Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
Cereb Cortex. 2017 Dec 1;27(12):5804-5816. doi: 10.1093/cercor/bhx265.
Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) often share phenotypes of repetitive behaviors, possibly underpinned by abnormal decision-making. To compare neural correlates underlying decision-making between these disorders, brain activation of boys with ASD (N = 24), OCD (N = 20) and typically developing controls (N = 20) during gambling was compared, and computational modeling compared performance. Patients were unimpaired on number of risky decisions, but modeling showed that both patient groups had lower choice consistency and relied less on reinforcement learning compared to controls. ASD individuals had disorder-specific choice perseverance abnormalities compared to OCD individuals. Neurofunctionally, ASD and OCD boys shared dorsolateral/inferior frontal underactivation compared to controls during decision-making. During outcome anticipation, patients shared underactivation compared to controls in lateral inferior/orbitofrontal cortex and ventral striatum. During reward receipt, ASD boys had disorder-specific enhanced activation in inferior frontal/insular regions relative to OCD boys and controls. Results showed that ASD and OCD individuals shared decision-making strategies that differed from controls to achieve comparable performance to controls. Patients showed shared abnormalities in lateral-(orbito)fronto-striatal reward circuitry, but ASD boys had disorder-specific lateral inferior frontal/insular overactivation, suggesting that shared and disorder-specific mechanisms underpin decision-making in these disorders. Findings provide evidence for shared neurobiological substrates that could serve as possible future biomarkers.
自闭症谱系障碍 (ASD) 和强迫症 (OCD) 常表现出重复行为的表型，这可能是由异常决策所支撑的。为了比较这些疾病决策的神经基础，比较了患有 ASD（N=24）、OCD（N=20）和典型发育对照组（N=20）男孩在赌博期间的大脑激活情况，并进行了计算模型比较。患者在风险决策数量上没有受损，但模型表明，与对照组相比，两组患者的选择一致性较低，对强化学习的依赖程度较低。与 OCD 患者相比，ASD 患者具有特定于疾病的选择坚持异常。神经功能上，与对照组相比，ASD 和 OCD 男孩在决策时背外侧/下额叶激活不足。在结果预期期间，与对照组相比，患者在外侧下/眶额皮质和腹侧纹状体中激活不足。在奖励接收期间，与 OCD 男孩和对照组相比，ASD 男孩在额下回/岛叶区域存在特定于疾病的过度激活。结果表明，ASD 和 OCD 个体共享决策策略，与对照组不同，以达到与对照组相当的表现。患者表现出外侧（眶额）-纹状体奖励回路的共同异常，但 ASD 男孩存在特定于疾病的外侧下额叶/岛叶过度激活，表明这些疾病的决策存在共同和特定于疾病的机制。研究结果为共享的神经生物学基础提供了证据，这些基础可能成为未来的潜在生物标志物。
