Emotion and Motivation

Emotion: Background

  • Emotions are complex and universal.

  • The study of emotion was previously neglected in Neuroscience.

  • New technologies like fMRI have advanced our understanding of emotions

Identifying and Perceiving Emotions

  • Darwin's work in the 1850s identified six basic facial expressions.

  • Ekman's research in remote Papua New Guinea suggests some emotions are 'hardwired' in the brain.

  • Recognition of emotion is altered in some neurological conditions (Cowen, 2019).

Emotional Responses

  • Emotional responses comprise physiological, psychological, and behavioral responses (Van Wijck & McBean, 2013).

    • Physiological responses involve the endocrine, CNS, and musculoskeletal systems.

    • Psychological responses include thoughts, beliefs, and expectations.

    • Behavioral responses are expressed through voice, posture, and movement.

The Brain and Emotion

  • Pre-frontal and temporal pole association areas are involved in emotion (Lundy-Ekman, 2023).

Additional Brain Structures: Emotion

  • The amygdala generates feelings and interprets facial expressions, body language, and social signals.

  • It's essential for social behavior and important for emotional learning.

Brain Structures: Regulating Emotion

  • Recognition, generation, and perception of emotions, and regulation of autonomic aspects of emotions (Lundy-Ekman, 2023).

  • Automatic and voluntary regulation of emotion.

  • Voluntary regulation of emotion.

Brain Structures and Emotion: Summary

  • Brain structures and their functions in emotion regulation.

    • Medial prefrontal cortex, amygdala, Area 25, ventral striatum, anterior insula, and dorsal anterior cingulate cortex identify emotional significance of stimuli, generate and perceive emotions, and regulate autonomic aspects of emotions.

    • Rostral cingulate cortex, orbital (ventrolateral prefrontal) cortex, and ventromedial prefrontal cortex facilitate automatic and voluntary emotional regulation.

The Social-Behavior Circuit

  • Emotion and behavior are regulated depending on the setting (Lundy-Ekman, 2023).

The Emotion Loop

  • The Emotion Loop integrates emotions with other loops and is partly responsible for the perception and experience of emotion.

  • Structures involved: medial prefrontal cortex, ventral striatum, ventral pallidum, and medial group of thalamic nuclei (MG).

  • An essential function of the Emotion Loop is seeking rewards.

Emotional Lability

  • Emotional lability involves abrupt and intense changes in emotions.

  • It is the inability to maintain a consistent emotional state over time.

  • May present as excessive crying or laughter.

  • Presents in different neurological conditions (Leaberry et al., 2020).

Traumatic Brain Injury (TBI)

  • TBI is defined as "Injury from an external trauma to the head; when the head suddenly and violently hits an object or when an object pierces the skull" (Lohmann & Vas, 2021).

  • Categorized as Open or Closed.

  • Incidence in Australia is approximately 107 per 100,000 people (Jagnoor & Cameron, 2015).

  • Can result in physical, cognitive, emotional, and behavioral changes.

  • Changes after TBI can compromise return to school and work, leisure activities, and relationships (Jeffay et al., 2023).

Mental Health Conditions and the Brain

  • Schizophrenia:

    • Definition: Group of disorders with disordered thinking, delusions, hallucinations, lack of motivation, apathy, social withdrawal.

    • Overactive: Amygdala, hippocampus

    • Underactive: Lateral prefrontal cortex, ventral prefrontal cortex, ventral striatum, and medial prefrontal cortex.

  • Depression:

    • Definition: A syndrome of hopelessness and a sense of worthlessness.

    • Overactive: Area 25, amygdala, ventral prefrontal cortex, ventral striatum

    • Underactive: Lateral prefrontal cortex.

  • Anxiety:

    • Definition: A feeling of tension or uneasiness that accompanies anticipating danger.

    • Overactive: Amygdala, medial prefrontal cortex, hippocampus

    • Underactive: Ventral prefrontal, rostral cingulate cortex.

Motivation: Background

  • Motivation: Processes that initiate and sustain goal-directed activity.

  • Motivation and emotion are intricately linked (Cromwell et al., 2020; Schunk, 2020).

  • Goal-directed behavior involves deciding on a goal, planning, executing a plan, and evaluating the plan.

Brain Structures: Motivation

  • Motivation and reward are centered in the ventral striatum (Lundy-Ekman, 2023).

The Ventral Striatum

  • Ventral striatum sensitivity can be a vulnerability or opportunity (Telzer, 2016).

    • Vulnerability: Orientation towards negative rewards (drug experimentation, dangerous driving), sensitivity to social threat (negative peer influence).

    • Opportunity: Orientation towards positive rewards (academic motivation, passions and hobbies), sensitivity to social connection (healthy peer relationships, prosocial behaviors).

Goal-Directed Behavior Loop

  • Structures involved in goal-directed behavior and divergent thinking (Lundy-Ekman, 2023).

Reward-Seeking and Avoidance-Seeking Pathways

  • The Ventral Tegmental Area is a ‘Dopamine Distributor’.

  • The amygdala is the ‘Emotion trigger’.

  • The nucleus accumbens is the ‘Reward anticipator’ (Khan Academy, 2023).

Assessment Approaches

  • Frontal Systems Behaviour Scale (FrSBe) (Grace & Molloy, 2001): Measures pre- and post-injury apathy, disinhibition, and executive dysfunction in day-to-day life.

  • Behavioural Assessment of the Dysexecutive Syndrome (BADS) (Wilson et al., 1996): Assesses four domains of executive functioning: emotional, motivational, behavioral, and cognitive.

  • Executive Functioning Performance Test (EFPT) (Baum et al., 2008): Assesses initiation, organization, sequencing, safety, and judgement in functional activities.

  • Deficits in motivation and emotional regulation rarely exist in isolation, so assessments of executive functioning and social cognition more broadly are considered.

Assessment: Community Re-integration

  • Considering factors that impact community re-integration and participation.

  • Mayo-Portland Adaptability Inventory (MPAI-4): MPAI-4 items represent the range of physical, cognitive, emotional, behavioral, and social problems that people may encounter after ABI.

Clinical Guidelines for TBI

  • INCOG 2.0 Guidelines 2023 Examples include:

    • Clinicians should consider evaluating aspects of social cognition ability, including emotion perception, theory of mind (ToM), and emotional empathy. Interventions aimed at improving these areas are recommended (Level of Evidence A).

    • Metacognitive strategy instructions (e.g. goal management training, plan-do-check-review, and prediction performance) should be used with individuals with TBI for difficulties with executive functioning impairments (Level of Evidence A) (Jeffay et al., 2023; Bayley et al., 2023).

Take Home Messages

  • Emotional and behavioral changes are common after a Traumatic Brain Injury (TBI).

  • The neural basis of motivation and emotion are intricately linked.

  • The pre-frontal cortex is responsible for complex functions, including goal-directed behavior and emotions.

  • Emotional lability is an abrupt change in emotions and presents with individuals with certain neurological conditions (such as TBI).

  • A multi-disciplinary approach is required for the assessment and treatment of changes in motivation and emotion after brain injury.