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Moccia L, di Luzio M, Conte E, Modica M, Ambrosecchia M, Ardizzi M, Lanzotti P, Kotzalidis GD, Janiri D, Di Nicola M, Janiri L, Gallese V, Sani G. Sense of agency and its disturbances: A systematic review targeting the intentional binding effect in neuropsychiatric disorders. Psychiatry Clin Neurosci 2024; 78:3-18. [PMID: 37755315 DOI: 10.1111/pcn.13601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/12/2023] [Accepted: 09/19/2023] [Indexed: 09/28/2023]
Abstract
Sense of agency (SoA) indicates a person's ability to perceive her/his own motor acts as actually being her/his and, through them, to exert control over the course of external events. Disruptions in SoA may profoundly affect the individual's functioning, as observed in several neuropsychiatric disorders. This is the first article to systematically review studies that investigated intentional binding (IB), a quantitative proxy for SoA measurement, in neurological and psychiatric patients. Eligible were studies of IB involving patients with neurological and/or psychiatric disorders. We included 15 studies involving 692 individuals. Risk of bias was low throughout studies. Abnormally increased action-outcome binding was found in schizophrenia and in patients with Parkinson's disease taking dopaminergic medications or reporting impulsive-compulsive behaviors. A decreased IB effect was observed in Tourette's disorder and functional movement disorders, whereas increased action-outcome binding was found in patients with the cortico-basal syndrome. The extent of IB deviation from healthy control values correlated with the severity of symptoms in several disorders. Inconsistent effects were found for autism spectrum disorders, anorexia nervosa, and borderline personality disorder. Findings pave the way for treatments specifically targeting SoA in neuropsychiatric disorders where IB is altered.
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Affiliation(s)
- Lorenzo Moccia
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Michelangelo di Luzio
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Eliana Conte
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Modica
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marianna Ambrosecchia
- Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy
| | - Martina Ardizzi
- Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy
| | - Pierluigi Lanzotti
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Georgios D Kotzalidis
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- NESMOS Department, University of Rome La Sapienza, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Delfina Janiri
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Luigi Janiri
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Vittorio Gallese
- Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy
- Italian Academy for Advanced Studies in America at Columbia University, New York, New York, USA
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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2
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Hezemans FH, Wolpe N, O’Callaghan C, Ye R, Rua C, Jones PS, Murley AG, Holland N, Regenthal R, Tsvetanov KA, Barker RA, Williams-Gray CH, Robbins TW, Passamonti L, Rowe JB. Noradrenergic deficits contribute to apathy in Parkinson's disease through the precision of expected outcomes. PLoS Comput Biol 2022; 18:e1010079. [PMID: 35533200 PMCID: PMC9119485 DOI: 10.1371/journal.pcbi.1010079] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 05/19/2022] [Accepted: 04/05/2022] [Indexed: 02/06/2023] Open
Abstract
Apathy is a debilitating feature of many neuropsychiatric diseases, that is typically described as a reduction of goal-directed behaviour. Despite its prevalence and prognostic importance, the mechanisms underlying apathy remain controversial. Degeneration of the locus coeruleus-noradrenaline system is known to contribute to motivational deficits, including apathy. In healthy people, noradrenaline has been implicated in signalling the uncertainty of expectations about the environment. We proposed that noradrenergic deficits contribute to apathy by modulating the relative weighting of prior beliefs about action outcomes. We tested this hypothesis in the clinical context of Parkinson's disease, given its associations with apathy and noradrenergic dysfunction. Participants with mild-to-moderate Parkinson's disease (N = 17) completed a randomised double-blind, placebo-controlled, crossover study with 40 mg of the noradrenaline reuptake inhibitor atomoxetine. Prior weighting was inferred from psychophysical analysis of performance in an effort-based visuomotor task, and was confirmed as negatively correlated with apathy. Locus coeruleus integrity was assessed in vivo using magnetisation transfer imaging at ultra-high field 7T. The effect of atomoxetine depended on locus coeruleus integrity: participants with a more degenerate locus coeruleus showed a greater increase in prior weighting on atomoxetine versus placebo. The results indicate a contribution of the noradrenergic system to apathy and potential benefit from noradrenergic treatment of people with Parkinson's disease, subject to stratification according to locus coeruleus integrity. More broadly, these results reconcile emerging predictive processing accounts of the role of noradrenaline in goal-directed behaviour with the clinical symptom of apathy and its potential pharmacological treatment.
