-making capacity of people with AD. These include the frontal lobe hypothesis, physiological theory, dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, and the Person-Task-Fit (PTF) framework. Both internal and external factors can affect decision-making by people with AD. Internal factors are affected by changes in the brain and neurotransmitters, as well as alterations in cognitive ability and emotion. External factors include task characters, task contents, and situation influence. Since feedback has a significant effect on decision-making capacity, a series of suggestions may be helpful to improve this capacity, such as explicit advice, simple options, pleasant rewards, the Talking Mats approach, memory and organizational aid, support by caregivers, cognitive training and feedback. Thus, in providing decision-making support for people with AD, it is important to identify the internal and external factors that impair this process and to deal with these factors.
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Affiliation(s)
- Weiyi Sun
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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10
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Liu L, Bulley A, Irish M. Subjective Time in Dementia: A Critical Review. Brain Sci 2021; 11:1502. [PMID: 34827501 PMCID: PMC8616021 DOI: 10.3390/brainsci11111502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 12/31/2022] Open
Abstract
The capacity for subjective time in humans encompasses the perception of time's unfolding from moment to moment, as well as the ability to traverse larger temporal expanses of past- and future-oriented thought via mental time travel. Disruption in time perception can result in maladaptive outcomes-from the innocuous lapse in timing that leads to a burnt piece of toast, to the grievous miscalculation that produces a traffic accident-while disruption to mental time travel can impact core functions from planning appointments to making long-term decisions. Mounting evidence suggests that disturbances to both time perception and mental time travel are prominent in dementia syndromes. Given that such disruptions can have severe consequences for independent functioning in everyday life, here we aim to provide a comprehensive exposition of subjective timing dysfunction in dementia, with a view to informing the management of such disturbances. We consider the neurocognitive mechanisms underpinning changes to both time perception and mental time travel across different dementia disorders. Moreover, we explicate the functional implications of altered subjective timing by reference to two key and representative adaptive capacities: prospective memory and intertemporal decision-making. Overall, our review sheds light on the transdiagnostic implications of subjective timing disturbances in dementia and highlights the high variability in performance across clinical syndromes and functional domains.
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Affiliation(s)
- Lulu Liu
- School of Psychology, The University of Sydney, Sydney, NSW 2006, Australia; (L.L.); (A.B.)
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
| | - Adam Bulley
- School of Psychology, The University of Sydney, Sydney, NSW 2006, Australia; (L.L.); (A.B.)
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- Department of Psychology, Harvard University, Boston, MA 02138, USA
| | - Muireann Irish
- School of Psychology, The University of Sydney, Sydney, NSW 2006, Australia; (L.L.); (A.B.)
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
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11
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Fernandes C, Macedo I, Barbosa F, Marques-Teixeira J. Economic decision-making in the continuum between healthy aging and Alzheimer's Disease: A systematic review of 20 years of research. Neurosci Biobehav Rev 2021; 131:1243-1263. [PMID: 34715151 DOI: 10.1016/j.neubiorev.2021.10.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/23/2021] [Accepted: 10/23/2021] [Indexed: 01/21/2023]
Abstract
The effect of pathological aging on economic decision-making is a topic of major relevance as impairments in this domain place older adults at increased risk for financial abuse. This review aims to characterize decision-making across the continuum that goes from healthy aging to Alzheimer's Dementia. We included 42 studies comparing patients with Mild Cognitive Impairment (MCI) and healthy older adults, patients with Alzheimer's Disease (AD) and healthy older adults, and patients with MCI and patients with AD. Substantial evidence emerged suggesting that both MCI as AD affect economic decision-making. However, a non-negligible number of behavioural tasks failed to find significant differences between patients and controls, and no differences were reported between patients with MCI and AD. On the contrary, measures of financial capacity reached more robust findings, showing that healthy older adults had better performance than patients, while MCI patients showed better performance than AD patients. This review presents the main conclusions that may be drawn from significant findings, as well as the hypotheses and recommendations for future research.
