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Aberrant function of learning and cognitive control networks underlie inefficient cognitive flexibility in anorexia nervosa: a cross-sectional fMRI study.

Lao-Kaim NP, Fonville L, Giampietro VP, Williams SC, Simmons A, Tchanturia K - PLoS ONE (2015)

Bottom Line: This has previously been attributed to problematic behavioural shifting, characterised by a decrease in fronto-striatal activity.Furthermore, learning was associated with lower blood-oxygenated-level dependent response in the caudate body, as compared to healthy controls.Whilst cognitive flexibility appears to be associated with aberrant functioning of the fronto-parietal control network that mediates between internally and externally directed cognition, fronto-striatal alterations, particularly within the caudate body, were associated with instrumental learning.

View Article: PubMed Central - PubMed

Affiliation: King's College London, Institute of Psychiatry, Department of Psychological Medicine, London, United Kingdom.

ABSTRACT

Objectives: People with Anorexia Nervosa exhibit difficulties flexibly adjusting behaviour in response to environmental changes. This has previously been attributed to problematic behavioural shifting, characterised by a decrease in fronto-striatal activity. Additionally, alterations of instrumental learning, which relies on fronto-striatal networks, may contribute to the observation of inflexible behaviour. The authors sought to investigate the neural correlates of cognitive flexibility and learning in Anorexia Nervosa.

Method: Thirty-two adult females with Anorexia Nervosa and thirty-two age-matched female control participants completed the Wisconsin Card Sorting Task whilst undergoing functional magnetic resonance imaging. Event-related analysis permitted the comparison of cognitive shift trials against those requiring maintenance of rule-sets and allowed assessment of trials representing learning.

Results: Although both groups performed similarly, we found significant interactions in the left middle frontal gyrus, precuneus and superior parietal lobule whereby blood-oxygenated-level dependent response was higher in Anorexia Nervosa patients during shifting but lower when maintaining rule-sets, as compared to healthy controls. During learning, posterior cingulate cortex activity in healthy controls decreased whilst increasing in the Anorexia Nervosa group, whereas the right precuneus exhibited the opposite pattern. Furthermore, learning was associated with lower blood-oxygenated-level dependent response in the caudate body, as compared to healthy controls.

Conclusions: People with Anorexia Nervosa display widespread changes in executive function. Whilst cognitive flexibility appears to be associated with aberrant functioning of the fronto-parietal control network that mediates between internally and externally directed cognition, fronto-striatal alterations, particularly within the caudate body, were associated with instrumental learning. Together, this shows how perseverative tendencies could be a substrate of multiple high-order processes that may contribute to the maintenance of Anorexia Nervosa.

No MeSH data available.


