Chase H W, Fournier J C, Bertocci M A, Greenberg T, Aslam H, Stiffler R, Lockovich J, Graur S, Bebko G, Forbes E E, Phillips M L
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Transl Psychiatry. 2017 Apr 18;7(4):e1096. doi: 10.1038/tp.2017.60.
High trait impulsive sensation seeking (ISS) is common in 18-25-year olds, and is associated with risky decision-making and deleterious outcomes. We examined relationships among: activity in reward regions previously associated with ISS during an ISS-relevant context, uncertain reward expectancy (RE), using fMRI; ISS impulsivity and sensation-seeking subcomponents; and risky decision-making in 100, transdiagnostically recruited 18-25-year olds. ISS, anhedonia, anxiety, depression and mania were measured using self-report scales; clinician-administered scales also assessed the latter four. A post-scan risky decision-making task measured 'risky' (possible win/loss/mixed/neutral) fMRI-task versus 'sure thing' stimuli. 'Bias' reflected risky over safe choices. Uncertain RE-related activity in left ventrolateral prefrontal cortex and bilateral ventral striatum was positively associated with an ISS composite score, comprising impulsivity and sensation-seeking-fun-seeking subcomponents (ISSc; P⩽0.001). Bias positively associated with sensation seeking-experience seeking (ES; P=0.003). This relationship was moderated by ISSc (P=0.009): it was evident only in high ISSc individuals. Whole-brain analyses showed a positive relationship between: uncertain RE-related left ventrolateral prefrontal cortical activity and ISSc; uncertain RE-related visual attention and motor preparation neural network activity and ES; and uncertain RE-related dorsal anterior cingulate cortical activity and bias, specifically in high ISSc participants (all ps<0.05, peak-level, family-wise error corrected). We identify an indirect pathway linking greater levels of uncertain RE-related activity in reward, visual attention and motor networks with greater risky decision-making, via positive relationships with impulsivity, fun seeking and ES. These objective neural markers of high ISS can guide new treatment developments for young adults with high levels of this debilitating personality trait.
高特质冲动性寻求刺激（ISS）在18至25岁人群中很常见，且与冒险决策和有害后果相关。我们使用功能磁共振成像（fMRI）研究了以下因素之间的关系：在与ISS相关的情境中，先前与ISS相关的奖赏区域的活动、不确定奖赏预期（RE）；ISS冲动性和寻求刺激的子成分；以及100名经跨诊断招募的18至25岁人群的冒险决策。使用自我报告量表测量ISS、快感缺失、焦虑、抑郁和躁狂；临床医生施测的量表也评估了后四项。扫描后进行的冒险决策任务测量了“冒险”（可能赢/输/混合/中性）fMRI任务与“确定之事”刺激。“偏差”反映了冒险选择超过安全选择的情况。左侧腹外侧前额叶皮层和双侧腹侧纹状体中与不确定RE相关的活动与一个ISS综合得分呈正相关，该综合得分包括冲动性和寻求刺激-寻求乐趣子成分（ISSc；P⩽0.001）。偏差与寻求刺激-寻求体验（ES）呈正相关（P = 0.003）。这种关系受到ISSc的调节（P = 0.009）：仅在高ISSc个体中明显。全脑分析显示：与不确定RE相关的左侧腹外侧前额叶皮层活动与ISSc之间呈正相关；与不确定RE相关的视觉注意和运动准备神经网络活动与ES之间呈正相关；与不确定RE相关的背侧前扣带回皮层活动与偏差之间呈正相关，特别是在高ISSc参与者中（所有p<0.05，峰值水平，家族性错误校正）。我们确定了一条间接途径，通过与冲动性、寻求乐趣和ES的正相关关系，将奖赏、视觉注意和运动网络中更高水平的与不确定RE相关的活动与更大的冒险决策联系起来。这些高ISS的客观神经标志物可为具有这种使人衰弱的人格特质的年轻人的新治疗方法开发提供指导。
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