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Atkinson-Clement C, Lebreton M, Patsalides L, de Liege A, Klein Y, Roze E, Deniau E, Hartmann A, Palminteri S, Worbe Y. Decision-making under risk and ambiguity in adults with Tourette syndrome. Psychol Med 2023; 53:5256-5266. [PMID: 35899867 DOI: 10.1017/s0033291722002318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Tourette syndrome (TS) as well as its most common comorbidities are associated with a higher propensity for risky behaviour in everyday life. However, it is unclear whether this increased risk propensity in real-life contexts translates into a generally increased attitude towards risk. We aimed to assess decision-making under risk and ambiguity based on prospect theory by considering the effects of comorbidities and medication. METHODS Fifty-four individuals with TS and 32 healthy controls performed risk and ambiguity decision-making tasks under both gains and losses conditions. Behavioural and computational parameters were evaluated using (i) univariate analysis to determine parameters difference taking independently; (ii) supervised multivariate analysis to evaluate whether our parameters could jointly account for between-group differences (iii) unsupervised multivariate analysis to explore the potential presence of sub-groups. RESULTS Except for general 'noisier' (less consistent) decisions in TS, we showed no specific risk-taking behaviour in TS or any relation with tics severity or antipsychotic medication. However, the presence of comorbidities was associated with distortion of decision-making. Specifically, TS with obsessive-compulsive disorder comorbidity was associated with a higher risk-taking profile to increase gain and a higher risk-averse profile to decrease loss. TS with attention-deficit hyperactivity disorder comorbidity was associated with risk-seeking in the ambiguity context to reduce a potential loss. CONCLUSIONS Impaired valuation of risk and ambiguity was not related to TS per se. Our findings are important for clinical practice: the involvement of individuals with TS in real-life risky situations may actually rather result from other factors such as psychiatric comorbidities.
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Affiliation(s)
- Cyril Atkinson-Clement
- Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France
- Movement Investigation and Therapeutics Team, Paris, France
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Mael Lebreton
- Paris School of Economics, Paris, France
- Swiss Center for Affective Science, University of Geneva, Geneva, Switzerland
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
| | - Leïla Patsalides
- Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France
- Movement Investigation and Therapeutics Team, Paris, France
| | - Astrid de Liege
- Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France
- Movement Investigation and Therapeutics Team, Paris, France
- National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France
| | - Yanica Klein
- Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France
- Movement Investigation and Therapeutics Team, Paris, France
- National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France
| | - Emmanuel Roze
- Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France
- Movement Investigation and Therapeutics Team, Paris, France
- Department of Neurology, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France
| | - Emmanuelle Deniau
- Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France
- Movement Investigation and Therapeutics Team, Paris, France
- National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France
| | - Andreas Hartmann
- Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France
- Movement Investigation and Therapeutics Team, Paris, France
- National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France
| | - Stefano Palminteri
- Laboratoire de Neurosciences Cognitives et Computationnelles, INSERM, Paris, France
- Département d'Etudes Cognitives, ENS, PSL Research University, Paris, France
- Institute for Cognitive Neuroscience, HSE, Moscow, Russian Federation
| | - Yulia Worbe
- Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France
- Movement Investigation and Therapeutics Team, Paris, France
- National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France
- Department of Neurophysiology, Saint Antoine Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
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Atkinson-Clement C, Sofia F, Fernandez-Egea E, de Liege A, Beranger B, Klein Y, Deniau E, Roze E, Hartmann A, Worbe Y. Structural and functional abnormalities within sensori-motor and limbic networks underpin intermittent explosive symptoms in Tourette disorder. J Psychiatr Res 2020; 125:1-6. [PMID: 32169732 DOI: 10.1016/j.jpsychires.2020.02.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Intermittent explosive outbursts (IEO), manifesting as sudden episodes of verbal or physical aggression, are frequently present in patients with Tourette disorder (TD) and considered as one of the most disabling symptoms by patients and families. The neuronal correlates of these behaviours are poorly understood, and this was the primary objective of the present study. METHODS We assessed the presence of IEO in 55 patients with TD and then compared the subgroup of the patients with IEO to those without these manifestations using a multimodal neuroimaging approach. RESULTS 47% of TD patients presented IEO, which was frequently associated with attention deficit hyperactivity disorder (ADHD). TD patients (without ADHD) with IEO compared to TD without IEO, showed structural changes in the right supplementary motor area as well as in the right hippocampus (increased fractional anisotropy), and in the left orbitofrontal cortex (decreased mean diffusivity). Using these three nodes as seeds for resting state functional connectivity, we showed a lower connectivity within the sensori-motor cortico-basal ganglia network, and an altered connectivity pattern among the orbito-frontal cortex, amygdala and hippocampus. CONCLUSIONS Overall, our results indicate that TD with IEO is associated with brain dysfunction related to a less efficient top-down control on action selection, and impairments related to emotional regulation, impulse control and aggressive behaviours.
