Two sides of the same coin? What neural processing of emotion and rewards can tell us about complex post-traumatic stress disorder and borderline personality disorder.

BACKGROUND: Borderline personality disorder (BPD) and complex posttraumatic stress disorder (cPTSD) share clinical similarities, complicating diagnosis and treatment. Research on the neurobiology of BPD and monotraumatic PTSD has shown that a prefrontal-limbic imbalance in emotional and reward processing is a hallmark of both disorders, but studies examining this network in cPTSD are lacking. Therefore, this study aimed to directly compare neural processing of emotion and reward during decision making in cPTSD and BPD. METHODS: Using functional magnetic resonance imaging, we measured neural activity in female patients (27 patients with cPTSD, 21 patients with BPD and 37 healthy controls) during a Desire-Reason Dilemma task featuring distracting fearful facial expressions. RESULTS: We found no differences in neural activation when comparing cPTSD and BPD. However, when grouping patients based on symptom severity instead on diagnosis, we found that increased symptoms of cPTSD were associated with increased activation of dorsolateral prefrontal cortex during reward rejection, whereas increased symptoms of BPD were associated with decreased activation in prefrontal and limbic regions during reward rejection with distracting negative emotional stimuli. CONCLUSION: This is the first study to investigate and compare emotional processing and reward-based decision making in cPTSD and BPD. Although we found no neural differences between disorders, we identified symptom-related neural patterns. Specifically, we found that elevated cPTSD symptoms were related to greater sensitivity to reward stimuli, whereas heightened BPD symptoms were related to increased susceptibility to emotional stimuli during goal-directed decision making. These findings enhance our understanding of neural pathomechanisms in trauma-related disorders.

Social reward and nonsocial reward processing across the adult lifespan: An interim multi-echo fMRI and diffusion dataset.

Social relationships change across the lifespan as social networks narrow and motivational priorities shift. These changes may affect, or reflect, differences in how older adults make decisions related to processing social and non-social rewards. While we have shown initial evidence that older adults have a blunted response to some features of social reward, further work in larger samples is needed to replicate our results and probe the extent to which age-related differences translate to real world consequences, such as financial exploitation. To address this gap, we are conducting a 5-year study funded by the National Institute on Aging (NIH R01-AG067011). Over the course of the funding period (2021-2026), this study seeks to: 1) characterize neural responses to social rewards across adulthood; 2) relate those responses to risk for financial exploitation and sociodemographic factors tied to risk; and 3) examine changes in risk for financial exploitation over time in healthy and vulnerable groups of older adults. This paper describes the preliminary release of data for the larger study. Adults (N = 114; 40 male / 70 female / 4 other or non-binary; 21-80 years of age M = 42.78, SD = 17.13) were recruited from the community to undergo multi-echo fMRI while completing tasks that measure brain function during social reward and decision making. Tasks probe neural response to social reward (e.g., peer vs. monetary feedback) and social context and closeness (e.g., sharing a monetary reward with a friend compared to a stranger). Neural response to social decision making is probed via economic trust and ultimatum games. Functional data are complimented by a T1 weighted anatomical scan and multi-shell diffusion-weighted imaging (DWI) to enable tractography and assess neurite orientation dispersion and density. Overall, this dataset has extensive potential for re-use, including leveraging multimodal neuroimaging data, within subject measures of fMRI data from different tasks - data features that are rarely seen in an adult lifespan dataset. Finally, the functional data will allow for developmentally sensitive cross-sectional analyses of differences in brain response to nuanced differences in reward contexts and outcomes (e.g., monetary vs. social; sharing winnings with a friend vs. stranger; stranger vs. computer).

Effort-based decision-making in ultra-high-risk for psychosis and bipolar disorder.