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Affiliation(s)
- Frank H. Hezemans
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, United Kingdom
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Noham Wolpe
- Department of Physical Therapy, The Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Claire O’Callaghan
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Brain and Mind Centre and School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Rong Ye
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, United Kingdom
| | - Catarina Rua
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, United Kingdom
| | - P. Simon Jones
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, United Kingdom
| | - Alexander G. Murley
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, United Kingdom
| | - Negin Holland
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, United Kingdom
| | - Ralf Regenthal
- Division of Clinical Pharmacology, Rudolf-Boehm-Institute for Pharmacology and Toxicology, University of Leipzig, Leipzig, Germany
| | - Kamen A. Tsvetanov
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Roger A. Barker
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
- Wellcome–MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom
| | - Caroline H. Williams-Gray
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Trevor W. Robbins
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Luca Passamonti
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, United Kingdom
- Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - James B. Rowe
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, United Kingdom
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3
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Hezemans FH, Wolpe N, Rowe JB. Apathy is associated with reduced precision of prior beliefs about action outcomes. J Exp Psychol Gen 2020; 149:1767-1777. [PMID: 32039624 PMCID: PMC7397861 DOI: 10.1037/xge0000739] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 12/11/2019] [Accepted: 12/23/2019] [Indexed: 01/06/2023]
Abstract
Apathy is a debilitating syndrome that is associated with reduced goal-directed behavior. Although apathy is common and detrimental to prognosis in many neuropsychiatric diseases, its underlying mechanisms remain controversial. We propose a new model of apathy, in the context of Bayesian theories of brain function, whereby actions require predictions of their outcomes to be held with sufficient precision for "explaining away" differences in sensory inputs. In the active inference model, apathy results from reduced precision of prior beliefs about action outcomes. We tested this hypothesis using a visuomotor task in healthy adults (N = 47), with experimental manipulation of physical effort and financial reward. Bayesian modeling of performance and participants' perception of their performance was used to infer the precision of their priors. We confirmed that the perception of performance was biased toward the target, which was accounted for by relatively precise prior beliefs about action outcomes. These priors were consistently more precise than the corresponding performance distribution, and were scaled to effort and reward. Crucially, prior precision was negatively associated with trait apathy, suggesting that apathetic individuals had less precise prior beliefs about action outcomes. The results support a Bayesian account of apathy that could inform future studies of clinical populations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Frank H Hezemans
- Medical Research Council (MRC) Cognition, University of Cambridge
| | - Noham Wolpe
- Medical Research Council (MRC) Cognition, University of Cambridge
| | - James B Rowe
- Medical Research Council (MRC) Cognition, University of Cambridge
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Trempler I, Bürkner PC, El-Sourani N, Binder E, Reker P, Fink GR, Schubotz RI. Impaired context-sensitive adjustment of behaviour in Parkinson's disease patients tested on and off medication: An fMRI study. Neuroimage 2020; 212:116674. [PMID: 32097724 DOI: 10.1016/j.neuroimage.2020.116674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 10/24/2022] Open
Abstract
The brain's sensitivity to and accentuation of unpredicted over predicted sensory signals plays a fundamental role in learning. According to recent theoretical models of the predictive coding framework, dopamine is responsible for balancing the interplay between bottom-up input and top-down predictions by controlling the precision of surprise signals that guide learning. Using functional MRI, we investigated whether patients with Parkinson's disease (PD) show impaired learning from prediction errors requiring either adaptation or stabilisation of current predictions. Moreover, we were interested in whether deficits in learning over a specific time scale would be accompanied by altered surprise responses in dopamine-related brain structures. To this end, twenty-one PD patients tested on and off dopaminergic medication and twenty-one healthy controls performed a digit prediction paradigm. During the task, violations of sequence-based predictions either signalled the need to update or to stabilise the current prediction and, thus, to react to them or ignore them, respectively. To investigate contextual adaptation to prediction errors, the probability (or its inverse, surprise) of the violations fluctuated across the experiment. When the probability of prediction errors over a specific time scale increased, healthy controls but not PD patients off medication became more flexible, i.e., error rates at violations requiring a motor response decreased in controls but increased in patients. On the neural level, this learning deficit in patients was accompanied by reduced signalling in the substantia nigra and the caudate nucleus. In contrast, differences between the groups regarding the probabilistic modulation of behaviour and neural responses were much less pronounced at prediction errors requiring only stabilisation but no adaptation. Interestingly, dopaminergic medication could neither improve learning from prediction errors nor restore the physiological, neurotypical pattern. Our findings point to a pivotal role of dysfunctions of the substantia nigra and caudate nucleus in deficits in learning from flexibility-demanding prediction errors in PD. Moreover, the data witness poor effects of dopaminergic medication on learning in PD.
