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Zhao YJ, Zhang Y, Wang Q, Manssuer L, Cui H, Ding Q, Sun B, Liu W, Voon V. Evidence Accumulation and Neural Correlates of Uncertainty in Obsessive-Compulsive Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:1058-1065. [PMID: 37343660 PMCID: PMC10555851 DOI: 10.1016/j.bpsc.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Decision making is frequently associated with risk taking under uncertainty. Elevated intolerance of uncertainty is suggested to be a critical feature of obsessive-compulsive disorder (OCD). However, impairments of latent constructs of uncertainty processing and its neural correlates remain unclear in OCD. METHODS In 83 participants (24 OCD patients treated with capsulotomy, 28 OCD control participants, and 31 healthy control participants), we performed magnetic resonance imaging using a card gambling task in which participants made decisions whether to bet or not that the next card would be larger than the current one. A hierarchical drift diffusion model was used to dissociate speed and amount of evidence accumulated before a decisional threshold (i.e., betting or no betting) was reached. RESULTS High uncertainty was characterized by a smaller amount of evidence accumulation (lower thresholds), thus dissociating uncertainty from conflict tasks and highlighting the specificity of this task to test value-based uncertainty. OCD patients exhibited greater caution with poor performance and greater evidence accumulation overall along with slower speed of accumulation, particularly under low uncertainty. Bilateral dorsal anterior cingulate and anterior insula distinguished high- and low-uncertainty decision processes in healthy control participants but not in the OCD groups, indicating impairments in anticipation of differences in outcome variance and salience network activity. There were no behavioral or imaging differences relating to capsulotomy despite improvements in OCD symptoms. CONCLUSIONS Our findings highlight greater impairments particularly in more certain trials in the OCD groups along with impaired neural differentiation of high and low uncertainty and suggest uncertainty processing as a trait cognitive endophenotype rather than a state-specific factor.
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Affiliation(s)
- Yi-Jie Zhao
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, China; Zhangjiang Fudan International Innovation Center, Shanghai, China; Department of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yingying Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, China; Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Qianfeng Wang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, China; Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Luis Manssuer
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Hailun Cui
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Qiong Ding
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Bomin Sun
- Department of Neurosurgery, Center for Functional Neurosurgery, Clinical Neuroscience Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjuan Liu
- Department of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Valerie Voon
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, China; Zhangjiang Fudan International Innovation Center, Shanghai, China; Department of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
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2
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Han S, Gao J, Hu J, Ye Y, Huang H, Liu J, Liu M, Ai H, Qiu J, Luo Y, Xu P. Disruptions of salience network during uncertain anticipation of conflict control in anxiety. Asian J Psychiatr 2023; 88:103721. [PMID: 37562270 DOI: 10.1016/j.ajp.2023.103721] [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: 03/06/2023] [Revised: 06/20/2023] [Accepted: 08/01/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Anxiety has been characterized by disrupted processing of conflict control, while little is known about anticipatory processing of conflicts in anxiety. Anticipation is the key factor in both anxiety and cognitive control, especially under uncertain conditions. The current study therefore examined neurocomputational mechanisms of uncertain anticipation of conflict control in anxiety. METHODS Twenty-six participants with high-trait anxiety and twenty-nine low-trait anxiety participants completed a cue-flanker task with functional magnetic resonance imaging. The hierarchical drift diffusion model (HDDM) was used to measure the cognitive computations during the task. To identify the neurocomputational mechanism of anticipatory control in anxiety, mediation analysis and dynamic causal modelling (DCM) analysis were conducted to examine the relationship between functional connectivity of brain networks and the parameters of HDDM. RESULTS We found influences of regulatory signals from the dorsolateral prefrontal cortex to dorsal anterior cingulate cortex on decision threshold in low-trait anxiety (LTA), but not in high-trait anxiety (HTA), especially for the condition with uncertain cues. The results indicate deficient top-down anticipatory control of upcoming conflicts in anxious individuals. DCM and HDDM analyses revealed that lower decision threshold was associated with higher intrinsic connectivity of salience network (SN) in anxious individuals, suggesting that dysfunctional SN disrupts anticipation of conflict control under uncertainty in anxiety. CONCLUSIONS Our results suggest hyperfunction of the SN underlies the deficient information accumulation during uncertain anticipation of upcoming conflicts in anxiety. Our findings shed new light on the mechanisms of anticipation processing and the psychopathology of anxiety.
