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Chen H, Zhang H, Li W, Zhang X, Xu Z, Wang Z, Jiang W, Liu N, Zhang N. Resting-state functional connectivity of goal-directed and habitual-learning systems: The efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder. J Affect Disord 2024; 362:287-296. [PMID: 38944296 DOI: 10.1016/j.jad.2024.06.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 06/16/2024] [Accepted: 06/25/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND There is an imbalance between goal-directed and habitual-learning system in patients with obsessive-compulsive disorder (OCD). At present, the relationship between cognitive behavior therapy (CBT) as a first-line therapy and goal-directed and habitual-learning disorder is still unclear. We attempted to discuss the effect of CBT treatment in patients with OCD, using abnormalities in goal-directed and habitual-learning-related brain regions at baseline as predictive factors. METHODS A total of 71 subjects, including 35 OCD patients and 36 healthy controls, were recruited. The OCD patients underwent 8 weeks of CBT. These patients were divided into two groups based on treatment response (Nresponders = 18, Nnonresponders = 17). Further subgroup analysis was conducted based on disease duration (Nshort = 17, Nlong = 18) and age of onset (Nearly = 14, Nlate = 21). We collected resting-state ROI-ROI functional connectivity data and apply repeated-measures linear mixed-effects models to investigate the differences of different subgroups. RESULTS CBT led to symptom improvement in OCD patients, with varying degrees of effectiveness across subgroups. The orbitofrontal cortex (OFC) and insula, key regions for goal-directed behavior and habitual-learning, respectively, showed significant impacts on CBT efficacy in subgroups with different disease durations and ages of onset. CONCLUSION The findings suggest that the goal-directed system may influence the efficacy of CBT through goal selection, maintenance, and emotion regulation. Furthermore, we found that disease duration and age of onset may affect treatment outcomes by modulating functional connectivity between goal-directed and habitual-learning brain regions.
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Affiliation(s)
- Haocheng Chen
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Huan Zhang
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wangyue Li
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xuedi Zhang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhihan Xu
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhongqi Wang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wenjing Jiang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Na Liu
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Ning Zhang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
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Mas-Cuesta L, Baltruschat S, Cándido A, Verdejo-Lucas C, Catena-Verdejo E, Catena A. Brain changes following mindfulness: Reduced caudate volume is associated with decreased positive urgency. Behav Brain Res 2024; 461:114859. [PMID: 38216057 DOI: 10.1016/j.bbr.2024.114859] [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: 05/19/2023] [Revised: 11/22/2023] [Accepted: 01/06/2024] [Indexed: 01/14/2024]
Abstract
Mindfulness training has been shown to improve psychological health and general well-being. However, it is unclear which brain and personality systems may be affected by this practice for improving adaptive behavior and quality of life. The present study explores the effects of a 5-week mindfulness-based intervention (MBI) at the neuroanatomical level and its relationship with dispositional mindfulness and impulsivity. Sixty-six risky drivers were quasi-randomly assigned to a mindfulness training group (MT) or a control group (N). Participants underwent magnetic resonance imaging and completed the Five Facet Mindfulness Questionnaire (FFMQ) and the UPPS-P impulsivity scale twice, at baseline and after receiving the MBI. We observed that MBI changes dispositional mindfulness in the non-reactivity and observing facets. Further, we observed that the magnitude of change in impulsivity was associated with the change in dispositional mindfulness. Whole-brain voxel-wise analysis revealed that the volume of the right caudate nucleus of the MT group (n = 27) showed a reduction compared to that of the control group (n = 33), which increased in terms of the pre-post measurement (MT=-1.76 mm3; N = 6.31 mm3). We also observed that reduced caudate nucleus volume correlated with decreased positive urgency in the MT group. Taken together, our results show that MBI improves the skills of observing and non-reactivity to inner experience, while producing changes in the structure of the caudate nucleus. These structural changes are associated with a reduction in impulsivity levels, decreasing the tendency to act rashly in situations that generate positive emotions and thus facilitating more adaptive behavior.
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Affiliation(s)
- Laura Mas-Cuesta
- Mind, Brain and Behavior Research Center, University of Granada, Campus de Cartuja s/n, 18011 Granada, Spain.
