Disordered Brain Exam 2 - CS Psychopathology

What are the mood disorders affected in this circuit?

MDD and Bipolar disorder

What are the anxiety disorders affected in this circuit?

Obsessive-Compulsive Disorder, but not really anxiety

What are the social behavior disorders affected in this circuit?

Antisocial Personality Disorder

What are the disorders of childhood affected in this circuit?

Attention Deficit Hyperactivity Disorder

Tourette’s Syndrome

What are the eating disorders affected in this circuit?

Anorexia Nervosa

Bulimia Nervosa

What is the key symptom of MDD in terms of the CS circuit?

Anhedonia. (Lack of pleasure)

Explain the water study that looked at Pavlovian Learning for depressed individuals. What were the key results? What is the interpretation?

People were water starved for like 8 hours, then given cues to associate with water, like Pavlovian training. The controls and patients (with depression) were then scanned.

For healthy controls, there is robust activity in the VS. For the depressed patients, there is a lack of activity in the VS for reward cue, but more activity in the VTA and insula.

Interpretation is that for MDD people in the CS circuitry, the learning is still happening… VTA is still active, sending dopamine to the VS, but the VS is not opening!

For the monetary incentive delay task, how do MDD patients do compared to healthy controls (in terms of CS structural activity differences)? Talk about during the diff phases of the task (reward anticipation vs. feedback)

During the reward anticipation phase (presented with cue), there is no diff between controls and depressed ppl. General activation of the thalamus and VS in both. But there is greater ACC activation for depressed ppl.

During the reward outcome phase (presented with outcome/reward), controls had greater activation in the mPFC, putamen (striatum!), and insula compared to depressed ppl.

KEY: Dysfunction/lower activity of the striatum in response to these monetary incentive delay tasks for ppl with depression. For reward anticipation, its putamen blunted. For reward feedback, its caudate and VS blunted.

For the guessing game task, how do MDD patients do compared to healthy controls (in terms of CS structural activity differences)?

People with depression have less response in the VS and the caudate compared to healthy controls.

Effects of medication on results of the MIDT? Effects of CBT?

Medication: Increase in activity of the VS!

CBT: Increase in activity of the mPFC and dorsal striatum!

__________ ventral striatum response at baseline predicts ______________ anhedonia in those undergoing treatment.

Greater, reduced

Explain the word processing experiments and the results/interpretation.

Healthy controls and MDD patients with anhedonia were given words that are either positive, neutral, or negative. MDD pt. rate negative words as more negative, had better memory for negative words, and the VS negatively correlated with less pleasure of activities. For brain activation, MDD pts had hypo-reactivity of the VS to positive words.

Explain the emotional regulation study and the results/interpretation.

Healthy controls and pt. were asked to regulate their emotions by enhancing positive feelings or just attending to them.

Depressed people were able to do it at first, but throughout the experiment/later on, they were unable to keep it up for both maintaining positive enhancement and attending. VS hyporeactive later on!

How does Deep Brain Stimulation on the VS work?

Insert electrodes that stimulate the VS areas. Doing so increases the activity of it!

For the monetary incentive delay task, how do OCD patients do compared to healthy controls? (in terms of brain structure responses) What is the interpretation?

During reward anticipation, there is blunted/no VS response, but not really for reward outcome. Signaling a lack of ability to update based on environmental signals.

What is the incentive flanker task?

There is cue, target, and feedback, but for the target, there is interference were a target letter is surrounded by other letters and you have to focus on the target letter in the middle. There can be high interference or low interference depending on what button press is “correct”. There are loss, gain, and null trials similar to the monetary incentive delay paradigms.

For error sensitivity for the incentive flanker task, what is highly activated? OCD vs. healthy controls? Interpretation?

For both, ACC is very active, also dlPFC and putamen.

OFC is more active in OCD patients compared to healthy controls, since for healthy controls the OFC is deactivated comparatively.

The OFC is in charge of subjective evaluation, and the fact that it is less active to correct responses for the OCD patients means that correct responses are not being subjectively logged.

For loss sensitivity, what is highly activated? OCD vs. healthy controls? Interpretation?

When OCD patients make an error and are losing money, hyperactivity in the vmPFC and OFC compared to controls. Making an error is tagging it with more importance!

For interference sensitivity, what is highly activated? OCD vs. healthy controls? Interpretation?

For OCD patients, the ACC is more active than for healthy controls!

For error sensitivity for the monitor and interference task, what is highly activated? OCD vs. healthy controls? Interpretation?