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Affiliation(s)
- Carina Fernandes
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal.
| | - Inês Macedo
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - João Marques-Teixeira
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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12
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Rijpma MG, Shdo SM, Shany-Ur T, Toller G, Kramer JH, Miller BL, Rankin KP. Salience driven attention is pivotal to understanding others' intentions. Cogn Neuropsychol 2021; 38:88-106. [PMID: 33522407 DOI: 10.1080/02643294.2020.1868984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Interpreting others' beliefs, desires and intentions is known as "theory of mind" (ToM), and is often evaluated using simplified measurement tools, which may not correctly reflect the brain circuits that are required for real-life ToM functioning. We aimed to identify the brain structures necessary to correctly infer intentions from realistic scenarios by administering The Awareness of Social Inference Test, Enriched subtest to 47 patients with behavioural variant frontotemporal dementia, 24 patients with progressive supranuclear palsy syndrome, 31 patients with Alzheimer's syndrome, and 77 older healthy controls. Neuroimaging data was analyzed using voxel based morphometry, and participants' understanding of intentions was correlated with voxel-wise and region-of interest data. We found that structural integrity of the cinguloinsular cortex in the salience network (SN) was more pivotal for accurate ToM than previously described, emphasizing the importance of the SN for selectively recognizing and attending to social cues during ToM inferences.
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Affiliation(s)
- Myrthe G Rijpma
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Suzanne M Shdo
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Tal Shany-Ur
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Gianina Toller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Katherine P Rankin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
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13
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Wang Q, Wang Y, Wang P, Peng M, Zhang M, Zhu Y, Wei S, Chen C, Chen X, Luo S, Bai X. Neural representations of the amount and the delay time of reward in intertemporal decision making. Hum Brain Mapp 2021; 42:3450-3469. [PMID: 33934449 PMCID: PMC8249888 DOI: 10.1002/hbm.25445] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/28/2021] [Accepted: 03/30/2021] [Indexed: 11/08/2022] Open
Abstract
Numerous studies have examined the neural substrates of intertemporal decision-making, but few have systematically investigated separate neural representations of the two attributes of future rewards (i.e., the amount of the reward and the delay time). More importantly, no study has used the novel analytical method of representational connectivity analysis (RCA) to map the two dimensions' functional brain networks at the level of multivariate neural representations. This study independently manipulated the amount and delay time of rewards during an intertemporal decision task. Both univariate and multivariate pattern analyses showed that brain activity in the dorsomedial prefrontal cortex (DMPFC) and lateral frontal pole cortex (LFPC) was modulated by the amount of rewards, whereas brain activity in the DMPFC and dorsolateral prefrontal cortex (DLPFC) was modulated by the length of delay. Moreover, representational similarity analysis (RSA) revealed that even for the regions of the DMPFC that overlapped between the two dimensions, they manifested distinct neural activity patterns. In terms of individual differences, those with large delay discounting rates (k) showed greater DMPFC and LFPC activity as the amount of rewards increased but showed lower DMPFC and DLPFC activity as the delay time increased. Lastly, RCA suggested that the topological metrics (i.e., global and local efficiency) of the functional connectome subserving the delay time dimension inversely predicted individual discounting rate. These findings provide novel insights into neural representations of the two attributes in intertemporal decisions, and offer a new approach to construct task-based functional brain networks whose topological properties are related to impulsivity.
