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

• 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
• 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

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.

项目摘要/摘要 认知和行为僵化是许多严重的精神疾病的关键特征。特别是 行为刚性的危险原型在不断追求厌食的厌食症中显而易见 （an），一种发病率和死亡率高度高的疾病。先前努力干预心理 一个不灵活的人无效。这可能是由于富裕性包含了一系列认知能力 和行为过程可能是由于需要不同的不同决策功能障碍而产生的 干预措施。决策神经科学，将转化和计算神经科学与 经济学，提供了一个有希望的新范式，以增强精神科的机理科学精确性 疾病。这种方法认为，精神疾病是由神经造成的独特错误计算引起的 可以通过神经经济范式探测的可分离决策系统。这种方法有望 用于确定适合不同形式的精神病的精确治疗目标。 我们使用新型神经经济范式从决策神经科学方法得出的试验数据（ Web-Surf任务）为AN中的独特决策过程提供了一些见解。首先，在此任务上， 具有独特决定功能障碍的人表明对基于规则的决定过高依赖 通过快速决策的重点是最大化长期目标的系统。这种方法可以 导致行为不灵活，对当前环境不敏感。其次，这个决策系统似乎 受到额心认知控制电路中的多动症（例如，背外侧和 腹外侧前额叶皮层），与长期规则遵循有关。第三，这些生物行为模式 与An中的BMI和短期重量控制行为有关。这项基于额叶驱动的规则决定 过程不同于其他决策模式（例如，额外的纹状体习惯学习） 涉及在其他精神疾病（例如OCD）中促进行为僵化。 扩展这项研究以确定决策模式是否将A与非临床和相关的区分开 临床组，我们将招募：a）AN； b）健康比较（HC）； （c）强迫症（临床比较）组。 强迫症代表与假设的表型相似的表型，该表型通过不同的决策过程促进。 在fMRI期间，受试者将完成Web-SURF任务以识别神经经济决策模式（例如，规则 - 每组基于，基于奖励或习惯决策）；这些将与其他 决策任务。然后，参与者将通过访谈和生态瞬间提供有关症状的数据 基线和12个月的随访评估，以检查不同的决策过程对 和强迫症症状。这项研究将评估通过过度依赖对A维持A的特异性 基于额叶规则的决策系统。这将允许告知精确神经科学的第一步 - 基于决策机制的基于精神病治疗，而不是仅通过表型表现。