| | - Sabina Baltruschat
- Brain Research Imaging Centre, Cardiff University, Maindy Rd, Cardiff CF24 4HQ, UK
| | - Antonio Cándido
- Mind, Brain and Behavior Research Center, University of Granada, Campus de Cartuja s/n, 18011 Granada, Spain
| | | | | | - Andrés Catena
- School of Psychology, University of Granada, Campus de Cartuja s/n, 18011 Granada, Spain
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Brown CS, Devine S, Otto AR, Bischoff-Grethe A, Wierenga CE. Greater reliance on model-free learning in adolescent anorexia nervosa: An examination of dual-system reinforcement learning. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.31.24302097. [PMID: 38352608 PMCID: PMC10863009 DOI: 10.1101/2024.01.31.24302097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Alterations in learning and decision-making systems are thought to contribute to core features of anorexia nervosa (AN), a psychiatric disorder characterized by persistent dietary restriction and weight loss. Instrumental learning theory identifies a dual-system of habit and goal-directed decision-making, linked to model-free and model-based reinforcement learning algorithms. Difficulty arbitrating between these systems, resulting in an over-reliance on one strategy over the other, has been implicated in compulsivity and extreme goal pursuit, both of which are observed in AN. Characterizing alterations in model-free and model-based systems, and their neural correlates, in AN may clarify mechanisms contributing to symptom heterogeneity (e.g., binge/purge symptoms). This study tested whether adolescents with restricting AN (AN-R; n = 36) and binge/purge AN (AN-BP; n = 20) differentially utilized model-based and model-free learning systems compared to a healthy control group (HC; n = 28) during a Markov two-step decision-making task under conditions of reward and punishment. Associations between model-free and model-based learning and resting-state functional connectivity between neural regions of interest, including orbitofrontal cortex (OFC), nucleus accumbens (NAcc), putamen, and sensory motor cortex (SMC) were examined. AN-R showed higher utilization of model-free learning compared to HC for reward, but attenuated model-free and model-based learning for punishment. In AN-R only, higher model-based learning was associated with stronger OFC-to-left NAcc functional connectivity, regions linked to goal-directed behavior. Greater utilization of model-free learning for reward in AN-R may differentiate this group, particularly during adolescence, and facilitate dietary restriction by prioritizing habitual control in rewarding contexts.
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Affiliation(s)
- Carina S. Brown
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology
- Department of Psychiatry, University of California, San Diego
| | | | | | | | - Christina E. Wierenga
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology
- Department of Psychiatry, University of California, San Diego
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4
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Valachová M, Lisá E. Dispositional mindfulness and BIS/BAS up-close: can the self-regulation of people be seen in the eyes? Front Psychol 2023; 14:1217129. [PMID: 37637927 PMCID: PMC10448391 DOI: 10.3389/fpsyg.2023.1217129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Pigmentation in animal models is related to behavioral regulation and development, suggesting that both may belong to the same biological system. However, such models are poorly documented in humans. The current study explored personality and group differences in self-regulation among healthy subjects and their specific eye structures (contraction furrows and pigment spots). Three objectives were proposed: to analyze statistical differences in dispositional mindfulness (DM), behavioral inhibition system (BIS), and behavioral approach system (BAS) among subjects with a specific iris type of contraction furrows and pigment spots. Methods The study sample consisted of 194 university students. One month after taking photographs of their eyes, the students completed the online scales of DM, BIS, and BAS. Results DM was negatively related to pigment spots (rs = -0.193; p < 0.01). Cluster analysis of the iris structures converged at a four-cluster solution. The cluster types 2 (absence of pigment spots and contraction furrows extending 8/10 of iris circle or more) and 3 (one or more pigment spots and contraction furrows extending 8/10 of iris circle or more) significantly differed in DM with a small effect size (F = 3.37; p = 0.021; η2 = 0.051). Participants with contraction furrows (8/10 or more circle extent) and without pigment spots had a significantly higher DM than those with pigment spots. No significant differences existed among the iris types in BIS/BAS. Discussion Future research directions are suggested.
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Affiliation(s)
| | - Elena Lisá
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University in Bratislava, Bratislava, Slovakia
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5
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van de Vijver I, Verhoeven AAC, de Wit S. Individual Differences in Corticostriatal White-matter Tracts Predict Successful Daily-life Routine Formation. J Cogn Neurosci 2023; 35:571-587. [PMID: 36724394 DOI: 10.1162/jocn_a_01967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Despite good intentions, people often fail to cross the "intention-behavior gap," especially when goal achievement requires repeated action. To bridge this gap, the formation of automatized routines may be crucial. However, people may differ in the tendency to switch from goal-directed toward habitual control. To shed light on why some people succeed in forming routines while others struggle, the present study related the automatization of a novel, daily routine to individual differences in white-matter connectivity in corticostriatal networks that have been implicated in goal-directed and habitual control. Seventy-seven participants underwent diffusion-weighted imaging and formed the daily routine of taking a (placebo) pill for 3 weeks. Pill intake was measured by electronic pill boxes, and participants filled out a daily online questionnaire on the subjective automaticity of this behavior. Automatization of pill intake was negatively related to striatal (mainly caudate) connectivity with frontal goal-directed and cognitive control regions, namely, ventromedial pFC and anterior cingulate gyrus. Furthermore, daily pill intake was positively related to individual differences in striatal (mainly caudate) connectivity with cognitive control regions, including dorsolateral and anterior pFC. Therefore, strong control networks may be relevant for implementing a new routine but may not benefit its automatization. We also show that habit tendency (assessed with an outcome-devaluation task), conscientiousness, and daily life regularity were positively related to routine automatization. This translational study moves the field of habit research forward by relating self-reported routine automatization to individual differences in performance on an experimental habit measure and to brain connectivity.
