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Pollok B, Depperschmidt C, Koester M, Schmidt-Wilcke T, Krause V. Cathodal high-definition transcranial direct current stimulation (HD-tDCS) of the left ventral prefrontal cortex (vPFC) interferes with conscious error correction. Behav Brain Res 2023; 454:114661. [PMID: 37696453 DOI: 10.1016/j.bbr.2023.114661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 09/13/2023]
Abstract
Precise motor timing requires the ability to flexibly adapt one's own movements with respect to changes in the environment. Previous studies suggest that the correction of perceived as compared to non-perceived timing errors involves at least partially distinct brain networks. The dorsolateral prefrontal cortex (dPFC) has been linked to the correction of perceived timing errors and evidence for a contribution of the ventrolateral PFC (vPFC) specifically to the correction of non-perceived errors exists. The present study aimed at clarifying the functional contribution of the left vPFC for the correction of timing errors by adopting high-definition transcranial direct current stimulation (HD-tDCS). Twenty-one young healthy volunteers synchronized their right index finger taps with respect to an isochronous auditory pacing signal. Perceivable and non-perceivable step-changes of the metronome were interspersed, and error correction was analyzed by means of the phase-correction response (PCR). In subsequent sessions anodal and cathodal HD-tDCS was applied to the left vPFC to establish a brain-behavior relationship. Sham stimulation served as control condition. Synchronization accuracy as well as error correction were determined immediately prior to and after HD-tDCS. The analysis suggests a detrimental effect of cathodal HD-tDCS distinctively on error correction in trials with perceived timing errors. The data support the significance of the left vPFC for error correction in the temporal domain but contradicts the view of a role in the correction of non-perceived errors.
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Affiliation(s)
- Bettina Pollok
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany.
| | - Carina Depperschmidt
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Maximilian Koester
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Tobias Schmidt-Wilcke
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany; Center of Neurology, District Hospital Mainkofen, 94469 Deggendorf, Germany
| | - Vanessa Krause
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany; Department of Neuropsychology, Mauritius Hospital and Neurorehabilitation Center Meerbusch, 40670 Meerbusch, Germany
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Liu S, Shi C, Meng H, Meng Y, Gong X, Chen X, Tao L. Cognitive control subprocess deficits and compensatory modulation mechanisms in patients with frontal lobe injury revealed by EEG markers: a basic study to guide brain stimulation. Gen Psychiatr 2023; 36:e101144. [PMID: 37720910 PMCID: PMC10503333 DOI: 10.1136/gpsych-2023-101144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/22/2023] [Indexed: 09/19/2023] Open
Abstract
Background Frontal lobe injury (FLI) is related to cognitive control impairments, but the influences of FLI on the internal subprocesses of cognitive control remain unclear. Aims We sought to identify specific biomarkers for long-term dysfunction or compensatory modulation in different cognitive control subprocesses. Methods A retrospective case-control study was conducted. Event-related potentials (ERP), oscillations and functional connectivity were used to analyse electroencephalography (EEG) data from 12 patients with unilateral frontal lobe injury (UFLI), 12 patients with bilateral frontal lobe injury (BFLI) and 26 healthy controls (HCs) during a Go/NoGo task, which included several subprocesses: perceptual processing, anticipatory preparation, conflict monitoring and response decision. Results Compared with the HC group, N2 (the second negative peak in the averaged ERP waveform) latency, and frontal and parietal oscillations were decreased only in the BFLI group, whereas P3 (the third positive peak in the averaged ERP waveform) amplitudes and sensorimotor oscillations were decreased in both patient groups. The functional connectivity of the four subprocesses was as follows: alpha connections of posterior networks in the BFLI group were lower than in the HC and UFLI groups, and these alpha connections were negatively correlated with neuropsychological tests. Theta connections of the dorsal frontoparietal network in the bilateral hemispheres of the BFLI group were lower than in the HC and UFLI groups, and these connections in the uninjured hemisphere of the UFLI group were higher than in the HC group, which were negatively correlated with behavioural performances. Delta and theta connections of the midfrontal-related networks in the BFLI group were lower than in the HC group. Theta across-network connections in the HC group were higher than in the BFLI group but lower than in the UFLI group. Conclusions The enhancement of low-frequency connections reflects compensatory mechanisms. In contrast, alpha connections are the opposite, therefore revealing more abnormal neural activity and less compensatory connectivity as the severity of injury increases. The nodes of the above networks may serve as stimulating targets for early treatment to restore corresponding functions. EEG biomarkers can measure neuromodulation effects in heterogeneous patients.