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Affiliation(s)
- Ima Trempler
- Department of Psychology, University of Muenster, 48149, Münster, Germany; Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, 48149, Münster, Germany.
| | | | - Nadiya El-Sourani
- Department of Psychology, University of Muenster, 48149, Münster, Germany
| | - Ellen Binder
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, 50937, Cologne, Germany; Institute of Neuroscience and Medicine (INM3), Cognitive Neuroscience, Research Centre Jülich, 52425, Jülich, Germany
| | - Paul Reker
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, 50937, Cologne, Germany
| | - Gereon R Fink
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, 50937, Cologne, Germany; Institute of Neuroscience and Medicine (INM3), Cognitive Neuroscience, Research Centre Jülich, 52425, Jülich, Germany
| | - Ricarda I Schubotz
- Department of Psychology, University of Muenster, 48149, Münster, Germany; Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, 48149, Münster, Germany; Faculty of Medicine and University Hospital Cologne, Department of Neurology, 50937, Cologne, Germany
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Wolpe N, Hezemans FH, Rowe JB. Alien limb syndrome: A Bayesian account of unwanted actions. Cortex 2020; 127:29-41. [PMID: 32155475 PMCID: PMC7212084 DOI: 10.1016/j.cortex.2020.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 12/06/2019] [Accepted: 02/04/2020] [Indexed: 11/13/2022]
Abstract
An alien limb is a debilitating disorder of volitional control. The core feature of alien limb is the performance of simple or complex semi-purposeful movements which the patient reports to be unintentional or unwanted, or occasionally in opposition to their intentions. Theories of the mechanism of alien limb phenomena have emphasised the role of disinhibition in the brain, and exaggerated action ‘affordances’. However, despite advances in cognitive neuroscience research and a large public and media interest, there has been no unifying computational and anatomical account of the cause of alien limb movements. Here, we extend Bayesian brain principles to propose that alien limb is a disorder of ‘predictive processing’ in hierarchical sensorimotor brain networks. Specifically, we suggest that alien limb results from predictions about action outcomes that are afforded unduly high precision. The principal mechanism for this abnormally high precision is an impairment in the relay of input from medial regions, predominantly the supplementary motor area (SMA), which modulate the precision of lateral brain regions encoding the predicted action outcomes. We discuss potential implications of this model for future research and treatment of alien limb.
