Rule-Based Decision-Making: A Novel Neuroeconomic Mechanism of Anorexia Nervosa

基于规则的决策：神经性厌食症的一种新的神经经济机制

基本信息

批准号：
10704026
负责人：
Ann Frances Haynos
金额：
$ 54.19万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-15 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10704026
关键词：
Address Anorexia Nervosa Area Automobile Driving Behavior Behavior Control Behavior Disorders Behavioral Biological Body Weight decreased Body mass index Brain Budgets Categories Cessation of life Characteristics Clinical Cognitive Compulsive Behavior Computer Models Conflict (Psychology)Corpus striatum structure Dangerousness Data Decision Making Diffusion Disease Dorsal Eating Disorders Ecological momentary assessment Economics Food Functional Magnetic Resonance Imaging Functional disorder Future Goals Habits Hyperactivity Impairment Individual Internet Intervention Interview Lead Link Mental disorders Metric System Modeling Morbidity - disease rate Neurophysiology - biologic function Neurosciences Obsessive-Compulsive Disorder Outcome Parietal Lobe Participant Pathologic Pathway interactions Pattern Persons Phenotype Prefrontal Cortex Process Psychiatric therapeutic procedure Reaction Time Research Rewards Role Science Specificity Symptoms System Testing Time Training Weight maintenance regimen biobehavior cognitive control cohort comparison group computational neuroscience cost design effective therapy executive function follow-up habit learning insight mortality mortality risk neural neuroeconomics novel predict clinical outcome prototype psychologic recruit response reward circuitry severe psychiatric disorder standard care translational neuroscience

项目摘要

PROJECT SUMMARY/ABSTRACT Cognitive and behavioral inflexibility are key features of many severe psychiatric disorders. One particularly dangerous prototype of behavioral rigidity is evident in the relentless pursuit of weight loss in anorexia nervosa (AN), a disorder with alarmingly high morbidity and mortality rates. Prior efforts to intervene upon psychological inflexibility in AN have been ineffective. This may be due to inflexibility encompassing a broad set of cognitive and behavioral processes that can result from multiple distinct decision dysfunctions that require different interventions. Decision Neuroscience, which integrates translational and computational neuroscience with economics, offers a promising new paradigm for enhancing the precision of mechanistic science for psychiatric disorders. This approach posits that mental illnesses result from unique miscalculations performed by neurally- separable decision systems that can be probed with neuroeconomic paradigms. This approach holds promise for identifying precise treatment targets suited for different forms of psychiatric illness. Our pilot data derived from a Decision Neuroscience approach using a novel neuroeconomic paradigm (the Web-Surf task) have provided several insights into unique decision-making processes in AN. First, on this task, individuals with AN showed a distinct decision dysfunction suggesting overreliance on a rule-based decision system, reflected through rapid decision-making focused on maximizing long-term goals. This approach can lead to behavior that is inflexible and insensitive to current context. Second, this decision system appeared to be supported by hyperactivity within the frontoparietal cognitive control circuit (e.g., dorsolateral and ventrolateral prefrontal cortex), which is involved in long-term rule-following. Third, these biobehavioral patterns were linked to BMI and short-term weight-control behavior in AN. This frontoparietal-driven rule-based decision process differs from other decision-making patterns (e.g., fronto-dorsal striatal habit learning) that have been implicated in promoting behavioral rigidity in other psychiatric disorders, such as OCD. To extend this research to establish whether decision patterns distinguish AN from non-clinical and related clinical groups, we will recruit: a) AN; b) healthy comparison (HC); and (c) OCD (clinical comparison) groups. OCD represents a similar phenotype to AN hypothesized to be promoted through different decision processes. During fMRI, subjects will complete the Web-Surf task to identify neuroeconomic decision patterns (e.g., rule- based, reward-based, or habitual decision-making) in each group; these will be validated against other decision tasks. Participants will then provide data on symptoms via interviews and ecological momentary assessment at baseline and 12-month follow-up to examine the influence of distinct decision processes on AN and OCD symptoms. This study will evaluate the specificity with which AN is maintained by over-reliance on a frontoparietal rule-based decision system. This will permit first steps towards informing precision neuroscience- based psychiatric treatments informed by decision mechanisms, rather than solely by phenotypic presentation.

项目概要/摘要认知和行为缺乏灵活性是许多严重精神疾病的关键特征。特别是一行为僵化的危险原型在神经性厌食症患者对减肥的不懈追求中显而易见 (AN)，一种发病率和死亡率高得惊人的疾病。之前的心理干预努力 AN 中的僵化是无效的。这可能是由于广泛的认知不灵活所致以及可能由多种不同的决策功能障碍导致的行为过程，这些决策功能障碍需要不同的干预措施。决策神经科学，它将转化和计算神经科学与经济学，为提高精神病学机械科学的精度提供了一个有前途的新范式失调。这种方法假设精神疾病是由神经系统执行的独特错误计算造成的。可以用神经经济学范式进行探索的可分离决策系统。这种方法很有希望用于确定适合不同形式精神疾病的精确治疗目标。我们的试点数据源自决策神经科学方法，使用一种新颖的神经经济范式（ Web-Surf 任务）为 AN 中独特的决策过程提供了一些见解。首先，针对这个任务，患有 AN 的个体表现出明显的决策功能障碍，表明过度依赖基于规则的决策系统，通过专注于最大化长期目标的快速决策来体现。这种方法可以导致行为不灵活且对当前环境不敏感。其次，这个决策系统似乎得到额顶叶认知控制回路（例如，背外侧和腹外侧前额叶皮层），它参与长期的规则遵循。三、这些生物行为模式与 AN 中的 BMI 和短期体重控制行为有关。这种额叶驱动的基于规则的决策过程不同于其他决策模式（例如，额背纹状体习惯学习）与促进其他精神疾病（例如强迫症）的行为僵化有关。扩展这项研究以确定决策模式是否将 AN 与非临床和相关的区分开来临床组，我们将招募： a) AN； b) 健康比较（HC）； (c) OCD（临床比较）组。 OCD 代表了与 AN 类似的表型，假设通过不同的决策过程来促进。在功能磁共振成像期间，受试者将完成网络冲浪任务来识别神经经济决策模式（例如，规则- 基于、基于奖励或习惯性决策）在每个组中；这些将根据其他内容进行验证决策任务。然后，参与者将通过访谈和生态瞬时提供有关症状的数据基线评估和 12 个月随访，以检查不同决策过程对 AN 的影响和强迫症症状。本研究将评估通过过度依赖来维持 AN 的特异性。基于额顶规则的决策系统。这将为精确神经科学提供信息迈出第一步—— 基于决策机制的精神治疗，而不仅仅是表型表现。