Dopamine, effort, and decision making: theoretical comment on Bardgett et al. (2009)

Effects of virtual reality-based intervention on depression in stroke patients: a meta-analysis

As one of the most common neuropsychiatric complications after stroke, post-stroke depression can significantly affect the initiative of rehabilitation exercise and the rehabilitation of neurological function of patients. Virtual reality (VR) has been widely used in health-related fields in recent years. There is some evidence that VR-based interventions have benefits for depression. The aim of this study was to assess the effectiveness of VR-based intervention on depression in stroke patients. A total of 752 patients with stroke from 11 randomized controlled trials (RCTs) studies were included in this meta-analysis and the studies derived from seven electronic databases searched from database inception to August 2021. Different tools were used to measure depression. For continuous results, the standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated to synthesize the effects. We assessed the risk of bias by using the Cochrane Collaboration criteria. The results showed that compared to the control group, VR-based interventions significantly decreased the depression scale score (SMD =  - 0.75, 95% CI - 1.35, - 0.15). The meta-analysis indicated that VR-based intervention had a moderate effect on depression in stroke patients compared to control group. There was no evidence of potential publication bias as assessed by visual inspection of funnel plots in Egger and Begg tests. Substantial heterogeneity between studies was observed, meta-regression analysis showed that mean age might be the source of heterogeneity.

The time, the path, its length and strenuousness in maze learning

Previous findings show that rats in a maze tend to choose the shortest path to reach food. But it is not clear whether this choice is based on path length solely, or some other factors. The aim of this experiment was to investigate which factor dominates the behavior in a maze: path (longer and shorter), time (longer and shorter), or effort (more or less strenuous). The experiment involved 40 mice (4 groups), learning a maze with two paths. Each group went through only one of the situations within which we kept one factor constant on two paths while the remaining two factors were varied. Only in the fourth situation all factors were equalized. The results show that there is a statistically significant difference in the maze path preference between four situations. Preference between the paths is such that mice always choose paths requiring less effort.

D1- and D2-like receptors differentially mediate the effects of dopaminergic transmission on cost-benefit evaluation and motivation in monkeys

It has been widely accepted that dopamine (DA) plays a major role in motivation, yet the specific contribution of DA signaling at D₁-like receptor (D₁R) and D₂-like receptor (D₂R) to cost–benefit trade-off remains unclear. Here, by combining pharmacological manipulation of DA receptors (DARs) and positron emission tomography (PET) imaging, we assessed the relationship between the degree of D₁R/D₂R blockade and changes in benefit- and cost-based motivation for goal-directed behavior of macaque monkeys. We found that the degree of blockade of either D₁R or D₂R was associated with a reduction of the positive impact of reward amount and increasing delay discounting. Workload discounting was selectively increased by D₂R antagonism. In addition, blocking both D₁R and D₂R had a synergistic effect on delay discounting but an antagonist effect on workload discounting. These results provide fundamental insight into the distinct mechanisms of DA action in the regulation of the benefit- and cost-based motivation, which have important implications for motivational alterations in both neurological and psychiatric disorders.

Using quantitatively controlled pharmacological manipulations, this study teases apart the role of D1- and D2-like dopamine receptors in motivation and goal-directed behavior in monkeys, revealing complementary roles of two dopamine receptor subtypes in the computation of the cost/benefit trade-off to guide action.

Reinforcing value and hypothetical behavioral economic demand for food and their relation to BMI

Food is a primary reinforcer, and food reinforcement is related to obesity. The reinforcing value of food can be measured by establishing how hard someone will work to get food on progressive-ratio schedules. An alternative way to measure food reinforcement is a hypothetical purchase task which creates behavioral economic demand curves. This paper studies whether reinforcing value and hypothetical behavioral demand approaches are assessing the same or unique aspects of food reinforcement for low (LED) and high (HED) energy density foods using a combination of analytic approaches in females of varying BMI. Results showed absolute reinforcing value for LED and HED foods and relative reinforcing value were related to demand intensity (r's = 0.20-0.30, p's < 0.01), and demand elasticity (r's = 0.17-0.22, p's < 0.05). Correlations between demographic, BMI and restraint, disinhibition and hunger variables with the two measures of food reinforcement were different. Finally, the two measures provided unique contributions to predicting BMI. Potential reasons for differences between the reinforcing value and hypothetical purchase tasks were actual responding versus hypothetical purchasing, choice of reinforcers versus purchasing of individual foods in the demand task, and the differential role of effort in the two tasks. Examples of how a better understanding of food reinforcement may be useful to prevent or treat obesity are discussed, including engaging in alternative non-food reinforcers as substitutes for food, such as crafts or socializing in a non-food environment, and reducing the value of immediate food reinforcers by episodic future thinking.