Related in: MedlinePlus

Time course of a WCST trial and events of interest for behavioural and fMRI analysis.Each example presents the current rule chosen by the program (‘correct rule’) with concurrent trial-by-trial participant responses (‘chosen rule’), illustrating different WCST ‘event types’. Note that for event-related fMRI analysis, each event is modelled as the period between two consecutive responses and the ‘event type’ is defined by the combination of the two responses. EXAMPLE A: I) Efficient Shifts (Eff-Sh) were when participants changed sorting rules following negative feedback to one that had not been previously tested. II) Stuck-in-set perseverations (SiS-P) occurred if the same sorting rule that was incorrect in the previous trial was applied in the subsequent trial. III) First correct sort (F-Corr) of a new set. IV) Second correct sort (S-Corr) follows first correct sort. V) fMRI baseline (Baseline) was designated as trials 3–8 of a string of 8 consecutive correct sorts. EXAMPLE B: VI) Recurrent perseverations (Rec-P) constituted shifts to another sorting rule following incorrect feedback, but to one that had been tested two trials previously and already fed back as incorrect. EXAMPLE C: VII) Error Set trials (Error Set) were correct sorts not included as baseline trials due to occurrence of ‘loss of set’ errors within that particular set. VIII) Loss of set (Loss of set) trials are shifts to a different rule following positive feedback.
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pone.0124027.g001: Time course of a WCST trial and events of interest for behavioural and fMRI analysis.Each example presents the current rule chosen by the program (‘correct rule’) with concurrent trial-by-trial participant responses (‘chosen rule’), illustrating different WCST ‘event types’. Note that for event-related fMRI analysis, each event is modelled as the period between two consecutive responses and the ‘event type’ is defined by the combination of the two responses. EXAMPLE A: I) Efficient Shifts (Eff-Sh) were when participants changed sorting rules following negative feedback to one that had not been previously tested. II) Stuck-in-set perseverations (SiS-P) occurred if the same sorting rule that was incorrect in the previous trial was applied in the subsequent trial. III) First correct sort (F-Corr) of a new set. IV) Second correct sort (S-Corr) follows first correct sort. V) fMRI baseline (Baseline) was designated as trials 3–8 of a string of 8 consecutive correct sorts. EXAMPLE B: VI) Recurrent perseverations (Rec-P) constituted shifts to another sorting rule following incorrect feedback, but to one that had been tested two trials previously and already fed back as incorrect. EXAMPLE C: VII) Error Set trials (Error Set) were correct sorts not included as baseline trials due to occurrence of ‘loss of set’ errors within that particular set. VIII) Loss of set (Loss of set) trials are shifts to a different rule following positive feedback.

Mentions: Participants performed a modified version of the WCST during the scan. At the start of each trial, a single ‘stimulus’ card was presented in the centre of a grey screen, surrounded by four ‘reference’ cards (Fig 1). ‘References’ were chosen at random at the beginning of each experimental run from a deck of 64 cards that differed along three dimensions; shape (diamond, square, triangle, cross), colour (blue, red, green, yellow) and quantity (one, two, three, four), such that each ‘reference’ was unique on every dimension. ‘Reference’ cards remained unchanged throughout a participants’ experimental run. The remaining 60 cards were used to draw a ‘stimulus’ at random for each trial.


Aberrant function of learning and cognitive control networks underlie inefficient cognitive flexibility in anorexia nervosa: a cross-sectional fMRI study.

Lao-Kaim NP, Fonville L, Giampietro VP, Williams SC, Simmons A, Tchanturia K - PLoS ONE (2015)

Time course of a WCST trial and events of interest for behavioural and fMRI analysis.Each example presents the current rule chosen by the program (‘correct rule’) with concurrent trial-by-trial participant responses (‘chosen rule’), illustrating different WCST ‘event types’. Note that for event-related fMRI analysis, each event is modelled as the period between two consecutive responses and the ‘event type’ is defined by the combination of the two responses. EXAMPLE A: I) Efficient Shifts (Eff-Sh) were when participants changed sorting rules following negative feedback to one that had not been previously tested. II) Stuck-in-set perseverations (SiS-P) occurred if the same sorting rule that was incorrect in the previous trial was applied in the subsequent trial. III) First correct sort (F-Corr) of a new set. IV) Second correct sort (S-Corr) follows first correct sort. V) fMRI baseline (Baseline) was designated as trials 3–8 of a string of 8 consecutive correct sorts. EXAMPLE B: VI) Recurrent perseverations (Rec-P) constituted shifts to another sorting rule following incorrect feedback, but to one that had been tested two trials previously and already fed back as incorrect. EXAMPLE C: VII) Error Set trials (Error Set) were correct sorts not included as baseline trials due to occurrence of ‘loss of set’ errors within that particular set. VIII) Loss of set (Loss of set) trials are shifts to a different rule following positive feedback.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4430209&req=5