BACKGROUND: Effort-based decision-making has been proposed as a potential mechanism contributing to transdiagnostic motivational deficits in psychotic disorder and bipolar disorder. However, very limited information is available about deficits in effort-cost-decision-making in the early stages of psychotic disorder and no study has investigated effort allocation deficits before the onset of bipolar disorder. Our aim was to investigate effort-based-decision-making in ultra-high-risk for psychosis (UHR-P) and bipolar disorder (UHR-BD). METHODS: Effort-cost decision-making performance was evaluated in UHR-P (n = 72) and UHR-BD (n = 68) and healthy controls (n = 38). Effort-Expenditure for Reward Task (EEfRT) was used. RESULTS: Compared to controls, both UHR-P and UHR-BD groups were associated with a reduced possibility to choose the harder task when the reward magnitudes and/or the likelihood of receiving the reward were high. In both groups, effort allocation abnormalities were associated with poor social functioning. CONCLUSIONS: The current findings suggest that difficulties in effort-cost computation are transdiagnostic markers of illness liability in psychotic and bipolar disorders. In early intervention services, effort-based decision-making abnormalities should be considered as a target for interventions to manage motivational deficits in individuals at high risk for psychosis and BD.

Anticipatory and Consummatory Responses Across Reward Domains in Adolescents With Anorexia Nervosa.

OBJECTIVE: Anorexia nervosa (AN) is characterized by a tendency to limit intake of food, with specific restriction of foods that are generally considered highly palatable. This observation raises questions about whether reward processing is disturbed in AN. This study examined whether adolescents with AN differ from healthy control peers (HC) in anticipatory and consummatory reward processing. METHOD: Adolescents with AN (n = 71) and HC (n = 41) completed the Temporal Experience of Pleasure Scale (TEPS). The TEPS Anticipatory Pleasure scale was divided into two further subscales (Food and Non-food). Anticipatory (Food and Non-food) and Consummatory Pleasure (Non-food) scores were compared between adolescents with AN and HC using independent t-tests. RESULTS: TEPS scores were significantly lower among adolescents with AN than HC in Anticipatory Pleasure Food (t(110) = 7.80, p < 0.001) and Non-food (t(110) = 4.36, p < 0.001), and Consummatory Pleasure (t(110) = 2.60, p = 0.01) subscales. When controlling for BDI score, there was no significant group difference in TEPS Consummatory Pleasure scores (t(108) = 0.88, p = 0.38). Among adolescents with AN, Food Anticipatory Pleasure was significantly negatively correlated with all EDE-Q subscales and global score (r(68) = -0.38, p = 0.002) and positively correlated with food intake at a laboratory buffet meal (r(61) = 0.53, p < 0.001). DISCUSSION: Measures of both anticipatory and consummatory reward were reduced among adolescents with AN with a short duration of illness. In this study, eating disorder symptoms were related to diminished reward responses in anticipation of food. Dampened anticipatory reward response may comprise a mechanism of illness in AN that should be subject to further study.

Increased Sensitivity to Effort and Perception of Effort in People with Schizophrenia.

OBJECTIVE: Motivational deficits in schizophrenia are proposed to be attributable in part to abnormal effort-cost computations, calculations weighing the costs vs. the benefits of actions. Several reports have shown that people with schizophrenia display a reduced willingness to exert effort for monetary rewards when compared to controls. The primary goal of the current study was to further characterize reduced willingness to exert effort in schizophrenia by determining whether reduced willingness reflects (1) reduced sensitivity to reward, (2) increased sensitivity to effort, or (3) a combination of both. DESIGN: We assessed effort-cost decision-making in 30 controls and 30 people with schizophrenia, using 2 separate experimental tasks. Critically, one paradigm allowed for independent estimation of effects of reward and effort sensitivity on choice behavior. The other task isolated effort sensitivity by measuring effort in the absence of reward. Clinical interviews and self-report questionnaires were administered to people with schizophrenia to determine negative symptom severity. RESULTS: Across both tasks, we found evidence for reduced willingness to exert effort in people with schizophrenia compared to controls. Further, in both paradigms reduced willingness to exert effort was driven by increased sensitivity to effort in people with schizophrenia compared to controls. In contrast, measures of reward sensitivity did not significantly differ between groups. Surprisingly, we did not find correlations between task variables and measures of negative symptom severity. CONCLUSIONS AND RELEVANCE: These findings further specify prior work by identifying a specific contributory role for increased effort sensitivity in effort-cost decision-making deficits in schizophrenia.

Aberrant high-beta band functional connectivity during reward processing in melancholic major depressive disorder: An MEG study.