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Guida P, Foffani G, Obeso I. The Supplementary Motor Area and Automatic Cognitive Control: Lack of Evidence from Two Neuromodulation Techniques. J Cogn Neurosci 2023; 35:439-451. [PMID: 36603037 DOI: 10.1162/jocn_a_01954] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The SMA is fundamental in planning voluntary movements and execution of some cognitive control operations. Specifically, the SMA has been known to play a dominant role in controlling goal-directed actions as well as those that are highly predicted (i.e., automatic). Yet, the essential contribution of SMA in goal-directed or automatic control of behavior is scarce. Our objective was to test the possible direct role of SMA in automatic and voluntary response inhibition. We separately applied two noninvasive brain stimulation (NIBS) inhibitory techniques over SMA: either continuous theta-burst stimulation using repetitive transcranial magnetic stimulation or transcranial static magnetic field stimulation. Each NIBS technique was performed in a randomized, crossover, sham-controlled design. Before applying NIBS, participants practiced a go/no-go learning task where associations between stimulus and stopping behaviors were created (initiation and inhibition). After applying each NIBS, participants performed a go/no-go task with reversed associations (automatic control) and the stop signal task (voluntary control). Learning associations between stimuli and response initiation/inhibition was achieved by participants and therefore automatized during training. However, no significant differences between real and sham NIBS were found in either automatic (go/no-go learning task) or voluntary inhibition (stop signal task), with Bayesian statistics providing moderate evidence of absence. In conclusion, our results are compatible with a nondirect involvement of SMA in automatic control of behavior. Further studies are needed to prove a noncausal link between prior neuroimaging findings relative to SMA controlling functions and the observed behavior.
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Affiliation(s)
- Pasqualina Guida
- Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Autonoma de Madrid University-Cajal Institute, Madrid, Spain
| | - Guglielmo Foffani
- Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Instituto Carlos III, Madrid, Spain.,Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | - Ignacio Obeso
- Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Complutense University of Madrid, Spain
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7
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Zühlsdorff K, López-Cruz L, Dutcher EG, Jones JA, Pama C, Sawiak S, Khan S, Milton AL, Robbins TW, Bullmore ET, Dalley JW. Sex-dependent effects of early life stress on reinforcement learning and limbic cortico-striatal functional connectivity. Neurobiol Stress 2023; 22:100507. [PMID: 36505960 PMCID: PMC9731893 DOI: 10.1016/j.ynstr.2022.100507] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
Major depressive disorder (MDD) is a stress-related condition hypothesized to involve aberrant reinforcement learning (RL) with positive and negative stimuli. The present study investigated whether repeated early maternal separation (REMS) stress, a procedure widely recognized to cause depression-like behaviour, affects how subjects learn from positive and negative feedback. The REMS procedure was implemented by separating male and female rats from their dam for 6 h each day from post-natal day 5-19. Control rat offspring were left undisturbed during this period. Rats were tested as adults for behavioral flexibility and feedback sensitivity on a probabilistic reversal learning task. A computational approach based on RL theory was used to derive latent behavioral variables related to reward learning and flexibility. To assess underlying brain substrates, a seed-based functional MRI connectivity analysis was applied both before and after an additional adulthood stressor in control and REMS rats. Female but not male rats exposed to REMS stress showed increased response 'stickiness' (repeated responses regardless of reward outcome). Following repeated adulthood stress, reduced functional connectivity from the basolateral amygdala (BLA) to the dorsolateral striatum (DLS), cingulate cortex (Cg), and anterior insula (AI) cortex was observed in females. By contrast, control male rats exposed to the second stressor showed impaired learning from negative feedback (i.e., non-reward) and reduced functional connectivity from the BLA to the DLS and AI compared to maternally separated males. RL in male rats exposed to REMS was unaffected. The fMRI data further revealed that connectivity between the mOFC and other prefrontal cortical and subcortical structures was positively correlated with response 'stickiness'. These findings reveal differences in how females and males respond to early life adversity and subsequent stress. These effects may be mediated by functional divergence in resting-state connectivity between the basolateral amygdala and fronto-striatal brain regions.