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Affiliation(s)
- Noham Wolpe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK; MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
| | - Frank H Hezemans
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK; MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK; MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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Wolpe N, Zhang J, Nombela C, Ingram JN, Wolpert DM, Rowe JB. Sensory attenuation in Parkinson's disease is related to disease severity and dopamine dose. Sci Rep 2018; 8:15643. [PMID: 30353104 PMCID: PMC6199336 DOI: 10.1038/s41598-018-33678-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 09/25/2018] [Indexed: 01/10/2023] Open
Abstract
Abnormal initiation and control of voluntary movements are among the principal manifestations of Parkinson's disease (PD). However, the processes underlying these abnormalities and their potential remediation by dopamine treatment remain poorly understood. Normally, movements depend on the integration of sensory information with the predicted consequences of action. This integration leads to a suppression in the intensity of predicted sensations, reflected in a 'sensory attenuation'. We examined this integration process and its relation to dopamine in PD, by measuring sensory attenuation. Patients with idiopathic PD (n = 18) and population-derived controls (n = 175) matched a set of target forces applied to their left index finger by a torque motor. To match the force, participants either pressed with their right index finger ('Direct' condition) or moved a knob that controlled a motor through a linear potentiometer ('Slider' condition). We found that despite changes in sensitivity to different forces, overall sensory attenuation did not differ between medicated PD patients and controls. Importantly, the degree of attenuation was negatively related to PD motor severity but positively related to individual patient dopamine dose, as measured by levodopa dose equivalent. The results suggest that dopamine could regulate the integration of sensorimotor prediction with sensory information to facilitate the control of voluntary movements.
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Affiliation(s)
- Noham Wolpe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SZ, UK.
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK.
- Cambridge Centre for Ageing and Neuroscience, University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 3EB, UK.
| | - Jiaxiang Zhang
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Cristina Nombela
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SZ, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - James N Ingram
- Cambridge Centre for Ageing and Neuroscience, University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 3EB, UK
- Computational and Biological Learning Laboratory, Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, UK
- Zuckerman Mind Brain Behavior Institute, Department of Neuroscience, Columbia University, New York, United States
| | - Daniel M Wolpert
- Cambridge Centre for Ageing and Neuroscience, University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 3EB, UK
- Computational and Biological Learning Laboratory, Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, UK
- Zuckerman Mind Brain Behavior Institute, Department of Neuroscience, Columbia University, New York, United States
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SZ, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
- Cambridge Centre for Ageing and Neuroscience, University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 3EB, UK
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Trenado C, Boschheidgen M, Rübenach J, N'Diaye K, Schnitzler A, Mallet L, Wojtecki L. Assessment of Metacognition and Reversal Learning in Parkinson's Disease: Preliminary Results. Front Hum Neurosci 2018; 12:343. [PMID: 30254576 PMCID: PMC6141660 DOI: 10.3389/fnhum.2018.00343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/10/2018] [Indexed: 12/12/2022] Open
Abstract
Reversal learning (RL) has been widely used for assessment of behavioral adaptation, impulsivity, obsession, and compulsion in healthy controls as well as people suffering from psychiatric and neurological disorders such as Parkinson’s disease (PD). Nevertheless, studies addressing high cognitive functions such as metacognition in PD are scarce. Here, we address for the first time the effect of levodopa and PD on metacognition within the framework of a RL paradigm. In agreement with previous reports, PD patients exhibited reversal shifting impairment with respect to healthy controls (CTRL) regardless of medication condition (MED-ON and MED-OFF), which was supported by a well-known model of learning conditioning (Rescorla–Wagner). In spite that we found a significant association between accuracy and decision confidence level for MED-OFF and CTRL, analysis of metacognitive sensitivity assessed by type 2 signal detection theory (SDT) revealed only a significant underperformance for patients without medication (MED-OFF). This finding points toward a non-compromising positive effect of dopaminergic medication on metacognition for PD.
