MRI Markers of Feedback Timing during Learning in Individuals with TBI with and without Clinical Depression

项目概要/摘要 该项目的总体目标是研究个体学习过程中的大脑机制 患有创伤性脑损伤 (TBI)，伴或不伴临床抑郁症。这些知识可以帮助指导康复 策略并减轻 TBI 的负担。关于一个人行为准确性的反馈可以提高学习能力 通过告知个人他们的行为是否正确。研究表明患有抑郁症的人 与健康人相比，在学习过程中存在学习缺陷和大脑活动改变 返回立即呈现。在Par-中也观察到通过即时反馈而导致的学习受损 金森病（PD）患者。然而，PD 患者能够从反馈中学习—— 通过单独的神经机制的参与来延迟。我们表明，患有 TBI 的个体表现出明显的 通过即时反馈来学习的冲动可能会因抑郁症状而加剧。赤字 通过即时反馈学习可能会导致坚持不正确的行为并减少策略 康复期间使用。然而，没有证据直接检验学习的神经机制 患有或不患有抑郁症的 TBI 患者。拟议的研究填补了这一空白。鉴定 患有或不患有临床抑郁症的 TBI 患者与学习相关的神经机制将 告知 1) 关于抑郁症对受损大脑影响的科学知识，2) 关于抑郁症的 TBI 干预措施 反馈的有效性及其时机，以及 3) 为其他临床制定通用干预措施 需要康复且抑郁症高发的人群。这些目标在于 NINDS 的核心使命是拓宽“关于大脑和神经的基础知识” 系统”与 TBI 学习相关。从实现上述目标中获得的知识将“减少 TBI 后学习缺陷的负担”。为了检验我们的假设，将根据以下条件招募 TBI 参与者 结构化临床访谈。合格的参与者将进行一项实验，他们研究单词对—— 功能性磁共振成像 (MRI) 扫描仪的侧面。然后，在 MRI 中，参与者将看到单词 以多项选择的形式进行配对，以及新颖的干扰项，并选择正确的配对。每次之后 选择，反馈将通过实验操纵立即呈现或在 25 分钟后呈现 延迟。在 MRI 之外的最后阶段，参与者完成第二个诊断配对关联 多项选择评估，以评估即时反馈与延迟反馈对学习的影响。我们嘿- 假设患有 TBI 的抑郁症患者在学习延迟方面会表现出进步 立即反馈。这种学习分离将会发生，因为通过延迟反馈进行的学习依赖于 不受 TBI 和抑郁症负面影响的神经回路。没有 TBI 的非抑郁症个体 还将招募没有 TBI 的临床抑郁症患者来区分抑郁症的影响 TBI 对大脑的影响。

Project Summary/Abstract The overall objective of the proposed project is to investigate brain mechanisms during learning in individuals with traumatic brain injury (TBI) with and without clinical depression. Such knowledge can help guide rehabilita- tion strategies and reduce the burden of TBI. Feedback about the accuracy of one’s actions can improve learn- ing by informing individuals whether their action is correct or not. Individuals with depression have been shown to have learning deficits and altered brain activity during learning compared to healthy individuals when feed- back is presented immediately. Impaired learning through immediate feedback has also been observed in Par- kinson’s disease (PD) patients. However, PD patients are able to learn from feedback when it is presented af- ter a delay through engagement of separate neural mechanisms. We show that individuals with TBI exhibit def- icits in learning through immediate feedback that are likely exacerbated by depressive symptoms. Deficits in learning through immediate feedback can lead to perseveration of incorrect actions and decreased strategy use during rehabilitation. However, there is no evidence directly examining the neural mechanisms of learning in individuals with TBI with and without depression. The proposed research fills this gap. The identification of the neural mechanisms associated with learning in individuals with TBI with and without clinical depression will inform 1) scientific knowledge about the effect of depression on the injured brain, 2) TBI interventions about the effectiveness of feedback and its timing, and 3) the development of generalized interventions for other clinical populations that require rehabilitation and have high occurrence of depression. These objectives lie at the heart of the mission of the NINDS as they will broaden “fundamental knowledge about the brain and nervous system” associated with learning in TBI. The knowledge gained from fulfilling the above objectives will “reduce the burden” of learning deficits after TBI. To test our hypotheses, TBI participants will be recruited based on structured clinical interview. Qualified participants will perform an experiment where they study word pairs out- side of the functional magnetic resonance imaging (MRI) scanner. Then, in the MRI, participants will see word pairs in multiple-choice format, along with novel distractors, and select the correct paired-associate. After each choice, feedback will be experimentally manipulated to be presented either immediately or after a 25-minute delay. During the final phase outside of the MRI, participants complete a second diagnostic paired-associate multiple-choice assessment to evaluate the influence of immediate vs. delayed feedback on learning. We hy- pothesize that depressed individuals with TBI will show improvements in learning from delayed compared to immediate feedback. This learning dissociation will occur because learning through delayed feedback relies on neurocircuitry that is not negatively affected by TBI and depression. Non-depressed individuals without TBI and clinically depressed individuals without TBI will also be recruited to differentiate the influences of depres- sion from the impact of TBI on the brain.