pone.0124027.g001: Time course of a WCST trial and events of interest for behavioural and fMRI analysis.Each example presents the current rule chosen by the program (‘correct rule’) with concurrent trial-by-trial participant responses (‘chosen rule’), illustrating different WCST ‘event types’. Note that for event-related fMRI analysis, each event is modelled as the period between two consecutive responses and the ‘event type’ is defined by the combination of the two responses. EXAMPLE A: I) Efficient Shifts (Eff-Sh) were when participants changed sorting rules following negative feedback to one that had not been previously tested. II) Stuck-in-set perseverations (SiS-P) occurred if the same sorting rule that was incorrect in the previous trial was applied in the subsequent trial. III) First correct sort (F-Corr) of a new set. IV) Second correct sort (S-Corr) follows first correct sort. V) fMRI baseline (Baseline) was designated as trials 3–8 of a string of 8 consecutive correct sorts. EXAMPLE B: VI) Recurrent perseverations (Rec-P) constituted shifts to another sorting rule following incorrect feedback, but to one that had been tested two trials previously and already fed back as incorrect. EXAMPLE C: VII) Error Set trials (Error Set) were correct sorts not included as baseline trials due to occurrence of ‘loss of set’ errors within that particular set. VIII) Loss of set (Loss of set) trials are shifts to a different rule following positive feedback.
Mentions: Participants performed a modified version of the WCST during the scan. At the start of each trial, a single ‘stimulus’ card was presented in the centre of a grey screen, surrounded by four ‘reference’ cards (Fig 1). ‘References’ were chosen at random at the beginning of each experimental run from a deck of 64 cards that differed along three dimensions; shape (diamond, square, triangle, cross), colour (blue, red, green, yellow) and quantity (one, two, three, four), such that each ‘reference’ was unique on every dimension. ‘Reference’ cards remained unchanged throughout a participants’ experimental run. The remaining 60 cards were used to draw a ‘stimulus’ at random for each trial.

Bottom Line: This has previously been attributed to problematic behavioural shifting, characterised by a decrease in fronto-striatal activity.Furthermore, learning was associated with lower blood-oxygenated-level dependent response in the caudate body, as compared to healthy controls.Whilst cognitive flexibility appears to be associated with aberrant functioning of the fronto-parietal control network that mediates between internally and externally directed cognition, fronto-striatal alterations, particularly within the caudate body, were associated with instrumental learning.

View Article: PubMed Central - PubMed

Affiliation: King's College London, Institute of Psychiatry, Department of Psychological Medicine, London, United Kingdom.

ABSTRACT

Objectives: People with Anorexia Nervosa exhibit difficulties flexibly adjusting behaviour in response to environmental changes. This has previously been attributed to problematic behavioural shifting, characterised by a decrease in fronto-striatal activity. Additionally, alterations of instrumental learning, which relies on fronto-striatal networks, may contribute to the observation of inflexible behaviour. The authors sought to investigate the neural correlates of cognitive flexibility and learning in Anorexia Nervosa.

Method: Thirty-two adult females with Anorexia Nervosa and thirty-two age-matched female control participants completed the Wisconsin Card Sorting Task whilst undergoing functional magnetic resonance imaging. Event-related analysis permitted the comparison of cognitive shift trials against those requiring maintenance of rule-sets and allowed assessment of trials representing learning.

Results: Although both groups performed similarly, we found significant interactions in the left middle frontal gyrus, precuneus and superior parietal lobule whereby blood-oxygenated-level dependent response was higher in Anorexia Nervosa patients during shifting but lower when maintaining rule-sets, as compared to healthy controls. During learning, posterior cingulate cortex activity in healthy controls decreased whilst increasing in the Anorexia Nervosa group, whereas the right precuneus exhibited the opposite pattern. Furthermore, learning was associated with lower blood-oxygenated-level dependent response in the caudate body, as compared to healthy controls.

Conclusions: People with Anorexia Nervosa display widespread changes in executive function. Whilst cognitive flexibility appears to be associated with aberrant functioning of the fronto-parietal control network that mediates between internally and externally directed cognition, fronto-striatal alterations, particularly within the caudate body, were associated with instrumental learning. Together, this shows how perseverative tendencies could be a substrate of multiple high-order processes that may contribute to the maintenance of Anorexia Nervosa.

No MeSH data available.


Related in: MedlinePlus