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Affiliation(s)
- Shangfeng Han
- Department of Psychology and Center for Brain and Cognitive Sciences, School of Education, Guangzhou University, Guangzhou, China; Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
| | - Jie Gao
- School of Psychology, Chengdu Medical College, Chengdu, China
| | - Jie Hu
- School of Psychology, Chengdu Medical College, Chengdu, China
| | - Yanghua Ye
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
| | - Huiya Huang
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
| | - Jing Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Mingfang Liu
- Community Health Service Center of Beijing Normal University, China
| | - Hui Ai
- Institute of Applied Psychology, Tianjin University, Tianjin, China; Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Jianyin Qiu
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuejia Luo
- School of Psychology, Chengdu Medical College, Chengdu, China; Institute for Neuropsychological Rehabilitation, University of Health and Rehabilitation Sciences, Qingdao, China.
| | - Pengfei Xu
- The State Key Lab of Cognitive and Learning, Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (BNU), Faculty of Psychology, Beijing Normal University, Beijing, China; Center for Emotion and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China.
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3
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Biernacki K, Molokotos E, Han C, Dillon DG, Leventhal AM, Janes AC. Enhanced decision-making in nicotine dependent individuals who abstain: A computational analysis using Hierarchical Drift Diffusion Modeling. Drug Alcohol Depend 2023; 250:110890. [PMID: 37480798 PMCID: PMC10530296 DOI: 10.1016/j.drugalcdep.2023.110890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/26/2023] [Accepted: 07/04/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Variability in decision-making capacity and reward responsiveness may underlie differences in the ability to abstain from smoking. Computational modeling of choice behavior, as with the Hierarchical Drift Diffusion Model (HDDM), can help dissociate reward responsiveness from underlying components of decision-making. Here we used the HDDM to identify which decision-making or reward-related parameters, extracted from data acquired in a reward processing task, contributed to the ability of people who smoke that are not seeking treatment to abstain from cigarettes during a laboratory task. METHODS 80 adults who smoke cigarettes completed the Probabilistic Reward Task (PRT) - a signal detection task with a differential reinforcement schedule - following smoking as usual, and the Relapse Analogue Task (RAT) - a task in which participants could earn money for delaying smoking up to 50min - after a period of overnight abstinence. Two cohorts were defined by the RAT; those who waited either 0-min (n=36) or the full 50-min (n=44) before smoking. RESULTS PRT signal detection metrics indicated all subjects learned the task contingencies, with no differences in response bias or discriminability between the two groups. However, HDDM analyses indicated faster drift rates in 50-min vs. 0-min waiters. CONCLUSIONS Relative to those who did not abstain, computational modeling indicated that people who abstained from smoking for 50min showed faster evidence accumulation during reward-based decision-making. These results highlight the importance of decision-making mechanisms to smoking abstinence, and suggest that focusing on the evidence accumulation process may yield new targets for treatment.
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Affiliation(s)
- Kathryn Biernacki
- National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD21224, United States.
| | - Elena Molokotos
- Suffolk University, Boston, MA02116, United States; CBTeam, Lexington, MA02421, United States
| | - Chungmin Han
- National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD21224, United States
| | - Daniel G Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA02478, United States; Harvard Medical School, Boston, MA02115, United States
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, CA90033, United States
| | - Amy C Janes
- National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD21224, United States
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Chu S, Hutcherson C, Ito R, Lee ACH. Elucidating medial temporal and frontal lobe contributions to approach-avoidance conflict decision-making using functional MRI and the hierarchical drift diffusion model. Cereb Cortex 2023; 33:7797-7815. [PMID: 36944537 PMCID: PMC10267625 DOI: 10.1093/cercor/bhad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 03/23/2023] Open
Abstract
The prefrontal cortex (PFC) has long been associated with arbitrating between approach and avoidance in the face of conflicting and uncertain motivational information, but recent work has also highlighted medial temporal lobe (MTL) involvement. It remains unclear, however, how the contributions of these regions differ in their resolution of conflict information and uncertainty. We designed an fMRI paradigm in which participants approached or avoided object pairs that differed by motivational conflict and outcome uncertainty (complete certainty vs. complete uncertainty). Behavioral data and decision-making parameters estimated using the hierarchical drift diffusion model revealed that participants' responding was driven by conflict rather than uncertainty. Our neural data suggest that PFC areas contribute to cognitive control during approach-avoidance conflict by potentially adjusting response caution and the strength of evidence generated towards either choice, with differential involvement of anterior cingulate cortex and dorsolateral prefrontal cortex. The MTL, on the other hand, appears to contribute to evidence generation, with the hippocampus linked to evidence accumulation for stimuli. Although findings within perirhinal cortex were comparatively equivocal, some evidence suggests contributions to perceptual representations, particularly under conditions of threat. Our findings provide evidence that MTL and PFC regions may contribute uniquely to arbitrating approach-avoidance conflict.