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Affiliation(s)
- Katharina Zühlsdorff
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
- Corresponding author. Department of Psychology, University of Cambridge, Downing St, Cambridge, CB2 3EB, UK.
| | - Laura López-Cruz
- Faculty of Science, Technology, Engineering & Mathematics, The Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA, UK
| | - Ethan G. Dutcher
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
| | - Jolyon A. Jones
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
| | - Claudia Pama
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
| | - Stephen Sawiak
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Box 65, Cambridge, CB2 0QQ, UK
| | - Shahid Khan
- GlaxoSmithKline Research & Development, Stevenage, UK
| | - Amy L. Milton
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
| | - Trevor W. Robbins
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
| | - Edward T. Bullmore
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
- Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Cambridge, CB2 0SZ, UK
| | - Jeffrey W. Dalley
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
- Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Cambridge, CB2 0SZ, UK
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Alhassen W, Alhassen S, Chen J, Monfared RV, Alachkar A. Cilia in the Striatum Mediate Timing-Dependent Functions. Mol Neurobiol 2023; 60:545-565. [PMID: 36322337 PMCID: PMC9849326 DOI: 10.1007/s12035-022-03095-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/16/2022] [Indexed: 11/07/2022]
Abstract
Almost all brain cells contain cilia, antennae-like microtubule-based organelles. Yet, the significance of cilia, once considered vestigial organelles, in the higher-order brain functions is unknown. Cilia act as a hub that senses and transduces environmental sensory stimuli to generate an appropriate cellular response. Similarly, the striatum, a brain structure enriched in cilia, functions as a hub that receives and integrates various types of environmental information to drive appropriate motor response. To understand cilia's role in the striatum functions, we used loxP/Cre technology to ablate cilia from the dorsal striatum of male mice and monitored the behavioral consequences. Our results revealed an essential role for striatal cilia in the acquisition and brief storage of information, including learning new motor skills, but not in long-term consolidation of information or maintaining habitual/learned motor skills. A fundamental aspect of all disrupted functions was the "time perception/judgment deficit." Furthermore, the observed behavioral deficits form a cluster pertaining to clinical manifestations overlapping across psychiatric disorders that involve the striatum functions and are known to exhibit timing deficits. Thus, striatal cilia may act as a calibrator of the timing functions of the basal ganglia-cortical circuit by maintaining proper timing perception. Our findings suggest that dysfunctional cilia may contribute to the pathophysiology of neuro-psychiatric disorders, as related to deficits in timing perception.
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Affiliation(s)
- Wedad Alhassen
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California-Irvine, 356A Med Surge II, Irvine, CA 92697-4625 USA
| | - Sammy Alhassen
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California-Irvine, 356A Med Surge II, Irvine, CA 92697-4625 USA
| | - Jiaqi Chen
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California-Irvine, 356A Med Surge II, Irvine, CA 92697-4625 USA
| | - Roudabeh Vakil Monfared
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California-Irvine, 356A Med Surge II, Irvine, CA 92697-4625 USA
| | - Amal Alachkar
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California-Irvine, 356A Med Surge II, Irvine, CA 92697-4625 USA ,UC Irvine Center for the Neurobiology of Learning and Memory, University of California-Irvine, Irvine, CA 92697 USA ,Institute for Genomics and Bioinformatics, School of Information and Computer Sciences, University of California-Irvine, Irvine, CA 92697 USA
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9
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Guida P, Michiels M, Redgrave P, Luque D, Obeso I. An fMRI meta-analysis of the role of the striatum in everyday-life vs laboratory-developed habits. Neurosci Biobehav Rev 2022; 141:104826. [PMID: 35963543 DOI: 10.1016/j.neubiorev.2022.104826] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/17/2022] [Accepted: 08/09/2022] [Indexed: 11/30/2022]
Abstract
The dorsolateral striatum plays a critical role in the acquisition and expression of stimulus-response habits that are learned in experimental laboratories. Here, we use meta-analytic procedures to contrast the neural circuits activated by laboratory-acquired habits with those activated by stimulus-response behaviours acquired in everyday-life. We confirmed that newly learned habits rely more on the anterior putamen with activation extending into caudate and nucleus accumbens. Motor and associative components of everyday-life habits were identified. We found that motor-dominant stimulus-response associations developed outside the laboratory primarily engaged posterior dorsal putamen, supplementary motor area (SMA) and cerebellum. Importantly, associative components were also represented in the posterior putamen. Thus, common neural representations for both naturalistic and laboratory-based habits were found in the left posterior and right anterior putamen. These findings suggest a partial common striatal substrate for habitual actions that are performed predominantly by stimulus-response associations represented in the posterior striatum. The overlapping neural substrates for laboratory and everyday-life habits supports the use of both methods for the analysis of habitual behaviour.
