Altered orbitofrontal sulcogyral patterns in gambling disorder: a multicenter study.

Gambling disorder is a serious psychiatric condition characterized by decision-making and reward processing impairments that are associated with dysfunctional brain activity in the orbitofrontal cortex (OFC). However, it remains unclear whether OFC functional abnormalities in gambling disorder are accompanied by structural abnormalities. We addressed this question by examining the organization of sulci and gyri in the OFC. This organization is in place very early and stable across life, such that OFC sulcogyral patterns (classified into Types I, II, and III) can be regarded as potential pre-morbid markers of pathological conditions. We gathered structural brain data from nine existing studies, reaching a total of 165 individuals with gambling disorder and 159 healthy controls. Our results, supported by both frequentist and Bayesian statistics, show that the distribution of OFC sulcogyral patterns is skewed in individuals with gambling disorder, with an increased prevalence of Type II pattern compared with healthy controls. Examination of gambling severity did not reveal any significant relationship between OFC sulcogyral patterns and disease severity. Altogether, our results provide evidence for a skewed distribution of OFC sulcogyral patterns in gambling disorder and suggest that pattern Type II might represent a pre-morbid structural brain marker of the disease. It will be important to investigate more closely the functional implications of these structural abnormalities in future work.

Tuning the Brake While Raising the Stake: Network Dynamics during Sequential Decision-Making.

UNLABELLED: When gathering valued goods, risk and reward are often coupled and escalate over time, for instance, during foraging, trading, or gambling. This escalating frame requires agents to continuously balance expectations of reward against those of risk. To address how the human brain dynamically computes these tradeoffs, we performed whole-brain fMRI while healthy young individuals engaged in a sequential gambling task. Participants were repeatedly confronted with the option to continue with throwing a die to accumulate monetary reward under escalating risk, or the alternative option to stop to bank the current balance. Within each gambling round, the accumulation of gains gradually increased reaction times for "continue" choices, indicating growing uncertainty in the decision to continue. Neural activity evoked by "continue" choices was associated with growing activity and connectivity of a cortico-subcortical "braking" network that positively scaled with the accumulated gains, including pre-supplementary motor area (pre-SMA), inferior frontal gyrus, caudate, and subthalamic nucleus (STN). The influence of the STN on continue-evoked activity in the pre-SMA was predicted by interindividual differences in risk-aversion attitudes expressed during the gambling task. Furthermore, activity in dorsal anterior cingulate cortex (ACC) reflected individual choice tendencies by showing increased activation when subjects made nondefault "continue" choices despite an increasing tendency to stop, but ACC activity did not change in proportion with subjective choice uncertainty. Together, the results implicate a key role of dorsal ACC, pre-SMA, inferior frontal gyrus, and STN in computing the trade-off between escalating reward and risk in sequential decision-making. SIGNIFICANCE STATEMENT: Using a paradigm where subjects experienced increasing potential rewards coupled with increasing risk, this study addressed two unresolved questions in the field of decision-making: First, we investigated an "inhibitory" network of regions that has so far been investigated with externally cued action inhibition. In this study, we show that the dynamics in this network under increasingly risky decisions are predictive of subjects' risk attitudes. Second, we contribute to a currently ongoing debate about the anterior cingulate cortex's role in sequential foraging decisions by showing that its activity is related to making nondefault choices rather than to choice uncertainty.

Aberrant neural signatures of decision-making: Pathological gamblers display cortico-striatal hypersensitivity to extreme gambles.