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Affiliation(s)
- Sonja Chu
- Department of Psychological Clinical Science, University of Toronto, 1265 Military Trail, Toronto, ON M1C 1A4, Canada
| | - Cendri Hutcherson
- Department of Psychological Clinical Science, University of Toronto, 1265 Military Trail, Toronto, ON M1C 1A4, Canada
- Department of Psychology (Scarborough), University of Toronto, 1265 Military Trail, Toronto, ON M1C 1A4, Canada
- Rotman School of Management, University of Toronto, 105 St. George Street, Toronto, ON M5S 3E6, Canada
| | - Rutsuko Ito
- Department of Psychological Clinical Science, University of Toronto, 1265 Military Trail, Toronto, ON M1C 1A4, Canada
- Department of Psychology (Scarborough), University of Toronto, 1265 Military Trail, Toronto, ON M1C 1A4, Canada
- Department of Cell and Systems Biology, University of Toronto, 25 Harbord Street, Toronto, ON M5S 3G5, Canada
| | - Andy C H Lee
- Department of Psychological Clinical Science, University of Toronto, 1265 Military Trail, Toronto, ON M1C 1A4, Canada
- Department of Psychology (Scarborough), University of Toronto, 1265 Military Trail, Toronto, ON M1C 1A4, Canada
- Rotman Research Institute, Baycrest Centre, 3560 Bathurst Street, Toronto, ON M6A 2E1, Canada
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Gupta A, Bansal R, Alashwal H, Kacar AS, Balci F, Moustafa AA. Neural Substrates of the Drift-Diffusion Model in Brain Disorders. Front Comput Neurosci 2022; 15:678232. [PMID: 35069160 PMCID: PMC8776710 DOI: 10.3389/fncom.2021.678232] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 11/25/2021] [Indexed: 12/01/2022] Open
Abstract
Many studies on the drift-diffusion model (DDM) explain decision-making based on a unified analysis of both accuracy and response times. This review provides an in-depth account of the recent advances in DDM research which ground different DDM parameters on several brain areas, including the cortex and basal ganglia. Furthermore, we discuss the changes in DDM parameters due to structural and functional impairments in several clinical disorders, including Parkinson's disease, Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorders, Obsessive-Compulsive Disorder (OCD), and schizophrenia. This review thus uses DDM to provide a theoretical understanding of different brain disorders.
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Affiliation(s)
- Ankur Gupta
- CNRS UMR 5293, Institut des Maladies Neurodégénératives, Université de Bordeaux, Bordeaux, France
| | - Rohini Bansal
- Department of Medical Neurobiology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hany Alashwal
- College of Information Technology, United Arab Emirates University, Al-Ain, United Arab Emirates
- *Correspondence: Hany Alashwal
| | - Anil Safak Kacar
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
| | - Fuat Balci
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
- Department of Biological Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Ahmed A. Moustafa
- School of Psychology & Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, NSW, Australia
- School of Psychology, Faculty of Society and Design, Bond University, Robina, QLD, Australia
- Faculty of Health Sciences, Department of Human Anatomy and Physiology, University of Johannesburg, Johannesburg, South Africa
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Marzuki AA, Tomić I, Ip SHY, Gottwald J, Kanen JW, Kaser M, Sule A, Conway-Morris A, Sahakian BJ, Robbins TW. Association of Environmental Uncertainty With Altered Decision-making and Learning Mechanisms in Youths With Obsessive-Compulsive Disorder. JAMA Netw Open 2021; 4:e2136195. [PMID: 34842925 PMCID: PMC8630570 DOI: 10.1001/jamanetworkopen.2021.36195] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/01/2021] [Indexed: 02/05/2023] Open
Abstract
