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Sheffield JM, Brinen AP, Feola B, Heckers S, Corlett PR. Understanding Cognitive Behavioral Therapy for Psychosis Through the Predictive Coding Framework. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100333. [PMID: 38952435 PMCID: PMC11215207 DOI: 10.1016/j.bpsgos.2024.100333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 05/02/2024] [Accepted: 05/04/2024] [Indexed: 07/03/2024] Open
Abstract
Psychological treatments for persecutory delusions, particularly cognitive behavioral therapy for psychosis, are efficacious; however, mechanistic theories explaining why they work rarely bridge to the level of cognitive neuroscience. Predictive coding, a general brain processing theory rooted in cognitive and computational neuroscience, has increasing experimental support for explaining symptoms of psychosis, including the formation and maintenance of delusions. Here, we describe recent advances in cognitive behavioral therapy for psychosis-based psychotherapy for persecutory delusions, which targets specific psychological processes at the computational level of information processing. We outline how Bayesian learning models employed in predictive coding are superior to simple associative learning models for understanding the impact of cognitive behavioral interventions at the algorithmic level. We review hierarchical predictive coding as an account of belief updating rooted in prediction error signaling. We examine how this process is abnormal in psychotic disorders, garnering noisy sensory data that is made sense of through the development of overly strong delusional priors. We argue that effective cognitive behavioral therapy for psychosis systematically targets the way sensory data are selected, experienced, and interpreted, thus allowing for the strengthening of alternative beliefs. Finally, future directions based on these arguments are discussed.
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Affiliation(s)
- Julia M. Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Aaron P. Brinen
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brandee Feola
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Philip R. Corlett
- Department of Psychiatry, Clinical Neuroscience Research Unit, Yale School of Medicine, New Haven, Connecticut
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2
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McNally GP, Jean-Richard-Dit-Bressel P. A Cognitive Pathway to Persistent, Maladaptive Choice. Eur Addict Res 2024; 30:233-242. [PMID: 38865985 DOI: 10.1159/000538103] [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: 12/18/2023] [Accepted: 02/27/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Correctly recognising that alcohol or other substances are causing problems is a necessary condition for those problems to spur beneficial behaviour change. Yet such recognition is neither immediate nor straightforward. Recognition that one's alcohol or drug use is causing negative consequences often occurs gradually. Contemporary addiction neuroscience has yet to make progress in understanding and addressing these recognition barriers, despite evidence that a lack of problem recognition is a primary impediment to seeking treatment. SUMMARY Based on our recent empirical work, this article shows how recognition barriers can emerge from dual constraints on how we learn about the negative consequences of our actions. One constraint is imposed by the characteristics of negative consequences themselves. A second constraint is imposed by the characteristics of human cognition and information processing. In some people, the joint action of these constraints causes a lack of correct awareness of the consequences of their behaviour and reduced willingness to update that knowledge and behaviour when confronted with counterevidence. KEY MESSAGES This "cognitive pathway" can drive persistent, maladaptive choice.
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Affiliation(s)
- Gavan P McNally
- School of Psychology, UNSW, Sydney, New South Wales, Australia
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3
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Kalhan S, Schwartenbeck P, Hester R, Garrido MI. People with a tobacco use disorder exhibit misaligned Bayesian belief updating by falsely attributing non-drug cues as worse predictors of positive outcomes compared to drug cues. Drug Alcohol Depend 2024; 256:111109. [PMID: 38354476 DOI: 10.1016/j.drugalcdep.2024.111109] [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: 07/05/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 02/16/2024]
Abstract
Adaptive behaviours depend on dynamically updating internal representations of the world based on the ever-changing environmental contingencies. People with a substance use disorder (pSUD) show maladaptive behaviours with high persistence in drug-taking, despite severe negative consequences. We recently proposed a salience misattribution model for addiction (SMMA; Kalhan et al., 2021), arguing that pSUD have aberrations in their updating processes where drug cues are misattributed as strong predictors of positive outcomes, but weaker predictors of negative outcomes. We also argued that conversely, non-drug cues are misattributed as weak predictors of positive outcomes, but stronger predictors of negative outcomes. We tested these hypotheses using a multi-cue reversal learning task, with reversals in whether drug or non-drug cues are relevant in predicting the outcome (monetary win or loss). We show that people with a tobacco use disorder (pTUD), do form misaligned internal representations. We found that pTUD updated less towards learning the drug cue's relevance in predicting a loss. Further, when neither drug nor non-drug cue predicted a win, pTUD updated more towards the drug cue being relevant predictors of that win. Our Bayesian belief updating model revealed that pTUD had a low estimated likelihood of non-drug cues being predictors of wins, compared to drug cues, which drove the misaligned updating. Overall, several hypotheses of the SMMA were supported, but not all. Our results implicate that strengthening the non-drug cue association with positive outcomes may help restore the misaligned internal representation in pTUD, and offers a quantifiable, computational account of these updating processes.
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Affiliation(s)
- Shivam Kalhan
- The University of Melbourne, Melbourne School of Psychological Sciences, Melbourne, VIC, Australia.
| | - Philipp Schwartenbeck
- Max Planck Institute for Biological Cybernetics, Tübingen, Baden-Württemberg, Germany; University of Tübingen, Tübingen, Germany
| | - Robert Hester
- The University of Melbourne, Melbourne School of Psychological Sciences, Melbourne, VIC, Australia
| | - Marta I Garrido
- The University of Melbourne, Melbourne School of Psychological Sciences, Melbourne, VIC, Australia; Graeme Clark Institute for Biomedical Engineering, Melbourne, VIC, Australia
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4
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Antony JW, Van Dam J, Massey JR, Barnett AJ, Bennion KA. Long-term, multi-event surprise correlates with enhanced autobiographical memory. Nat Hum Behav 2023; 7:2152-2168. [PMID: 37322234 DOI: 10.1038/s41562-023-01631-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/16/2023] [Indexed: 06/17/2023]
Abstract
Neurobiological and psychological models of learning emphasize the importance of prediction errors (surprises) for memory formation. This relationship has been shown for individual momentary surprising events; however, it is less clear whether surprise that unfolds across multiple events and timescales is also linked with better memory of those events. We asked basketball fans about their most positive and negative autobiographical memories of individual plays, games and seasons, allowing surprise measurements spanning seconds, hours and months. We used advanced analytics on National Basketball Association play-by-play data and betting odds spanning 17 seasons, more than 22,000 games and more than 5.6 million plays to compute and align the estimated surprise value of each memory. We found that surprising events were associated with better recall of positive memories on the scale of seconds and months and negative memories across all three timescales. Game and season memories could not be explained by surprise at shorter timescales, suggesting that long-term, multi-event surprise correlates with memory. These results expand notions of surprise in models of learning and reinforce its relevance in real-world domains.
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Affiliation(s)
- James W Antony
- Department of Psychology and Child Development, California Polytechnic State University, San Luis Obispo, CA, USA.
| | - Jacob Van Dam
- Department of Psychology and Child Development, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Jarett R Massey
- Department of Psychology and Child Development, California Polytechnic State University, San Luis Obispo, CA, USA
| | | | - Kelly A Bennion
- Department of Psychology and Child Development, California Polytechnic State University, San Luis Obispo, CA, USA
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Romaniuk L, MacSweeney N, Atkinson K, Chan SWY, Barbu MC, Lawrie SM, Whalley HC. Striatal correlates of Bayesian beliefs in self-efficacy in adolescents and their relation to mood and autonomy: a pilot study. Cereb Cortex Commun 2023; 4:tgad020. [PMID: 38089939 PMCID: PMC10712445 DOI: 10.1093/texcom/tgad020] [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: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 02/02/2024] Open
Abstract
Major depressive disorder often originates in adolescence and is associated with long-term functional impairment. Mechanistically characterizing this heterogeneous illness could provide important leads for optimizing treatment. Importantly, reward learning is known to be disrupted in depression. In this pilot fMRI study of 21 adolescents (16-20 years), we assessed how reward network disruption impacts specifically on Bayesian belief representations of self-efficacy (SE-B) and their associated uncertainty (SE-U), using a modified instrumental learning task probing activation induced by the opportunity to choose, and an optimal Hierarchical Gaussian Filter computational model. SE-U engaged caudate, nucleus accumbens (NAcc), precuneus, posterior parietal and dorsolateral prefrontal cortex (PFWE < 0.005). Sparse partial least squares analysis identified SE-U striatal activation as associating with one's sense of perceived choice and depressive symptoms, particularly anhedonia and negative feelings about oneself. As Bayesian uncertainty modulates belief flexibility and their capacity to steer future actions, this suggests that these striatal signals may be informative developmentally, longitudinally and in assessing response to treatment.
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Affiliation(s)
- Liana Romaniuk
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5H, United Kingdom
| | - Niamh MacSweeney
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5H, United Kingdom
| | - Kimberley Atkinson
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5H, United Kingdom
| | - Stella W Y Chan
- School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, Whiteknights, Reading RG6 6ES, United Kingdom
| | - Miruna C Barbu
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5H, United Kingdom
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5H, United Kingdom
| | - Heather C Whalley
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5H, United Kingdom
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Qi W, Wen Z, Chen J, Capichioni G, Ando F, Chen ZS, Wang J, Yoncheva Y, Castellanos FX, Milad M, Goff DC. Aberrant resting-state functional connectivity of the globus pallidus interna in first-episode schizophrenia. Schizophr Res 2023; 261:100-106. [PMID: 37716202 DOI: 10.1016/j.schres.2023.09.018] [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: 11/18/2022] [Revised: 04/05/2023] [Accepted: 09/04/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND The striatal-pallidal pathway plays an important role in cognitive control and modulation of behaviors. Globus pallidus interna (GPi), as a primary output structure, is crucial in modulating excitation and inhibition. Studies of GPi in psychiatric illnesses are lacking given the technical challenges of examining this small and functionally diverse subcortical structure. METHODS 71 medication-naïve first episode schizophrenia (FES) participants and 73 healthy controls (HC) were recruited at the Shanghai Mental Health Center. Clinical symptoms and imaging data were collected at baseline and, in a subset of patients, 8 weeks after initiating treatment. Resting-state functional connectivity of sub-regions of the GP were assessed using a novel mask that combines two atlases to create 8 ROIs in the GP. RESULTS Baseline imaging data from 63 FES patients and 55 HC met quality standards and were analyzed. FES patients exhibited less negative connectivity and increased positive connectivity between the right anterior GPi and several cortical and subcortical areas at baseline compared to HC (PFWE < 0.05). Positive functional connectivity between the right anterior GPi and several brain areas, including the right dorsal anterior cingulate gyrus, was associated with severity of positive symptoms (PFWE < 0.05) and predicted treatment response after 8 weeks (n = 28, adjusted R2 = 0.486, p < 0.001). CONCLUSIONS Our results implicate striatal-pallidal-thalamic pathways in antipsychotic efficacy. If replicated, these findings may reflect failure of neurodevelopmental processes in adolescence and early adulthood that decrease functional connectivity as an index of failure of the limbic/associative GPi to appropriately inhibit irrelevant signals in psychosis.
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Affiliation(s)
- Wei Qi
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Zhenfu Wen
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Jingyun Chen
- Clinical Consult Department, Icometrix, Boston, MA, United States of America
| | - Gillian Capichioni
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Fumika Ando
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Zhe Sage Chen
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America; Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States of America
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuliya Yoncheva
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Francisco X Castellanos
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States of America; Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Mohammed Milad
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Donald C Goff
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States of America.
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7
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Mikus N, Eisenegger C, Mathys C, Clark L, Müller U, Robbins TW, Lamm C, Naef M. Blocking D2/D3 dopamine receptors in male participants increases volatility of beliefs when learning to trust others. Nat Commun 2023; 14:4049. [PMID: 37422466 PMCID: PMC10329681 DOI: 10.1038/s41467-023-39823-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 06/29/2023] [Indexed: 07/10/2023] Open
Abstract
The ability to learn about other people is crucial for human social functioning. Dopamine has been proposed to regulate the precision of beliefs, but direct behavioural evidence of this is lacking. In this study, we investigate how a high dose of the D2/D3 dopamine receptor antagonist sulpiride impacts learning about other people's prosocial attitudes in a repeated Trust game. Using a Bayesian model of belief updating, we show that in a sample of 76 male participants sulpiride increases the volatility of beliefs, which leads to higher precision weights on prediction errors. This effect is driven by participants with genetically conferred higher dopamine availability (Taq1a polymorphism) and remains even after controlling for working memory performance. Higher precision weights are reflected in higher reciprocal behaviour in the repeated Trust game but not in single-round Trust games. Our data provide evidence that the D2 receptors are pivotal in regulating prediction error-driven belief updating in a social context.