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Affiliation(s)
- Pasqualina Guida
- HM CINAC, Centro Integral de Neurociencias AC. Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain; CIBERNED, Instituto de Salud Carlos III, Madrid, Spain; Ph.D. Program in Neuroscience, Universidad Autónoma de Madrid Cajal Institute, Madrid 28029, Spain
| | - Mario Michiels
- HM CINAC, Centro Integral de Neurociencias AC. Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain; CIBERNED, Instituto de Salud Carlos III, Madrid, Spain; Ph.D. Program in Neuroscience, Universidad Autónoma de Madrid Cajal Institute, Madrid 28029, Spain
| | - Peter Redgrave
- Department of Psychology, University of Sheffield, Sheffield S10 2TN, UK
| | - David Luque
- Departamento de Psicología Básica, Universidad Autónoma de Madrid, Madrid, Spain; Departamento de Psicología Básica, Universidad de Málaga, Madrid, Spain
| | - Ignacio Obeso
- HM CINAC, Centro Integral de Neurociencias AC. Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain; CIBERNED, Instituto de Salud Carlos III, Madrid, Spain; Psychobiology department, Complutense University of Madrid, Madrid, Spain.
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10
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Xu C, Hou G, He T, Ruan Z, Chen J, Wei Z, Seger CA, Chen Q, Peng Z. Imbalance in Functional and Structural Connectivity Underlying Goal-Directed and Habitual Learning Systems in Obsessive-Compulsive Disorder. Cereb Cortex 2021; 32:3690-3705. [PMID: 34905765 DOI: 10.1093/cercor/bhab441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/06/2021] [Accepted: 11/07/2021] [Indexed: 01/09/2023] Open
Abstract
An imbalance between the goal-directed and habitual learning systems has been proposed to underlie compulsivity in obsessive-compulsive disorder (OCD). In addition, the overall balance between these systems may be influenced by stress hormones. We examined the multimodal networks underlying these dual learning systems. Both functional and structural measures indicated reduced connectivity within the goal-directed subnetwork (FC: P = 0.042; SC-FN: P = 0.014) and reduced connectivity between the goal-directed and habitual subnetworks (FC: P = 0.014; SC-FA: P = 0.052), but no differences within the habitual subnetwork in patients with OCD compared with controls. Path modeling indicated that anatomical connectivity in the goal-directed subnetwork influenced compulsive symptoms (R2 = 0.41), whereas functional connectivity within the habit subnetwork and between goal-directed and habitual subnetworks influenced obsessive symptoms (R2 = 0.63). In addition, the relationship between anatomical connectivity in the goal-directed subnetwork and compulsion was moderated by the stress hormone ACTH (adrenocorticotropic hormone), such that at low levels of ACTH greater connectivity resulted in lower compulsion, but at high levels of ACTH this relationship was reversed. These results provide new insights into the neural correlates of the imbalance between dual learning systems, and their relationship with symptom dimensions in patients with OCD. It may further support the reconceptualization of OCD as "compulsive-obsessive disorder," with a greater focus on the transdiagnostic dimension of compulsivity.
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Affiliation(s)
- Chuanyong Xu
- Department of Child Psychiatry and Rehabilitation, Institute of Maternity and Child Medical Research, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen 518047, China.,Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, 510631, China.,School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China
| | - Gangqiang Hou
- Department of Radiology, Shenzhen Kangning Hospital, Shenzhen 518020, China
| | - Tingxin He
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, 510631, China.,School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China
| | - Zhongqiang Ruan
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, 510631, China.,School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China
| | - Jierong Chen
- Department of Child Psychiatry and Rehabilitation, Institute of Maternity and Child Medical Research, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen 518047, China
| | - Zhen Wei
- Department of Child Psychiatry and Rehabilitation, Institute of Maternity and Child Medical Research, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen 518047, China
| | - Carol A Seger
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, 510631, China.,School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China.,Department of Psychology, Colorado State University, Fort Collins, CO 80523, USA
| | - Qi Chen
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, 510631, China.,School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China
| | - Ziwen Peng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, 510631, China.,School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China.,Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen University School of Medicine, Shenzhen 518061, China
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Beneath the surface: hyper-connectivity between caudate and salience regions in ADHD fMRI at rest. Eur Child Adolesc Psychiatry 2021; 30:619-631. [PMID: 32385695 DOI: 10.1007/s00787-020-01545-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/24/2020] [Indexed: 12/12/2022]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) comprises disturbances in attention, emotional regulation, and reward-related processes. In spite of the active efforts in researching neurofunctional correlates of these symptoms, how the activity of subcortical regions-such as basal ganglia-is related to ADHD has yet to be clarified. More specifically, how age may influence the critical changes observed in functional dynamics from childhood to adulthood remains relatively unexplored. We hence selected five core subcortical regions (amygdala, caudate, putamen, pallidum and hippocampus) as regions of interest from the previous literature, measuring their whole-brain voxel-wise rsFC in a sample of 95 ADHD and 90 neurotypical children and adolescents aged from 7 to 18. The only subcortical structure showing significant differences in rsFC was the caudate nucleus. Specifically, we measured increased rsFC with anterior cingulate and right insula, two mesolimbic regions pertaining to the Salience Network. The degree of hyper-rsFC positively correlated with ADHD symptomatology, and showed different patterns of evolution in ADHD vs neurotypical subjects. Finally, the rsFC scores allowed a fair discrimination of the ADHD group (Area Under the Curve ≥ 0.7). These findings shed further light on the fundamental role covered by subcortical structures in ADHD pathogenesis and neurodevelopment, providing new evidence to fill the gap between neurofunctional and clinical expressions of ADHD.