When OCD patients have error sensitivity, there is hyperactivity in the vmPFC and OFC compared to controls. MEANING THAT correct responses are not being subjectively logged!

As ACC becomes more active, the vmPFC becomes _____________ active for OCD patients. What about for healthy controls?

more for OCD, less for healthy controls

OCD patients make significantly _________ mistakes than healthy controls for task switching.

more

When you have to switch a task, the ACC, OFC, and vmPFC become _____________ active in healthy controls. What about for OCD patients?

More

For OCD, the activity in those regions are blunted!

OFC patients show relatively _____________ amygdala activity compared to healthy controls. To general aversive stimuli or specific obsessions?

more/hyperactivity

for both/everything!

VS is _________ coupled with the vmPFC for OCD patients. What about the putamen with vmPFC?

More for VS, Less for putamen

When is there hypo reactivity of the DS, OFC, ACC, and vmPFC? When is there hyper?

Hypo when doing task switching, Hyper when monitoring!

ADHD is very ___________.

heritable

For reward anticipation and loss avoidance anticipation in teens with ADHD, there is ____________ in the VS compared to in healthy controls. What about for outcomes?

Hypoactivity

No diff for reward outcome!

For people with ADHD, how is impulsivity correlated with VS activity? (what is the thing for normal people?)

Impulsivity is negatively correlated with VS activity (more impulsive = less VS activity). For normal ppl it is positively correlated.

For reward anticipation in adults with ADHD, there is ____________ in the VS compared to in healthy controls.

again hyporeactivity

ADHD kids show _____________ VS response to reward delivery/outcome.

greater

Overall polygenic risk for ADHD is correlated with ___________ VS response to reward outcomes/delivery.

greater

Explain the idea that ADHD is a reward learning deficit. What evidence points to this and how?

People with ADHD have blunted VS response for reward anticipation and increased VS response for reward outcomes. This indicates that perhaps the behevaior in searching for reward/confronting boredom is just not fully tied to the environmental contingencies, that is the dopamine isn’t fully responding to the predictor of the reward and is still bursting/phasing at the reward outcome level, indicating a failure to learn.

People with ADHD are at greater risk for __________________.

Substance use disorders.

Individuals with ADHD are much ___________ to choose the immediate reward compared to controls. They also make this choice more ____________ compared to controls.

more likely

quickly

Individuals with ADHD have ___________ activity in the VS for delay discounting for both immediate and delayed choices compared to controls.

blunted/decreased

When immediate choice is made, ADHD people have __________ activity in the VS/DS compared to controls. When delayed choice is made, ADHD people have _______________ activity in the DS and ____________ activity in the VS compared to controls.

Blunted/decreased

Increased, then decreased

Individuals with ADHD report getting _________________ reward (self-report) when choose the immediate reward compared to controls.

more

For ADHD adults, when doing tasks that measures attention, their inattention correlates with _____________ of the dlPFC, putamen, VS, vlPFC, and OFC.

hypoactivity

For no-go trials testing response inhibition, adults with ADHD have __________ activity of the caudate (and ACC), resulting in them making ___________________ mistakes for the no-go trials. This lack of caudal activity is associated with _______________ inattentive symptoms. The lack of ACC activity is associated with _______________ impulsivity symptoms.

reduced

more

greater

greater

For no-go trials in teens, there is _____________ in the OFC, dlPFC, mPFC, ACC. What is the interpretation of this?

hyperactivity

For kids, the coriticostriatal circuit is inefficient/unable to regulate behaviors but trying hard to. For adults, the circuit gives up and so doesn’t come online.

For Bipolar Disorder people, during euthymic state (not manic or depressive), there is _____________.

conflicting literature

During manic phase, for reward anticipation from monetary incentive delayed paradigm, bipolar disorder patients have ______________ activity in the VS for high magnitude rewards, and _____________ activity in the VS for low magnitude rewards compared to controls.

No diff for high magnitude rewards, but for low magnitude reward, VS is less active (hypoactive!)

For schizophrenic and controls, the VTA usually is ____________ active for high reward compared to no reward during reward anticipation. For patients with bipolar disorder though, ________________.

more

the high magnitude reward and no magnitude reward have the same level of activation! (no differentiation)

For reward outcome, bipolar disorder patients in manic phase have _____________ in activity of the VS for getting reward vs. not getting reward.

No differentiation.

What are the reaction time differences for Bipolar patients compared to schizophrenic and controls?