Importance Adults with obsessive-compulsive disorder (OCD) display perseverative behavior in stable environments but exhibit vacillating choice when payoffs are uncertain. These findings may be associated with intolerance of uncertainty and compulsive behaviors; however, little is known about the mechanisms underlying learning and decision-making in youths with OCD because research into this population has been limited. Objective To investigate cognitive mechanisms associated with decision-making in youths with OCD by using executive functioning tasks and computational modeling. Design, Setting, and Participants In this cross-sectional study, 50 youths with OCD (patients) and 53 healthy participants (controls) completed a probabilistic reversal learning (PRL) task between January 2014 and March 2020. A separate sample of 27 patients and 46 controls completed the Wisconsin Card Sorting Task (WCST) between January 2018 and November 2020. The study took place at the University of Cambridge in the UK. Main Outcomes and Measures Decision-making mechanisms were studied by fitting hierarchical bayesian reinforcement learning models to the 2 data sets and comparing model parameters between participant groups. Model parameters included reward and punishment learning rates (feedback sensitivity), reinforcement sensitivity and decision consistency (exploitation), and stickiness (perseveration). Associations of receipt of serotonergic medication with performance were assessed. Results In total, 50 patients (29 female patients [58%]; median age, 16.6 years [IQR, 15.3-18.0 years]) and 53 controls (30 female participants [57%]; median age, 16.4 years [IQR, 14.8-18.0 years]) completed the PRL task. A total of 27 patients (18 female patients [67%]; median age, 16.1 years [IQR, 15.2-17.2 years]) and 46 controls (28 female participants [61%]; median age, 17.2 [IQR, 16.3-17.6 years]) completed the WCST. During the reversal phase of the PRL task, patients made fewer correct responses (mean [SD] proportion: 0.83 [0.16] for controls and 0.61 [0.31] for patients; 95% CI, -1.31 to -0.64) and switched choices more often following false-negative feedback (mean [SD] proportion: 0.09 [0.16] for controls vs 0.27 [0.34] for patients; 95% CI, 0.60-1.26) and true-positive feedback (mean [SD] proportion: 0.93 [0.17] for controls vs 0.73 [0.34] for patients; 95% CI, -2.17 to -1.31). Computational modeling revealed that patients displayed enhanced reward learning rates (mean difference [MD], 0.21; 95% highest density interval [HDI], 0.04-0.38) but decreased punishment learning rates (MD, -0.29; 95% HDI, -0.39 to -0.18), reinforcement sensitivity (MD, -4.91; 95% HDI, -9.38 to -1.12), and stickiness (MD, -0.35; 95% HDI, -0.57 to -0.11) compared with controls. There were no group differences on standard WCST measures and computational model parameters. However, patients who received serotonergic medication showed slower response times (mean [SD], 1420.49 [279.71] milliseconds for controls, 1471.42 [212.81] milliseconds for patients who were unmedicated, and 1738.25 [349.23] milliseconds for patients who were medicated) (control vs medicated MD, -320.26 [95% CI, -547.00 to -88.68]) and increased unique errors (mean [SD] proportion: 0.001 [0.004] for controls, 0.002 [0.004] for patients who were unmedicated, and 0.008 [0.01] for patients who were medicated) (control vs medicated MD, -0.007 [95% CI, -3.14 to -0.36]) on the WCST. Conclusions and Relevance The results of this cross-sectional study indicated that youths with OCD showed atypical probabilistic reversal learning but were generally unimpaired on the deterministic WCST, although unexpected results were observed for patients receiving serotonergic medication. These findings have implications for reframing the understanding of early-onset OCD as a disorder in which decision-making is associated with uncertainty in the environment, a potential target for therapeutic treatment. These results provide continuity with findings in adults with OCD.