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Affiliation(s)
- Nace Mikus
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria.
- Interacting Minds Centre, Aarhus University, Aarhus, Denmark.
| | - Christoph Eisenegger
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Behavioural and Clinical Neuroscience Institute and Department of Psychology, University of Cambridge, Cambridge, UK
| | - Christoph Mathys
- Interacting Minds Centre, Aarhus University, Aarhus, Denmark
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
- Scuola Internazionale Superiore di Studi Avanzati (SISSA), Trieste, Italy
| | - Luke Clark
- Centre for Gambling Research at UBC, Department of Psychology, University of British, Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Ulrich Müller
- Behavioural and Clinical Neuroscience Institute and Department of Psychology, University of Cambridge, Cambridge, UK
- Adult Neurodevelopmental Services, Health & Community Services, Government of Jersey, St Helier, Jersey
| | - Trevor W Robbins
- Behavioural and Clinical Neuroscience Institute and Department of Psychology, University of Cambridge, Cambridge, UK
| | - Claus Lamm
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria.
| | - Michael Naef
- Department of Economics, University of Durham, Durham, UK.
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8
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McNally GP, Jean-Richard-Dit-Bressel P, Millan EZ, Lawrence AJ. Pathways to the persistence of drug use despite its adverse consequences. Mol Psychiatry 2023; 28:2228-2237. [PMID: 36997610 PMCID: PMC10611585 DOI: 10.1038/s41380-023-02040-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 04/01/2023]
Abstract
The persistence of drug taking despite its adverse consequences plays a central role in the presentation, diagnosis, and impacts of addiction. Eventual recognition and appraisal of these adverse consequences is central to decisions to reduce or cease use. However, the most appropriate ways of conceptualizing persistence in the face of adverse consequences remain unclear. Here we review evidence that there are at least three pathways to persistent use despite the negative consequences of that use. A cognitive pathway for recognition of adverse consequences, a motivational pathway for valuation of these consequences, and a behavioral pathway for responding to these adverse consequences. These pathways are dynamic, not linear, with multiple possible trajectories between them, and each is sufficient to produce persistence. We describe these pathways, their characteristics, brain cellular and circuit substrates, and we highlight their relevance to different pathways to self- and treatment-guided behavior change.
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Affiliation(s)
- Gavan P McNally
- School of Psychology, UNSW Sydney, Sydney, NSW, 2052, Australia.
| | | | - E Zayra Millan
- School of Psychology, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Andrew J Lawrence
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, 3010, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia
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9
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Fromm SP, Wieland L, Klettke A, Nassar MR, Katthagen T, Markett S, Heinz A, Schlagenhauf F. Computational mechanisms of belief updating in relation to psychotic-like experiences. Front Psychiatry 2023; 14:1170168. [PMID: 37215663 PMCID: PMC10196365 DOI: 10.3389/fpsyt.2023.1170168] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/07/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Psychotic-like experiences (PLEs) may occur due to changes in weighting prior beliefs and new evidence in the belief updating process. It is still unclear whether the acquisition or integration of stable beliefs is altered, and whether such alteration depends on the level of environmental and belief precision, which reflects the associated uncertainty. This motivated us to investigate uncertainty-related dynamics of belief updating in relation to PLEs using an online study design. Methods We selected a sample (n = 300) of participants who performed a belief updating task with sudden change points and provided self-report questionnaires for PLEs. The task required participants to observe bags dropping from a hidden helicopter, infer its position, and dynamically update their belief about the helicopter's position. Participants could optimize performance by adjusting learning rates according to inferred belief uncertainty (inverse prior precision) and the probability of environmental change points. We used a normative learning model to examine the relationship between adherence to specific model parameters and PLEs. Results PLEs were linked to lower accuracy in tracking the outcome (helicopter location) (β = 0.26 ± 0.11, p = 0.018) and to a smaller increase of belief precision across observations after a change point (β = -0.003 ± 0.0007, p < 0.001). PLEs were related to slower belief updating when participants encountered large prediction errors (β = -0.03 ± 0.009, p = 0.001). Computational modeling suggested that PLEs were associated with reduced overall belief updating in response to prediction errors (βPE = -1.00 ± 0.45, p = 0.028) and reduced modulation of updating at inferred environmental change points (βCPP = -0.84 ± 0.38, p = 0.023). Discussion We conclude that PLEs are associated with altered dynamics of belief updating. These findings support the idea that the process of balancing prior belief and new evidence, as a function of environmental uncertainty, is altered in PLEs, which may contribute to the development of delusions. Specifically, slower learning after large prediction errors in people with high PLEs may result in rigid beliefs. Disregarding environmental change points may limit the flexibility to establish new beliefs in the face of contradictory evidence. The present study fosters a deeper understanding of inferential belief updating mechanisms underlying PLEs.
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Affiliation(s)
- Sophie Pauline Fromm
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lara Wieland
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Arne Klettke
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthew R. Nassar
- Carney Institute for Brain Science, Brown University, Providence, RI, United States
- Department of Neuroscience, Brown University, Providence, RI, United States
| | - Teresa Katthagen
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sebastian Markett
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Florian Schlagenhauf
- Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin Institute of Health CCM, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
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10
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McFadyen J, Dolan RJ. Spatiotemporal Precision of Neuroimaging in Psychiatry. Biol Psychiatry 2023; 93:671-680. [PMID: 36376110 DOI: 10.1016/j.biopsych.2022.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/20/2022] [Accepted: 08/12/2022] [Indexed: 12/23/2022]
Abstract
Aberrant patterns of cognition, perception, and behavior seen in psychiatric disorders are thought to be driven by a complex interplay of neural processes that evolve at a rapid temporal scale. Understanding these dynamic processes in vivo in humans has been hampered by a trade-off between spatial and temporal resolutions inherent to current neuroimaging technology. A recent trend in psychiatric research has been the use of high temporal resolution imaging, particularly magnetoencephalography, often in conjunction with sophisticated machine learning decoding techniques. Developments here promise novel insights into the spatiotemporal dynamics of cognitive phenomena, including domains relevant to psychiatric illnesses such as reward and avoidance learning, memory, and planning. This review considers recent advances afforded by exploiting this increased spatiotemporal precision, with specific reference to applications that seek to drive a mechanistic understanding of psychopathology and the realization of preclinical translation.
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Affiliation(s)
- Jessica McFadyen
- UCL Max Planck Centre for Computational Psychiatry and Ageing Research and Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom; State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
| | - Raymond J Dolan
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
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11
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de Bartolomeis A, Ciccarelli M, De Simone G, Mazza B, Barone A, Vellucci L. Canonical and Non-Canonical Antipsychotics' Dopamine-Related Mechanisms of Present and Next Generation Molecules: A Systematic Review on Translational Highlights for Treatment Response and Treatment-Resistant Schizophrenia. Int J Mol Sci 2023; 24:ijms24065945. [PMID: 36983018 PMCID: PMC10051989 DOI: 10.3390/ijms24065945] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Schizophrenia is a severe psychiatric illness affecting almost 25 million people worldwide and is conceptualized as a disorder of synaptic plasticity and brain connectivity. Antipsychotics are the primary pharmacological treatment after more than sixty years after their introduction in therapy. Two findings hold true for all presently available antipsychotics. First, all antipsychotics occupy the dopamine D2 receptor (D2R) as an antagonist or partial agonist, even if with different affinity; second, D2R occupancy is the necessary and probably the sufficient mechanism for antipsychotic effect despite the complexity of antipsychotics' receptor profile. D2R occupancy is followed by coincident or divergent intracellular mechanisms, implying the contribution of cAMP regulation, β-arrestin recruitment, and phospholipase A activation, to quote some of the mechanisms considered canonical. However, in recent years, novel mechanisms related to dopamine function beyond or together with D2R occupancy have emerged. Among these potentially non-canonical mechanisms, the role of Na2+ channels at the dopamine at the presynaptic site, dopamine transporter (DAT) involvement as the main regulator of dopamine concentration at synaptic clefts, and the putative role of antipsychotics as chaperones for intracellular D2R sequestration, should be included. These mechanisms expand the fundamental role of dopamine in schizophrenia therapy and may have relevance to considering putatively new strategies for treatment-resistant schizophrenia (TRS), an extremely severe condition epidemiologically relevant and affecting almost 30% of schizophrenia patients. Here, we performed a critical evaluation of the role of antipsychotics in synaptic plasticity, focusing on their canonical and non-canonical mechanisms of action relevant to the treatment of schizophrenia and their subsequent implication for the pathophysiology and potential therapy of TRS.
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Affiliation(s)
- Andrea de Bartolomeis
- Section of Psychiatry, Laboratory of Translational and Molecular Psychiatry and Unit of Treatment-Resistant Psychosis, Department of Neuroscience, Reproductive Sciences and Dentistry, University Medical School of Naples "Federico II", 80131 Naples, Italy
| | - Mariateresa Ciccarelli
- Section of Psychiatry, Laboratory of Translational and Molecular Psychiatry and Unit of Treatment-Resistant Psychosis, Department of Neuroscience, Reproductive Sciences and Dentistry, University Medical School of Naples "Federico II", 80131 Naples, Italy
| | - Giuseppe De Simone
- Section of Psychiatry, Laboratory of Translational and Molecular Psychiatry and Unit of Treatment-Resistant Psychosis, Department of Neuroscience, Reproductive Sciences and Dentistry, University Medical School of Naples "Federico II", 80131 Naples, Italy
| | - Benedetta Mazza
- Section of Psychiatry, Laboratory of Translational and Molecular Psychiatry and Unit of Treatment-Resistant Psychosis, Department of Neuroscience, Reproductive Sciences and Dentistry, University Medical School of Naples "Federico II", 80131 Naples, Italy
| | - Annarita Barone
- Section of Psychiatry, Laboratory of Translational and Molecular Psychiatry and Unit of Treatment-Resistant Psychosis, Department of Neuroscience, Reproductive Sciences and Dentistry, University Medical School of Naples "Federico II", 80131 Naples, Italy
| | - Licia Vellucci
- Section of Psychiatry, Laboratory of Translational and Molecular Psychiatry and Unit of Treatment-Resistant Psychosis, Department of Neuroscience, Reproductive Sciences and Dentistry, University Medical School of Naples "Federico II", 80131 Naples, Italy
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12
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Fromm S, Katthagen T, Deserno L, Heinz A, Kaminski J, Schlagenhauf F. Belief Updating in Subclinical and Clinical Delusions. SCHIZOPHRENIA BULLETIN OPEN 2023; 4:sgac074. [PMID: 39145350 PMCID: PMC11207849 DOI: 10.1093/schizbullopen/sgac074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background and Hypothesis Current frameworks propose that delusions result from aberrant belief updating due to altered prediction error (PE) signaling and misestimation of environmental volatility. We aimed to investigate whether behavioral and neural signatures of belief updating are specifically related to the presence of delusions or generally associated with manifest schizophrenia. Methods Our cross-sectional design includes human participants (n[female/male] = 66[25/41]), stratified into four groups: healthy participants with minimal (n = 22) or strong delusional-like ideation (n = 18), and participants with diagnosed schizophrenia with minimal (n = 13) or strong delusions (n = 13), resulting in a 2 × 2 design, which allows to test for the effects of delusion and diagnosis. Participants performed a reversal learning task with stable and volatile task contingencies during fMRI scanning. We formalized learning with a hierarchical Gaussian filter model and conducted model-based fMRI analysis regarding beliefs of outcome uncertainty and volatility, precision-weighted PEs of the outcome- and the volatility-belief. Results Patients with schizophrenia as compared to healthy controls showed lower accuracy and heightened choice switching, while delusional ideation did not affect these measures. Participants with delusions showed increased precision-weighted PE-related neural activation in fronto-striatal regions. People with diagnosed schizophrenia overestimated environmental volatility and showed an attenuated neural representation of volatility in the anterior insula, medial frontal and angular gyrus. Conclusions Delusional beliefs are associated with altered striatal PE-signals. Juxtaposing, the potentially unsettling belief that the environment is constantly changing and weaker neural encoding of this subjective volatility seems to be associated with manifest schizophrenia, but not with the presence of delusional ideation.
