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Vascular Risk Factors and Diseases Modulate Deficits of Reward-Based Reversal Learning in Acute Basal Ganglia Stroke.

Seidel UK, Gronewold J, Wicking M, Bellebaum C, Hermann DM - PLoS ONE (2016)

Bottom Line: We re-examined the acquisition and reversal of stimulus-stimulus-reward associations and acquired equivalence in eleven patients with acute basal ganglia stroke (8 men, 3 women; 57.8±13.3 years), whose performance was compared eleven healthy subjects of comparable age, sex distribution and education, who were recruited outside the hospital.Compared with healthy subjects, control patients with vascular risk factors exhibited significantly reduced performance in the reversal phase (F[2,30] = 3.47; p = 0.044; post-hoc comparison between risk factor controls and healthy controls: p = 0.030), but not the acquisition phase (F[2,30] = 1.01; p = 0.376) and the acquired equivalence (F[2,30] = 1.04; p = 0.367) tasks.Correlation studies revealed a significant association of the number of vascular risk factors with reversal learning (r = -0.33, p = 0.012), but not acquisition learning (r = -0.20, p = 0.121) or acquired equivalence (r = -0.22, p = 0.096).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Germany.

ABSTRACT

Background: Besides motor function, the basal ganglia have been implicated in feedback learning. In patients with chronic basal ganglia infarcts, deficits in reward-based reversal learning have previously been described.

Methods: We re-examined the acquisition and reversal of stimulus-stimulus-reward associations and acquired equivalence in eleven patients with acute basal ganglia stroke (8 men, 3 women; 57.8±13.3 years), whose performance was compared eleven healthy subjects of comparable age, sex distribution and education, who were recruited outside the hospital. Eleven hospitalized patients with a similar vascular risk profile as the stroke patients but without stroke history served as clinical control group.

Results: In a neuropsychological assessment 7±3 days post-stroke, verbal and spatial short-term and working memory and inhibition control did not differ between groups. Compared with healthy subjects, control patients with vascular risk factors exhibited significantly reduced performance in the reversal phase (F[2,30] = 3.47; p = 0.044; post-hoc comparison between risk factor controls and healthy controls: p = 0.030), but not the acquisition phase (F[2,30] = 1.01; p = 0.376) and the acquired equivalence (F[2,30] = 1.04; p = 0.367) tasks. In all tasks, the performance of vascular risk factor patients closely resembled that of basal ganglia stroke patients. Correlation studies revealed a significant association of the number of vascular risk factors with reversal learning (r = -0.33, p = 0.012), but not acquisition learning (r = -0.20, p = 0.121) or acquired equivalence (r = -0.22, p = 0.096).

Conclusions: The previously reported impairment of reward-based learning may be attributed to vascular risk factors and associated diseases, which are enriched in stroke patients. This study emphasizes the necessity of appropriate control subjects in cognition studies.

No MeSH data available.


Related in: MedlinePlus

Performance of healthy control subjects, control patients without stroke with vascular risk factors (‘risk factor patients’) and stroke patients in the reward-based acquisition and reversal, broken down into learning blocks and reward magnitude.Data are means of correct responses with S.D. values. ANOVA revealed a significant main effect for the factor group in the reversal phase [F(2,30) = 3.47; p = 0.044] reflecting a significantly lower number of correct responses in risk factor patients than healthy controls (p = 0.032). The performance of stroke patients and risk factor patients was very similar (p = 0.999).
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pone.0155267.g002: Performance of healthy control subjects, control patients without stroke with vascular risk factors (‘risk factor patients’) and stroke patients in the reward-based acquisition and reversal, broken down into learning blocks and reward magnitude.Data are means of correct responses with S.D. values. ANOVA revealed a significant main effect for the factor group in the reversal phase [F(2,30) = 3.47; p = 0.044] reflecting a significantly lower number of correct responses in risk factor patients than healthy controls (p = 0.032). The performance of stroke patients and risk factor patients was very similar (p = 0.999).

Mentions: Mean values acquisition: 75.1±18.8; 64.7±9.7 and 72.5±22.4 in healthy control subjects, risk factor patients and stroke patients, respectively (see also Fig 2).