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Affiliation(s)
- Sinan Liu
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Affiliated Guangji Hospital, Soochow University, Suzhou, Jiangsu, China
- Department of Forensic Medicine, Institute of Forensic Medicine and Laboratory Medicine, Jining Medical University, Jining, Shandong, China
| | - Chaoqun Shi
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Affiliated Guangji Hospital, Soochow University, Suzhou, Jiangsu, China
- Department of Pathology, Forensic and Pathology Laboratory, Institute of Forensic Science, Jiaxing University, Jiaxing, Zhejiang, China
| | - Huanhuan Meng
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Affiliated Guangji Hospital, Soochow University, Suzhou, Jiangsu, China
- Department of Forensic Medicine, Institute of Forensic Medicine and Laboratory Medicine, Jining Medical University, Jining, Shandong, China
| | - Yu Meng
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Affiliated Guangji Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Xin Gong
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Affiliated Guangji Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Xiping Chen
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Affiliated Guangji Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Luyang Tao
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Affiliated Guangji Hospital, Soochow University, Suzhou, Jiangsu, China
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Liao YC, Guo NW, Su BY, Chen SJ, Tsai HF. Effects of Twenty Hours of Neurofeedback-Based Neuropsychotherapy on the Executive Functions and Achievements among ADHD Children. Clin EEG Neurosci 2022; 53:387-398. [PMID: 35611492 DOI: 10.1177/15500594221101693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. Neurofeedback can reduce ADHD symptoms; however, current programs are relatively long, with fewer concerns about executive function (EF). The present study aimed to investigate a 20-hour combined computerized training neurofeedback program. Methods. Fifty ADHD children were randomly assigned to either the experimental group (EXP) or the wait-list control group (CON), who took training after the post-tests. The EF measures were the Tower of London (ToL), Wisconsin Card Sorting Test (WCST), and Comprehensive Nonverbal Attention Test (CNAT). SNAP-IV and questionnaires reported by parents constituted the behavioral measures. Two-way repeated-measures ANOVA and bootstrapping dependent t-tests were also used. Results. The F-tests revealed the interaction effects on ADHD symptoms and math scores. The EXP had increased the ToL scores, decreased the error and perseverative error rates on WCST, as well as the dysexecutive index on CNAT in the t-test. Conclusions. The training effects were related to behavioral symptoms and functions, EFs, and generalized achievement performances. We suggest that future studies could apply to different patients and examine the maintenance of the program.
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Affiliation(s)
- Yu-Chi Liao
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.,Clinical Psychology Center, Asia University Hospital, Taichung, Taiwan
| | - Nai-Wen Guo
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Taichung, Taiwan.,Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taichung, Taiwan
| | - Bei-Yi Su
- Department of Psychology, Chung-Shan Medical University, Taichung, Taiwan.,Room of Clinical Psychology, Chung Shan Medical University Hospital, Taichung, Taiwan
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Transcriptome Profiling of the Dorsomedial Prefrontal Cortex in Suicide Victims. Int J Mol Sci 2022; 23:ijms23137067. [PMID: 35806070 PMCID: PMC9266666 DOI: 10.3390/ijms23137067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 01/27/2023] Open
Abstract
The default mode network (DMN) plays an outstanding role in psychiatric disorders. Still, gene expressional changes in its major component, the dorsomedial prefrontal cortex (DMPFC), have not been characterized. We used RNA sequencing in postmortem DMPFC samples to investigate suicide victims compared to control subjects. 1400 genes differed using log2FC > ±1 and adjusted p-value < 0.05 criteria between groups. Genes associated with depressive disorder, schizophrenia and impaired cognition were strongly overexpressed in top differentially expressed genes. Protein−protein interaction and co-expressional networks coupled with gene set enrichment analysis revealed that pathways related to cytokine receptor signaling were enriched in downregulated, while glutamatergic synaptic signaling upregulated genes in suicidal individuals. A validated differentially expressed gene, which is known to be associated with mGluR5, was the N-terminal EF-hand calcium-binding protein 2 (NECAB2). In situ hybridization histochemistry and immunohistochemistry proved that NECAB2 is expressed in two different types of inhibitory neurons located in layers II-IV and VI, respectively. Our results imply extensive gene expressional alterations in the DMPFC related to suicidal behavior. Some of these genes may contribute to the altered mental state and behavior of suicide victims.
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Liebrand M, Solbakk AK, Funderud I, Buades-Rotger M, Knight RT, Krämer UM. Intact Proactive Motor Inhibition after Unilateral Prefrontal Cortex or Basal Ganglia Lesions. J Cogn Neurosci 2021; 33:1862-1879. [PMID: 34375417 DOI: 10.1162/jocn_a_01691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Previous research provided evidence for the critical importance of the PFC and BG for reactive motor inhibition, that is, when actions are cancelled in response to external signals. Less is known about the role of the PFC and BG in proactive motor inhibition, referring to preparation for an upcoming stop signal. In this study, patients with unilateral lesions to the BG or lateral PFC performed in a cued go/no-go task, whereas their EEG was recorded. The paradigm called for cue-based preparation for upcoming, lateralized no-go signals. Based on previous findings, we focused on EEG indices of cognitive control (prefrontal beta), motor preparation (sensorimotor mu/beta, contingent negative variation [CNV]), and preparatory attention (occipital alpha, CNV). On a behavioral level, no differences between patients and controls were found, suggesting an intact ability to proactively prepare for motor inhibition. Patients showed an altered preparatory CNV effect, but no other differences in electrophysiological activity related to proactive and reactive motor inhibition. Our results suggest a context-dependent role of BG and PFC structures in motor inhibition, being critical in reactive, unpredictable contexts, but less so in situations where one can prepare for stopping on a short timescale.