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Affiliation(s)
- Sophie Fromm
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health CCM, Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Germany
| | - Teresa Katthagen
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health CCM, Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin, Germany
| | - Lorenz Deserno
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, Technische Universität, Dresden, Germany
| | - Andreas Heinz
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health CCM, Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Jakob Kaminski
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health CCM, Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin, Germany
| | - Florian Schlagenhauf
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health CCM, Department of Psychiatry and Neuroscience | CCM, NeuroCure Clinical Research Center, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
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13
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Accelerated atrophy in dopaminergic targets and medial temporo-parietal regions precedes the onset of delusions in patients with Alzheimer's disease. Eur Arch Psychiatry Clin Neurosci 2023; 273:229-241. [PMID: 35554669 PMCID: PMC9958148 DOI: 10.1007/s00406-022-01417-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/11/2022] [Indexed: 12/21/2022]
Abstract
People with Alzheimer's disease (AD) and delusions have worse quality of life and prognosis. However, early markers of delusions have not been identified yet. The present study investigated whether there are any detectable differences in grey matter (GM) volume and cognitive changes in the year before symptom onset between patients with AD who did and did not develop delusions. Two matched samples of AD patients, 63 who did (PT-D) and 63 who did not develop delusions (PT-ND) over 1 year, were identified from the Alzheimer's Disease Neuroimaging Initiative database. The Neuropsychiatric Inventory (NPI) was used to assess the presence of delusions. Sixty-three additional matched healthy controls (HC) were selected. Repeated-measures ANCOVA models were used to investigate group-by-time effects on the volume of selected GM regions of interest and on cognitive performance. No neurocognitive differences were observed between patient groups prior to symptom onset. Greater episodic memory decline and GM loss in bilateral caudate nuclei, medio-temporal and midline cingulo-parietal regions were found in the PT-D compared with the PT-ND group. A pattern of faster GM loss in brain areas typically affected by AD and in cortical and subcortical targets of dopaminergic pathways, paralleled by worsening of episodic memory and behavioural symptoms, may explain the emergence of delusions in patients with AD.
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14
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Liang D, Liu M, Fu Y, Sun J, Wang H. A New Explanation for the Frog-in-the-Pan Phenomenon Based on the Cognitive-Evolutionary Model of Surprise. Behav Sci (Basel) 2022; 13:bs13010007. [PMID: 36661579 PMCID: PMC9854531 DOI: 10.3390/bs13010007] [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: 10/17/2022] [Revised: 11/27/2022] [Accepted: 12/15/2022] [Indexed: 12/25/2022] Open
Abstract
The frog-in-the-pan (FIP) phenomenon suggests that investors are more sensitive to abrupt price changes than gradual price changes in the stock market. Based on the cognitive-evolutionary model of surprise and the reinforcement learning model, this paper provides a new explanation for the FIP phenomenon in that this phenomenon could be explained by the elicitation of surprise emotion. We predict that when a change substantially and abruptly occurs, the significant prediction error triggers participants' surprise, which makes participants more sensitive to the change. To ascertain these hypotheses, we recruited 109 participants and compared participants' learning rates and surprise responses under different contexts. We observed that participants' learning rate soared when the prediction error was large enough to trigger surprise emotion under abruptly changed conditions and confirmed that the FIP phenomenon could be explained by the elicitation of surprise emotion. In a word, this research demonstrates the significant role of surprise emotion in the decision-making process.
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Affiliation(s)
- Dapeng Liang
- School of Management, Harbin Institute of Technology, Harbin 150001, China
| | - Mengting Liu
- School of Management, Harbin Institute of Technology, Harbin 150001, China
| | - Yang Fu
- School of Management, Harbin Institute of Technology, Harbin 150001, China
| | - Jiayin Sun
- School of Humanities and Social Sciences, Harbin Institute of Technology, Harbin 150001, China
- Correspondence:
| | - Hongyan Wang
- School of Mathematical Science, Heilongjiang University, Harbin 150080, China
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15
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Kotler S, Mannino M, Kelso S, Huskey R. First few seconds for flow: A comprehensive proposal of the neurobiology and neurodynamics of state onset. Neurosci Biobehav Rev 2022; 143:104956. [PMID: 36368525 DOI: 10.1016/j.neubiorev.2022.104956] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/22/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022]
Abstract
Flow is a cognitive state that manifests when there is complete attentional absorption while performing a task. Flow occurs when certain internal as well as external conditions are present, including intense concentration, a sense of control, feedback, and a balance between the challenge of the task and the relevant skillset. Phenomenologically, flow is accompanied by a loss of self-consciousness, seamless integration of action and awareness, and acute changes in time perception. Research has begun to uncover some of the neurophysiological correlates of flow, as well as some of the state's neuromodulatory processes. We comprehensively review this work and consider the neurodynamics of the onset of the state, considering large-scale brain networks, as well as dopaminergic, noradrenergic, and endocannabinoid systems. To accomplish this, we outline an evidence-based hypothetical situation, and consider the flow state in a broader context including other profound alterations in consciousness, such as the psychedelic state and the state of traumatic stress that can induce PTSD. We present a broad theoretical framework which may motivate future testable hypotheses.
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Affiliation(s)
| | | | - Scott Kelso
- Human Brain & Behavior Laboratory, Center for Complex Systems and Brain Sciences, Florida Atlantic University, United States; Intelligent Systems Research Centre, Ulster University, Derry∼Londonderry, North Ireland
| | - Richard Huskey
- Cognitive Communication Science Lab, Department of Communication, University of California Davis, United States; Cognitive Science Program, University of California Davis, United States; Center for Mind and Brain, University of California Davis, United States.
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16
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Fan L, Bass E, Klein H, Springfield C, Pinkham A. A preliminary investigation of paranoia variability and its association with social functioning. Schizophr Res Cogn 2022; 29:100258. [PMID: 35620385 PMCID: PMC9126935 DOI: 10.1016/j.scog.2022.100258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 12/21/2022]
Abstract
Background Paranoid ideation is a core feature of psychosis and is associated with impaired social functioning. Severity of paranoia can fluctuate across time as symptoms wax and wane; however, no study has systematically investigated how this intra-individual variability in paranoia may relate to social impairments and social functioning. Methods Fifty-five patients with DSM-5 diagnoses and recent paranoia were followed for up to one year and completed the suspiciousness/persecution section (P6) of the Positive and Negative Symptom Scale (PANSS) on a monthly basis to monitor fluctuations in paranoia. Categorical changes between paranoid and non-paranoid status were monitored and tallied. Participants self-reported current paranoia and anxiety levels as well as social functioning when demonstrating paranoia changes. Results Most patients showed changes between paranoid categories (60%). Individuals with no paranoia change showed higher current paranoia and lower independence-competence subscores of the Birchwood Social Functioning Scale (SFS) compared with those with one change. Current paranoia and state anxiety explained significant variance in the prosocial activities subscore of SFS, and importantly, paranoia changes accounted for variance above and beyond these effects. Individuals with higher current paranoia participated less in prosocial activities, however those with higher paranoia variability were more involved in social activities. Similarly, individuals with more paranoia variability demonstrated better overall social functioning as measured by the averaged SFS total score. Conclusion Paranoia fluctuation is prevalent across time, and both paranoia severity and variability impact social functioning, in that lower levels of paranoia severity and higher levels of paranoia variability are associated with better interpersonal functioning.
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Affiliation(s)
- Linlin Fan
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Emily Bass
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Hans Klein
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Cassi Springfield
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Amy Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States.,Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, United States
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17
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Nour MM, Liu Y, Dolan RJ. Functional neuroimaging in psychiatry and the case for failing better. Neuron 2022; 110:2524-2544. [PMID: 35981525 DOI: 10.1016/j.neuron.2022.07.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/06/2022] [Accepted: 07/08/2022] [Indexed: 12/27/2022]
Abstract
Psychiatric disorders encompass complex aberrations of cognition and affect and are among the most debilitating and poorly understood of any medical condition. Current treatments rely primarily on interventions that target brain function (drugs) or learning processes (psychotherapy). A mechanistic understanding of how these interventions mediate their therapeutic effects remains elusive. From the early 1990s, non-invasive functional neuroimaging, coupled with parallel developments in the cognitive neurosciences, seemed to signal a new era of neurobiologically grounded diagnosis and treatment in psychiatry. Yet, despite three decades of intense neuroimaging research, we still lack a neurobiological account for any psychiatric condition. Likewise, functional neuroimaging plays no role in clinical decision making. Here, we offer a critical commentary on this impasse and suggest how the field might fare better and deliver impactful neurobiological insights.
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Affiliation(s)
- Matthew M Nour
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London WC1B 5EH, UK; Wellcome Trust Centre for Human Neuroimaging, University College London, London WC1N 3AR, UK; Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK.
| | - Yunzhe Liu
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London WC1B 5EH, UK; State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; Chinese Institute for Brain Research, Beijing 102206, China
| | - Raymond J Dolan
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London WC1B 5EH, UK; Wellcome Trust Centre for Human Neuroimaging, University College London, London WC1N 3AR, UK; State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China.
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18
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D'Ambrosio E, Pergola G, Pardiñas AF, Dahoun T, Veronese M, Sportelli L, Taurisano P, Griffiths K, Jauhar S, Rogdaki M, Bloomfield MAP, Froudist-Walsh S, Bonoldi I, Walters JTR, Blasi G, Bertolino A, Howes OD. A polygenic score indexing a DRD2-related co-expression network is associated with striatal dopamine function. Sci Rep 2022; 12:12610. [PMID: 35871219 PMCID: PMC9308811 DOI: 10.1038/s41598-022-16442-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/11/2022] [Indexed: 11/09/2022] Open
Abstract
The D2 dopamine receptor (D2R) is the primary site of the therapeutic action of antipsychotics and is involved in essential brain functions relevant to schizophrenia, such as attention, memory, motivation, and emotion processing. Moreover, the gene coding for D2R (DRD2) has been associated with schizophrenia at a genome-wide level. Recent studies have shown that a polygenic co-expression index (PCI) predicting the brain-specific expression of a network of genes co-expressed with DRD2 was associated with response to antipsychotics, brain function during working memory in patients with schizophrenia, and with the modulation of prefrontal cortex activity after pharmacological stimulation of D2 receptors. We aimed to investigate the relationship between the DRD2 gene network and in vivo striatal dopaminergic function, which is a phenotype robustly associated with psychosis and schizophrenia. To this aim, a sample of 92 healthy subjects underwent 18F-DOPA PET and was genotyped for genetic variations indexing the co-expression of the DRD2-related genetic network in order to calculate the PCI for each subject. The PCI was significantly associated with whole striatal dopamine synthesis capacity (p = 0.038). Exploratory analyses on the striatal subdivisions revealed a numerically larger effect size of the PCI on dopamine function for the associative striatum, although this was not significantly different than effects in other sub-divisions. These results are in line with a possible relationship between the DRD2-related co-expression network and schizophrenia and extend it by identifying a potential mechanism involving the regulation of dopamine synthesis. Future studies are needed to clarify the molecular mechanisms implicated in this relationship.
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Affiliation(s)
- Enrico D'Ambrosio
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Giulio Pergola
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MD, USA
| | - Antonio F Pardiñas
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Tarik Dahoun
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mattia Veronese
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Information Engineering, University of Padua, Padua, Italy
| | - Leonardo Sportelli
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Paolo Taurisano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Kira Griffiths
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Sameer Jauhar
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Maria Rogdaki
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Michael A P Bloomfield
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | | | - Ilaria Bonoldi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - James T R Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Giuseppe Blasi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.
| | - Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.
- Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College London, Du Cane Road, London, UK.
- H. Lundbeck A/S, Ottiliavej 9, 2500, Valby, Denmark.
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Rethinking delusions: A selective review of delusion research through a computational lens. Schizophr Res 2022; 245:23-41. [PMID: 33676820 PMCID: PMC8413395 DOI: 10.1016/j.schres.2021.01.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 02/06/2023]
Abstract
Delusions are rigid beliefs held with high certainty despite contradictory evidence. Notwithstanding decades of research, we still have a limited understanding of the computational and neurobiological alterations giving rise to delusions. In this review, we highlight a selection of recent work in computational psychiatry aimed at developing quantitative models of inference and its alterations, with the goal of providing an explanatory account for the form of delusional beliefs in psychosis. First, we assess and evaluate the experimental paradigms most often used to study inferential alterations in delusions. Based on our review of the literature and theoretical considerations, we contend that classic draws-to-decision paradigms are not well-suited to isolate inferential processes, further arguing that the commonly cited 'jumping-to-conclusion' bias may reflect neither delusion-specific nor inferential alterations. Second, we discuss several enhancements to standard paradigms that show promise in more effectively isolating inferential processes and delusion-related alterations therein. We further draw on our recent work to build an argument for a specific failure mode for delusions consisting of prior overweighting in high-level causal inferences about partially observable hidden states. Finally, we assess plausible neurobiological implementations for this candidate failure mode of delusional beliefs and outline promising future directions in this area.