OBJECTIVE: To identify the spatial-temporal pattern variation of whole-brain functional connectivity (FC) during reward processing in melancholic major depressive disorder (MDD) patients, and to determine the clinical correlates of connectomic differences. METHODS: 61 MDD patients and 32 healthy controls were enrolled into the study. During magnetoencephalography (MEG) scanning, all participants completed the facial emotion recognition task. The MDD patients were further divided into two groups: melancholic (n = 31) and non-melancholic (n = 30), based on the Mini International Neuropsychiatric Interview (M.I.N.I.) assessment. Melancholic symptoms were examined by using the 6-item melancholia subscale from the Hamilton Depression Rating Scale (HAM-D6). The whole-brain orthogonalized power envelope connections in the high-beta band (20-35 Hz) were constructed in each period after the happy emotional stimuli (0-200 ms, 100-300 ms, 200-400 ms, 300-500 ms, and 400-600 ms). Then, the network-based statistic (NBS) was used to determine the specific abnormal connection patterns in melancholic MDD patients. RESULTS: The NBS identified a sub-network difference at the mid-late period (300-500 ms) in response to happy faces among the three groups (corrected P = 0.035). Then, the post hoc and correlation analyses found five FCs were decreased in melancholic MDD patients and were related to HAM-D6 score, including FCs of left fusiform gyrus-right orbital inferior frontal gyrus (r = -0.52, P < 0.001), left fusiform gyrus-left amygdala (r = -0.26, P = 0.049), left posterior cingulate gyrus-right precuneus (r = -0.32, P = 0.025), left precuneus-right precuneus (r = -0.27, P = 0.049), and left precuneus-left inferior occipital gyrus (r = -0.32, P = 0.025). CONCLUSION: In response to happy faces, melancholic MDD patients demonstrated a disrupted functional connective pattern (20-35 Hz, 300-500 ms), which involved brain regions in visual information processing and the limbic system. The aberrant functional connective pattern in reward processing might be a biomarker of melancholic MDD.

Blunted reward-related activation to food scenes distinguishes individuals with alcohol use disorder in a pilot case-control fMRI pilot study.

BACKGROUND: Alcohol use disorder (AUD) is thought to bias the neurocircuitry underlying reward processing and motivation to preferentially attend to conditioned alcohol cues over natural rewards. The present case-control pilot study evaluated this hypothesis using novel natural reward paradigms. METHODS: Twenty-eight participants (AUD, n = 14, light drinkers, n = 14) were recruited-AUD participants reported 44.0% heavy drinking days (%HDD) and 4.67 drinks/day over the preceding 90 days. Functional magnetic resonance imaging (fMRI) data were acquired during the administration of three separate picture-viewing paradigms of alcohol cues, food scenes, and social reward, respectively. Independent samples t-tests were performed to compare groups' fMRI data and exploratory correlation analyses were performed to examine associations with clinical characteristics of AUD. RESULTS: Food scenes elicited abnormally low reward-related activation, within the superior frontal gyrus and caudate bilaterally, among AUD participants. Lower activation to food scenes within the superior frontal gyrus was, in turn, associated with higher levels of past-month %HDD among AUD participants, specifically, along with craving and alcohol dependence severity when examined across the full sample. Contrasting reward types (e.g., alcohol cues vs. food scenes) did not reveal "preferential" activation to differentiate groups. CONCLUSIONS: Heavy drinking appears associated with reduced responsivity to natural rewards, specifically food rather than social cues. Neural mechanisms underlying the high prevalence of malnutrition among individuals with AUD may involve some combination of blunted approach-related affect and reduced craving-related motivation to eat when food is present, resulting in limited engagement of cortico-striato-thalamic motor circuitry supporting food acquisition. However, given the preliminary nature of this pilot study, such formulations remain tentative until larger follow-up studies can be conducted. From a potential translational standpoint, the ability of promising therapeutics to demonstrate increased responsivity to natural rewards, specifically nutritive reward may serve as a valuable complementary efficacy indicator for future clinical neuroimaging trials in AUD.

Neural dynamics underlying the illusion of control during reward processing.