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Affiliation(s)
| | - Anne-Kristin Solbakk
- University of Oslo, Norway.,Oslo University Hospital, Norway.,Helgeland Hospital, Mosjøen, Norway
| | - Ingrid Funderud
- University of Oslo, Norway.,Helgeland Hospital, Mosjøen, Norway
| | - Macià Buades-Rotger
- University of Lübeck, Germany.,Radboud University, Nijmegen, The Netherlands
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6
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Zhang F, Wang S, Feng Y, Qin K, Li H, Wu B, Jia Z, Gong Q. Regional gray matter volume associated with exercise dependence: A voxel-based morphometry study. Hum Brain Mapp 2021; 42:4857-4868. [PMID: 34236128 PMCID: PMC8449116 DOI: 10.1002/hbm.25585] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 06/07/2021] [Accepted: 06/26/2021] [Indexed: 02/05/2023] Open
Abstract
Although regular physical exercise has multiple positive benefits for the general population, excessive exercise may lead to exercise dependence (EXD), which is harmful to one's physical and mental health. Increasing evidence suggests that stress is a potential risk factor for the onset and development of EXD. However, little is known about the neural substrates of EXD and the underlying neuropsychological mechanism by which stress affects EXD. Herein, we investigate these issues in 86 individuals who exercise regularly by estimating their cortical gray matter volume (GMV) utilizing a voxel‐based morphometry method based on structural magnetic resonance imaging. Whole‐brain correlation analyses and prediction analyses showed negative relationships between EXD and GMV of the right orbitofrontal cortex (OFC), left subgenual cingulate gyrus (sgCG), and left inferior parietal lobe (IPL). Furthermore, mediation analyses found that the GMV of the right OFC was an important mediator between stress and EXD. Importantly, these results remained significant even when adjusting for sex, age, body mass index, family socioeconomic status, general intelligence and total intracranial volume, as well as depression and anxiety. Collectively, the results of the present study provide crucial evidence of the neuroanatomical basis of EXD and reveal a potential neuropsychological pathway in predicting EXD in which GMV mediates the relationship between stress and EXD.
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Affiliation(s)
- Feifei Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Yang Feng
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Kun Qin
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Huiru Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Baolin Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Zhiyun Jia
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, China.,Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
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Roles of the prefrontal cortex in learning to time the onset of pre-existing motor programs. PLoS One 2020; 15:e0241562. [PMID: 33166309 PMCID: PMC7652266 DOI: 10.1371/journal.pone.0241562] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 10/19/2020] [Indexed: 11/19/2022] Open
Abstract
The prefrontal cortex (PFC) is involved in cognitive control of motor activities and timing of future intensions. This study investigated the cognitive control of balance recovery in response to unpredictable gait perturbations and the role of PFC subregions in learning by repetition. Bilateral dorsolateral (DLPFC), ventrolateral (VLPFC), frontopolar (FPFC) and orbitofrontal (OFC) cortex hemodynamic changes induced by unpredictable slips were analyzed as a function of successive trials in ten healthy young adults. Slips were induced by the acceleration of one belt as the participant walked on a split-belt treadmill. A portable functional near-infrared spectroscope monitored PFC activities quantified by oxyhemoglobin (ΔO2Hb) and deoxyhemoglobin (ΔHbR) during the consecutive trial phases: standing, walking, slip-recovery. During the first 3 trials, the average oxyhemoglobin (ΔO2Hbavg) in the DLPFC, VLPFC, FPFC, and OFC cortex was significantly higher during slip-recovery than unperturbed walking or the standing baseline. Then, ΔO2Hbavg decreased progressively from trial-to-trial in the DLPFC, VLPFC, and FPFC, but increased and then remained constant in the OFC. The average deoxyhemoglobin (ΔHbRavg) presented mirror patterns. These changes after the third trial were paralleled by the progressive improvement of recovery revealed by kinematic variables. The results corroborate our previous hypothesis that only timing of the onset of a “good enough recovery motor program” is learned with practice. They also strongly support the assumption that the PFC contributes to the recall of pre-existing motor programs whose onset timing is adjusted by the OFC. Hence, learning is clearly divided into two steps delineated by the switch in activity of the OFC. Additionally, motor processes appear to share the working memory as well as decisional and predictive resources of the cognitive system.