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20
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McGovern HT, Leptourgos P, Hutchinson BT, Corlett PR. Do psychedelics change beliefs? Psychopharmacology (Berl) 2022; 239:1809-1821. [PMID: 35507071 DOI: 10.1007/s00213-022-06153-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/19/2022] [Indexed: 01/29/2023]
Abstract
Renewed interest in psychedelics has reignited the debate about whether and how they change human beliefs. In both the clinical and social-cognitive domains, psychedelic consumption may be accompanied by profound, and sometimes lasting, belief changes. We review these changes and their possible underlying mechanisms. Rather than inducing de novo beliefs, we argue psychedelics may instead change the impact of affect and of others' suggestions on how beliefs are imputed. Critically, we find that baseline beliefs (in the possible effects of psychedelics, for example) might color the acute effects of psychedelics as well as longer-term changes. If we are to harness the apparent potential of psychedelics in the clinic and for human flourishing more generally, these possibilities must be addressed empirically.
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Affiliation(s)
- H T McGovern
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - P Leptourgos
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - B T Hutchinson
- Research School of Psychology, The Australian National University, Canberra, ACT, Australia
| | - P R Corlett
- Department of Psychiatry, Yale University, New Haven, CT, USA.
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21
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Ribeiro D, Hallett W, Howes O, McCutcheon R, Nour MM, Tavares AAS. Assessing the impact of different penalty factors of the Bayesian reconstruction algorithm Q.Clear on in vivo low count kinetic analysis of [ 11C]PHNO brain PET-MR studies. EJNMMI Res 2022; 12:11. [PMID: 35184229 PMCID: PMC8859021 DOI: 10.1186/s13550-022-00883-1] [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: 08/26/2021] [Accepted: 01/26/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Q.Clear is a Bayesian penalised likelihood (BPL) reconstruction algorithm available on General Electric (GE) Positron Emission Tomography (PET)-Computed Tomography (CT) and PET-Magnetic Resonance (MR) scanners. This algorithm is regulated by a β value which acts as a noise penalisation factor and yields improvements in signal to noise ratio (SNR) in clinical scans, and in contrast recovery and spatial resolution in phantom studies. However, its performance in human brain imaging studies remains to be evaluated in depth. This pilot study aims to investigate the impact of Q.Clear reconstruction methods using different β value versus ordered subset expectation maximization (OSEM) on brain kinetic modelling analysis of low count brain images acquired in the PET-MR. METHODS Six [11C]PHNO PET-MR brain datasets were reconstructed with Q.Clear with β100-1000 (in increments of 100) and OSEM. The binding potential relative to non-displaceable volume (BPND) were obtained for the Substantia Nigra (SN), Striatum (St), Globus Pallidus (GP), Thalamus (Th), Caudate (Cd) and Putamen (Pt), using the MIAKAT™ software. Intraclass correlation coefficients (ICC), repeatability coefficients (RC), coefficients of variation (CV) and bias from Bland-Altman plots were reported. Statistical analysis was conducted using a 2-way ANOVA model with correction for multiple comparisons. RESULTS When comparing a standard OSEM reconstruction of 6 iterations/16 subsets and 5 mm filter with Q.Clear with different β values under low counts, the bias and RC were lower for Q.Clear with β100 for the SN (RC = 2.17), Th (RC = 0.08) and GP (RC = 0.22) and with β200 for the St (RC = 0.14), Cd (RC = 0.18)and Pt (RC = 0.10). The p-values in the 2-way ANOVA model corroborate these findings. ICC values obtained for Th, St, GP, Pt and Cd demonstrate good reliability (0.87, 0.99, 0.96, 0.99 and 0.96, respectively). For the SN, ICC values demonstrate poor reliability (0.43). CONCLUSION BPND results obtained from quantitative low count brain PET studies using [11C]PHNO and reconstructed with Q.Clear with β < 400, which is the value used for clinical [18F]FDG whole-body studies, demonstrate the lowest bias versus the typical iterative reconstruction method OSEM.
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Affiliation(s)
- Daniela Ribeiro
- Invicro, Centre for Imaging Sciences, Hammersmith Hospital, Invicro, Imperial College London, Burlington Danes Building, Du Cane Road, London, W12 0NN, UK.
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, UK.
| | - William Hallett
- Invicro, Centre for Imaging Sciences, Hammersmith Hospital, Invicro, Imperial College London, Burlington Danes Building, Du Cane Road, London, W12 0NN, UK
| | - Oliver Howes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Institute of Medical Sciences, Medical Research Council London, London, UK
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Robert McCutcheon
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Institute of Medical Sciences, Medical Research Council London, London, UK
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Matthew M Nour
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Max Planck Centre for Computational Psychiatry and Ageing Research, Institute of Neurology, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, UK
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22
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Katthagen T, Fromm S, Wieland L, Schlagenhauf F. Models of Dynamic Belief Updating in Psychosis-A Review Across Different Computational Approaches. Front Psychiatry 2022; 13:814111. [PMID: 35492702 PMCID: PMC9039658 DOI: 10.3389/fpsyt.2022.814111] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/18/2022] [Indexed: 11/20/2022] Open
Abstract
To understand the dysfunctional mechanisms underlying maladaptive reasoning of psychosis, computational models of decision making have widely been applied over the past decade. Thereby, a particular focus has been on the degree to which beliefs are updated based on new evidence, expressed by the learning rate in computational models. Higher order beliefs about the stability of the environment can determine the attribution of meaningfulness to events that deviate from existing beliefs by interpreting these either as noise or as true systematic changes (volatility). Both, the inappropriate downplaying of important changes as noise (belief update too low) as well as the overly flexible adaptation to random events (belief update too high) were theoretically and empirically linked to symptoms of psychosis. Whereas models with fixed learning rates fail to adjust learning in reaction to dynamic changes, increasingly complex learning models have been adopted in samples with clinical and subclinical psychosis lately. These ranged from advanced reinforcement learning models, over fully Bayesian belief updating models to approximations of fully Bayesian models with hierarchical learning or change point detection algorithms. It remains difficult to draw comparisons across findings of learning alterations in psychosis modeled by different approaches e.g., the Hierarchical Gaussian Filter and change point detection. Therefore, this review aims to summarize and compare computational definitions and findings of dynamic belief updating without perceptual ambiguity in (sub)clinical psychosis across these different mathematical approaches. There was strong heterogeneity in tasks and samples. Overall, individuals with schizophrenia and delusion-proneness showed lower behavioral performance linked to failed differentiation between uninformative noise and environmental change. This was indicated by increased belief updating and an overestimation of volatility, which was associated with cognitive deficits. Correlational evidence for computational mechanisms and positive symptoms is still sparse and might diverge from the group finding of instable beliefs. Based on the reviewed studies, we highlight some aspects to be considered to advance the field with regard to task design, modeling approach, and inclusion of participants across the psychosis spectrum. Taken together, our review shows that computational psychiatry offers powerful tools to advance our mechanistic insights into the cognitive anatomy of psychotic experiences.
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Affiliation(s)
- Teresa Katthagen
- Department of Psychiatry and Neurosciences, CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sophie Fromm
- Department of Psychiatry and Neurosciences, CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Einstein Center for Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Lara Wieland
- Department of Psychiatry and Neurosciences, CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Einstein Center for Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Florian Schlagenhauf
- Department of Psychiatry and Neurosciences, CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Einstein Center for Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Bernstein Center for Computational Neuroscience, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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23
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Yu LQ, Wilson RC, Nassar MR. Adaptive learning is structure learning in time. Neurosci Biobehav Rev 2021; 128:270-281. [PMID: 34144114 PMCID: PMC8422504 DOI: 10.1016/j.neubiorev.2021.06.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/19/2021] [Accepted: 06/11/2021] [Indexed: 10/21/2022]
Abstract
People use information flexibly. They often combine multiple sources of relevant information over time in order to inform decisions with little or no interference from intervening irrelevant sources. They adjust the degree to which they use new information over time rationally in accordance with environmental statistics and their own uncertainty. They can even use information gained in one situation to solve a problem in a very different one. Learning flexibly rests on the ability to infer the context at a given time, and therefore knowing which pieces of information to combine and which to separate. We review the psychological and neural mechanisms behind adaptive learning and structure learning to outline how people pool together relevant information, demarcate contexts, prevent interference between information collected in different contexts, and transfer information from one context to another. By examining all of these processes through the lens of optimal inference we bridge concepts from multiple fields to provide a unified multi-system view of how the brain exploits structure in time to optimize learning.
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Affiliation(s)
- Linda Q Yu
- Carney Institute for Brain Sciences, Brown University, 164 Angell Street, Providence, RI, 02912, USA.
| | - Robert C Wilson
- Department of Psychology, University of Arizona, Tucson, AZ, 85721, USA
| | - Matthew R Nassar
- Carney Institute for Brain Sciences, Brown University, 164 Angell Street, Providence, RI, 02912, USA
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24
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Pálffy Z, Farkas K, Csukly G, Kéri S, Polner B. Cross-modal auditory priors drive the perception of bistable visual stimuli with reliable differences between individuals. Sci Rep 2021; 11:16943. [PMID: 34417496 PMCID: PMC8379237 DOI: 10.1038/s41598-021-96198-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/27/2021] [Indexed: 11/17/2022] Open
Abstract
It is a widely held assumption that the brain performs perceptual inference by combining sensory information with prior expectations, weighted by their uncertainty. A distinction can be made between higher- and lower-level priors, which can be manipulated with associative learning and sensory priming, respectively. Here, we simultaneously investigate priming and the differential effect of auditory vs. visual associative cues on visual perception, and we also examine the reliability of individual differences. Healthy individuals (N = 29) performed a perceptual inference task twice with a one-week delay. They reported the perceived direction of motion of dot pairs, which were preceded by a probabilistic visuo-acoustic cue. In 30% of the trials, motion direction was ambiguous, and in half of these trials, the auditory versus the visual cue predicted opposing directions. Cue-stimulus contingency could change every 40 trials. On ambiguous trials where the visual and the auditory cue predicted conflicting directions of motion, participants made more decisions consistent with the prediction of the acoustic cue. Increased predictive processing under stimulus uncertainty was indicated by slower responses to ambiguous (vs. non-ambiguous) stimuli. Furthermore, priming effects were also observed in that perception of ambiguous stimuli was influenced by perceptual decisions on the previous ambiguous and unambiguous trials as well. Critically, behavioural effects had substantial inter-individual variability which showed high test-retest reliability (intraclass correlation coefficient (ICC) > 0.78). Overall, higher-level priors based on auditory (vs. visual) information had greater influence on visual perception, and lower-level priors were also in action. Importantly, we observed large and stable differences in various aspects of task performance. Computational modelling combined with neuroimaging could allow testing hypotheses regarding the potential mechanisms causing these behavioral effects. The reliability of the behavioural differences implicates that such perceptual inference tasks could be valuable tools during large-scale biomarker and neuroimaging studies.
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Affiliation(s)
- Zsófia Pálffy
- Department of Cognitive Science, Budapest University of Technology and Economics, 1 Egry József utca, Building T, Floor 5, Budapest, 1111, Hungary.
| | - Kinga Farkas
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Gábor Csukly
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Szabolcs Kéri
- Department of Cognitive Science, Budapest University of Technology and Economics, 1 Egry József utca, Building T, Floor 5, Budapest, 1111, Hungary
- National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Bertalan Polner
- Department of Cognitive Science, Budapest University of Technology and Economics, 1 Egry József utca, Building T, Floor 5, Budapest, 1111, Hungary
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25
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Seitz RJ. Beliefs: A challenge in neuropsychological disorders. J Neuropsychol 2021; 16:21-37. [PMID: 33969626 DOI: 10.1111/jnp.12249] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/11/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Beliefs have recently been defined as the neural product of perception of objects and events in the external world and of an affirmative internal affective state reflecting personal meaning. It is, however, undetermined in which way diseases of the brain affect these integrative processes. METHODS Here, the formation and updating of abnormal beliefs in cerebral disorders are described. RESULTS It will be shown that well-defined neuropsychological syndromes resulting from brain lesions also interfere with the neural processes that enable the formation, up-dating and communication of beliefs. Similarly, in neuropsychiatric disorders abnormal and delusional beliefs appear to be caused by altered perception and/or misattribution of aversive meaning. CONCLUSION Given the importance of beliefs for ordinary social behaviour, abnormal beliefs are a challenge in neuropsychological disorders.