Pathological gambling is an addictive disorder characterized by an irresistible urge to gamble despite severe consequences. One of the hallmarks of pathological gambling is maladaptive and highly risky decision-making, which has been linked to dysregulation of reward-related brain regions such as the ventral striatum. However, previous studies have produced contradictory results regarding the implication of this network, revealing either hypo- or hypersensitivity to monetary gains and losses. One possible explanation is that the gambling brain might be misrepresenting the benefits and costs when weighting the potential outcomes, and not the gains and losses per se. To address this issue, we investigated whether pathological gambling is associated with abnormal brain activity during decisions that weight the utility of possible gains against possible losses. Pathological gamblers and healthy human subjects underwent functional magnetic resonance imaging while they accepted or rejected mixed gain/loss gambles with fifty-fifty chances of winning or losing. Contrary to healthy individuals, gamblers showed a U-shaped response profile reflecting hypersensitivity to the most appetitive and most aversive bets in an executive cortico-striatal network including the dorsolateral prefrontal cortex and caudate nucleus. This network is concerned with the evaluation of action-outcome contingencies, monitoring recent actions and anticipating their consequences. The dysregulation of this specific network, especially for extreme bets with large potentials consequences, offers a novel understanding of the neural basis of pathological gambling in terms of deficient associations between gambling actions and their financial impact.

Neural dynamics of prediction and surprise in infants.

Prior expectations shape neural responses in sensory regions of the brain, consistent with a Bayesian predictive coding account of perception. Yet, it remains unclear whether such a mechanism is already functional during early stages of development. To address this issue, we study how the infant brain responds to prediction violations using a cross-modal cueing paradigm. We record electroencephalographic responses to expected and unexpected visual events preceded by auditory cues in 12-month-old infants. We find an increased response for unexpected events. However, this effect of prediction error is only observed during late processing stages associated with conscious access mechanisms. In contrast, early perceptual components reveal an amplification of neural responses for predicted relative to surprising events, suggesting that selective attention enhances perceptual processing for expected events. Taken together, these results demonstrate that cross-modal statistical regularities are used to generate predictions that differentially influence early and late neural responses in infants.

Amygdala signals subjective appetitiveness and aversiveness of mixed gambles.

People are more sensitive to losses than to equivalent gains when making financial decisions. We used functional magnetic resonance imaging (fMRI) to illuminate how the amygdala contributes to loss aversion. The blood oxygen level dependent (BOLD) response of the amygdala was mapped while healthy individuals were responding to 50/50 gambles with varying potential gain and loss amounts. Overall, subjects demanded twice as high potential gain as loss to accept a gamble. The individual level of loss aversion was expressed by the decision boundary, i.e., the gain-loss ratio at which subjects accepted and rejected gambles with equal probability. Amygdala activity increased the more the gain-loss ratio deviated from the individual decision boundary showing that the amygdala codes action value. This response pattern was more strongly expressed in loss aversive individuals, linking amygdala activity with individual differences in loss aversion. Together, the results show that the amygdala signals subjective appetitiveness or aversiveness of gain-loss ratios at the time of choice.

A neural marker of perceptual consciousness in infants.

Infants have a sophisticated behavioral and cognitive repertoire suggestive of a capacity for conscious reflection. Yet, demonstrating conscious access in infants remains challenging, mainly because they cannot report their thoughts. Here, to circumvent this problem, we studied whether an electrophysiological signature of consciousness found in adults, corresponding to a late nonlinear cortical response [~300 milliseconds (ms)] to brief pictures, already exists in infants. We recorded event-related potentials while 5-, 12-, and 15-month-old infants (N = 80) viewed masked faces at various levels of visibility. In all age groups, we found a late slow wave showing a nonlinear profile at the expected perceptual thresholds. However, this late component shifted from a weak and delayed response in 5-month-olds (starting around 900 ms) to a more sustained and faster response in older infants (around 750 ms). These results reveal that the brain mechanisms underlying the threshold for conscious perception are already present in infancy but undergo a slow acceleration during development.

Psychophysical thresholds of face visibility during infancy.

The ability to detect and focus on faces is a fundamental prerequisite for developing social skills. But how well can infants detect faces? Here, we address this question by studying the minimum duration at which faces must appear to trigger a behavioral response in infants. We used a preferential looking method in conjunction with masking and brief presentations (300 ms and below) to establish the temporal thresholds of visibility at different stages of development. We found that 5 and 10 month-old infants have remarkably similar visibility thresholds about three times higher than those of adults. By contrast, 15 month-olds not only revealed adult-like thresholds, but also improved their performance through memory-based strategies. Our results imply that the development of face visibility follows a non-linear course and is determined by a radical improvement occurring between 10 and 15 months.