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Casals-Gutiérrez S, Abbey H. Interoception, mindfulness and touch: A meta-review of functional MRI studies. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2019.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Zhou YQ, Zhang LY, Yu ZP, Zhang XQ, Shi J, Shen HW. Tropisetron Facilitates Footshock Suppression of Compulsive Cocaine Seeking. Int J Neuropsychopharmacol 2019; 22:574-584. [PMID: 31125405 PMCID: PMC6754734 DOI: 10.1093/ijnp/pyz023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/25/2019] [Accepted: 05/23/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The hallmark characteristics of the murine model of drug addiction include the escalation of cocaine consumption and compulsive punishment-resistant drug seeking. In this study, we evaluated the motivation for drug seeking in cocaine self-administering rats exposed to an escalated dosing regimen that endeavored to mimic the characteristic of escalating drug intake in human addicts. Tropisetron is a 5-HT3 receptor antagonist and α7-nicotinic receptor partial agonist. Utilizing rats trained on the escalated-dosing regimen, we examined the effects of tropisetron on control over compulsive drug-seeking behavior that was defined as footshock-resistant lever pressing. METHODS Rats were trained to self-administer cocaine with incremental-infusion doses (from 0.6 to 2.4 mg/kg/infusion) across training sessions (3 h/session) or with a long-access paradigm (i.e., 0.6 mg/kg/infusion, 6 h/d training session). The drug-seeking motivations of 2 groups were estimated by the patterns of drug intake and progressive-ratio schedule. The compulsivity for drug seeking of the group with an escalated dose was further evaluated using the footshock-associated seeking-taking chain task. RESULTS The rats trained on the dose-escalated protocol achieved the same levels of motivated drug seeking as those subjected to a long-access paradigm, as indicated by cocaine intake per training session and breakpoints on a progressive ratio schedule. Tropisetron attenuated compulsive behavior of rats when pressing of the seeking lever potentially led to footshock. Intriguingly, tropisetron did not change the motivation to seek cocaine when footshock was absent. Tropisetron had no effect on locomotor activities or saccharin self-administration. CONCLUSIONS These results demonstrate that tropisetron restored control over compulsive cocaine seeking, and they indicate that 5-HT3/α7-nicotinic receptors may be potential therapeutic targets for relieving compulsive drug seeking.
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Affiliation(s)
- Yue-Qing Zhou
- Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Lan-Yuan Zhang
- Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Zhi-Peng Yu
- Department of Pharmacology, Medical School of Ningbo University, WangChanglai, Ningbo, Zhejiang, China
| | - Xiao-Qin Zhang
- Department of Pharmacology, Medical School of Ningbo University, WangChanglai, Ningbo, Zhejiang, China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University, Beijing, China,Correspondence: H. W. Shen, PhD, Department of Pharmacology, 818 Fenghua Rd., WangChanglai A403, Ningbo, Zhejiang 315211, China (); and J. Shi, PhD, National Institute on Drug Dependence, Peking University, Beijing, China ()
| | - Hao-Wei Shen
- Department of Pharmacology, Medical School of Ningbo University, WangChanglai, Ningbo, Zhejiang, China,Correspondence: H. W. Shen, PhD, Department of Pharmacology, 818 Fenghua Rd., WangChanglai A403, Ningbo, Zhejiang 315211, China (); and J. Shi, PhD, National Institute on Drug Dependence, Peking University, Beijing, China ()
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Zhou F, Montag C, Sariyska R, Lachmann B, Reuter M, Weber B, Trautner P, Kendrick KM, Markett S, Becker B. Orbitofrontal gray matter deficits as marker of Internet gaming disorder: converging evidence from a cross-sectional and prospective longitudinal design. Addict Biol 2019; 24:100-109. [PMID: 29057579 DOI: 10.1111/adb.12570] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 07/28/2017] [Accepted: 09/11/2017] [Indexed: 01/16/2023]
Abstract
Internet gaming disorder represents a growing health issue. Core symptoms include unsuccessful attempts to control the addictive patterns of behavior and continued use despite negative consequences indicating a loss of regulatory control. Previous studies revealed brain structural deficits in prefrontal regions subserving regulatory control in individuals with excessive Internet use. However, because of the cross-sectional nature of these studies, it remains unknown whether the observed brain structural deficits preceded the onset of excessive Internet use. Against this background, the present study combined a cross-sectional and longitudinal design to determine the consequences of excessive online video gaming. Forty-one subjects with a history of excessive Internet gaming and 78 gaming-naive subjects were enrolled in the present study. To determine effects of Internet gaming on brain structure, gaming-naive subjects were randomly assigned to 6 weeks of daily Internet gaming (training group) or a non-gaming condition (training control group). At study inclusion, excessive Internet gamers demonstrated lower right orbitofrontal gray matter volume compared with Internet gaming-naive subjects. Within the Internet gamers, a lower gray matter volume in this region was associated with higher online video gaming addiction severity. Longitudinal analysis revealed initial evidence that left orbitofrontal gray matter volume decreased during the training period in the training group as well as in the group of excessive gamers. Together, the present findings suggest an important role of the orbitofrontal cortex in the development of Internet addiction with a direct association between excessive engagement in online gaming and structural deficits in this brain region.