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Affiliation(s)
- Rüdiger J Seitz
- Department of Neurology, Centre of Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany.,Florey Neuroscience Institutes, Melbourne, Victoria, Australia
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26
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A salience misattribution model for addictive-like behaviors. Neurosci Biobehav Rev 2021; 125:466-477. [PMID: 33657434 DOI: 10.1016/j.neubiorev.2021.02.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 11/21/2022]
Abstract
Adapting to the changing environment is a key component of optimal decision-making. Internal-models that accurately represent and selectively update from behaviorally relevant/salient stimuli may facilitate adaptive behaviors. Anterior cingulate cortex (ACC) and dopaminergic systems may produce these adaptive internal-models through selective updates from behaviorally relevant stimuli. Dysfunction of ACC and dopaminergic systems could therefore produce misaligned internal-models where updates are disproportionate to the salience of the cues. An aspect of addictive-like behaviors is reduced adaptation and, ACC and dopaminergic systems typically exhibit dysfunction in drug-dependents. We argue that ACC and dopaminergic dysfunction in dependents may produce misaligned internal-models such that drug-related stimuli are misattributed with a higher salience compared to non-drug related stimuli. Hence, drug-related rewarding stimuli generate over-weighted updates to the internal-model, while negative feedback and non-drug related rewarding stimuli generate down-weighted updates. This misaligned internal-model may therefore incorrectly reinforce maladaptive drug-related behaviors. We use the proposed framework to discuss ways behavior may be made more adaptive and how the framework may be supported or falsified experimentally.
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27
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Caravaggio F, Porco N, Kim J, Torres-Carmona E, Brown E, Iwata Y, Nakajima S, Gerretsen P, Remington G, Graff-Guerrero A. Measuring amphetamine-induced dopamine release in humans: A comparative meta-analysis of [ 11 C]-raclopride and [ 11 C]-(+)-PHNO studies. Synapse 2021; 75:e22195. [PMID: 33471400 DOI: 10.1002/syn.22195] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/02/2021] [Accepted: 01/13/2021] [Indexed: 02/06/2023]
Abstract
The radiotracers [11 C]-raclopride and [11 C]-(+)-PHNO are commonly used to measure differences in amphetamine-induced dopamine release between healthy persons and persons with neuropsychiatric diseases. As an agonist radiotracer, [11 C]-(+)-PHNO should theoretically be roughly 2.7 times more sensitive to displacement by endogenous dopamine than [11 C]raclopride. To date, only one study has been published comparing the sensitivity of these two radiotracers to amphetamine-induced dopamine release in healthy persons. Unfortunately, conflicting findings in the literature suggests that the dose of amphetamine they employed (0.3 mg/kg, p.o.) may not reliably reduce [11 C]-raclopride binding in the caudate. Thus, it is unclear whether the preponderance of evidence supports the theory that [11 C]-(+)-PHNO is more sensitive to displacement by amphetamine in humans than [11 C]-raclopride. In order to clarify these issues, we conducted a comparative meta-analysis summarizing the effects of amphetamine on [11 C]-raclopride and [11 C]-(+)-PHNO binding in healthy humans. Our analysis indicates that amphetamine given at 0.3 mg/kg, p.o. does not reliably reduce [11 C]-raclopride binding in the caudate. Second, the greater sensitivity of [11 C]-(+)-PHNO is evidenced at 0.5 mg/kg, p.o., but not at lower doses of amphetamine. Third, our analysis suggests that [11 C]-(+)-PHNO may be roughly 1.5 to 2.5 times more sensitive to displacement by amphetamine than [11 C]-raclopride in healthy persons. We recommend that future displacement studies with these radiotracers employ 0.5 mg/kg, p.o. of amphetamine with a dose, post-scan interval of at least 3 hr. Using this dose of amphetamine, [11 C]-raclopride studies should employ at least n = 34 participants per group, while [11 C]-(+)-PHNO studies should employ at least n = 6 participants per group, in order to be sufficiently powered (80%) to detect changes in radiotracer binding within the caudate.
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Affiliation(s)
- Fernando Caravaggio
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Natasha Porco
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Julia Kim
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Edgardo Torres-Carmona
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Eric Brown
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yusuke Iwata
- Department of Neuropsychiatry, University of Yamanashi, Chuo, Japan
| | | | - Philip Gerretsen
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Gary Remington
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ariel Graff-Guerrero
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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28
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Abstract
A large body of work has linked dopaminergic signaling to learning and reward processing. It stresses the role of dopamine in reward prediction error signaling, a key neural signal that allows us to learn from past experiences, and that facilitates optimal choice behavior. Latterly, it has become clear that dopamine does not merely code prediction error size but also signals the difference between the expected value of rewards, and the value of rewards actually received, which is obtained through the integration of reward attributes such as the type, amount, probability and delay. More recent work has posited a role of dopamine in learning beyond rewards. These theories suggest that dopamine codes absolute or unsigned prediction errors, playing a key role in how the brain models associative regularities within its environment, while incorporating critical information about the reliability of those regularities. Work is emerging supporting this perspective and, it has inspired theoretical models of how certain forms of mental pathology may emerge in relation to dopamine function. Such pathology is frequently related to disturbed inferences leading to altered internal models of the environment. Thus, it is critical to understand the role of dopamine in error-related learning and inference.
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Affiliation(s)
- Kelly M. J. Diederen
- Department of Psychosis Studies,
Institute of Psychiatry, Psychology and Neuroscience, King’s College London,
London, UK
| | - Paul C. Fletcher
- Department of Psychiatry,
University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough
NHS Foundation Trust, Cambridge, UK
- Wellcome Trust MRC Institute of
Metabolic Science, University of Cambridge, Cambridge Biomedical Campus,
Cambridge, UK
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29
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Schulreich S, Schwabe L. Causal Role of the Dorsolateral Prefrontal Cortex in Belief Updating under Uncertainty. Cereb Cortex 2021; 31:184-200. [PMID: 32820317 DOI: 10.1093/cercor/bhaa219] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/26/2020] [Accepted: 07/19/2020] [Indexed: 11/14/2022] Open
Abstract
Adaptive performance in uncertain environments depends on the ability to continuously update internal beliefs about environmental states. Recent correlative evidence suggests that a frontoparietal network including the dorsolateral prefrontal cortex (dlPFC) supports belief updating under uncertainty, but whether the dlPFC serves a "causal" role in this process is currently not clear. To elucidate its contribution, we leveraged transcranial direct current stimulation (tDCS) over the right dlPFC, while 91 participants performed an incentivized belief-updating task. Participants also underwent a psychosocial stress or control manipulation to investigate the role of stress, which is known to modulate dlPFC functioning. We observed enhanced monetary value updating after anodal tDCS when it was normatively expected from a Bayesian perspective. A model-based analysis indicates that this effect was driven by belief updating. However, we also observed enhanced non-normative value updating, which might have been driven instead by expectancy violation. Enhanced normative and non-normative value updating reflected increased vs. decreased Bayesian rationality, respectively. Furthermore, cortisol increases were associated with enhanced positive, but not with negative, value updating. The present study thereby sheds light on the causal role of the right dlPFC in the remarkable human ability to navigate uncertain environments by continuously updating prior knowledge following new evidence.
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Affiliation(s)
- Stefan Schulreich
- Department of Cognitive Psychology, Faculty of Psychology and Human Movement Science, Universität Hamburg, 20146 Hamburg, Germany
| | - Lars Schwabe
- Department of Cognitive Psychology, Faculty of Psychology and Human Movement Science, Universität Hamburg, 20146 Hamburg, Germany
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30
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Huys QJM, Browning M, Paulus MP, Frank MJ. Advances in the computational understanding of mental illness. Neuropsychopharmacology 2021; 46:3-19. [PMID: 32620005 PMCID: PMC7688938 DOI: 10.1038/s41386-020-0746-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 12/11/2022]
Abstract
Computational psychiatry is a rapidly growing field attempting to translate advances in computational neuroscience and machine learning into improved outcomes for patients suffering from mental illness. It encompasses both data-driven and theory-driven efforts. Here, recent advances in theory-driven work are reviewed. We argue that the brain is a computational organ. As such, an understanding of the illnesses arising from it will require a computational framework. The review divides work up into three theoretical approaches that have deep mathematical connections: dynamical systems, Bayesian inference and reinforcement learning. We discuss both general and specific challenges for the field, and suggest ways forward.
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Affiliation(s)
- Quentin J M Huys
- Division of Psychiatry and Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK.
- Camden and Islington NHS Trust, London, UK.
| | - Michael Browning
- Computational Psychiatry Lab, Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Trust, Oxford, UK
| | - Martin P Paulus
- Laureate Institute For Brain Research (LIBR), Tulsa, OK, USA
| | - Michael J Frank
- Cognitive, Linguistic & Psychological Sciences, Neuroscience Graduate Program, Brown University, Providence, RI, USA
- Carney Center for Computational Brain Science, Carney Institute for Brain Science Psychiatry and Human Behavior, Brown University, Providence, RI, USA
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31
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Stogios N, Smith E, Asgariroozbehani R, Hamel L, Gdanski A, Selby P, Sockalingam S, Graff-Guerrero A, Taylor VH, Agarwal SM, Hahn MK. Exploring Patterns of Disturbed Eating in Psychosis: A Scoping Review. Nutrients 2020; 12:E3883. [PMID: 33353080 PMCID: PMC7768542 DOI: 10.3390/nu12123883] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/03/2020] [Accepted: 12/09/2020] [Indexed: 12/19/2022] Open
Abstract
Disturbed eating behaviours have been widely reported in psychotic disorders since the early 19th century. There is also evidence that antipsychotic (AP) treatment may induce binge eating or other related compulsive eating behaviours. It is therefore possible that abnormal eating patterns may contribute to the significant weight gain and other metabolic disturbances observed in patients with psychosis. In this scoping review, we aimed to explore the underlying psychopathological and neurobiological mechanisms of disrupted eating behaviours in psychosis spectrum disorders and the role of APs in this relationship. A systematic search identified 35 studies that met our eligibility criteria and were included in our qualitative synthesis. Synthesizing evidence from self-report questionnaires and food surveys, we found that patients with psychosis exhibit increased appetite and craving for fatty food, as well as increased caloric intake and snacking, which may be associated with increased disinhibition. Limited evidence from neuroimaging studies suggested that AP-naïve first episode patients exhibit similar neural processing of food to healthy controls, while chronic AP exposure may lead to decreased activity in satiety areas and increased activity in areas associated with reward anticipation. Overall, this review supports the notion that AP use can lead to disturbed eating patterns in patients, which may contribute to AP-induced weight gain. However, intrinsic illness-related effects on eating behaviors remain less well elucidated, and many confounding factors as well as variability in study designs limits interpretation of existing literature in this field and precludes firm conclusions from being made.
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Affiliation(s)
- Nicolette Stogios
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Emily Smith
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Roshanak Asgariroozbehani
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Laurie Hamel
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
| | - Alexander Gdanski
- Department of Human Biology, University of Toronto, Toronto, ON M5S 3J6, Canada;
| | - Peter Selby
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Sanjeev Sockalingam
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Bariatric Surgery Program, University Health Network, Toronto, ON M5T 2S8, Canada
| | - Ariel Graff-Guerrero
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Valerie H. Taylor
- Department of Psychiatry, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Sri Mahavir Agarwal
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Margaret K. Hahn
- Centre for Addiction and Mental Health (CAMH), Toronto, ON M6J 1H3, Canada; (N.S.); (E.S.); (R.A.); (L.H.); (P.S.); (S.S.); (A.G.-G.); (S.M.A.)
