Bipolar symptoms and lithium treatment affect neural signatures of adaptation of risk-taking to past outcomes during reward-guided decision-making
Bipolar symptoms and lithium treatment affect neural signatures of adaptation of risk-taking to past outcomes during reward-guided decision-making
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双相情感障碍症状和锂治疗会影响奖励引导决策过程中冒险适应过去结果的神经特征
DOI：
10.1101/2023.03.13.23287200
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Scholl J
中科院分区：
文献类型：
--
作者：
Scholl J
双相情感障碍（BD）的认知和神经机制及其治疗仍然知之甚少。在这里，我们研究的作用，适应风险承担使用奖励导向的决策任务。我们招募了情绪障碍问卷（MDQ）得分高的志愿者（n= 40），疑似双相情感障碍高风险的志愿者和得分低的志愿者（n= 37）。我们还招募了被诊断为BD的患者，他们在两周的基线期（FMRI为n= 22）后被分配（随机，双盲）到锂（n= 19）或安慰剂（n= 16）六周。参与者在50天（MDQ研究）或42天（BD研究）内每天完成情绪评级，以及风险决策任务和功能性磁共振成像。该任务测量了风险承担对过去结果的适应性（在之前的胜利与损失之后增加的风险厌恶，“结果历史”）。虽然低MDQ组在获胜后是风险厌恶的，但这在高MDQ组中不太明显，在BD患者中最不明显。在功能磁共振成像中，“结果历史”与决策时的内侧额叶激活有关，并且这种激活在高风险MDQ组与低风险MDQ组中减少。虽然锂并没有逆转BD在任务中的模式，也没有改变躁狂或抑郁的临床症状，但它改变了背外侧前额叶皮层的奖励处理。参与者对奖励结果的风险承担的调节作为BD和诊断BD的风险的函数而降低。这些结果为奖励如何引发双相情感障碍中风险相关行为的升级以及情绪稳定治疗如何发挥作用提供了一个模型。
Cognitive and neural mechanisms underlying bipolar disorder (BD) and its treatment are still poorly understood. Here we examined the role of adaptations in risk-taking using a reward-guided decision-making task. We recruited volunteers with high (n= 40) scores on the Mood Disorder Questionnaire, MDQ, suspected of high risk for bipolar disorder and those with low-risk scores (n= 37). We also recruited patients diagnosed with BD who were assigned (randomized, double-blind) to six weeks of lithium (n= 19) or placebo (n= 16) after a two-week baseline period (n= 22 for FMRI). Participants completed mood ratings daily over 50 (MDQ study) or 42 (BD study) days, as well as a risky decision-making task and functional magnetic resonance imaging. The task measured adaptation of risk taking to past outcomes (increased risk aversion after a previous win vs. loss, ‘outcome history’). While the low MDQ group was risk averse after a win, this was less evident in the high MDQ group and least so in the patients with BD. During fMRI, ‘outcome history’ was linked to medial frontal pole activation at the time of the decision and this activation was reduced in the high risk MDQ vs. the low risk MDQ group. While lithium did not reverse the pattern of BD in the task, nor changed clinical symptoms of mania or depression, it changed reward processing in the dorsolateral prefrontal cortex. Participants’ modulation of risk-taking in response to reward outcomes was reduced as a function of risk for BD and diagnosed BD. These results provide a model for how reward may prime escalation of risk-related behaviours in bipolar disorder and how mood stabilising treatments may work.
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影响因子：
4.1
作者：
Nusslock R;Young CB;Damme KS
通讯作者：
Damme KS
好的、坏的和不相关的：学习真实和假设的奖励和努力的神经机制
影响因子：
5.3
作者：
J. Scholl;Nils Kolling;N. Nelissen;Marco K. Wittmann;C. Harmer;M. Rushworth
通讯作者：
M. Rushworth
影响因子：
2.5
作者：
Saunders KE;Cipriani A;Rendell J;Attenburrow MJ;Nelissen N;Bilderbeck AC;Vasudevan SR;Churchill G;Goodwin GM;Nobre AC;Harmer CJ;Harrison PJ;Geddes JR
通讯作者：
Geddes JR
影响因子：
5.6
作者：
Jimenez, E.;Sole, B.;Benabarre, A.
通讯作者：
Benabarre, A.
通过捕捉学习和决策的生态相关特征来了解精神疾病
影响因子：
2.7
作者：
J. Scholl;M. Klein
通讯作者：
M. Klein