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Affiliation(s)
- Feng Zhou
- Key Laboratory for NeuroInformation, Center for Information in Medicine, School of Life Science and Technology; University of Electronic Science and Technology of China; China
| | - Christian Montag
- Key Laboratory for NeuroInformation, Center for Information in Medicine, School of Life Science and Technology; University of Electronic Science and Technology of China; China
- Institute of Psychology and Education; Ulm University; Germany
| | - Rayna Sariyska
- Institute of Psychology and Education; Ulm University; Germany
| | - Bernd Lachmann
- Institute of Psychology and Education; Ulm University; Germany
| | - Martin Reuter
- Department of Psychology; University of Bonn; Germany
- Center for Economics and Neuroscience; University of Bonn; Germany
| | - Bernd Weber
- Center for Economics and Neuroscience; University of Bonn; Germany
- Department for NeuroCognition; Life & Brain Center; Germany
- Department of Epileptology; University Hospital of Bonn; Germany
| | - Peter Trautner
- Department for NeuroCognition; Life & Brain Center; Germany
| | - Keith M. Kendrick
- Key Laboratory for NeuroInformation, Center for Information in Medicine, School of Life Science and Technology; University of Electronic Science and Technology of China; China
| | - Sebastian Markett
- Department of Psychology; University of Bonn; Germany
- Center for Economics and Neuroscience; University of Bonn; Germany
| | - Benjamin Becker
- Key Laboratory for NeuroInformation, Center for Information in Medicine, School of Life Science and Technology; University of Electronic Science and Technology of China; China
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Burks JD, Conner AK, Bonney PA, Glenn CA, Baker CM, Boettcher LB, Briggs RG, O’Donoghue DL, Wu DH, Sughrue ME. Anatomy and white matter connections of the orbitofrontal gyrus. J Neurosurg 2018; 128:1865-1872. [DOI: 10.3171/2017.3.jns162070] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVEThe orbitofrontal cortex (OFC) is understood to have a role in outcome evaluation and risk assessment and is commonly involved with infiltrative tumors. A detailed understanding of the exact location and nature of associated white matter tracts could significantly improve postoperative morbidity related to declining capacity. Through diffusion tensor imaging–based fiber tracking validated by gross anatomical dissection as ground truth, the authors have characterized these connections based on relationships to other well-known structures.METHODSDiffusion imaging from the Human Connectome Project for 10 healthy adult controls was used for tractography analysis. The OFC was evaluated as a whole based on connectivity with other regions. All OFC tracts were mapped in both hemispheres, and a lateralization index was calculated with resultant tract volumes. Ten postmortem dissections were then performed using a modified Klingler technique to demonstrate the location of major tracts.RESULTSThe authors identified 3 major connections of the OFC: a bundle to the thalamus and anterior cingulate gyrus, passing inferior to the caudate and medial to the vertical fibers of the thalamic projections; a bundle to the brainstem, traveling lateral to the caudate and medial to the internal capsule; and radiations to the parietal and occipital lobes traveling with the inferior fronto-occipital fasciculus.CONCLUSIONSThe OFC is an important center for processing visual, spatial, and emotional information. Subtle differences in executive functioning following surgery for frontal lobe tumors may be better understood in the context of the fiber-bundle anatomy highlighted by this study.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Dee H. Wu
- 3Radiological Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Buse J, Beste C, Roessner V. Neural correlates of prediction violations in boys with Tourette syndrome: Evidence from harmonic expectancy. World J Biol Psychiatry 2018; 19:130-141. [PMID: 28010171 DOI: 10.1080/15622975.2016.1274052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES It has been suggested that Tourette syndrome (TS) might be associated with alterations of the attention system, but the nature of these alterations and the underlying neuroanatomical network remains elusive. We aimed at investigating the functional neuroanatomical modulators of attention allocation towards predictable versus unpredictable stimuli in boys with TS. METHODS Using functional magnetic resonance imaging, we ran a harmonic expectancy violation paradigm in 17 boys with TS and 23 matched healthy controls (HCs). We presented chord sequence in which the first four chords induced a strong expectancy for a harmonic chord at the next position. In 70% this expectancy was fulfilled (harmonic), in 30% the expectancy was violated (disharmonic). RESULTS HCs responded faster to the disharmonic compared to harmonic chords, indicating a stronger attention allocation towards unpredictable stimuli, while this effect was not found in boys with TS. HCs showed stronger anterior cingulate cortex (ACC) activation during disharmonic compared to harmonic chords. Boys with TS showed stronger ACC activation during harmonic chords, which was associated with greater tic severity. CONCLUSIONS Our findings indicate that boys with TS showed altered reactions towards predictable versus unpredictable stimuli in brain regions playing an important role in attention control. This might indicate altered allocation of attention towards those stimuli.