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Affiliation(s)
- Aleya A. Marzuki
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- International University Malaya–Wales, Kuala Lumpur, Malaysia
| | - Ivan Tomić
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Samantha Hiu Yan Ip
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Julia Gottwald
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jonathan W. Kanen
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Muzaffer Kaser
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Akeem Sule
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Anna Conway-Morris
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Barbara J. Sahakian
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Trevor W. Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
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Saleh Y, Le Heron C, Petitet P, Veldsman M, Drew D, Plant O, Schulz U, Sen A, Rothwell PM, Manohar S, Husain M. Apathy in small vessel cerebrovascular disease is associated with deficits in effort-based decision making. Brain 2021; 144:1247-1262. [PMID: 33734344 PMCID: PMC8240747 DOI: 10.1093/brain/awab013] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/23/2020] [Accepted: 11/04/2020] [Indexed: 11/16/2022] Open
Abstract
Patients with small vessel cerebrovascular disease frequently suffer from apathy, a debilitating neuropsychiatric syndrome, the underlying mechanisms of which remain to be established. Here we investigated the hypothesis that apathy is associated with disrupted decision making in effort-based decision making, and that these alterations are associated with abnormalities in the white matter network connecting brain regions that underpin such decisions. Eighty-two patients with MRI evidence of small vessel disease were assessed using a behavioural paradigm as well as diffusion weighted MRI. The decision-making task involved accepting or rejecting monetary rewards in return for performing different levels of physical effort (hand grip force). Choice data and reaction times were integrated into a drift diffusion model that framed decisions to accept or reject offers as stochastic processes approaching a decision boundary with a particular drift rate. Tract-based spatial statistics were used to assess the relationship between white matter tract integrity and apathy, while accounting for depression. Overall, patients with apathy accepted significantly fewer offers on this decision-making task. Notably, while apathetic patients were less responsive to low rewards, they were also significantly averse to investing in high effort. Significant reductions in white matter integrity were observed to be specifically related to apathy, but not to depression. These included pathways connecting brain regions previously implicated in effort-based decision making in healthy people. The drift rate to decision parameter was significantly associated with both apathy and altered white matter tracts, suggesting that both brain and behavioural changes in apathy are associated with this single parameter. On the other hand, depression was associated with an increase in the decision boundary, consistent with an increase in the amount of evidence required prior to making a decision. These findings demonstrate altered effort-based decision making for reward in apathy, and also highlight dissociable mechanisms underlying apathy and depression in small vessel disease. They provide clear potential brain and behavioural targets for future therapeutic interventions, as well as modelling parameters that can be used to measure the effects of treatment at the behavioural level.
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Affiliation(s)
- Youssuf Saleh
- Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, UK.,Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK
| | - Campbell Le Heron
- Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, UK.,New Zealand Brain Research Institute, Christchurch 8011, New Zealand.,Department of Medicine, University of Otago, Christchurch 8011, New Zealand
| | - Pierre Petitet
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK
| | - Michele Veldsman
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK
| | - Daniel Drew
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK
| | - Olivia Plant
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK
| | - Ursula Schulz
- Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Arjune Sen
- Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, UK.,Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Peter M Rothwell
- Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, UK.,Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Dept Clinical Neurosciences, University of Oxford, UK
| | - Sanjay Manohar
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, UK.,Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK.,NIHR Oxford Biomedical Research Centre, Oxford, UK.,Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
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8
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Mandali A, Sethi A, Cercignani M, Harrison NA, Voon V. Shifting uncertainty intolerance: methylphenidate and attention-deficit hyperactivity disorder. Transl Psychiatry 2021; 11:12. [PMID: 33414411 PMCID: PMC7791121 DOI: 10.1038/s41398-020-01118-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 10/24/2020] [Accepted: 11/16/2020] [Indexed: 12/27/2022] Open
Abstract
Risk evaluation is a critical component of decision making. Risk tolerance is relevant in both daily decisions and pathological disorders such as attention-deficit hyperactivity disorder (ADHD), where impulsivity is a cardinal symptom. Methylphenidate, a commonly prescribed drug in ADHD, improves attention but has mixed reports on risk-based decision making. Using a double-blinded placebo protocol, we studied the risk attitudes of ADHD patients and age-matched healthy volunteers while performing the 2-step sequential learning task and examined the effect of methylphenidate on their choices. We then applied a novel computational analysis using the hierarchical drift-diffusion model to extract parameters such as threshold ('a'-amount of evidence accumulated before making a decision), drift rate ('v'-information processing speed) and response bias ('z' apriori bias towards a specific choice) focusing specifically on risky choice preference. Critically, we show that ADHD patients on placebo have an apriori bias towards risky choices compared to controls. Furthermore, methylphenidate enhanced preference towards risky choices (higher apriori bias) in both groups but had a significantly greater effect in the patient population independent of clinical scores. Thus, methylphenidate appears to shift tolerance towards risky uncertain choices possibly mediated by prefrontal dopaminergic and noradrenergic modulation. We emphasise the utility of computational models in detecting underlying processes. Our findings have implications for subtle yet differential effects of methylphenidate on ADHD compared to healthy population.