- Institute of Medical Science (IMS), University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
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32
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D’Alessandro M, Radev ST, Voss A, Lombardi L. A Bayesian brain model of adaptive behavior: an application to the Wisconsin Card Sorting Task. PeerJ 2020; 8:e10316. [PMID: 33335805 PMCID: PMC7713598 DOI: 10.7717/peerj.10316] [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] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/16/2020] [Indexed: 12/28/2022] Open
Abstract
Adaptive behavior emerges through a dynamic interaction between cognitive agents and changing environmental demands. The investigation of information processing underlying adaptive behavior relies on controlled experimental settings in which individuals are asked to accomplish demanding tasks whereby a hidden regularity or an abstract rule has to be learned dynamically. Although performance in such tasks is considered as a proxy for measuring high-level cognitive processes, the standard approach consists in summarizing observed response patterns by simple heuristic scoring measures. With this work, we propose and validate a new computational Bayesian model accounting for individual performance in the Wisconsin Card Sorting Test (WCST), a renowned clinical tool to measure set-shifting and deficient inhibitory processes on the basis of environmental feedback. We formalize the interaction between the task's structure, the received feedback, and the agent's behavior by building a model of the information processing mechanisms used to infer the hidden rules of the task environment. Furthermore, we embed the new model within the mathematical framework of the Bayesian Brain Theory (BBT), according to which beliefs about hidden environmental states are dynamically updated following the logic of Bayesian inference. Our computational model maps distinct cognitive processes into separable, neurobiologically plausible, information-theoretic constructs underlying observed response patterns. We assess model identification and expressiveness in accounting for meaningful human performance through extensive simulation studies. We then validate the model on real behavioral data in order to highlight the utility of the proposed model in recovering cognitive dynamics at an individual level. We highlight the potentials of our model in decomposing adaptive behavior in the WCST into several information-theoretic metrics revealing the trial-by-trial unfolding of information processing by focusing on two exemplary individuals whose behavior is examined in depth. Finally, we focus on the theoretical implications of our computational model by discussing the mapping between BBT constructs and functional neuroanatomical correlates of task performance. We further discuss the empirical benefit of recovering the assumed dynamics of information processing for both clinical and research practices, such as neurological assessment and model-based neuroscience.
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Affiliation(s)
- Marco D’Alessandro
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Stefan T. Radev
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Andreas Voss
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Luigi Lombardi
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
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Behavioral, Physiological, and Neural Signatures of Surprise during Naturalistic Sports Viewing. Neuron 2020; 109:377-390.e7. [PMID: 33242421 DOI: 10.1016/j.neuron.2020.10.029] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/07/2020] [Accepted: 10/22/2020] [Indexed: 12/13/2022]
Abstract
Surprise signals a discrepancy between past and current beliefs. It is theorized to be linked to affective experiences, the creation of particularly resilient memories, and segmentation of the flow of experience into discrete perceived events. However, the ability to precisely measure naturalistic surprise has remained elusive. We used advanced basketball analytics to derive a quantitative measure of surprise and characterized its behavioral, physiological, and neural correlates in human subjects observing basketball games. We found that surprise was associated with segmentation of ongoing experiences, as reflected by subjectively perceived event boundaries and shifts in neocortical patterns underlying belief states. Interestingly, these effects differed by whether surprising moments contradicted or bolstered current predominant beliefs. Surprise also positively correlated with pupil dilation, activation in subcortical regions associated with dopamine, game enjoyment, and long-term memory. These investigations support key predictions from event segmentation theory and extend theoretical conceptualizations of surprise to real-world contexts.
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Barnby JM, Bell V, Mehta MA, Moutoussis M. Reduction in social learning and increased policy uncertainty about harmful intent is associated with pre-existing paranoid beliefs: Evidence from modelling a modified serial dictator game. PLoS Comput Biol 2020; 16:e1008372. [PMID: 33057428 PMCID: PMC7591074 DOI: 10.1371/journal.pcbi.1008372] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/27/2020] [Accepted: 09/07/2020] [Indexed: 02/07/2023] Open
Abstract
Current computational models suggest that paranoia may be explained by stronger higher-order beliefs about others and increased sensitivity to environments. However, it is unclear whether this applies to social contexts, and whether it is specific to harmful intent attributions, the live expression of paranoia. We sought to fill this gap by fitting a computational model to data (n = 1754) from a modified serial dictator game, to explore whether pre-existing paranoia could be accounted by specific alterations to cognitive parameters characterising harmful intent attributions. We constructed a ‘Bayesian brain’ model of others’ intent, which we fitted to harmful intent and self-interest attributions made over 18 trials, across three different partners. We found that pre-existing paranoia was associated with greater uncertainty about other’s actions. It moderated the relationship between learning rates and harmful intent attributions, making harmful intent attributions less reliant on prior interactions. Overall, the magnitude of harmful intent attributions was directly related to their uncertainty, and importantly, the opposite was true for self-interest attributions. Our results explain how pre-existing paranoia may be the result of an increased need to attend to immediate experiences in determining intentional threat, at the expense of what is already known, and more broadly, they suggest that environments that induce greater probabilities of harmful intent attributions may also induce states of uncertainty, potentially as an adaptive mechanism to better detect threatening others. Importantly, we suggest that if paranoia were able to be explained exclusively by core domain-general alterations we would not observe differential parameter estimates underlying harmful-intent and self-interest attributions. A great deal of work has tried to explain paranoia through general cognitive principles, although relatively little has tried to understand whether paranoia may be explained by specific changes to social learning processes. This question is crucial, as paranoia is inherently a social phenomenon, and requires mechanistic explanations to match with its dynamic phenomenology. In this paper we wanted to test whether pre-existing and live paranoid beliefs about others specifically altered how an individual attributed harmful intent–the live expression of paranoia–to partners over a series of live interactions. To do this we applied a novel computational model and network analysis to behavioural data from a large sample of participants in the general population that had played a modified Dictator game online, and required them to attribute whether the behaviour of their partner was due to their intent to harm, or their self-interest, on two mutually exclusive scales. Pre-existing paranoid beliefs about others reduced the value of new partner behaviours on evolving attributions of harmful intent. We suggest that both pre-existing paranoid beliefs and momentary paranoia may incur an adaptive cognitive state to better track potentially threatening others, and demonstrate phenomenological specificity associated with mechanisms of live paranoia.
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Affiliation(s)
- Joseph M. Barnby
- Cultural and Social Neuroscience Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Neuropharmacology Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- * E-mail:
| | - Vaughan Bell
- Cultural and Social Neuroscience Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Research Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
| | - Mitul A. Mehta
- Cultural and Social Neuroscience Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Neuropharmacology Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Michael Moutoussis
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
- Max-Planck–UCL Centre for Computational Psychiatry and Ageing, University College London, London, United Kingdom
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Howes OD, Hird EJ, Adams RA, Corlett PR, McGuire P. Aberrant Salience, Information Processing, and Dopaminergic Signaling in People at Clinical High Risk for Psychosis. Biol Psychiatry 2020; 88:304-314. [PMID: 32430200 DOI: 10.1016/j.biopsych.2020.03.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 01/24/2023]
Abstract
The aberrant salience hypothesis proposes that striatal dopamine dysregulation causes misattribution of salience to irrelevant stimuli leading to psychosis. Recently, new lines of preclinical evidence on information coding by subcortical dopamine coupled with computational models of the brain's ability to predict and make inferences about the world (predictive processing) provide a new perspective on this hypothesis. We review these and summarize the evidence for dopamine dysfunction, reward processing, and salience abnormalities in people at clinical high risk of psychosis (CHR) relative to findings in patients with psychosis. This review identifies consistent evidence for dysregulated subcortical dopamine function in people at CHR, but also indicates a number of areas where neurobiological processes are different in CHR subjects relative to patients with psychosis, particularly in reward processing. We then consider how predictive processing models may explain psychotic symptoms in terms of alterations in prediction error and precision signaling using Bayesian approaches. We also review the potential role of environmental risk factors, particularly early adverse life experiences, in influencing the prior expectations that individuals have about their world in terms of computational models of the progression from being at CHR to frank psychosis. We identify a number of key outstanding questions, including the relative roles of prediction error or precision signaling in the development of symptoms and the mechanism underlying dopamine dysfunction. Finally, we discuss how the integration of computational psychiatry with biological investigation may inform the treatment for people at CHR of psychosis.
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Affiliation(s)
- Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Institute of Health Research Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust, London, United Kingdom; Medical Research Council London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom.
| | - Emily J Hird
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Institute of Health Research Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Rick A Adams
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom; Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, United Kingdom
| | - Philip R Corlett
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Institute of Health Research Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
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36
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Dopamine manipulations modulate paranoid social inferences in healthy people. Transl Psychiatry 2020; 10:214. [PMID: 32624569 PMCID: PMC7335741 DOI: 10.1038/s41398-020-00912-4] [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: 06/03/2020] [Revised: 06/11/2020] [Accepted: 06/23/2020] [Indexed: 12/14/2022] Open
Abstract
Altered dopamine transmission is thought to influence the formation of persecutory delusions. However, despite extensive evidence from clinical studies there is little experimental evidence on how modulating the dopamine system changes social attributions related to paranoia, and the salience of beliefs more generally. Twenty seven healthy male participants received 150mg L-DOPA, 3 mg haloperidol, or placebo in a double-blind, randomised, placebo-controlled study, over three within-subject sessions. Participants completed a multi-round Dictator Game modified to measure social attributions, and a measure of belief salience spanning themes of politics, religion, science, morality, and the paranormal. We preregistered predictions that altering dopamine function would affect (i) attributions of harmful intent and (ii) salience of paranormal beliefs. As predicted, haloperidol reduced attributions of harmful intent across all conditions compared to placebo. L-DOPA reduced attributions of harmful intent in fair conditions compared to placebo. Unexpectedly, haloperidol increased attributions of self-interest about opponents' decisions. There was no change in belief salience within any theme. These results could not be explained by scepticism or subjective mood. Our findings demonstrate the selective involvement of dopamine in social inferences related to paranoia in healthy individuals.
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Adams RA, Moutoussis M, Nour MM, Dahoun T, Lewis D, Illingworth B, Veronese M, Mathys C, de Boer L, Guitart-Masip M, Friston KJ, Howes OD, Roiser JP. Variability in Action Selection Relates to Striatal Dopamine 2/3 Receptor Availability in Humans: A PET Neuroimaging Study Using Reinforcement Learning and Active Inference Models. Cereb Cortex 2020; 30:3573-3589. [PMID: 32083297 PMCID: PMC7233027 DOI: 10.1093/cercor/bhz327] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/18/2019] [Accepted: 12/05/2019] [Indexed: 12/17/2022] Open
Abstract
Choosing actions that result in advantageous outcomes is a fundamental function of nervous systems. All computational decision-making models contain a mechanism that controls the variability of (or confidence in) action selection, but its neural implementation is unclear-especially in humans. We investigated this mechanism using two influential decision-making frameworks: active inference (AI) and reinforcement learning (RL). In AI, the precision (inverse variance) of beliefs about policies controls action selection variability-similar to decision 'noise' parameters in RL-and is thought to be encoded by striatal dopamine signaling. We tested this hypothesis by administering a 'go/no-go' task to 75 healthy participants, and measuring striatal dopamine 2/3 receptor (D2/3R) availability in a subset (n = 25) using [11C]-(+)-PHNO positron emission tomography. In behavioral model comparison, RL performed best across the whole group but AI performed best in participants performing above chance levels. Limbic striatal D2/3R availability had linear relationships with AI policy precision (P = 0.029) as well as with RL irreducible decision 'noise' (P = 0.020), and this relationship with D2/3R availability was confirmed with a 'decision stochasticity' factor that aggregated across both models (P = 0.0006). These findings are consistent with occupancy of inhibitory striatal D2/3Rs decreasing the variability of action selection in humans.