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Affiliation(s)
- Judith Buse
- a Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden , Dresden , Germany
| | - Christian Beste
- a Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden , Dresden , Germany.,b Experimental Neurobiology , National Institute of Mental Health , Klecany , Czech Republic
| | - Veit Roessner
- a Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden , Dresden , Germany
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Su H, Zhong N, Gan H, Wang J, Han H, Chen T, Li X, Ruan X, Zhu Y, Jiang H, Zhao M. High frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex for methamphetamine use disorders: A randomised clinical trial. Drug Alcohol Depend 2017; 175:84-91. [PMID: 28410525 DOI: 10.1016/j.drugalcdep.2017.01.037] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 12/14/2016] [Accepted: 01/26/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is a brain stimulation and modulation electrophysiological technique, it can change cortical excitability of target brain region, modulate neuron plasticity and brain connections. Previous researches indicated that rTMS could reduce cue-induced craving in drug addiction. OBJECTIVE In this study, we employed real and sham rTMS of the left dorsolateral prefrontal cortex (DLPFC) to test whether it could reduce cue-induced craving for methamphetamine (MA) and influence cognitive function in a randomised clinical trial. METHODS Thirty MA-addicted patients were randomized to receive 5 sessions of 8min sham or 10Hz rTMS to the left DLPFC. Subjects rated their craving at baseline, after exposed to MA-associated cues and after rTMS sessions. RESULTS Real rTMS over the left DLPFC reduced craving significantly after 5 sessions of rTMS as compared to sham stimulation. Furthermore, real rTMS improved verbal learning and memory and social cognition in MA-addicted patients. CONCLUSIONS The present study suggests that 10Hz rTMS of the left DLPFC may reduce craving and have no negative effects on cognitive function in MA-addicted patients, supporting the safety of rTMS in treating MA addiction.
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Affiliation(s)
- Hang Su
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Zhong
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Gan
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jijun Wang
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Han
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianzhen Chen
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaotong Li
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaolu Ruan
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Youwei Zhu
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haifeng Jiang
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Zhao
- Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China.
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Slaker M, Barnes J, Sorg BA, Grimm JW. Impact of Environmental Enrichment on Perineuronal Nets in the Prefrontal Cortex following Early and Late Abstinence from Sucrose Self-Administration in Rats. PLoS One 2016; 11:e0168256. [PMID: 27977779 PMCID: PMC5158028 DOI: 10.1371/journal.pone.0168256] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/28/2016] [Indexed: 11/24/2022] Open
Abstract
Perineuronal nets (PNNs) are aggregates of extracellular matrix that form structures surrounding a subset of GABAergic interneurons. The staining intensity of PNNs appears to be related to plasticity. Environmental enrichment (EE) influences plasticity during adulthood: EE decreases the rewarding effects of drugs of abuse and diminishes both drug- and sucrose-seeking behavior. We determined the impact of EE on PNN intensity in the medial prefrontal cortex (mPFC) in rats trained to self-administer sucrose. We examined the number and intensity of PNNs within the prelimbic (PL), infralimbic (IL), and orbitofrontal (OF) regions of the mPFC of adult Long-Evans rats that were trained for sucrose self-administration followed by acute or chronic EE during abstinence and a cue-induced reinstatement test. Rats exposed to EE prior to a cue-induced reinstatement of sucrose seeking had an increase in PNN staining compared with rats in standard housing. Conversely, naïve rats given 1 day of EE had a decrease in PNN intensity in the PL, no change in the IL, and an increase in the OF. Our findings demonstrate that EE increases PNN intensity in the mPFC after sucrose training, suggesting that training enhances the ability of EE to increase PNN intensity. We further demonstrate an interaction between time of abstinence, duration of EE exposure, and cue-induced reinstatement. Our results suggest that increased PNN intensity after EE may alter the excitatory/inhibitory balance of mPFC neurons such that rats are less responsive to a sucrose cue.
