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Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories()

BACKGROUND: Functional neurological disorder (FND) is an elusive disorder characterized by unexplained neurological symptoms alongside aberrant cognitive processing and negative affect, often associated with amygdala reactivity. METHODS: We examined the effect of negative conditioning on cognitive f...

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Autores principales: Morris, Laurel S., To, Benjaman, Baek, Kwangyeol, Chang-Webb, Yee-Chien, Mitchell, Simon, Strelchuk, Daniela, Mikheenko, Yevheniia, Phillips, Wendy, Zandi, Michael, Jenaway, Allison, Walsh, Cathy, Voon, Valerie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5562176/
https://www.ncbi.nlm.nih.gov/pubmed/28856091
http://dx.doi.org/10.1016/j.nicl.2017.08.007
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author Morris, Laurel S.
To, Benjaman
Baek, Kwangyeol
Chang-Webb, Yee-Chien
Mitchell, Simon
Strelchuk, Daniela
Mikheenko, Yevheniia
Phillips, Wendy
Zandi, Michael
Jenaway, Allison
Walsh, Cathy
Voon, Valerie
author_facet Morris, Laurel S.
To, Benjaman
Baek, Kwangyeol
Chang-Webb, Yee-Chien
Mitchell, Simon
Strelchuk, Daniela
Mikheenko, Yevheniia
Phillips, Wendy
Zandi, Michael
Jenaway, Allison
Walsh, Cathy
Voon, Valerie
author_sort Morris, Laurel S.
collection PubMed
description BACKGROUND: Functional neurological disorder (FND) is an elusive disorder characterized by unexplained neurological symptoms alongside aberrant cognitive processing and negative affect, often associated with amygdala reactivity. METHODS: We examined the effect of negative conditioning on cognitive function and amygdala reactivity in 25 FND patients and 20 healthy volunteers (HV). Participants were first conditioned to stimuli paired with negative affective or neutral (CS +/CS −) information. During functional MRI, subjects then performed an instrumental associative learning task to avoid monetary losses in the context of the previously conditioned stimuli. We expected that FND patients would be better at learning to avoid losses when faced with negatively conditioned stimuli (increased harm avoidance). Multi-echo resting state fMRI was also collected from the same subjects and a robust denoising method was employed, important for removing motion and physiological artifacts. RESULTS: FND subjects were more sensitive to the negative CS + compared to HV, demonstrated by a reinforcement learning model. Contrary to expectation, FND patients were generally more impaired at learning to avoid losses under both contexts (CS +/CS −), persisting to choose the option that resulted in a negative outcome demonstrated by both behavioural and computational analyses. FND patients showed enhanced amygdala but reduced dorsolateral prefrontal cortex responses when they received negative feedback. Patients also had increased resting state functional connectivity between these two regions. CONCLUSIONS: FND patients had impaired instrumental avoidance learning, findings that parallel previous observations of impaired action-outcome binding. FND patients further show enhanced behavioural and neural sensitivity to negative information. However, this did not translate to improved avoidance learning. Put together, our findings do not support the theory of harm avoidance in FND. We highlight a potential mechanism by which negative contexts interfere with adaptive behaviours in this under-explored disorder.
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spelling pubmed-55621762017-08-30 Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories() Morris, Laurel S. To, Benjaman Baek, Kwangyeol Chang-Webb, Yee-Chien Mitchell, Simon Strelchuk, Daniela Mikheenko, Yevheniia Phillips, Wendy Zandi, Michael Jenaway, Allison Walsh, Cathy Voon, Valerie Neuroimage Clin Regular Article BACKGROUND: Functional neurological disorder (FND) is an elusive disorder characterized by unexplained neurological symptoms alongside aberrant cognitive processing and negative affect, often associated with amygdala reactivity. METHODS: We examined the effect of negative conditioning on cognitive function and amygdala reactivity in 25 FND patients and 20 healthy volunteers (HV). Participants were first conditioned to stimuli paired with negative affective or neutral (CS +/CS −) information. During functional MRI, subjects then performed an instrumental associative learning task to avoid monetary losses in the context of the previously conditioned stimuli. We expected that FND patients would be better at learning to avoid losses when faced with negatively conditioned stimuli (increased harm avoidance). Multi-echo resting state fMRI was also collected from the same subjects and a robust denoising method was employed, important for removing motion and physiological artifacts. RESULTS: FND subjects were more sensitive to the negative CS + compared to HV, demonstrated by a reinforcement learning model. Contrary to expectation, FND patients were generally more impaired at learning to avoid losses under both contexts (CS +/CS −), persisting to choose the option that resulted in a negative outcome demonstrated by both behavioural and computational analyses. FND patients showed enhanced amygdala but reduced dorsolateral prefrontal cortex responses when they received negative feedback. Patients also had increased resting state functional connectivity between these two regions. CONCLUSIONS: FND patients had impaired instrumental avoidance learning, findings that parallel previous observations of impaired action-outcome binding. FND patients further show enhanced behavioural and neural sensitivity to negative information. However, this did not translate to improved avoidance learning. Put together, our findings do not support the theory of harm avoidance in FND. We highlight a potential mechanism by which negative contexts interfere with adaptive behaviours in this under-explored disorder. Elsevier 2017-08-08 /pmc/articles/PMC5562176/ /pubmed/28856091 http://dx.doi.org/10.1016/j.nicl.2017.08.007 Text en © 2017 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Regular Article
Morris, Laurel S.
To, Benjaman
Baek, Kwangyeol
Chang-Webb, Yee-Chien
Mitchell, Simon
Strelchuk, Daniela
Mikheenko, Yevheniia
Phillips, Wendy
Zandi, Michael
Jenaway, Allison
Walsh, Cathy
Voon, Valerie
Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories()
title Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories()
title_full Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories()
title_fullStr Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories()
title_full_unstemmed Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories()
title_short Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories()
title_sort disrupted avoidance learning in functional neurological disorder: implications for harm avoidance theories()
topic Regular Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5562176/
https://www.ncbi.nlm.nih.gov/pubmed/28856091
http://dx.doi.org/10.1016/j.nicl.2017.08.007
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