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Tan Q, Li S, Niu J, Liu S, Li Y, Lu Y, Wang Z, Xu W, Wei Y, Guo Z. Resting-State Functional Magnetic Resonance Imaging Reveals Overactivation of the Habitual Control Brain System in Tobacco Dependence. Neuropsychiatr Dis Treat 2021; 17:3753-3768. [PMID: 34984003 PMCID: PMC8703225 DOI: 10.2147/ndt.s334403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 11/27/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION We studied the regulatory mechanism of the habitual brain network in tobacco dependence to provide a theoretical basis for the regulation and cessation of tobacco dependence. METHODS We used resting-state functional magnetic resonance imaging (rs-fMRI) to explore the Fractional amplitude of low-frequency fluctuations (fALFF) and functional connectivity (FC) of the habitual brain network in tobacco-dependent subjects and to evaluate the relationship between the FC level and tobacco selection preference behavior. In total, 29 male tobacco-dependent participants and 28 male nonsmoking participants were recruited. rs-fMRI was used to collect blood oxygen level-dependent signals of the participants in the resting and awake states. After rs-fMRI, all subjects completed cigarette/coin selection tasks (task 1 and task 2). RESULTS Compared with the control group, the tobacco dependence group showed increased fractional amplitude values of fALFF in the left posterior cingulate cortex and right parahippocampus. FC in the tobacco-dependent group was increased in the right inferior temporal gyrus, left middle frontal gyrus, left cingulated gyrus, and bilateral superior frontal gyrus, compared with that in the control group. Moreover, the preference selection behavior was associated with the enhancement of FC about parts of the brain regions in the habitual brain network of the tobacco-dependent participants. Thus, habitual network activity was significantly enhanced in tobacco-dependent participants in the resting state. Moreover, a positive correlation was found between the cigarette selection preference of the smokers and certain brain regions related to the habitual network. DISCUSSION This suggests that increased activity of the habitual brain network may be essential in the development of tobacco-dependent behavior.
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Affiliation(s)
- Qiaowen Tan
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong Province, People's Republic of China
| | - Shaoke Li
- Department of Medical Imaging, Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong Province, People's Republic of China
| | - Juan Niu
- Clinical Psychology Department, Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong Province, People's Republic of China
| | - Shien Liu
- Department of Medical Imaging, Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong Province, People's Republic of China
| | - Yaling Li
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong Province, People's Republic of China
| | - Yujie Lu
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong Province, People's Republic of China
| | - Zhihong Wang
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong Province, People's Republic of China
| | - Wanqun Xu
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong Province, People's Republic of China
| | - Yalin Wei
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong Province, People's Republic of China
| | - Zongjun Guo
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong Province, People's Republic of China
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Investigating resting brain perfusion abnormalities and disease target-engagement by intranasal oxytocin in women with bulimia nervosa and binge-eating disorder and healthy controls. Transl Psychiatry 2020; 10:180. [PMID: 32513936 PMCID: PMC7280271 DOI: 10.1038/s41398-020-00871-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/19/2020] [Accepted: 05/26/2020] [Indexed: 12/25/2022] Open
Abstract
Advances in the treatment of bulimia nervosa and binge-eating disorder (BN/BED) have been marred by our limited understanding of the underpinning neurobiology. Here we measured regional cerebral blood flow (rCBF) to map resting perfusion abnormalities in women with BN/BED compared with healthy controls and investigate whether intranasal oxytocin (OT), proposed as a potential treatment, can restore perfusion in disorder-related brain circuits. Twenty-four women with BN/BED and 23 healthy women participated in a randomized, double-blind, crossover, placebo-controlled study. We used arterial spin labelling MRI to measure rCBF and the effects of an acute dose of intranasal OT (40 IU) or placebo over 18-26 min post dosing, as we have previously shown robust OT-induced changes in resting rCBF in men in a similar time-window (15-36 min post dosing). We tested for effects of treatment, diagnosis and their interaction on extracted rCBF values in anatomical regions-of-interest previously implicated in BN/BED by other neuroimaging modalities, and conducted exploratory whole-brain analyses to investigate previously unidentified brain regions. We demonstrated that women with BN/BED presented increased resting rCBF in the medial prefrontal and orbitofrontal cortices, anterior cingulate gyrus, posterior insula and middle/inferior temporal gyri bilaterally. Hyperperfusion in these areas specifically correlated with eating symptoms severity in patients. Our data did not support a normalizing effect of intranasal OT on perfusion abnormalities in these patients, at least for the specific dose (40 IU) and post-dosing interval (18-26 min) examined. Our findings enhance our understanding of resting brain abnormalities in BN/BED and identify resting rCBF as a non-invasive potential biomarker for disease-related changes and treatment monitoring. They also highlight the need for a comprehensive investigation of intranasal OT pharmacodynamics in women before we can fully ascertain its therapeutic value in disorders affecting predominantly this gender, such as BN/BED.