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Affiliation(s)
- Megan Slaker
- Department of Integrative Physiology and Neuroscience and Translational Addiction Research Center, Washington State University, Vancouver, Washington, United States of America
| | - Jesse Barnes
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington, United States of America
- Department of Psychology and Behavioral Neuroscience Program, Western Washington University, Bellingham, Washington, United States of America
| | - Barbara A. Sorg
- Department of Integrative Physiology and Neuroscience and Translational Addiction Research Center, Washington State University, Vancouver, Washington, United States of America
- * E-mail:
| | - Jeffrey W. Grimm
- Department of Psychology and Behavioral Neuroscience Program, Western Washington University, Bellingham, Washington, United States of America
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Mäki-Marttunen V, Kuusinen V, Peräkylä J, Ogawa KH, Brause M, Brander A, Hartikainen KM. Greater Attention to Task-Relevant Threat Due to Orbitofrontal Lesion. J Neurotrauma 2016; 34:400-413. [PMID: 27502875 DOI: 10.1089/neu.2015.4390] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Injury to the orbitofrontal cortex (OFC) is a frequent consequence of head injury and may lead to dysfunctional regulation of emotional and social behavior. Dysfunctional emotional behavior may partly be related to the role of the OFC in emotion-attention interaction, as reported previously. In order to better understand its role in emotion-attention and emotion-cognitive control interactions, we investigated attention allocation to task-relevant and task-irrelevant threat-related emotional stimuli during a task requiring cognitive control in patients with lesion to the OFC. We measured the behavioral performance and event-related potentials (ERP) of 13 patients with OFC lesion and 11 control subjects during a Go/NoGo visual discrimination task. In the task, line drawings of threatening (spider) and neutral (flower) figures served as either task-relevant Go or NoGo signals, or as task-irrelevant distractors. Overall performance did not differ between the groups. In contrast to the control group performance, the orbitofrontal group performance was improved by relevant threat signal in comparison with neutral signal. Further, task-relevant threat signals evoked larger frontocentral N2-P3 amplitude in the orbitofrontal group. Taken together, behavioral and electrophysiological results suggest that patients with OFC injury allocated more attentional and cognitive control resources in the context of task-relevant emotional stimuli. This study provides new evidence for the role of the OFC in emotion-attention and emotion-cognitive control interactions. Further, the OFC seems to contribute to the balance between voluntary and involuntary attention networks in context of emotional stimuli. Better understanding of alterations in emotion-attention interaction offers insight into affective dysfunction due to OFC lesion.
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Affiliation(s)
- Verónica Mäki-Marttunen
- 1 Behavioral Neurology Research Unit, Department of Neurosciences and Rehabilitation, Tampere University Hospital , Tampere, Finland .,2 CONICET , Buenos Aires, Argentina
| | - Venla Kuusinen
- 1 Behavioral Neurology Research Unit, Department of Neurosciences and Rehabilitation, Tampere University Hospital , Tampere, Finland .,6 Medical School, University of Tampere , Tampere, Finland
| | - Jari Peräkylä
- 1 Behavioral Neurology Research Unit, Department of Neurosciences and Rehabilitation, Tampere University Hospital , Tampere, Finland .,6 Medical School, University of Tampere , Tampere, Finland
| | - Keith H Ogawa
- 3 John Magaddino Neuroscience Laboratory, Saint Mary's College of California , Moraga, California
| | - Maarja Brause
- 1 Behavioral Neurology Research Unit, Department of Neurosciences and Rehabilitation, Tampere University Hospital , Tampere, Finland
| | - Antti Brander
- 4 Department of Radiology, Tampere University Hospital , Tampere, Finland
| | - Kaisa M Hartikainen
- 1 Behavioral Neurology Research Unit, Department of Neurosciences and Rehabilitation, Tampere University Hospital , Tampere, Finland .,5 Department of Neurology and Rehabilitation, Tampere University Hospital , Tampere, Finland .,6 Medical School, University of Tampere , Tampere, Finland
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16
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ERP Correlates of Proactive and Reactive Cognitive Control in Treatment-Naïve Adult ADHD. PLoS One 2016; 11:e0159833. [PMID: 27448275 PMCID: PMC4957760 DOI: 10.1371/journal.pone.0159833] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 07/08/2016] [Indexed: 11/19/2022] Open
Abstract
This study investigated whether treatment naïve adults with Attention Deficit Hyperactivity Disorder (ADHD; n = 33; 19 female) differed from healthy controls (n = 31; 17 female) in behavioral performance, event-related potential (ERP) indices of preparatory attention (CueP3 and late CNV), and reactive response control (Go P3, NoGo N2, and NoGo P3) derived from a visual cued Go/NoGo task. On several critical measures, Cue P3, late CNV, and NoGo N2, there were no significant differences between the groups. This indicated normal preparatory processes and conflict monitoring in ADHD patients. However, the patients had attenuated Go P3 and NoGoP3 amplitudes relative to controls, suggesting reduced allocation of attentional resources to processes involved in response control. The patients also had a higher rate of Go signal omission errors, but no other performance decrements compared with controls. Reduced Go P3 and NoGo P3 amplitudes were associated with poorer task performance, particularly in the ADHD group. Notably, the ERPs were not associated with self-reported mood or anxiety. The results provide electrophysiological evidence for reduced effortful engagement of attentional resources to both Go and NoGo signals when reactive response control is needed. The absence of group differences in ERP components indexing proactive control points to impairments in specific aspects of cognitive processes in an untreated adult ADHD cohort. The associations between ERPs and task performance provided additional support for the altered electrophysiological responses.