Blunted Dopamine Transmission in Addiction: Potential Mechanisms and Implications for Behavior

Positron emission tomography (PET) imaging consistently shows blunted striatal dopamine release and decreased dopamine D2 receptor availability in addiction. Here, we review the preclinical and clinical studies indicating that this neurobiological phenotype is likely to be both a consequence of chronic drug consumption and a vulnerability factor in the development of addiction. We propose that, behaviorally, blunted striatal dopamine transmission could reflect the increased impulsivity and altered cost/benefit computations that are associated with addiction. The factors that influence blunted striatal dopamine transmission in addiction are unknown. Herein, we give an overview of various factors, genetic, environmental, and social, that are known to affect dopamine transmission and that have been associated with the vulnerability to develop addiction. Altogether, these data suggest that blunted dopamine transmission and decreased D2 receptor availability are biomarkers both for the development of addiction and resistance to treatment. These findings support the view that blunted dopamine reflects impulsive behavior and deficits in motivation, which lead to the escalation of drug use.

Dopamine antagonism decreases willingness to expend physical, but not cognitive, effort: a comparison of two rodent cost/benefit decision-making tasks

Successful decision making often requires weighing a given option's costs against its associated benefits, an ability that appears perturbed in virtually every severe mental illness. Animal models of such cost/benefit decision making overwhelmingly implicate mesolimbic dopamine in our willingness to exert effort for a larger reward. Until recently, however, animal models have invariably manipulated the degree of physical effort, whereas human studies of effort have primarily relied on cognitive costs. Dopamine's relationship to cognitive effort has not been directly examined, nor has the relationship between individuals' willingness to expend mental versus physical effort. It is therefore unclear whether willingness to work hard in one domain corresponds to willingness in the other. Here we utilize a rat cognitive effort task (rCET), wherein animals can choose to allocate greater visuospatial attention for a greater reward, and a previously established physical effort-discounting task (EDT) to examine dopaminergic and noradrenergic contributions to effort. The dopamine antagonists eticlopride and SCH23390 each decreased willingness to exert physical effort on the EDT; these drugs had no effect on willingness to exert mental effort for the rCET. Preference for the high effort option correlated across the two tasks, although this effect was transient. These results suggest that dopamine is only minimally involved in cost/benefit decision making with cognitive effort costs. The constructs of mental and physical effort may therefore comprise overlapping, but distinct, circuitry, and therapeutic interventions that prove efficacious in one effort domain may not be beneficial in another.

Conflict acts as an implicit cost in reinforcement learning

Conflict has been proposed to act as a cost in action selection, implying a general function of medio-frontal cortex in the adaptation to aversive events. Here we investigate if response conflict acts as a cost during reinforcement learning by modulating experienced reward values in cortical and striatal systems. Electroencephalography recordings show that conflict diminishes the relationship between reward-related frontal theta power and cue preference yet it enhances the relationship between punishment and cue avoidance. Individual differences in the cost of conflict on reward versus punishment sensitivity are also related to a genetic polymorphism associated with striatal D1 versus D2 pathway balance (DARPP-32). We manipulate these patterns with the D2 agent cabergoline, which induces a strong bias to amplify the aversive value of punishment outcomes following conflict. Collectively, these findings demonstrate that interactive cortico-striatal systems implicitly modulate experienced reward and punishment values as a function of conflict.