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Affiliation(s)
- Cyril Atkinson-Clement
- Sorbonne University, 75005, Paris, France; Inserm U1127, CNRS UMR7225, UM75, ICM, Paris, France; Movement Investigation and Therapeutics Team, F-75013, Paris, France
| | - Fuaad Sofia
- Department of Psychology, University of Oslo, 0373, Oslo, Norway
| | - Emilio Fernandez-Egea
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Astrid de Liege
- Sorbonne University, 75005, Paris, France; Inserm U1127, CNRS UMR7225, UM75, ICM, Paris, France; Movement Investigation and Therapeutics Team, F-75013, Paris, France; National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013, Paris, France
| | - Benoit Beranger
- Centre de NeuroImagerie de Recherche (CENIR), Sorbonne Université, UMRS975, CNRS UMR7225, ICM, F-75013, Paris, France
| | - Yanica Klein
- Sorbonne University, 75005, Paris, France; Inserm U1127, CNRS UMR7225, UM75, ICM, Paris, France; Movement Investigation and Therapeutics Team, F-75013, Paris, France; National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013, Paris, France
| | - Emmanuelle Deniau
- Sorbonne University, 75005, Paris, France; Inserm U1127, CNRS UMR7225, UM75, ICM, Paris, France; Movement Investigation and Therapeutics Team, F-75013, Paris, France; National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013, Paris, France
| | - Emmanuel Roze
- Sorbonne University, 75005, Paris, France; Inserm U1127, CNRS UMR7225, UM75, ICM, Paris, France; Movement Investigation and Therapeutics Team, F-75013, Paris, France
| | - Andreas Hartmann
- Sorbonne University, 75005, Paris, France; Inserm U1127, CNRS UMR7225, UM75, ICM, Paris, France; Movement Investigation and Therapeutics Team, F-75013, Paris, France; National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013, Paris, France
| | - Yulia Worbe
- Sorbonne University, 75005, Paris, France; Inserm U1127, CNRS UMR7225, UM75, ICM, Paris, France; Movement Investigation and Therapeutics Team, F-75013, Paris, France; National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013, Paris, France; Department of Neurophysiology, Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris, France.
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Atkinson-Clement C, Porte CA, de Liege A, Wattiez N, Klein Y, Beranger B, Valabregue R, Sofia F, Hartmann A, Pouget P, Worbe Y. Neural correlates and role of medication in reactive motor impulsivity in Tourette disorder. Cortex 2020; 125:60-72. [PMID: 31978743 DOI: 10.1016/j.cortex.2019.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/23/2019] [Accepted: 12/10/2019] [Indexed: 12/22/2022]
Abstract
Abnormality of inhibitory control is considered to be a potential cognitive marker of tics in Tourette disorder (TD), attention deficit hyperactivity disorder (ADHD), and impulse control disorders. The results of the studies on inhibitory control in TD showed discrepant results. The aim of the present study was to assess reactive inhibitory control in adult TD patients with and without antipsychotic medication, and under emotional stimulation (visual images with positive, neutral and negative content). We assessed 31 unmedicated and 19 medicated TD patients and 26 matched healthy controls using the stop signal task as an index of reactive motor impulsivity and emotional stimulation with the aim to increase impulsivity. We performed a multimodal neuroimaging analysis using a regions of interest approach on grey matter signal, resting-state spontaneous brain activity and functional connectivity analyses. We found a higher reactive motor impulsivity in TD patients medicated with antipsychotics compared to unmedicated TD patients and controls. This propensity for reactive motor impulsivity in medicated TD patients was not influenced by ADHD or emotional stimulation. Neuroimaging results in medicated TD patients suggested that reactive motor impulsivity was underpinned by an increased grey matter signal from the right supplementary motor area and inferior frontal gyrus; decreased resting-state spontaneous activity of the left putamen; higher functional connectivity between the inferior frontal gyrus and the superior temporal gyri (bilaterally); lower functional connectivity between the cerebellum and the right subthalamic nucleus. Taken together, our data suggested (i) a deficit in reactive motor impulsivity in TD patients medicated with atypical antipsychotics that was unrelated to ADHD and (ii) that motor impulsivity was underpinned by structures and by functional connectivity of the fronto-temporo-basal ganglia-cerebellar pathway.
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Affiliation(s)
- Cyril Atkinson-Clement
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, ICM, Movement Investigation and Therapeutics Team, Paris, France
| | - Camille-Albane Porte
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, ICM, Movement Investigation and Therapeutics Team, Paris, France
| | - Astrid de Liege
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, ICM, Movement Investigation and Therapeutics Team, Paris, France; National Reference Center for Tourette Syndrome, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Nicolas Wattiez
- Sorbonne University, Inserm, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Yanica Klein
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, ICM, Movement Investigation and Therapeutics Team, Paris, France; National Reference Center for Tourette Syndrome, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Benoit Beranger
- Centre de NeuroImagerie de Recherche (CENIR), Sorbonne Université, UMRS975, CNRS UMR7225, ICM, Paris, France
| | - Romain Valabregue
- Centre de NeuroImagerie de Recherche (CENIR), Sorbonne Université, UMRS975, CNRS UMR7225, ICM, Paris, France
| | - Fuaad Sofia
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Andreas Hartmann
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, ICM, Movement Investigation and Therapeutics Team, Paris, France; National Reference Center for Tourette Syndrome, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Pierre Pouget
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, ICM, Movement Investigation and Therapeutics Team, Paris, France
| | - Yulia Worbe
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, ICM, Movement Investigation and Therapeutics Team, Paris, France; National Reference Center for Tourette Syndrome, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Department of Neurophysiology, Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris, France.
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