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17
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Flores G, Morales-Medina JC, Diaz A. Neuronal and brain morphological changes in animal models of schizophrenia. Behav Brain Res 2016; 301:190-203. [DOI: 10.1016/j.bbr.2015.12.034] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 12/15/2015] [Accepted: 12/18/2015] [Indexed: 12/14/2022]
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18
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Waggel SE, Lipnicki DM, Delbaere K, Kochan NA, Draper B, Andrews G, Sachdev PS, Brodaty H. Neuroticism scores increase with late-life cognitive decline. Int J Geriatr Psychiatry 2015; 30:985-93. [PMID: 25581393 DOI: 10.1002/gps.4251] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 11/10/2014] [Accepted: 11/21/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Neuroticism has been reported as both a risk factor for cognitive decline and a characteristic that increases in parallel with the development of mild cognitive impairment (MCI) and dementia. However, the evidence for these associations is inconclusive, and whether effects are stronger for particular cognitive domains is unknown. We investigated these issues and determined if associations differ among different components of neuroticism. METHODS A neuroticism scale (NEO-FFI) and neuropsychological test battery were administered to 603 older adults without dementia, with 493 of these reassessed two years later. Diagnoses of MCI and dementia (at follow-up) were made, and global cognition and performance in six cognitive domains quantified. The neuroticism components were negative affect, self-reproach, and proneness to psychological distress. RESULTS For the whole sample, neuroticism scores remained stable between baseline (15.3 ± 7.0) and follow-up (15.5 ± 7.0), as did all neuroticism component scores. However, there were declines in global cognition (p < 0.05) and particular cognitive domains (p < 0.001). Higher neuroticism was associated with poorer cognition cross-sectionally (p < 0.01), but did not predict cognitive decline. For 43 participants who developed incident MCI or dementia, there were increases in neuroticism (15.3 ± 6.4 to 17.1 ± 8.3, p < 0.05) and negative affect (p < 0.05). Declines in all cognitive measures except executive function were associated with increases in neuroticism and component scores (p < 0.05). CONCLUSIONS Late-life cognitive decline is associated with an increase in neuroticism scores. However, associations vary between different cognitive domains and components of neuroticism. An increase in neuroticism or negative affect scores may be a sign of MCI or dementia.
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Affiliation(s)
- Stephanie E Waggel
- School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, UNSW, Australia
| | - Kim Delbaere
- Falls and Balance Research Group, Neuroscience Research Australia, UNSW, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, UNSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, New South Wales, Australia
| | - Brian Draper
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, UNSW, Australia.,Primary Dementia Collaborative Research Centre, School of Psychiatry, UNSW, Australia.,Academic Department for Old Age Psychiatry, Prince of Wales Hospital, New South Wales, Australia
| | | | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, UNSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, New South Wales, Australia.,Primary Dementia Collaborative Research Centre, School of Psychiatry, UNSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, UNSW, Australia.,Primary Dementia Collaborative Research Centre, School of Psychiatry, UNSW, Australia.,Academic Department for Old Age Psychiatry, Prince of Wales Hospital, New South Wales, Australia
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19
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Hosking JG, Cocker PJ, Winstanley CA. Prefrontal Cortical Inactivations Decrease Willingness to Expend Cognitive Effort on a Rodent Cost/Benefit Decision-Making Task. Cereb Cortex 2015; 26:1529-38. [PMID: 25596594 DOI: 10.1093/cercor/bhu321] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Personal success often necessitates expending greater effort for greater reward but, equally important, also requires judicious use of our limited cognitive resources (e.g., attention). Previous animal models have shown that the prelimbic (PL) and infralimbic (IL) regions of the prefrontal cortex (PFC) are not involved in (physical) effort-based choice, whereas human studies have demonstrated PFC contributions to (mental) effort. Here, we utilize the rat Cognitive Effort Task (rCET) to probe PFC's role in effort-based decision making. In the rCET, animals can choose either an easy trial, where the attentional demand is low but the reward (sugar) is small or a difficult trial on which both the attentional demand and reward are greater. Temporary inactivation of PL and IL decreased all animals' willingness to expend mental effort and increased animals' distractibility; PL inactivations more substantially affected performance (i.e., attention), whereas IL inactivations increased motor impulsivity. These data imply that the PFC contributes to attentional resources, and when these resources are diminished, animals shift their choice (via other brain regions) accordingly. Thus, one novel therapeutic approach to deficits in effort expenditure may be to focus on the resources that such decision making requires, rather than the decision-making process per se.
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Affiliation(s)
- Jay G Hosking
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Paul J Cocker
- Department of Psychology, University of British Columbia, Vancouver, Canada
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