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Affiliation(s)
- Qiang Wang
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China.,Faculty of Psychology, Tianjin Normal University, Tianjin, China.,Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin, China
| | - Yajie Wang
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Pinchun Wang
- Faculty of Education, Tianjin Normal University, Tianjin, China
| | - Maomiao Peng
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Manman Zhang
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China.,Faculty of Psychology, Tianjin Normal University, Tianjin, China.,Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin, China
| | - Yuxuan Zhu
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Shiyu Wei
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Chuansheng Chen
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Xiongying Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Shan Luo
- Department of Internal Medicine, Division of Endocrinology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.,Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Xuejun Bai
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China.,Faculty of Psychology, Tianjin Normal University, Tianjin, China.,Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin, China
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14
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Manuel AL, Roquet D, Landin-Romero R, Kumfor F, Ahmed RM, Hodges JR, Piguet O. Interactions between decision-making and emotion in behavioral-variant frontotemporal dementia and Alzheimer's disease. Soc Cogn Affect Neurosci 2020; 15:681-694. [PMID: 32613246 PMCID: PMC7393308 DOI: 10.1093/scan/nsaa085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/16/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022] Open
Abstract
Negative and positive emotions are known to shape decision-making toward more or less impulsive responses, respectively. Decision-making and emotion processing are underpinned by shared brain regions including the ventromedial prefrontal cortex (vmPFC) and the amygdala. How these processes interact at the behavioral and brain levels is still unclear. We used a lesion model to address this question. Study participants included individuals diagnosed with behavioral-variant frontotemporal dementia (bvFTD, n = 18), who typically present deficits in decision-making/emotion processing and atrophy of the vmPFC, individuals with Alzheimer’s disease (AD, n = 12) who present with atrophy in limbic structures and age-matched healthy controls (CTRL, n = 15). Prior to each choice on the delay discounting task participants were cued with a positive, negative or neutral picture and asked to vividly imagine witnessing the event. As hypothesized, our findings showed that bvFTD patients were more impulsive than AD patients and CTRL and did not show any emotion-related modulation of delay discounting rate. In contrast, AD patients showed increased impulsivity when primed by negative emotion. This increased impulsivity was associated with reduced integrity of bilateral amygdala in AD but not in bvFTD. Altogether, our results indicate that decision-making and emotion interact at the level of the amygdala supporting findings from animal studies.
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Affiliation(s)
- Aurélie L Manuel
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia.,Laboratory for Research in Neuroimaging LREN, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Daniel Roquet
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
| | - Ramon Landin-Romero
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
| | - Fiona Kumfor
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
| | - Rebekah M Ahmed
- Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia.,Clinical Medical School, The University of Sydney, Sydney, Australia
| | - John R Hodges
- Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia.,Clinical Medical School, The University of Sydney, Sydney, Australia
| | - Olivier Piguet
- School of Psychology, The University of Sydney, Sydney, Australia.,Brain & Mind Centre, The University of Sydney, Sydney, Australia.,ARC Centre of Excellence in Cognition & its Disorders, Sydney, Australia
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15
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Lempert KM, MacNear KA, Wolk DA, Kable JW. Links between autobiographical memory richness and temporal discounting in older adults. Sci Rep 2020; 10:6431. [PMID: 32286440 PMCID: PMC7156676 DOI: 10.1038/s41598-020-63373-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 02/27/2020] [Indexed: 02/06/2023] Open
Abstract
When making choices between smaller, sooner rewards and larger, later ones, people tend to discount future outcomes. Individual differences in temporal discounting in older adults have been associated with episodic memory abilities and entorhinal cortical thickness. The cause of this association between better memory and more future-oriented choice remains unclear, however. One possibility is that people with perceptually richer recollections are more patient because they also imagine the future more vividly. Alternatively, perhaps people whose memories focus more on the meaning of events (i.e., are more "gist-based") show reduced temporal discounting, since imagining the future depends on interactions between semantic and episodic memory. We examined which categories of episodic details - perception-based or gist-based - are associated with temporal discounting in older adults. Older adults whose autobiographical memories were richer in perception-based details showed reduced temporal discounting. Furthermore, in an exploratory neuroanatomical analysis, both discount rates and perception-based details correlated with entorhinal cortical thickness. Retrieving autobiographical memories before choice did not affect temporal discounting, however, suggesting that activating episodic memory circuitry at the time of choice is insufficient to alter discounting in older adults. These findings elucidate the role of episodic memory in decision making, which will inform interventions to nudge intertemporal choices.
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Affiliation(s)
- Karolina M Lempert
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, US
| | - Kameron A MacNear
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, US
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, US
| | - Joseph W Kable
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, US.
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