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Conn KA, Burne THJ, Kesby JP. Subcortical Dopamine and Cognition in Schizophrenia: Looking Beyond Psychosis in Preclinical Models. Front Neurosci 2020; 14:542. [PMID: 32655348 PMCID: PMC7325949 DOI: 10.3389/fnins.2020.00542] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/01/2020] [Indexed: 12/18/2022] Open
Abstract
Schizophrenia is characterized by positive, negative and cognitive symptoms. All current antipsychotic treatments feature dopamine-receptor antagonism that is relatively effective at addressing the psychotic (positive) symptoms of schizophrenia. However, there is no clear evidence that these medications improve the negative or cognitive symptoms, which are the greatest predictors of functional outcomes. One of the most robust pathophysiological observations in patients with schizophrenia is increased subcortical dopamine neurotransmission, primarily in the associative striatum. This brain area has an important role in a range of cognitive processes. Dopamine is also known to play a major part in regulating a number of cognitive functions impaired in schizophrenia but much of this research has been focused on cortical dopamine. Emerging research highlights the strong influence subcortical dopamine has on a range of cognitive domains, including attention, reward learning, goal-directed action and decision-making. Nonetheless, the precise role of the associative striatum in the cognitive impairments observed in schizophrenia remains poorly understood, presenting an opportunity to revisit its contribution to schizophrenia. Without a better understanding of the mechanisms underlying cognitive dysfunction, treatment development remains at a standstill. For this reason, improved preclinical animal models are needed if we are to understand the complex relationship between subcortical dopamine and cognition. A range of new techniques are facillitating the discrete manipulation of dopaminergic neurotransmission and measurements of cognitive performance, which can be investigated using a variety of sensitive translatable tasks. This has the potential to aid the successful incorporation of recent clinical research to address the lack of treatment strategies for cognitive symptoms in schizophrenia. This review will give an overview on the current state of research focused on subcortical dopamine and cognition in the context of schizophrenia research. We also discuss future strategies and approaches aimed at improving the translational outcomes for the treatment of cognitive deficits in schizophrenia.
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Affiliation(s)
- Kyna-Anne Conn
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Thomas H J Burne
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia.,Queensland Centre for Mental Health Research, Wacol, QLD, Australia
| | - James P Kesby
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia.,QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
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Park JS, Lee G, Choi JB, Hwang NK, Jung YJ. Game-based hand resistance exercise versus traditional manual hand exercises for improving hand strength, motor function, and compliance in stroke patients: A multi-center randomized controlled study. NeuroRehabilitation 2020; 45:221-227. [PMID: 31498145 DOI: 10.3233/nre-192829] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Game-based exercise is effective for improving strength and motor function in stroke patients undergoing rehabilitation, and it creates fun and motivation for exercise. OBJECTIVE We investigated the effect of game-based exercise on hand strength, motor function, and compliance in stroke patients. METHODS Fifty stroke patients were randomly divided into experimental and control groups. The experimental group performed a game-based hand resistance exercise. This exercise was divided into isotonic and isometric types and was performed 30 min/day, 5 days/week, for 6 weeks with 70% of the 1-repetition maximum. In contrast, the control group was given a traditional manual exercise by the occupational therapist, and the type of exercise and time involved were the same as those in the experimental group. The primary outcome measure was hand strength test measured using a dynamometer. Secondary outcome measures were manual function tests (MFT) and hand function tests using box and block test (BBT). Subject-based reports of motivation, fun, pain/fatigue evaluated on 0 to 10 numeric rating scales were compared between groups. RESULTS After training, hand strength, MFT and BBT was improved in the experimental group compared to the control group (P < 0.001, both). Subject-based reports of motivation and fun was significantly greater in the experimental group than the control group (P < 0.001, both), except to pain/fatigue (P = 0.728). CONCLUSIONS In conclusion, we demonstrated that game-based exercise is more effective than manual exercise in improving muscle strength, motor function, and compliance in stroke patients.