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Affiliation(s)
- Alekhya Mandali
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Arjun Sethi
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - Mara Cercignani
- grid.12082.390000 0004 1936 7590Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Neil A. Harrison
- grid.5600.30000 0001 0807 5670Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UK
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
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9
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Bernardes ET, Saraiva LC, e Souza MDM, Hoexter MQ, Chacon P, Requena G, Miguel EC, Shavitt RG, Polanczyk GV, Cappi C, Batistuzzo MC. Cognitive performance in children and adolescents at high-risk for obsessive-compulsive disorder. BMC Psychiatry 2020; 20:380. [PMID: 32690046 PMCID: PMC7370498 DOI: 10.1186/s12888-020-02751-5] [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: 06/06/2019] [Accepted: 06/23/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Cognitive performance has been studied in adults with obsessive-compulsive symptoms (OCS) and in adult relatives of patients with obsessive-compulsive disorder (OCD) Meanwhile, few studies have been conducted with children under the same conditions. This study compared the neurocognitive domains previously associated with dysfunction in OCD, especially visuoconstructive ability, visuospatial memory, executive functions, and intelligence, in children and adolescents at high risk (HR) for OCD (n = 18) and non-OCD controls (NOC) (n = 31). METHODS For the HR group, we considered the first-degree relatives of patients with OCD that present OCS, but do not meet diagnostic criteria for OCD. Psychiatric diagnosis was assessed by experienced clinicians using the Structured Clinical Interview for DSM-IV and OCS severity was measured by the Yale-Brown Obsessive-Compulsive Scale. Neurocognitive assessment was performed with a comprehensive neuropsychological battery. Performance on the cognitive domains was compared between groups using Multivariate Analysis of Variance, whereas performance on the neuropsychological variables was compared between groups using independent t-tests in a cognitive subdomain analysis. RESULTS The cognitive domain analysis revealed a trend towards significance for impairments in the motor and processing speed domain (p = 0.019; F = 3.12) in the HR group. Moreover, the cognitive subdomain analysis identified a statistically significant underperformance in spatial working memory in the HR group when compared to the NOC group (p = 0.005; t = - 2.94), and a trend towards significance for impairments in non-verbal memory and visuoconstructive tasks in the HR group. CONCLUSIONS Our results suggest impairments in spatial working memory and motor and processing speed in a non-clinical sample of HR participants. Considering the preliminary nature of our findings, further studies investigating these neurocognitive domains as potential predictors of pediatric OCD are warranted.
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Affiliation(s)
- Elisa Teixeira Bernardes
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP, Brazil.
| | - Leonardo Cardoso Saraiva
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP Brazil
| | - Marina de Marco e Souza
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP Brazil
| | - Marcelo Queiroz Hoexter
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP Brazil
| | - Priscila Chacon
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP Brazil
| | - Guaraci Requena
- grid.12799.340000 0000 8338 6359Instituto de Ciencias Exatas e Tecnologicas da Universidade Federal de Vicosa, Viçosa, Brazil
| | - Euripedes Constantino Miguel
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP Brazil
| | - Roseli Gedanke Shavitt
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP Brazil
| | - Guilherme Vanoni Polanczyk
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP Brazil
| | - Carolina Cappi
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP Brazil
| | - Marcelo Camargo Batistuzzo
- grid.11899.380000 0004 1937 0722Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP Brazil ,grid.412529.90000 0001 2149 6891Curso de Psicologia, Faculdade de Ciências Humanas e da Saúde, Pontifícia Universidade Católica de São Paulo, Sao Paulo, SP Brazil
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10
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The influence of subcortical shortcuts on disordered sensory and cognitive processing. Nat Rev Neurosci 2020; 21:264-276. [PMID: 32269315 DOI: 10.1038/s41583-020-0287-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2020] [Indexed: 12/14/2022]
Abstract
The very earliest stages of sensory processing have the potential to alter how we perceive and respond to our environment. These initial processing circuits can incorporate subcortical regions, such as the thalamus and brainstem nuclei, which mediate complex interactions with the brain's cortical processing hierarchy. These subcortical pathways, many of which we share with other animals, are not merely vestigial but appear to function as 'shortcuts' that ensure processing efficiency and preservation of vital life-preserving functions, such as harm avoidance, adaptive social interactions and efficient decision-making. Here, we propose that functional interactions between these higher-order and lower-order brain areas contribute to atypical sensory and cognitive processing that characterizes numerous neuropsychiatric disorders.
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11
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Rowe J. Editorial. Brain 2020; 143:381-382. [PMID: 32040560 DOI: 10.1093/brain/awaa010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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12
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Evans NJ, Wagenmakers EJ. Theoretically meaningful models can answer clinically relevant questions. Brain 2019; 142:1172-1175. [PMID: 31032844 PMCID: PMC6511748 DOI: 10.1093/brain/awz073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Nathan J Evans
- Department of Psychology, University of Amsterdam, The Netherlands
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