Vascular Risk Factors and Diseases Modulate Deficits of Reward-Based Reversal Learning in Acute Basal Ganglia Stroke.

Seidel UK, Gronewold J, Wicking M, Bellebaum C, Hermann DM - PLoS ONE (2016)

Performance of healthy control subjects, control patients without stroke with vascular risk factors (‘risk factor patients’) and stroke patients in the reward-based acquisition and reversal, broken down into learning blocks and reward magnitude.Data are means of correct responses with S.D. values. ANOVA revealed a significant main effect for the factor group in the reversal phase [F(2,30) = 3.47; p = 0.044] reflecting a significantly lower number of correct responses in risk factor patients than healthy controls (p = 0.032). The performance of stroke patients and risk factor patients was very similar (p = 0.999).
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4862682&req=5

pone.0155267.g002: Performance of healthy control subjects, control patients without stroke with vascular risk factors (‘risk factor patients’) and stroke patients in the reward-based acquisition and reversal, broken down into learning blocks and reward magnitude.Data are means of correct responses with S.D. values. ANOVA revealed a significant main effect for the factor group in the reversal phase [F(2,30) = 3.47; p = 0.044] reflecting a significantly lower number of correct responses in risk factor patients than healthy controls (p = 0.032). The performance of stroke patients and risk factor patients was very similar (p = 0.999).
Mentions: Mean values acquisition: 75.1±18.8; 64.7±9.7 and 72.5±22.4 in healthy control subjects, risk factor patients and stroke patients, respectively (see also Fig 2).

Bottom Line: We re-examined the acquisition and reversal of stimulus-stimulus-reward associations and acquired equivalence in eleven patients with acute basal ganglia stroke (8 men, 3 women; 57.8±13.3 years), whose performance was compared eleven healthy subjects of comparable age, sex distribution and education, who were recruited outside the hospital.Compared with healthy subjects, control patients with vascular risk factors exhibited significantly reduced performance in the reversal phase (F[2,30] = 3.47; p = 0.044; post-hoc comparison between risk factor controls and healthy controls: p = 0.030), but not the acquisition phase (F[2,30] = 1.01; p = 0.376) and the acquired equivalence (F[2,30] = 1.04; p = 0.367) tasks.Correlation studies revealed a significant association of the number of vascular risk factors with reversal learning (r = -0.33, p = 0.012), but not acquisition learning (r = -0.20, p = 0.121) or acquired equivalence (r = -0.22, p = 0.096).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Germany.

ABSTRACT

Background: Besides motor function, the basal ganglia have been implicated in feedback learning. In patients with chronic basal ganglia infarcts, deficits in reward-based reversal learning have previously been described.

Methods: We re-examined the acquisition and reversal of stimulus-stimulus-reward associations and acquired equivalence in eleven patients with acute basal ganglia stroke (8 men, 3 women; 57.8±13.3 years), whose performance was compared eleven healthy subjects of comparable age, sex distribution and education, who were recruited outside the hospital. Eleven hospitalized patients with a similar vascular risk profile as the stroke patients but without stroke history served as clinical control group.

Results: In a neuropsychological assessment 7±3 days post-stroke, verbal and spatial short-term and working memory and inhibition control did not differ between groups. Compared with healthy subjects, control patients with vascular risk factors exhibited significantly reduced performance in the reversal phase (F[2,30] = 3.47; p = 0.044; post-hoc comparison between risk factor controls and healthy controls: p = 0.030), but not the acquisition phase (F[2,30] = 1.01; p = 0.376) and the acquired equivalence (F[2,30] = 1.04; p = 0.367) tasks. In all tasks, the performance of vascular risk factor patients closely resembled that of basal ganglia stroke patients. Correlation studies revealed a significant association of the number of vascular risk factors with reversal learning (r = -0.33, p = 0.012), but not acquisition learning (r = -0.20, p = 0.121) or acquired equivalence (r = -0.22, p = 0.096).

Conclusions: The previously reported impairment of reward-based learning may be attributed to vascular risk factors and associated diseases, which are enriched in stroke patients. This study emphasizes the necessity of appropriate control subjects in cognition studies.

No MeSH data available.


Related in: MedlinePlus