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Affiliation(s)
- Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Center for Movement Disorders and Neuromodulation, Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Department of Psychology and Neurosciences, Translational Neuromodulation Unit, Leibniz Research Centre for Working Environment and Human Factors, TU Dortmund, Dortmund, Germany
| | - Matthias Boschheidgen
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Julia Rübenach
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Karim N'Diaye
- Institut du Cerveau et de la Moelle Épinière, Hôpital Pitié Salpêtrière, Paris, France
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Center for Movement Disorders and Neuromodulation, Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Luc Mallet
- Institut du Cerveau et de la Moelle Épinière, Hôpital Pitié Salpêtrière, Paris, France
| | - Lars Wojtecki
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Center for Movement Disorders and Neuromodulation, Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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8
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Vlasova RM, Siddarth P, Krause B, Leaver AM, Laird KT, St. Cyr N, Narr KL, Lavretsky H. Resilience and White Matter Integrity in Geriatric Depression. Am J Geriatr Psychiatry 2018; 26:874-883. [PMID: 29803529 PMCID: PMC6086733 DOI: 10.1016/j.jagp.2018.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Greater psychological resilience may protect against developing depression in a growing geriatric population. Identifying the neural correlates of resilience in geriatric depression could provide neurobiologic targets to inform clinical interventions. However, most prior neuroimaging studies have only considered the presence or absence of resilience and have not addressed the multifactorial nature of resilience. The current study aimed to establish the neural correlates of four factors of resilience in the depressed elderly. METHODS White matter integrity was assessed using diffusion-weighted magnetic resonance imaging data collected from 70 older adults with major depressive disorder. We used four resilience factors previously derived in an exploratory factor analysis of the Connor-Davidson Resilience Scale in a large sample of depressed older adults: 1, grit; 2, active coping self-efficacy; 3, accommodative coping self-efficacy; and 4, spirituality. RESULTS The resilience factor "grit" was positively associated with fractional anisotropy in the callosal region connecting prefrontal cortex and fractional anisotropy in cingulum fibers; however, the latter did not survive correction for multiple comparisons. CONCLUSION Structural integrity of major white matter pathways implicated in cognitive control and emotion regulation (i.e., connecting prefrontal cortex) was positively associated with the resilience factor "grit" in our sample of older adults with depression. Prospective studies are needed to determine the utility of the structural integrity of these pathways as a biomarker in predicting risk for depression and treatment response.
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Affiliation(s)
- Roza M. Vlasova
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Prabha Siddarth
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Beatrix Krause
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Amber M. Leaver
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, Los Angeles, CA, USA
| | - Kelsey T. Laird
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Natalie St. Cyr
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Katherine L. Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, Los Angeles, CA, USA
| | - Helen Lavretsky
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA.
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9
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Perugini A, Ditterich J, Shaikh AG, Knowlton BJ, Basso MA. Paradoxical Decision-Making: A Framework for Understanding Cognition in Parkinson's Disease. Trends Neurosci 2018; 41:512-525. [PMID: 29747856 PMCID: PMC6124671 DOI: 10.1016/j.tins.2018.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/09/2018] [Accepted: 04/16/2018] [Indexed: 12/11/2022]
Abstract
People with Parkinson's disease (PD) show impaired decision-making when sensory and memory information must be combined. This recently identified impairment results from an inability to accumulate the proper amount of information needed to make a decision and appears to be independent of dopamine tone and reinforcement learning mechanisms. Although considerable work focuses on PD and decisions involving risk and reward, in this Opinion article we propose that the emerging findings in perceptual decision-making highlight the multisystem nature of PD, and that unraveling the neuronal circuits underlying perceptual decision-making impairment may help in understanding other cognitive impairments in people with PD. We also discuss how a decision-making framework may be extended to gain insights into mechanisms of motor impairments in PD.
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Affiliation(s)
- Alessandra Perugini
- Fuster Laboratory of Cognitive Neuroscience, Department of Psychiatry and Biobehavioral Sciences, Department of Neurobiology, Semel Institute for Neuroscience and Human Behavior, Brain Research Institute, The David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Jochen Ditterich
- Center for Neuroscience and Department of Neurobiology, Physiology, and Behavior, University of California, Davis, CA, USA
| | - Aasef G Shaikh
- Department of Neurology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Barbara J Knowlton
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Michele A Basso
- Fuster Laboratory of Cognitive Neuroscience, Department of Psychiatry and Biobehavioral Sciences, Department of Neurobiology, Semel Institute for Neuroscience and Human Behavior, Brain Research Institute, The David Geffen School of Medicine, Los Angeles, CA 90095, USA.