The illusion of control refers to a behavioral bias in which people believe they have greater control over completely stochastic events than they actually do, leading to an inflated estimate of reward probability than objective probability warrants. In this study, we examined how reward system is modulated by the illusion of control through the lens of neural dynamics. Participants in a behavioral task exhibited a classical illusion of control, assigning a higher value to the gambling wheels they picked themselves than to those given randomly. An event-related potential study of the same task revealed that this behavioral bias is associated with reduced reward anticipation, as indexed by the stimulus-preceding negativity, diminished positive prediction error signals, as reflected by the reward positivity, and enhanced motivational salience, as revealed by the P300. Our findings offer a mechanistic understanding of the illusion of control in terms of reward dynamics.

Anhedonia is associated with higher functional connectivity between the nucleus accumbens and paraventricular nucleus of thalamus.

BACKGROUND: Anhedonia stands as a life-threatening transdiagnostic feature of many mental illnesses, most notably major depression and involves neural circuits for processing reward information. The paraventricular nucleus of the thalamus (PVT) is associated with reward-seeking behavior, however, links between the PVT circuit and anhedonia have not been investigated in humans. METHODS: In a sample of adults with and without psychiatric symptoms (n = 75, 18-41 years, 55 female), we generated an anhedonia factor score for each participant using a latent factor analysis, utilizing data from depression and anxiety assessments. Functional connectivity between the PVT and the nucleus accumbens (NAc) was calculated from high-resolution (1.5 mm) resting state fMRI. RESULTS: Anhedonia factor scores showed a positive relationship with functional connectivity between the PVT and the NAc, principally in males and in those with psychiatric symptoms. In males, connectivity between other midline thalamic nuclei and the NAc did not show these relationships, suggesting that this link may be specific to PVT. LIMITATIONS: This cohort was originally recruited to study depression and not anhedonia per se. The distribution of male and female participants in our cohort was not equal. Partial acquisition in high-resolution fMRI scans restricted regions of interest outside of the thalamus and reward networks. CONCLUSIONS: We report evidence that anhedonia is associated with enhanced functional connectivity between the PVT and the NAc, regions that are relevant to reward processing. These results offer clues as to the potential prevention and prevention and treatment of anhedonia.

Mindfulness facets are differentially related with reward processing stages in striatum and alcohol use in adolescence.

Attenuated functional processing of non-drug rewards in striatal regions is an important mechanism in the transition from normal to hazardous alcohol use. Recent interventions seek to enhance nondrug reward processing through mindfulness, a mechanism that targets attention regulation and self-regulatory processes. It is yet unclear which specific aspects of mindfulness and which stages of reward processing are relevant preventive targets, particularly in adolescence, where alcohol use is often initiated and reward relating processing streams undergo continuous maturation. Fifty-four 14- and 16-year-old adolescents (54% female) completed the monetary incentive delay task (MID) during event-related functional magnetic resonance imaging. Alcohol use and dispositional mindfulness facets were measured using self-report instruments. Mindful Attention Regulation was positively associated with anticipatory reward processing in ventral striatum, whereas feedback-related processing in dorsal striatum was associated with the mindfulness facet Body-Listening. Only Attention Regulation was additionally associated with frequency of alcohol consumption and mediated the relationship between functional activation in ventral striatum during reward anticipation and alcohol use. Attention Regulation, beyond other mindfulness facets, might contribute to potentially triggering neural mechanisms of anticipatory, but not feedback-related reward processing and alcohol use, presenting a potential target for preventive efforts in combating transitions to substance-related disorders in adolescents.

Multivariate Neural Patterns of Reward and Anxiety in Adolescents with Anorexia Nervosa.