Dissociable contributions of anterior cingulate cortex and basolateral amygdala on a rodent cost/benefit decision-making task of cognitive effort

Personal success often requires the choice to expend greater effort for larger rewards, and deficits in such effortful decision making accompany a number of illnesses including depression, schizophrenia, and attention-deficit/hyperactivity disorder. Animal models have implicated brain regions such as the basolateral amygdala (BLA) and anterior cingulate cortex (ACC) in physical effort-based choice, but disentangling the unique contributions of these two regions has proven difficult, and effort demands in industrialized society are predominantly cognitive in nature. Here we utilize the rodent cognitive effort task (rCET), a modification of the five-choice serial reaction-time task, wherein animals can choose to expend greater visuospatial attention to obtain larger sucrose rewards. Temporary inactivation (via baclofen-muscimol) of BLA and ACC showed dissociable effects: BLA inactivation caused hard-working rats to 'slack off' and 'slacker' rats to work harder, whereas ACC inactivation caused all animals to reduce willingness to expend mental effort. Furthermore, BLA inactivation increased the time needed to make choices, whereas ACC inactivation increased motor impulsivity. These data illuminate unique contributions of BLA and ACC to effort-based decision making, and imply overlapping yet distinct circuitry for cognitive vs physical effort. Our understanding of effortful decision making may therefore require expanding our models beyond purely physical costs.

Game-based digital interventions for depression therapy: a systematic review and meta-analysis

The aim of this study was to review the existing literature on game-based digital interventions for depression systematically and examine their effectiveness through a meta-analysis of randomized controlled trials (RCTs). Database searching was conducted using specific search terms and inclusion criteria. A standard meta-analysis was also conducted of available RCT studies with a random effects model. The standard mean difference (Cohen's d) was used to calculate the effect size of each study. Nineteen studies were included in the review, and 10 RCTs (eight studies) were included in the meta-analysis. Four types of game interventions-psycho-education and training, virtual reality exposure therapy, exercising, and entertainment-were identified, with various types of support delivered and populations targeted. The meta-analysis revealed a moderate effect size of the game interventions for depression therapy at posttreatment (d=-0.47 [95% CI -0.69 to -0.24]). A subgroup analysis showed that interventions based on psycho-education and training had a smaller effect than those based on the other forms, and that self-help interventions yielded better outcomes than supported interventions. A higher effect was achieved when a waiting list was used as the control. The review and meta-analysis support the effectiveness of game-based digital interventions for depression. More large-scale, high-quality RCT studies with sufficient long-term data for treatment evaluation are needed.

Anhedonia, avolition, and anticipatory deficits: assessments in animals with relevance to the negative symptoms of schizophrenia

Schizophrenia represents a complex, heterogeneous disorder characterized by several symptomatic domains that include positive and negative symptoms and cognitive deficits. Negative symptoms reflect a cluster of symptoms that remains therapeutically unresponsive to currently available medications. Therefore, the development of animal models that may contribute to the discovery of novel and efficacious treatment strategies is essential. An animal model consists of both an inducing condition or manipulation (i.e., independent variable) and an observable measure(s) (i.e., dependent variables) that are used to assess the construct(s) under investigation. The objective of this review is to describe currently available experimental procedures that can be used to characterize constructs relevant to the negative symptoms of schizophrenia in experimental animals. While negative symptoms can encompass aspects of social withdrawal and emotional blunting, this review focuses on the assessment of reward deficits that result in anhedonia, avolition, and abnormal reward anticipation. The development and utilization of animal procedures that accurately assess reward-based constructs related to negative symptomatology in schizophrenia will provide an improved understanding of the neural substrates involved in these processes.

Putting desire on a budget: dopamine and energy expenditure, reconciling reward and resources

