Apathy

Le Heron et al. (2018) defines apathy as a marked reduction in goal-directed behavior. But in order to move, one must be motivated to do so. Therefore, a generalized form of impaired motivation also hallmarks apathy.

The authors compiled for us a nice mini-review combing through the literature of motivation in order to identify, if possible, the neurobiological mechanism(s) of apathy. First, they go very succinctly though the neuroscience of motivated behavior. Very succinctly, because there are literally hundreds of thousands of worthwhile pages out there on this subject. Although there are several other models proposed out-there, the authors’ new model on motivation includes the usual suspects (dopamine, striatum, prefrontal cortex, anterior cingulate cortex) and you can see it in the Fig. 1.

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Fig. 1 from Le Heron et al. (2018). The red underlining is mine because I really liked how well and succinctly the authors put a universal truth about the brain: “A single brain region likely contributes to more than one process, but with specialisation”. © Author(s) (or their employer(s)) 2018.

After this intro, the authors go on to showcasing findings from the effort-based decision-making field, which suggest that the dopamine-producing neurons from ventral tegmental area (VTA) are fundamental in choosing an action that requires high-effort for high-reward versus a low-effort for low-reward. Contrary to what Wikipedia tells you, a reduction, not an increase, in mesolimbic dopamine is associated with apathy, i.e. preferring a low-effort for low-reward activity.

Next, the authors focus on why are the apathetic… apathetic? Basically, they asked the question: “For the apathetic, is the reward too little or is the effort too high?” By looking at some cleverly designed experiments destined to parse out sensitivity to reward versus sensitivity to effort costs, the authors conclude that the apathetics are indeed sensitive to the reward, meaning they don’t find the rewards good enough for them to move.  Therefore, the answer is the reward is too little.

In a nutshell, apathetic people think “It’s not worth it, so I’m not willing to put in the effort to get it”. But if somehow they are made to judge the reward as good enough, to think “it’s worth it”, they are willing to work their darndest to get it, like everybody else.

The application of this is that in order to get people off the couch and do stuff you have to present them a reward that they consider worth moving for, in other words to motivate them. To which any practicing psychologist or counselor would say: “Duh! We’ve been saying that for ages. Glad that neuroscience finally caught up”.  Because it’s easy to say people need to get motivated, but much much harder to figure out how.

This was a difficult write for me and even I recognize the quality of this blogpost as crappy. That’s because, more or less, this paper is within my narrow specialization field. There are points where I disagree with the authors (some definitions of terms), there are points where things are way more nuanced than presented (dopamine findings in reward), and finally there are personal preferences (the interpretation of data from Parkinson’s disease studies). Plus, Salamone (the second-to-last author) is a big name in dopamine research, meaning I’m familiar with his past 20 years or so worth of publications, so I can infer certain salient implications (one dopamine hypothesis is about saliency, get it?).

It’s an interesting paper, but it’s definitely written for the specialist. Hurray (or boo, whatever would be your preference) for another model of dopamine function(s).

REFERENCE: Le Heron C, Holroyd CB, Salamone J, & Husain M (26 Oct 2018, Epub ahead of print). Brain mechanisms underlying apathy. Journal of Neurology, Neurosurgery & Psychiatry. pii: jnnp-2018-318265. doi: 10.1136/jnnp-2018-318265. PMID: 30366958 ARTICLE | FREE FULLTEXT PDF

By Neuronicus, 24 November 2018

The superiority illusion

Following up on my promise to cover a few papers about self-deception, the second in the series is about the superiority illusion, another cognitive bias (the first was about depressive realism).

Yamada et al. (2013) sought to uncover the origins of the ubiquitous belief that oneself is “superior to average people along various dimensions, such as intelligence, cognitive ability, and possession of desirable traits” (p. 4363). The sad statistical truth is that MOST people are average; that’s the whole definitions of ‘average’, really… But most people think they are superior to others, a.k.a. the ‘above-average effect’.

Twenty-four young males underwent resting-state fMRI and PET scanning. The first scanner is of the magnetic resonance type and tracks where you have most of the blood going in the brain at any particular moment. More blood flow to a region is interpreted as that region being active at that moment.

The word ‘functional’ means that the subject is performing a task while in the scanner and the resultant brain image is correspondent to what the brain is doing at that particular moment in time. On the other hand, ‘resting-state’ means that the individual did not do any task in the scanner, s/he just sat nice and still on the warm pads listening to the various clicks, clacks, bangs & beeps of the scanner. The subjects were instructed to rest with their eyes open. Good instruction, given than many subjects fall asleep in resting state MRI studies, even in the terrible racket that the coils make that sometimes can reach 125 Db. Let me explain: an MRI is a machine that generates a huge magnetic field (60,000 times stronger than Earth’s!) by shooting rapid pulses of electricity through a coiled wire, called gradient coil. These pulses of electricity or, in other words, the rapid on-off switchings of the electrical current make the gradient coil vibrate very loudly.

A PET scanner functions on a different principle. The subject receives a shot of a radioactive substance (called tracer) and the machine tracks its movement through the subject’s body. In this experiment’s case, the tracer was raclopride, a D2 dopamine receptor antagonist.

The behavioral data (meaning the answers to the questionnaires) showed that, curiously, the superiority illusion belief was not correlated with anxiety or self-esteem scores, but, not curiously, it was negatively correlated with helplessness, a measure of depression. Makes sense, especially from the view of depressive realism.