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Affiliation(s)
- Rick A Adams
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK
- Division of Psychiatry, University College London, London W1T 7NF, UK
- Psychiatric Imaging Group, Robert Steiner MRI Unit, MRC London Institute of Medical Sciences, Hammersmith Hospital, London W12 0NN, UK
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
| | - Michael Moutoussis
- Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3BG, UK
- Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London WC1B 5EH, UK
| | - Matthew M Nour
- Psychiatric Imaging Group, Robert Steiner MRI Unit, MRC London Institute of Medical Sciences, Hammersmith Hospital, London W12 0NN, UK
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London SE5 8AF, UK
| | - Tarik Dahoun
- Psychiatric Imaging Group, Robert Steiner MRI Unit, MRC London Institute of Medical Sciences, Hammersmith Hospital, London W12 0NN, UK
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Declan Lewis
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK
| | - Benjamin Illingworth
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK
| | - Mattia Veronese
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
| | - Christoph Mathys
- Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London WC1B 5EH, UK
- Scuola Internazionale Superiore di Studi Avanzati (SISSA), 34136 Trieste, Italy
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, 8032 Zurich, Switzerland
| | - Lieke de Boer
- Aging Research Center, Karolinska Institute, 171 65 Stockholm, Sweden
| | - Marc Guitart-Masip
- Max Planck-UCL Centre for Computational Psychiatry and Ageing Research, London WC1B 5EH, UK
- Aging Research Center, Karolinska Institute, 171 65 Stockholm, Sweden
| | - Karl J Friston
- Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3BG, UK
| | - Oliver D Howes
- Psychiatric Imaging Group, Robert Steiner MRI Unit, MRC London Institute of Medical Sciences, Hammersmith Hospital, London W12 0NN, UK
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London SE5 8AF, UK
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK
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38
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Trempler I, Bürkner PC, El-Sourani N, Binder E, Reker P, Fink GR, Schubotz RI. Impaired context-sensitive adjustment of behaviour in Parkinson's disease patients tested on and off medication: An fMRI study. Neuroimage 2020; 212:116674. [PMID: 32097724 DOI: 10.1016/j.neuroimage.2020.116674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 10/24/2022] Open
Abstract
The brain's sensitivity to and accentuation of unpredicted over predicted sensory signals plays a fundamental role in learning. According to recent theoretical models of the predictive coding framework, dopamine is responsible for balancing the interplay between bottom-up input and top-down predictions by controlling the precision of surprise signals that guide learning. Using functional MRI, we investigated whether patients with Parkinson's disease (PD) show impaired learning from prediction errors requiring either adaptation or stabilisation of current predictions. Moreover, we were interested in whether deficits in learning over a specific time scale would be accompanied by altered surprise responses in dopamine-related brain structures. To this end, twenty-one PD patients tested on and off dopaminergic medication and twenty-one healthy controls performed a digit prediction paradigm. During the task, violations of sequence-based predictions either signalled the need to update or to stabilise the current prediction and, thus, to react to them or ignore them, respectively. To investigate contextual adaptation to prediction errors, the probability (or its inverse, surprise) of the violations fluctuated across the experiment. When the probability of prediction errors over a specific time scale increased, healthy controls but not PD patients off medication became more flexible, i.e., error rates at violations requiring a motor response decreased in controls but increased in patients. On the neural level, this learning deficit in patients was accompanied by reduced signalling in the substantia nigra and the caudate nucleus. In contrast, differences between the groups regarding the probabilistic modulation of behaviour and neural responses were much less pronounced at prediction errors requiring only stabilisation but no adaptation. Interestingly, dopaminergic medication could neither improve learning from prediction errors nor restore the physiological, neurotypical pattern. Our findings point to a pivotal role of dysfunctions of the substantia nigra and caudate nucleus in deficits in learning from flexibility-demanding prediction errors in PD. Moreover, the data witness poor effects of dopaminergic medication on learning in PD.
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Affiliation(s)
- Ima Trempler
- Department of Psychology, University of Muenster, 48149, Münster, Germany; Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, 48149, Münster, Germany.
| | | | - Nadiya El-Sourani
- Department of Psychology, University of Muenster, 48149, Münster, Germany
| | - Ellen Binder
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, 50937, Cologne, Germany; Institute of Neuroscience and Medicine (INM3), Cognitive Neuroscience, Research Centre Jülich, 52425, Jülich, Germany
| | - Paul Reker
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, 50937, Cologne, Germany
| | - Gereon R Fink
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, 50937, Cologne, Germany; Institute of Neuroscience and Medicine (INM3), Cognitive Neuroscience, Research Centre Jülich, 52425, Jülich, Germany
| | - Ricarda I Schubotz
- Department of Psychology, University of Muenster, 48149, Münster, Germany; Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, 48149, Münster, Germany; Faculty of Medicine and University Hospital Cologne, Department of Neurology, 50937, Cologne, Germany
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39
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Abstract
Perceptual disturbances in psychosis, such as auditory verbal hallucinations, are associated with increased baseline activity in the associative auditory cortex and increased dopamine transmission in the associative striatum. Perceptual disturbances are also associated with perceptual biases that suggest increased reliance on prior expectations. We review theoretical models of perceptual inference and key supporting physiological evidence, as well as the anatomy of associative cortico-striatal loops that may be relevant to auditory perceptual inference. Integrating recent findings, we outline a working framework that bridges neurobiology and the phenomenology of perceptual disturbances via theoretical models of perceptual inference.
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40
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Howes OD, Bonoldi I, McCutcheon RA, Azis M, Antoniades M, Bossong M, Modinos G, Perez J, Stone JM, Santangelo B, Veronese M, Grace A, Allen P, McGuire PK. Glutamatergic and dopaminergic function and the relationship to outcome in people at clinical high risk of psychosis: a multi-modal PET-magnetic resonance brain imaging study. Neuropsychopharmacology 2020; 45:641-648. [PMID: 31618752 PMCID: PMC7021794 DOI: 10.1038/s41386-019-0541-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 12/11/2022]
Abstract
Preclinical models of psychosis propose that hippocampal glutamatergic neuron hyperactivity drives increased striatal dopaminergic activity, which underlies the development of psychotic symptoms. The aim of this study was to examine the relationship between hippocampal glutamate and subcortical dopaminergic function in people at clinical high risk for psychosis, and to assess the association with the development of psychotic symptoms. 1H-MRS was used to measure hippocampal glutamate concentrations, and 18F-DOPA PET was used to measure dopamine synthesis capacity in 70 subjects (51 people at clinical high risk for psychosis and 19 healthy controls). Clinical assessments were undertaken at baseline and follow-up (median 15 months). Striatal dopamine synthesis capacity predicted the worsening of psychotic symptoms at follow-up (r = 0.35; p < 0.05), but not transition to a psychotic disorder (p = 0.22), and was not significantly related to hippocampal glutamate concentration (p = 0.13). There were no differences in either glutamate (p = 0.5) or dopamine (p = 0.5) measures in the total patient group relative to controls. Striatal dopamine synthesis capacity at presentation predicts the subsequent worsening of sub-clinical total and psychotic symptoms, consistent with a role for dopamine in the development of psychotic symptoms, but is not strongly linked to hippocampal glutamate concentrations.
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Affiliation(s)
- Oliver D Howes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Camberwell, London, SE5 8AF, UK.
- MRC London Institute of Medical Sciences, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK.
- TREAT Service, South London and Maudsley Foundation NHS Trust, Maudsley Hospital, London, SE5 8AZ, UK.
| | - Ilaria Bonoldi
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Camberwell, London, SE5 8AF, UK
- TREAT Service, South London and Maudsley Foundation NHS Trust, Maudsley Hospital, London, SE5 8AZ, UK
| | - Robert A McCutcheon
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Camberwell, London, SE5 8AF, UK.
- MRC London Institute of Medical Sciences, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK.
| | - Matilda Azis
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Camberwell, London, SE5 8AF, UK
| | - Mathilde Antoniades
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Camberwell, London, SE5 8AF, UK
| | - Matthijs Bossong
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Camberwell, London, SE5 8AF, UK
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gemma Modinos
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Camberwell, London, SE5 8AF, UK
| | - Jesus Perez
- Cambridge Early Onset service, Cambridgeshire and Peterborough Mental Health Partnership National Health Service Trust, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - James M Stone
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Camberwell, London, SE5 8AF, UK
| | - Barbara Santangelo
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Camberwell, London, SE5 8AF, UK
| | - Mattia Veronese
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Camberwell, London, SE5 8AF, UK
| | - Anthony Grace
- Department of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Paul Allen
- Department of Psychology, University of Roehampton, London, UK
| | - Philip K McGuire
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Camberwell, London, SE5 8AF, UK
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41
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Loued-Khenissi L, Preuschoff K. Information Theoretic Characterization of Uncertainty Distinguishes Surprise From Accuracy Signals in the Brain. Front Artif Intell 2020; 3:5. [PMID: 33733125 PMCID: PMC7861235 DOI: 10.3389/frai.2020.00005] [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: 10/30/2019] [Accepted: 02/03/2020] [Indexed: 12/02/2022] Open
Abstract
Uncertainty presents a problem for both human and machine decision-making. While utility maximization has traditionally been viewed as the motive force behind choice behavior, it has been theorized that uncertainty minimization may supersede reward motivation. Beyond reward, decisions are guided by belief, i.e., confidence-weighted expectations. Evidence challenging a belief evokes surprise, which signals a deviation from expectation (stimulus-bound surprise) but also provides an information gain. To support the theory that uncertainty minimization is an essential drive for the brain, we probe the neural trace of uncertainty-related decision variables, namely confidence, surprise, and information gain, in a discrete decision with a deterministic outcome. Confidence and surprise were elicited with a gambling task administered in a functional magnetic resonance imaging experiment, where agents start with a uniform probability distribution, transition to a non-uniform probabilistic state, and end in a fully certain state. After controlling for reward expectation, we find confidence, taken as the negative entropy of a trial, correlates with a response in the hippocampus and temporal lobe. Stimulus-bound surprise, taken as Shannon information, correlates with responses in the insula and striatum. In addition, we also find a neural response to a measure of information gain captured by a confidence error, a quantity we dub accuracy. BOLD responses to accuracy were found in the cerebellum and precuneus, after controlling for reward prediction errors and stimulus-bound surprise at the same time point. Our results suggest that, even absent an overt need for learning, the human brain expends energy on information gain and uncertainty minimization.
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Affiliation(s)
- Leyla Loued-Khenissi
- Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Kerstin Preuschoff
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
- Geneva Finance Research Institute, University of Geneva, Geneva, Switzerland
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42
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Seitz RJ, Angel HF. Belief formation - A driving force for brain evolution. Brain Cogn 2020; 140:105548. [PMID: 32062327 DOI: 10.1016/j.bandc.2020.105548] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/06/2020] [Accepted: 02/06/2020] [Indexed: 01/10/2023]
Abstract
The topic of belief has been neglected in the natural sciences for a long period of time. Recent neuroscience research in non-human primates and humans, however, has shown that beliefs are the neuropsychic product of fundamental brain processes that attribute affective meaning to concrete objects and events, enabling individual goal setting, decision making and maneuvering in the environment. With regard to the involved neural processes they can be categorized as empirical, relational, and conceptual beliefs. Empirical beliefs are about objects and relational beliefs are about events as in tool use and in interactions between subjects that develop below the level of awareness and are up-dated dynamically. Conceptual beliefs are more complex being based on narratives and participation in ritual acts. As neural processes are known to require computational space in the brain, the formation of inceasingly complex beliefs demands extra neural resources. Here, we argue that the evolution of human beliefs is related to the phylogenetic enlargement of the brain including the parietal and medial frontal cortex in humans.
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Affiliation(s)
- Rüdiger J Seitz
- Department of Neurology, Centre of Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; Florey Neuroscience Institutes, Melbourne, Australia.
| | - Hans-Ferdinand Angel
- Karl Franzens University Graz, Institute of Catechetic and Pedagogic of Religion, Graz, Austria
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43
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Cue-Evoked Dopamine Promotes Conditioned Responding during Learning. Neuron 2020; 106:142-153.e7. [PMID: 32027824 DOI: 10.1016/j.neuron.2020.01.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 10/28/2019] [Accepted: 01/13/2020] [Indexed: 11/20/2022]
Abstract
Dopamine neurons mediate the association of conditioned stimuli (CS) with reward (unconditioned stimuli, US) by signaling the discrepancy between predicted and actual reward during the US. Some theoretical models suggest that learning is also influenced by the salience or associability of the CS. A hallmark of CS associability models is that they can explain latent inhibition, i.e., the observation that novel CS are more effectively learned than familiar CS. Novel CS are known to activate dopamine neurons, but whether those responses affect associative learning has not been investigated. Here, we used fiber photometry to characterize dopamine responses to inconsequential familiar and novel stimuli. Using bidirectional optogenetic modulation during conditioning, we then show that CS-evoked dopamine promotes conditioned responses. This suggests that Pavlovian conditioning is influenced by CS dopamine, in addition to US reward prediction errors. Accordingly, the absence of dopamine responses to familiar CS might explain their slower learning in latent inhibition.
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44
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McCutcheon RA, Krystal JH, Howes OD. Dopamine and glutamate in schizophrenia: biology, symptoms and treatment. World Psychiatry 2020; 19:15-33. [PMID: 31922684 PMCID: PMC6953551 DOI: 10.1002/wps.20693] [Citation(s) in RCA: 283] [Impact Index Per Article: 70.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Glutamate and dopamine systems play distinct roles in terms of neuronal signalling, yet both have been proposed to contribute significantly to the pathophysiology of schizophrenia. In this paper we assess research that has implicated both systems in the aetiology of this disorder. We examine evidence from post-mortem, preclinical, pharmacological and in vivo neuroimaging studies. Pharmacological and preclinical studies implicate both systems, and in vivo imaging of the dopamine system has consistently identified elevated striatal dopamine synthesis and release capacity in schizophrenia. Imaging of the glutamate system and other aspects of research on the dopamine system have produced less consistent findings, potentially due to methodological limitations and the heterogeneity of the disorder. Converging evidence indicates that genetic and environmental risk factors for schizophrenia underlie disruption of glutamatergic and dopaminergic function. However, while genetic influences may directly underlie glutamatergic dysfunction, few genetic risk variants directly implicate the dopamine system, indicating that aberrant dopamine signalling is likely to be predominantly due to other factors. We discuss the neural circuits through which the two systems interact, and how their disruption may cause psychotic symptoms. We also discuss mechanisms through which existing treatments operate, and how recent research has highlighted opportunities for the development of novel pharmacological therapies. Finally, we consider outstanding questions for the field, including what remains unknown regarding the nature of glutamate and dopamine function in schizophrenia, and what needs to be achieved to make progress in developing new treatments.
