注意力缺陷多动障碍患者与健康对照者在决策过程中价值的差异神经处理。
Differential neural processing of value during decision-making in adults with attention-deficit/hyperactivity disorder and healthy controls.
机构信息
From the Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan (Lee, Goh, Gau); the Department of Psychology, National Taiwan University, Taipei, Taiwan (Goh, Gau); the Neurobiological and Cognitive Science Center, National Taiwan University, Taipei, Taiwan (Goh, Gau); the Artificial Intelligence and Robotics Center, National Taiwan University, Taipei, Taiwan (Goh); the Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan (Gau).
From the Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan (Lee, Goh, Gau); the Department of Psychology, National Taiwan University, Taipei, Taiwan (Goh, Gau); the Neurobiological and Cognitive Science Center, National Taiwan University, Taipei, Taiwan (Goh, Gau); the Artificial Intelligence and Robotics Center, National Taiwan University, Taipei, Taiwan (Goh); the Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan (Gau)
出版信息
J Psychiatry Neurosci. 2023 Mar 29;48(2):E115-E124. doi: 10.1503/jpn.220123. Print 2023 Mar-Apr.
BACKGROUND
Risk-taking behaviours are observed among adults with attention-deficit/hyperactivity disorder (ADHD). We sought to evaluate altered neural processing of stimuli values associated with risk-taking decision behaviour, distinct from learning requirements, among adults with ADHD.
METHODS
Overall, 32 adults with ADHD and 32 healthy controls without ADHD underwent a lottery choice task in a functional magnetic resonance imaging (fMRI) experiment. Participants accepted or rejected stakes with explicit information about variable probabilities of winning or losing points at different magnitudes. Outcomes were independent across trials, circumventing reward learning. Data analysis explored group differences in neurobehavioural responses to stimuli values during choice decision-making processing and outcome feedback.
RESULTS
Compared with healthy controls, adults with ADHD had slower response times and tended to accept more stakes with a middle-to-low probability of winning. Adults with ADHD had evidence of lower dorsolateral prefrontal cortex (DLPFC) activity and reduced sensitivity in the ventromedial prefrontal cortex (VMPFC) region of interest in response to linear changes in probability, compared with healthy controls. Lower DLPFC responses were associated with lower VMPFC probability sensitivity and greater risk-taking among healthy controls but not adults with ADHD. Compared with health controls, adults with ADHD showed higher responses to loss outcomes in the putamen and hippocampus.
LIMITATIONS
Assessments of real-life decision behaviours are required to further validate the experimental findings.
CONCLUSIONS
Our findings explore tonic and phasic neural processing of value-related information that modulates risk-taking behaviours among adults with ADHD. Dysregulated neural computation of the values of behavioural actions and outcomes in the frontostriatal circuits may underlie decision processing distinct from reward learning differences among adults with ADHD.
CLINICAL TRIAL REGISTRATION
NCT02642068.
背景
冒险行为在注意力缺陷/多动障碍（ADHD）的成年人中很常见。我们试图评估 ADHD 成年人在进行与冒险决策行为相关的刺激价值的神经处理过程中的变化，这与学习要求不同。
方法
共有 32 名 ADHD 成年患者和 32 名无 ADHD 的健康对照者在功能磁共振成像（fMRI）实验中进行了彩票选择任务。参与者接受或拒绝带有明确信息的赌注，这些信息涉及不同大小的赢分或输分的变量概率。结果在各次试验中是独立的，避免了奖励学习。数据分析探讨了神经行为反应的组间差异，这些差异与选择决策处理和结果反馈过程中的刺激价值有关。
结果
与健康对照组相比，ADHD 成年患者的反应时间较慢，并且更倾向于接受中等至低获胜概率的更多赌注。与健康对照组相比，ADHD 成年患者在背外侧前额叶皮质（DLPFC）区域的活动和对概率线性变化的敏感性降低，而 VMPFC 区域的活动和敏感性降低。DLPFC 反应越低，VMPFC 概率敏感性越低，健康对照组的冒险行为越大，但在 ADHD 成年患者中则不然。与健康对照组相比，ADHD 成年患者在纹状体和海马体中对损失结果的反应更高。
局限性
需要对现实生活中的决策行为进行评估，以进一步验证实验结果。
结论
我们的研究结果探讨了调节 ADHD 成年患者冒险行为的价值相关信息的紧张性和阶段性神经处理。前额叶-纹状体回路中行为动作和结果价值的神经计算失调可能是 ADHD 成年患者与奖励学习差异不同的决策处理的基础。
临床试验注册
NCT02642068。
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