Less of a difference in the reaction time for high magnitude reward compared to low and no. Schizo and health controls have significantly lower reaction time for the higher magnitude rewards compared to low or no reward.

What is the diff between Anorexia Nervosa and Bulimia nervosa and Binge-eating disorder?

Anorexia nervosa is about low body weight and fear of gaining weight, with a disturbance in body perception.

Bulimia nervosa is about binge eating and compensating due to fear of gaining weight or being unhappy about body weight, diff is that they exhibit normal range for age and weight.

For healthy controls after doing guessing game, for the caudate and the VS, there is _________ response to wins than to losses. For patients with anorexia nervosa, there is __________ response to wins than to losses.

greater

no differentiation in

When looking at idealized body images and asked to compare one own’s body to it, healthy controls see ___________ activity in the ACC, while anorexia patients see __________ activity in the ACC. What about the insula?

robust/high, low/no

low/no, robust/high

For anorexia patients, insula activity is _____________ correlated with increases in anxiety. What about for healthy controls?

positively

not

Explain the body image task:

Generate computerized image of women in 3 diff categories: underweight, normal, and overweight. Participants are given these images and asked to imagine if they have the same body shape and how they would feel, as well as estimating the weight of the body.

For the “weight” task, anorexia patients have ____________ estimations compared to healthy controls. For the “feel” task, anorexia patients have ____________ feelings compared to healthy controls for underweight images, normal images, and overweight images.

very similar/no difference

for underweight and overweight = no diff, but for normal weight, much more negative feelings for anorexia compared to controls

For healthy women, there is ___________ activity in the VS when viewing normal weight images vs. underweight images. For anorexia patients, there is ___________ activity in the VS when viewing normal weight images vs. underweight images

more

less/lack of

For behavioral control task, Anorexia patients are __________ accurate compared to controls for target and target shifting trials, suggesting they are __________ at behavioral control. Also during these shift trials (changing target or whatever), there is global __________ of the CS circuit including the ________.

less, worse

hypoactivity, ACC, VS

When presented with highly palatable food images, anorexia patients show ____________ self reported ratings for desire to eat and pleasure, and ____________ self reported ratings for fear and disgust compared to controls. This corresponds with ________ activity of the amygdala for the anorexia pts to food cues.

lower, higher

increased

When sugar solutions are delivered to participants, the insula activity is __________ for anorexia pts compared to controls. What about for dorsal striatum?

lower/less responsive

also less responsive/lower in dorsal striatum

When viewing underweight images, patients with AN show relative __________ reactivity in the VS.

increased

For healthy controls after doing guessing game, for the caudate, there is _________ response to wins than to losses. For patients with bulimia nervosa there is __________ response to wins than to losses.

greater

no/lack of differentiation

When looking at thin/idealized images, there is _________ activation of the insula and ACC for bulimia nervosa pts compared to controls.

greater

When viewing distorted, thick body images, there is ________ activation of the amygdala for pts with bulimia nervosa.

greater

For behavioral control tasks, pts with bulimia nervosa have ___________ activity of the dACC, DS, vlPFC, dlPFC, and amygdala. What about for self-referential emotion processing?

hypoactivity/lesser

same!

Substance use disorders encompass both __________ and __________ on psychoactive substances.

abuse and dependence

Substance abuse is about

Disruptions to daily life, failure to fulfill obligations, social or interpersonal problems, etc

Substance dependence is about

Tolerance and Withdrawal

Initial substance use and escalating use is driven by: (also what circuit?)

Reward and positive reinforcement. Coriticostriatal circuit driven.

Transition to more problematic use is driven by: (also what circuit)

Negative reinforcement. Both coriticostriatal circuit and corticolimbic circuit.

After cocaine infusion, there is _____________ activity in the VS, __________ activity in the amygdala, ____________ activity in the VTA. What about nicotine infusion? What about the rest of infusions?

increased

decreased

increased

Nicotine is same trends!

Increased CS circuit! Also thalamus increases

After administering amphetamine, VS activity in response to reward of money is ____________ compared to getting placebo.

blunted

PET studies show that over time when you are dependent on drugs or alcohol/addicted to something, dopamine receptor numbers ____________ in the VS.

decrease

After lesioning the ____________, _________ cessation occurs.

insula

smoking

What structure reduces cravings by reducing VS activity?

dlPFC

For reward/positive reinforcement, there is _________________ of the VS, VTA, whole CS circuit to drug cues,