People with anorexia nervosa (AN) commonly exhibit elevated anxiety and atypical reward responsiveness. To examine multivariate neural patterns associated with reward and the impact of anxiety on reward, we analyzed fMRI data from a monetary reward task using representational similarity analysis, a multivariate approach that measures trial-by-trial consistency of neural responses. Twenty-five adolescent girls with AN and 22 mildly anxious controls lacking any history of AN were presented personalized anxiety-provoking or neutral words before receiving a reward, and neural response patterns in reward regions were analyzed. Consistent with our preregistered hypothesis, AN participants showed lower representational similarity than controls during neutral-word rewarded trials. Within groups, controls showed significant representational similarity in reward circuit regions including the left nucleus accumbens, left basolateral amygdala, and left medial orbitofrontal cortex, which were not observed in AN. Further, reward-related prefrontal cognitive control areas - left ventrolateral prefrontal cortex and left dorsolateral prefrontal cortex - showed significant representational similarity in both groups, but a larger spatial extent in controls. Contrary to predictions, there were no significant between-group differences for the effects of anxiety-words on reward representational similarity, and representational similarity did not predict longitudinal symptom change over six months. Overall, the results demonstrate relatively inconsistent trial-by-trial responses to reward receipt in the neutral state in AN compared with controls in both reward circuit and cognitive control regions, but no significant differential effects of anxiety states on reward responses. These results add to dynamic understandings of reward processing in AN that have potential implications for planning and guiding reward-focused interventions.

Combined Effects of Social Exclusion and Social Rank Feedback on Risky Decision-Making Across Adolescence.

Adolescents' need to belong and concerns about social status are thought to increase risk-taking, however, not much is known about how feedback about social rank and the effects of social exclusion moderate risky decision-making. To this end, the present study examined how social rank feedback moderates the effects of social exclusion on risky decisions during adolescence. The experimental study included a total of 122 participants (11-19 years; 44% female). Participants were randomly assigned to receive either individual or social rank feedback in the Columbia Card Task after social inclusion and exclusion via the Cyberball paradigm. Contrary to expectations, social exclusion led to more cautious decision-making. Mid-adolescents were most influenced by the combination of social exclusion and social rank feedback, while late adolescents became more cautious with individual feedback. These findings suggest that peer influences also have adaptive effects, increasing sensitivity to risk information, with developmental differences in the role of social rank.

Abnormal neural sensitivity to rewards as a candidate process of high depression risk in the FMR1 premutation: A pilot study.

The etiological heterogeneity of depression poses a challenge for prevention and intervention efforts. One solution is to map unique etiological pathways for subgroups defined by a singular risk factor. A relevant population for this approach is women who carry the premutation of the fragile X messenger ribonucleoprotein 1 (FMR1) gene, who are at high risk for adult-onset depression. This study explores a candidate neurophysiological marker of depression risk: reduced reward sensitivity, indexed by the reward positivity (RewP). The RewP has been linked to depression risk in the general population, but is unexplored within FMR1 premutation carriers. 16 women with the FMR1 premutation and a matched control group completed a simple guessing task while the electroencephalogram was recorded. Among premutation carriers, RewP difference score (win versus loss) was reduced. These preliminary finding suggest that the FMR1 premutation may confer increased risk for depression in part through abnormal neural sensitivity to rewards.

Cellular and circuit architecture of the lateral septum for reward processing.

The lateral septum (LS) is composed of heterogeneous cell types that are important for various motivated behaviors. However, the transcriptional profiles, spatial arrangement, function, and connectivity of these cell types have not been systematically studied. Using single-nucleus RNA sequencing, we delineated diverse genetically defined cell types in the LS that play distinct roles in reward processing. Notably, we found that estrogen receptor 1 (Esr1)-expressing neurons in the ventral LS (LSEsr1) are key drivers of reward seeking via projections to the ventral tegmental area, and these neurons play an essential role in methamphetamine (METH) reward and METH-seeking behavior. Extended exposure to METH increases the excitability of LSEsr1 neurons by upregulating hyperpolarization-activated cyclic nucleotide-gated (HCN) channels, thereby contributing to METH-induced locomotor sensitization. These insights not only elucidate the intricate molecular, circuit, and functional architecture of the septal region in reward processing but also reveal a neural pathway critical for METH reward and behavioral sensitization.

Severe sexual abuse in childhood and altered neurophysiological response to reward in female adults.