Accumulating evidence indicates integration of dopamine function with metabolic signals, highlighting a potential role for dopamine in energy balance, frequently construed as modulating reward in response to homeostatic state. Though its precise role remains controversial, the reward perspective of dopamine has dominated investigation of motivational disorders, including obesity. In the hypothesis outlined here, we suggest instead that the primary role of dopamine in behavior is to modulate activity to adapt behavioral energy expenditure to the prevailing environmental energy conditions, with the role of dopamine in reward and motivated behaviors derived from its primary role in energy balance. Dopamine has long been known to modulate activity, exemplified by psychostimulants that act via dopamine. More recently, there has been nascent investigation into the role of dopamine in modulating voluntary activity, with some investigators suggesting that dopamine may serve as a final common pathway that couples energy sensing to regulated voluntary energy expenditure. We suggest that interposed between input from both the internal and external world, dopamine modulates behavioral energy expenditure along two axes: a conserve-expend axis that regulates generalized activity and an explore-exploit axes that regulates the degree to which reward value biases the distribution of activity. In this view, increased dopamine does not promote consumption of tasty food. Instead increased dopamine promotes energy expenditure and exploration while decreased dopamine favors energy conservation and exploitation. This hypothesis provides a mechanistic interpretation to an apparent paradox: the well-established role of dopamine in food seeking and the findings that low dopaminergic functions are associated with obesity. Our hypothesis provides an alternative perspective on the role of dopamine in obesity and reinterprets the "reward deficiency hypothesis" as a perceived energy deficit. We propose that dopamine, by facilitating energy expenditure, should be protective against obesity. We suggest the apparent failure of this protective mechanism in Western societies with high prevalence of obesity arises as a consequence of sedentary lifestyles that thwart energy expenditure.

Taste uncoupled from nutrition fails to sustain the reinforcing properties of food

Recent findings suggest the reward system encodes metabolic value independent of taste, provoking speculation that the hedonic value of taste could be derived from nutritional value as a secondary appetitive property. We therefore dissociated and compared the impact of nutrition and taste on appetitive behavior in several paradigms. Though taste alone induces preference and increased consumption, in the absence of nutritional value its reinforcing properties are greatly diminished and it does not, like sucrose, induce increased responding over time. In agreement with behavioral data, saccharin-evoked (but not sucrose-evoked) dopamine release is greatly attenuated following pre-exposure, suggesting that nutritional value is critical for dopamine-mediated reward and reinforcement. Further supporting the primacy of nutrition over taste, genetically increased dopaminergic tone enhances incentive associated with nutritional value with minimal impact on taste-based, hedonic incentive. Overall, we suggest that the sensory-hedonic incentive value associated with taste functions as a conditioned stimulus that requires nutritional value to sustainably organize appetitive behavior.

Effects of sensitization on the detection of an instrumental contingency

While prior exposure to drugs of abuse permanently changes many behaviors, the underlying psychological mechanisms are relatively obscure. Here, the effects of sensitization on the detection of an action-outcome relationship were assessed, using a particularly stringent contingency degradation procedure. Rats were trained to leverpress until the probability of reinforcement for a response on one lever, or alternative reinforcement for a response on a second lever was reduced to 0.05 per second. Sensitization was then carried out (1mg/kg d-amphetamine/day for 7 days). Then, one reinforcer was also made available for a lack of response on either lever (p=0.05/s), maintaining its contiguity with the original response but eliminating its contingent relationship. Sensitized animals were more active, particularly early in the contingency degradation phase, but reduced responding directed at the degraded action-outcome contingency at a similar rate as controls. However, controls also reduced responding directed at the nondegraded contingency until very late in training, while sensitized animals maintained nondegraded responding at baseline levels. It was suggested that the relatively specific response shown by sensitized animals may reflect either improved action-outcome utilization or discrimination of relevant task features.

Task-load-dependent activation of dopaminergic midbrain areas in the absence of reward

Dopamine release in cortical and subcortical structures plays a central role in reward-related neural processes. Within this context, dopaminergic inputs are commonly assumed to play an activating role, facilitating behavioral and cognitive operations necessary to obtain a prospective reward. Here, we provide evidence from human fMRI that this activating role can also be mediated by task-demand-related processes and thus extends beyond situations that only entail extrinsic motivating factors. Using a visual discrimination task in which varying levels of task demands were precued, we found enhanced hemodynamic activity in the substantia nigra (SN) for high task demands in the absence of reward or similar extrinsic motivating factors. This observation thus indicates that the SN can also be activated in an endogenous fashion. In parallel to its role in reward-related processes, reward-independent activation likely serves to recruit the processing resources needed to meet enhanced task demands. Simultaneously, activity in a wide network of cortical and subcortical control regions was enhanced in response to high task demands, whereas areas of the default-mode network were deactivated more strongly. The present observations suggest that the SN represents a core node within a broader neural network that adjusts the amount of available neural and behavioral resources to changing situational opportunities and task requirements, which is often driven by extrinsic factors but can also be controlled endogenously.