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Affiliation(s)
- Ji-Su Park
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, Busan, South Korea
| | - Gihyoun Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong-Bae Choi
- Department of Occupational Therapy, Kyunghee Medical Center, Seoul, South Korea
| | - Na-Kyoung Hwang
- Department of Occupational Therapy, Seoul North Municipal Hospital, Seoul, Republic of Korea
| | - Young-Jin Jung
- Department of Radiological Science at Health Sciences Division, DongSeo University, Busan, South Korea
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Augustine F, Rajendran S, Singer HS. Cortical endogenous opioids and their role in facilitating repetitive behaviors in deer mice. Behav Brain Res 2019; 379:112317. [PMID: 31676208 DOI: 10.1016/j.bbr.2019.112317] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 12/11/2022]
Abstract
Deer mice provide a non-pharmacologically induced model for the study of repetitive behaviors. In captivity, these animals develop frequent jumping and rearing that resemble clinical symptoms of obsessive-compulsive behavior (OCB), autism spectrum disorder (ASD), complex motor stereotypies (CMS), and Tourette's syndrome (TS). In this study, we pursue the mechanism of repetitive behaviors by performing stereological analyses and liquid chromatography/ mass spectrometry (LC-MS/MS) measurements of glutamate (Glut), GABA, 3,4-dihydroxyphenylacetic acid (DOPAC), dopamine (DA), leu-enkephalin (leu-enk), and dynorphin-A (dyn-A) in frontal cortex (FC), prefrontal cortex (PFC), and basal ganglia. The only significant stereological alteration was a negative correlation between repetitive behaviors and the cell count in the ventromedial striatum (VMS). Neurochemical analyses demonstrated a significant negative correlation between repetitive behaviors and endogenous opioids (leu-enk and dyn-A) in the FC - the site of origin of habitual behaviors and cortical projections to striatal MSNs participating in direct and indirect pathways. The precise neurochemical process by which endogenous opioids influence synaptic neurotransmission is unknown. One postulated cortical mechanism, supported by our findings, is an opioid effect on cortical interneuron GABA release and a consequent effect on glutamatergic cortical pyramidal cells. Anatomical changes in the VMS could have a role in repetitive behaviors, recognizing that this region influences goal-directed and habitual behaviors.
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Affiliation(s)
- Farhan Augustine
- Department of Neurology, Johns Hopkins University School of Medicine, USA
| | | | - Harvey S Singer
- Department of Neurology, Johns Hopkins University School of Medicine, USA.
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Conflicted between Goal-Directed and Habitual Control, an fMRI Investigation. eNeuro 2018; 5:eN-NWR-0240-18. [PMID: 30310863 PMCID: PMC6179575 DOI: 10.1523/eneuro.0240-18.2018] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 06/27/2018] [Indexed: 11/21/2022] Open
Abstract
“Slips of action” occur in everyday life when we momentarily lose sight of a goal (for example, when in a rush or distracted). Associative models propose that these habitual responses can be activated via a direct stimulus-response (S-R) mechanism, regardless of the current hedonic value of the outcome. The slips-of-action task (SOAT) has been extensively used in both healthy and pathological populations to measure habit tendencies, the likelihood of making erroneous responses for devalued outcomes. Inspection of behavioral performance does not reveal, however, whether the impairments were due to impaired goal-directed control or aberrantly strong habit formation. In the current study, we used functional MRI while human participants performed both the instrumental training and SOAT test phases, to elucidate the relative contributions of these mechanisms to performance on the SOAT. On trials in which conflict arises between competing goal-directed and habitual responses, we observed increased activation across areas including the anterior cingulate cortex, paracingulate gyrus, lateral orbitofrontal cortex (OFC), insula, and inferior frontal gyrus (IFG). Responding for devalued outcomes was related to increased activation in the premotor cortex and cerebellum, implicating these regions in habitual responding. Increased activation in the caudate, dorsolateral prefrontal cortex (dlPFC), and frontal pole during training was associated with better performance during the test phase, indicative of goal-directed action control. These results endorse interpretation of the SOAT in terms of competing goal-directed and habitual mechanisms and highlight that cognitive control processes present an additional bottleneck for successful performance on this task.
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Wong S, Balleine BW, Kumfor F. A new framework for conceptualizing symptoms in frontotemporal dementia: from animal models to the clinic. Brain 2018; 141:2245-2254. [DOI: 10.1093/brain/awy123] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/13/2018] [Indexed: 12/11/2022] Open
Affiliation(s)
- Stephanie Wong
- The University of Sydney, School of Psychology and Brain and Mind Centre, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Bernard W Balleine
- University of New South Wales, School of Psychology, Sydney, NSW, Australia
| | - Fiona Kumfor
- The University of Sydney, School of Psychology and Brain and Mind Centre, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
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Callaghan CK, Rouine J, O'Mara SM. Potential roles for opioid receptors in motivation and major depressive disorder. PROGRESS IN BRAIN RESEARCH 2018; 239:89-119. [DOI: 10.1016/bs.pbr.2018.07.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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