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10
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Perugini A, Basso MA. Perceptual decisions based on previously learned information are independent of dopaminergic tone. J Neurophysiol 2018; 119:849-861. [PMID: 29167328 PMCID: PMC5899318 DOI: 10.1152/jn.00761.2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 11/07/2017] [Accepted: 11/19/2017] [Indexed: 02/02/2023] Open
Abstract
Both cognitive and motor symptoms in people with Parkinson's disease (PD) arise from either too little or too much dopamine (DA). Akinesia stems from DA neuronal cell loss, and dyskinesia often stems from an overdose of DA medication. Cognitive behaviors typically associated with frontal cortical function, such as working memory and task switching, are also affected by too little or too much DA in PD. Whether motor and cognitive circuits overlap in PD is unknown. In this article, we show that whereas motor performance improves in people with PD when on dopaminergic medication compared with off medication, perceptual decision-making based on previously learned information (priors) remains impaired whether on or off medications. To rule out effects of long-term DA treatment and dopaminergic neuronal loss such as occur in PD, we also tested a group of people with dopa-unresponsive focal dystonia, a disease that involves the basal ganglia, like PD, but has motor symptoms that are insensitive to dopamine treatment and is not thought to involve frontal cortical DA circuits, unlike PD. We found that people with focal dystonia showed intact perceptual decision-making performance but impaired use of priors in perceptual decision-making, similar to people with PD. Together, the results show a dissociation between motor and cognitive performance in people with PD and reveal a novel cognitive impairment, independent of sensory and motor impairment, in people with focal dystonia. The combined results from people with PD and people with focal dystonia provide mechanistic insights into the role of basal ganglia non-dopaminergic circuits in perceptual decision-making based on priors.
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Affiliation(s)
- Alessandra Perugini
- Joaquin Fuster Laboratory of Cognitive Neuroscience, Department of Psychiatry and Biobehavioral Sciences, Department of Neurobiology, and The Semel Institute for Neuroscience and Human Behavior and the Brain Research Institute, David Geffen School of Medicine, University of California , Los Angeles, California
| | - Michele A Basso
- Joaquin Fuster Laboratory of Cognitive Neuroscience, Department of Psychiatry and Biobehavioral Sciences, Department of Neurobiology, and The Semel Institute for Neuroscience and Human Behavior and the Brain Research Institute, David Geffen School of Medicine, University of California , Los Angeles, California
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Yang YL, Li MY, Liu L, Wang L. Perceived stress and its associated demographic-clinical characteristics and positive expectations among Chinese cervical, kidney, and bladder cancer patients. Support Care Cancer 2018; 26:2303-2312. [PMID: 29404843 DOI: 10.1007/s00520-018-4081-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/29/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Positive expectations about personal abilities and future outcomes are important in shaping human behavior and emotion, which may influence the psychological adjustment in cancer patients. We aimed to assess two basic kinds of perceived stress in Chinese cancer patients and to investigate their associations with demographic-clinical characteristics and positive expectations. METHODS A multi-center, cross-sectional study was conducted in consecutive cervical, kidney, and bladder cancer inpatients from three general hospitals in Liaoning province from February 2013 to August 2014. A total of 790 patients eligible for this study completed questionnaires on demographic-clinical variables, optimism, general self-efficacy, perceived global, and cancer-related stress anonymously. Hierarchical regression analyses were conducted to examine the relationships between optimism, general self-efficacy, and perceived stress, after controlling for possible covariates. RESULTS Mean score of perceived global stress was 17.85 (SD 4.43). Mean score of perceived cancer-related stress was 37.15 (SD 12.66); 38.1% of the sample scored 44 and above, 20.1% scored 50 and above. Education, physical activity, cancer stage, and time since diagnosis were significantly associated with perceived stress. Optimism and general self-efficacy accounted for an additional variance in perceived global (14.9%) and cancer-related stress (16.9%), and both of them were independent and protective variables of perceived stress. CONCLUSIONS This study recognized cancer patients at risk for high levels of perceived stress and extended the understanding of the association between positive expectations and perceived global and cancer-related stress. Enhancing or maintaining optimism and general self-efficacy might be potential targets for future psychosocial interventions aimed at relieving perceived stress in cancer patients.
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Affiliation(s)
- Yi-Long Yang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, People's Republic of China
| | - Meng-Yao Li
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, People's Republic of China
| | - Li Liu
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, People's Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, People's Republic of China.
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