BACKGROUND: A relatively understudied but growing body of research indicates that individuals with a history of childhood trauma exhibit altered reward processing in adulthood. Research to date has focused on adversity broadly, with studies typically finding evidence of blunted response to rewards in adults with a history of childhood trauma. OBJECTIVE: Given the role of reward processing in risk for psychopathology and the particularly pathogenic nature of sexual abuse (SA), the present study sought to assess whether adults with a history of severe childhood SA exhibit altered neurophysiological response to rewards. PARTICIPANTS AND SETTING: Female adults (N = 105) were included from two study sites that used the same measures of childhood trauma (Childhood Trauma Questionnaire, CTQ), reward processing (Doors Task), and psychopathology (SCID). METHODS: Based on participants' CTQ and SCID responses, three groups were created: Severe SA (n = 36), Clinical Match (with comparable lifetime psychopathology but no-to-minimal SA history; n = 35), and Healthy Controls (n = 34). Group differences in RewP amplitude were assessed. RESULTS: The Severe SA group exhibited larger reward positivity (RewP) amplitude to monetary rewards than the Clinical Match and Healthy Control groups (partial ƞ2 = 0.06, p = .047). This effect remained after covarying for severity of other forms of childhood trauma. CONCLUSIONS: Our study found that severe SA in childhood was related to a heightened response to reward in adulthood. Furthermore, this was not attributable to the severity of other forms of early trauma or comorbid psychopathology. Future studies are needed to identify how heightened reward processing following severe childhood SA may be implicated in the onset and course of psychopathology.

Why creatives don't find the oddball odd: Neural and psychological evidence for atypical salience processing.

Creativity has previously been linked with various attentional phenomena, including unfocused or broad attention. Although this has typically been interpreted through an executive functioning framework, such phenomena may also arise from atypical incentive salience processing. Across two studies, we examine this hypothesis both neurally and psychologically. First we examine the relationship between figural creativity and event-related potentials during an audio-visual oddball task, finding that rater creativity of drawings is associated with a diminished P300 response at midline electrodes, while abstractness and elaborateness of the drawings is associated with an altered distribution of the P300 over posterior electrodes. These findings support the notion that creativity may involve an atypical attribution of salience to prominent information. We further explore the incentive salience hypothesis by examining relationships between creativity and a psychological indicator of incentive salience captured by participants' ratings of enjoyment (liking) and their motivation to pursue (wanting) diverse real world rewards, as well as their positive spontaneous thoughts about those rewards. Here we find enhanced motivation to pursue activities as well as a reduced relationship between the overall tendency to enjoy rewards and the tendency to pursue them. Collectively, these findings indicate that creativity may be associated with atypical allocation of attentional and motivational resources to novel and rewarding information, potentially allowing more types of information access to attentional resources and motivating more diverse behaviors. We discuss the possibility that salience attribution in creatives may be less dependent on task-relevance or hedonic pleasure, and suggest that atypical salience attribution may represent a trait-like feature of creativity.

The relationship between mental health and risky decision-making in children and adolescents: a scoping review.

BACKGROUND: Evidence from studies on adult participants and clinical samples of children suggest an association between risky decision-making and mental health problems. However, the extent and nature of this association in the general youth population remains unknown. Therefore, this scoping review explores the current evidence on the relationship between mental health (internalising and externalising symptoms) and risky decision-making in the general youth population. METHODS: A three-step search strategy was followed and applied to four databases. Selection criteria included participants < 18 years representative of the general population, and information on both risky decision-making (assessed using gambling tasks) and internalising /externalising symptoms. Data were extracted and synthesised for study and participant characteristics, aspects and measures for the main variables, and key findings. RESULTS: Following screening, twenty-one studies were retrieved. Non-significant associations were more frequent than significant associations for both internalising and externalising symptoms, particularly for social difficulties and broad externalising symptoms. Among the significant associations, hyperactivity/inattention and conduct problems appeared to be positively associated with risk-taking and negatively associated with quality of decision-making. However, patterns were less clear for links between risky decision-making and internalising symptoms, especially between risk-taking and anxiety symptoms. CONCLUSIONS: The present review suggests predominantly a lack of relationship between risky decision-making and mental health problems, and outlines several possible reasons for it. However, when specificity is considered carefully there seems to be a link between risk-taking and specific externalising problems. Future research should employ study designs aimed at disentangling the direction of this relationship and identifying specific aspects of mental health and risky decision-making that could be eventually addressed by tailored interventions.