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Affiliation(s)
- Robert A McCutcheon
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- MRC London Institute of Medical Sciences, Imperial College London, Hammersmith Hospital, London, UK
- South London and Maudsley Foundation NHS Trust, Maudsley Hospital, London, UK
| | - John H Krystal
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Oliver D Howes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- MRC London Institute of Medical Sciences, Imperial College London, Hammersmith Hospital, London, UK
- South London and Maudsley Foundation NHS Trust, Maudsley Hospital, London, UK
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Abstract
IMPORTANCE Schizophrenia is a common, severe mental illness that most clinicians will encounter regularly during their practice. This report provides an overview of the clinical characteristics, epidemiology, genetics, neuroscience, and psychopharmacology of schizophrenia to provide a basis to understand the disorder and its treatment. This educational review is integrated with a clinical case to highlight how recent research findings can inform clinical understanding. OBSERVATIONS The first theme considered is the role of early-life environmental and genetic risk factors in altering neurodevelopmental trajectories to predispose an individual to the disorder and leading to the development of prodromal symptoms. The second theme is the role of cortical excitatory-inhibitory imbalance in the development of the cognitive and negative symptoms of the disorder. The third theme considers the role of psychosocial stressors, psychological factors, and subcortical dopamine dysfunction in the onset of the positive symptoms of the disorder. The final theme considers the mechanisms underlying treatment for schizophrenia and common adverse effects of treatment. CONCLUSIONS AND RELEVANCE Schizophrenia has a complex presentation with a multifactorial cause. Nevertheless, advances in neuroscience have identified roles for key circuits, particularly involving frontal, temporal, and mesostriatal brain regions, in the development of positive, negative, and cognitive symptoms. Current pharmacological treatments operate using the same mechanism, blockade of dopamine D2 receptor, which contribute to their adverse effects. However, the circuit mechanisms discussed herein identify novel potential treatment targets that may be of particular benefit in symptom domains not well served by existing medications.
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Affiliation(s)
- Robert A McCutcheon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom.,Psychiatric Imaging Group, Medical Research Council, London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom.,Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom.,Psychiatric Imaging Group, Medical Research Council, London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom.,Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom.,Psychiatric Imaging Group, Medical Research Council, London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom.,Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
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46
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Higashi H, Minami T, Nakauchi S. Cooperative update of beliefs and state-transition functions in human reinforcement learning. Sci Rep 2019; 9:17704. [PMID: 31776353 PMCID: PMC6881319 DOI: 10.1038/s41598-019-53600-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 10/25/2019] [Indexed: 11/09/2022] Open
Abstract
It is widely known that reinforcement learning systems in the brain contribute to learning via interactions with the environment. These systems are capable of solving multidimensional problems, in which some dimensions are relevant to a reward, while others are not. To solve these problems, computational models use Bayesian learning, a strategy supported by behavioral and neural evidence in human. Bayesian learning takes into account beliefs, which represent a learner’s confidence in a particular dimension being relevant to the reward. Beliefs are given as a posterior probability of the state-transition (reward) function that maps the optimal actions to the states in each dimension. However, when it comes to implementing this learning strategy, the order in which beliefs and state-transition functions update remains unclear. The present study investigates this update order using a trial-by-trial analysis of human behavior and electroencephalography signals during a task in which learners have to identify the reward-relevant dimension. Our behavioral and neural results reveal a cooperative update—within 300 ms after the outcome feedback, the state-transition functions are updated, followed by the beliefs for each dimension.
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Affiliation(s)
- Hiroshi Higashi
- Graduate School of Informatics, Kyoto University, Kyoto, Japan.
| | - Tetsuto Minami
- Electronics-Inspired Interdisciplinary Research Institute, Toyohashi University of Technology, Toyohashi, Japan.,Department of Computer Science and Engineering, Toyohashi University of Technology, Toyohashi, Japan
| | - Shigeki Nakauchi
- Department of Computer Science and Engineering, Toyohashi University of Technology, Toyohashi, Japan
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The relationship between childhood trauma, dopamine release and dexamphetamine-induced positive psychotic symptoms: a [ 11C]-(+)-PHNO PET study. Transl Psychiatry 2019; 9:287. [PMID: 31712556 PMCID: PMC6848217 DOI: 10.1038/s41398-019-0627-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 09/17/2019] [Accepted: 10/20/2019] [Indexed: 02/08/2023] Open
Abstract
Childhood trauma is a risk factor for psychosis. Amphetamine increases synaptic striatal dopamine levels and can induce positive psychotic symptoms in healthy individuals and patients with schizophrenia. Socio-developmental hypotheses of psychosis propose that childhood trauma and other environmental risk factors sensitize the dopamine system to increase the risk of psychotic symptoms, but this remains to be tested in humans. We used [11C]-(+)-PHNO positron emission tomography to measure striatal dopamine-2/3 receptor (D2/3R) availability and ventral striatal dexamphetamine-induced dopamine release in healthy participants (n = 24). The relationships between dexamphetamine-induced dopamine release, dexamphetamine-induced positive psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS), and childhood trauma using the Childhood Trauma Questionnaire (CTQ) were assessed using linear regression and mediation analyses, with childhood trauma as the independent variable, dexamphetamine-induced dopamine release as the mediator variable, and dexamphetamine-induced symptoms as the dependent variable. There was a significant interaction between childhood trauma and ventral striatal dopamine release in predicting dexamphetamine-induced positive psychotic symptoms (standardized β = 1.83, p = 0.003), but a mediation analysis was not significant (standardized β = -0.18, p = 0.158). There were no significant effects of dopamine release and childhood trauma on change in negative (p = 0.280) or general PANSS symptoms (p = 0.061), and there was no relationship between ventral striatal baseline D2/3R availability and positive symptoms (p = 0.368). This indicates childhood trauma and dopamine release interact to influence the induction of positive psychotic symptoms. This is not consistent with a simple sensitization hypothesis, but suggests that childhood trauma moderates the cognitive response to dopamine release to make psychotic experiences more likely.
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48
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Nassar MR, Bruckner R, Frank MJ. Statistical context dictates the relationship between feedback-related EEG signals and learning. eLife 2019; 8:e46975. [PMID: 31433294 PMCID: PMC6716947 DOI: 10.7554/elife.46975] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 08/12/2019] [Indexed: 12/18/2022] Open
Abstract
Learning should be adjusted according to the surprise associated with observed outcomes but calibrated according to statistical context. For example, when occasional changepoints are expected, surprising outcomes should be weighted heavily to speed learning. In contrast, when uninformative outliers are expected to occur occasionally, surprising outcomes should be less influential. Here we dissociate surprising outcomes from the degree to which they demand learning using a predictive inference task and computational modeling. We show that the P300, a stimulus-locked electrophysiological response previously associated with adjustments in learning behavior, does so conditionally on the source of surprise. Larger P300 signals predicted greater learning in a changing context, but less learning in a context where surprise was indicative of a one-off outlier (oddball). Our results suggest that the P300 provides a surprise signal that is interpreted by downstream learning processes differentially according to statistical context in order to appropriately calibrate learning across complex environments.
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Affiliation(s)
- Matthew R Nassar
- Robert J. & Nancy D. Carney Institute for Brain ScienceBrown UniversityProvidenceUnited States
- Department of NeuroscienceBrown UniversityProvidenceUnited States
| | - Rasmus Bruckner
- Department of Education and PsychologyFreie Universität BerlinBerlinGermany
- Center for Lifespan PsychologyMax Planck Institute for Human DevelopmentBerlinGermany
- International Max Planck Research School on the Life Course (LIFE)BerlinGermany
| | - Michael J Frank
- Robert J. & Nancy D. Carney Institute for Brain ScienceBrown UniversityProvidenceUnited States
- Department of Cognitive, Linguistic, and Psychological SciencesBrown UniversityProvidenceUnited States
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49
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Pulcu E, Browning M. The Misestimation of Uncertainty in Affective Disorders. Trends Cogn Sci 2019; 23:865-875. [PMID: 31431340 DOI: 10.1016/j.tics.2019.07.007] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 01/28/2023]
Abstract
Our knowledge about the state of the world is often incomplete, making it difficult to select the best course of action. One strategy that can be used to improve our ability to make decisions is to identify the causes of our ignorance (i.e., why an unexpected event might have occurred) and use estimates of the uncertainty induced by these causes to guide our learning. Here, we explain the logic behind this process and describe the evidence that human learners use estimates of uncertainty to sculpt their learning. Finally, we describe recent work suggesting that misestimation of uncertainty is involved in the development of anxiety and depression and describe how these ideas may be advanced.
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Affiliation(s)
- Erdem Pulcu
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Michael Browning
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health Foundation Trust, Oxford, UK.
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50
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Nour MM, Dahoun T, McCutcheon RA, Adams RA, Wall MB, Howes OD. Task-induced functional brain connectivity mediates the relationship between striatal D2/3 receptors and working memory. eLife 2019; 8:e45045. [PMID: 31290741 PMCID: PMC6620042 DOI: 10.7554/elife.45045] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 06/18/2019] [Indexed: 12/21/2022] Open
Abstract
Working memory performance is thought to depend on both striatal dopamine 2/3 receptors (D2/3Rs) and task-induced functional organisation in key cortical brain networks. Here, we combine functional magnetic resonance imaging and D2/3R positron emission tomography in 51 healthy volunteers, to investigate the relationship between working memory performance, task-induced default mode network (DMN) functional connectivity changes, and striatal D2/3R availability. Increasing working memory load was associated with reduced DMN functional connectivity, which was itself associated with poorer task performance. Crucially, the magnitude of the DMN connectivity reduction correlated with striatal D2/3R availability, particularly in the caudate, and this relationship mediated the relationship between striatal D2/3R availability and task performance. These results inform our understanding of natural variation in working memory performance, and have implications for understanding age-related cognitive decline and cognitive impairments in neuropsychiatric disorders where dopamine signalling is altered.
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Affiliation(s)
- Matthew M Nour
- Institute of Psychiatry, Psychology and Neuroscience (IOPPN)King’s College LondonLondonUnited Kingdom
- MRC London Institute of Medical Sciences (LMS)Hammersmith HospitalLondonUnited Kingdom
- Institute of Clinical SciencesImperial College LondonLondonUnited Kingdom
- Max Planck UCL Centre for Computational Psychiatry and Ageing ResearchUniversity College LondonLondonUnited Kingdom
- Wellcome Centre for Human Neuroimaging (WCHN)University College LondonLondonUnited Kingdom
| | - Tarik Dahoun
- MRC London Institute of Medical Sciences (LMS)Hammersmith HospitalLondonUnited Kingdom
- Institute of Clinical SciencesImperial College LondonLondonUnited Kingdom
- Department of PsychiatryUniversity of OxfordOxfordUnited Kingdom
| | - Robert A McCutcheon
- Institute of Psychiatry, Psychology and Neuroscience (IOPPN)King’s College LondonLondonUnited Kingdom
- MRC London Institute of Medical Sciences (LMS)Hammersmith HospitalLondonUnited Kingdom
| | - Rick A Adams
- Institute of Cognitive Neuroscience (ICN)University College LondonLondonUnited Kingdom
- Division of PsychiatryUniversity College LondonLondonUnited Kingdom
| | - Matthew B Wall
- Imanova Centre for Imaging Sciences (Invicro Ltd)Hammersmith HospitalLondonUnited Kingdom
| | - Oliver D Howes
- Institute of Psychiatry, Psychology and Neuroscience (IOPPN)King’s College LondonLondonUnited Kingdom
- MRC London Institute of Medical Sciences (LMS)Hammersmith HospitalLondonUnited Kingdom
- Institute of Clinical SciencesImperial College LondonLondonUnited Kingdom
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