Exploring decision-making performance in young adults with mental health disorders: a comparative study using the Cambridge gambling task.

Decision-making deficits, assessed cognitively, are often associated with mental health symptoms, however, this relationship is not fully understood. This paper explores the relationship between mental health disorders and decision-making, using the Cambridge Gambling Task (CGT). Our study investigated how decision-making varied across 20 different mental health conditions compared to controls in a sample of 572 young adults from the Minneapolis and Chicago metropolitan areas, using a computerized laboratory-based task. Almost all mental health conditions were associated with at least mild (i.e. at least small effect size) impairment in all three studied parameters of the CGT (risk adjustment, quality of decision-making and overall proportion of bet). Notably, binge eating disorder had the largest cognitive impairment and gambling disorder had moderate impairment. Post-traumatic stress disorder (PTSD) was associated with impaired decision-making while obsessive-compulsive disorder (OCD) and depression showed moderate impairment. Additionally, half of the disorders assessed had moderate to large impairment in risk adjustment.These findings suggest that mental health conditions may have a more complex cognitive profile than previously thought, and a better understanding of these impairments may aid in risk assessment and targeted clinical interventions. This study underscores the need for further research to determine the causal pathways between mental health conditions and cognition, as well as to better understand the day-to-day impact of such deficits.

Corticostriatal responses to social reward are linked to trait reward sensitivity and subclinical substance use in young adults.

Aberrant levels of reward sensitivity have been linked to substance use disorder and are characterized by alterations in reward processing in the ventral striatum (VS). Less is known about how reward sensitivity and subclinical substance use relate to striatal function during social rewards (e.g. positive peer feedback). Testing this relation is critical for predicting risk for development of substance use disorder. In this pre-registered study, participants (N = 44) underwent fMRI while completing well-matched tasks that assess neural response to reward in social and monetary domains. Contrary to our hypotheses, aberrant reward sensitivity blunted the relationship between substance use and striatal activation during receipt of rewards, regardless of domain. Moreover, exploratory whole-brain analyses showed unique relations between substance use and social rewards in temporoparietal junction. Psychophysiological interactions demonstrated that aberrant reward sensitivity is associated with increased connectivity between the VS and ventromedial prefrontal cortex during social rewards. Finally, we found that substance use was associated with decreased connectivity between the VS and dorsomedial prefrontal cortex for social rewards, independent of reward sensitivity. These findings demonstrate nuanced relations between reward sensitivity and substance use, even among those without substance use disorder, and suggest altered reward-related engagement of cortico-VS responses as potential predictors of developing disordered behavior.

Change in brain activation after transcranial pulsed electromagnetic fields in treatment-resistant depression.

BACKGROUND: Preliminary evidence suggests antidepressant effects of transcranial pulsed electromagnetic fields (tPEMF). However, the precise mechanism of action in the brain is still unknown. The aim of this study was to investigate the influence of tPEMF on brain activation in patients with treatment-resistant depression (TRD) by studying two processes that might be of particular interest in relation to the symptoms of depression: emotional processing and reward processing. METHODS: Eligible participants (n = 50) with TRD in this sham-controlled double-blind multicenter trial [registered at the Dutch Trial Register ( http://www.trialregister.nl ), NTR3702] were randomly assigned to five weeks daily active or sham tPEMF. Pre- and post-treatment functional MR-scans were made during which participants performed a social-emotional task and a reward task. RESULTS: Participants in the active treatment group showed a stronger decrease in activation post-treatment compared to sham during reward-outcome processing in the left inferior frontal gyrus and in a cluster comprising the right lingual gyrus and the posterior part of the middle temporal gyrus. No effect of tPEMF was found on activation during the social-emotional task. Neurostimulation with tPEMF did also not affect behavioral performance for both tasks. CONCLUSIONS: We found a decrease in reward-related activation as a result of tPEMF stimulation, while no effect of tPEMF on social-emotional processing was found. The treatment-related reduction in activation of regulatory regions may reflect normalization and may have implications for anhedonia. These findings suggest that there is an effect of tPEMF on brain activation of relevant circuits, albeit in the absence of a clinical antidepressant effect.