The imaging data suggests that dopamine binding to its striatal D2 receptors attenuate the functional connectivity between the left sensoriomotor striatum (SMST, a.k.a postcommissural putamen) and the dorsal anterior cingulate cortex (daCC). And this state of affairs gives rise to the superiority illusion (see Fig. 1).

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Fig. 1. The superiority illusion arises from the suppression of the dorsal anterior cingulate cortex (daCC) – putamen functional connection by the dopamine coming from the substantia nigra/ ventral tegmental area complex (SN/VTA) and binding to its D2 striatal receptors. Credits: brain diagram: Wikipedia, other brain structures and connections: Neuronicus, data: Yamada et al. (2013, doi: 10.1073/pnas.1221681110). Overall: Public Domain

This was a frustrating paper. I cannot tell if it has methodological issues or is just poorly written. For instance, I have to assume that the dACC they’re talking about is bilateral and not ipsilateral to their SMST, meaning left. As a non-native English speaker myself I guess I should cut the authors a break for consistently misspelling ‘commissure’ or for other grammatical errors for fear of being accused of hypocrisy, but here you have it: it bugged me. Besides, mine is a blog and theirs is a published peer-reviewed paper. (Full Disclosure: I do get editorial help from native English speakers when I publish for real and, except for a few personal style quirks, I fully incorporate their suggestions). So a little editorial help would have gotten a long way to make the reading more pleasant. What else? Ah, the results are not clearly explained anywhere, it looks like the authors rely on obviousness, a bad move if you want to be understood by people slightly outside your field. From the first figure it looks like only 22 subjects out of 24 showed superiority illusion but the authors included 24 in the imaging analyses, or so it seems. The subjects were 23.5 +/- 4.4 years, meaning that not all subjects had the frontal regions of the brain fully developed: there are clear anatomical and functional differences between a 19 year old and a 27 year old.

I’m not saying it is a bad paper because I have covered bad papers; I’m saying it was frustrating to read it and it took me a while to figure out some things. Honestly, I shouldn’t even have covered it, but I spent some precious time going through it and its supplementals, what with me not being an imaging dude, so I said the hell with it, I’ll finish it; so here you have it :).

By Neuronicus, 13 December 2017

REFERENCE: Yamada M, Uddin LQ, Takahashi H, Kimura Y, Takahata K, Kousa R, Ikoma Y, Eguchi Y, Takano H, Ito H, Higuchi M, Suhara T (12 Mar 2013). Superiority illusion arises from resting-state brain networks modulated by dopamine. Proceedings of the National Academy of Sciences of the United States of America, 110(11):4363-4367. doi: 10.1073/pnas.1221681110. ARTICLE | FREE FULLTEXT PDF 

Amusia and stroke

Although a complete musical anti-talent myself, that doesn’t prohibit me from fully enjoying the works of the masters in the art. When my family is out of earshot, I even bellow – because it cannot be called music – from the top of my lungs alongside the most famous tenors ever recorded. A couple of days ago I loaded one of my most eclectic playlists. While remembering my younger days as an Iron Maiden concert goer (I never said I listen only to classical music :D) and screaming the “Fear of the Dark” chorus, I wondered what’s new on the front of music processing in the brain.

And I found an interesting recent paper about amusia. Amusia is, as those of you with ancient Greek proclivities might have surmised, a deficit in the perception of music, mainly the pitch but sometimes rhythm and other aspects of music. A small percentage of the population is born with it, but a whooping 35 to 69% of stroke survivors exhibit the disorder.

So Sihvonen et al. (2016) decided to take a closer look at this phenomenon with the help of 77 stroke patients. These patients had an MRI scan within the first 3 weeks following stroke and another one 6 months poststroke. They also completed a behavioral test for amusia within the first 3 weeks following stroke and again 3 months later. For reasons undisclosed, and thus raising my eyebrows, the behavioral assessment was not performed at 6 months poststroke, nor an MRI at the 3 months follow-up. It would be nice to have had behavioral assessment with brain images at the same time because a lot can happen in weeks, let alone months after a stroke.

Nevertheless, the authors used a novel way to look at the brain pictures, called voxel-based lesion-symptom mapping (VLSM). Well, is not really novel, it’s been around for 15 years or so. Basically, to ascertain the function of a brain region, researchers either get people with a specific brain lesion and then look for a behavioral deficit or get a symptom and then they look for a brain lesion. Both approaches have distinct advantages but also disadvantages (see Bates et al., 2003). To overcome the disadvantages of these methods, enter the scene VLSM, which is a mathematical/statistical gimmick that allows you to explore the relationship between brain and function without forming preconceived ideas, i.e. without forcing dichotomous categories. They also looked at voxel-based morphometry (VBM), which a fancy way of saying they looked to see if the grey and white matter differ over time in the brains of their subjects.

After much analyses, Sihvonen et al. (2016) conclude that the damage to the right hemisphere is more likely conducive to amusia, as opposed to aphasia which is due mainly to damage to the left hemisphere. More specifically,

“damage to the right temporal areas, insula, and putamen forms the crucial neural substrate for acquired amusia after stroke. Persistent amusia is associated with further [grey matter] atrophy in the right superior temporal gyrus (STG) and middle temporal gyrus (MTG), locating more anteriorly for rhythm amusia and more posteriorly for pitch amusia.”

The more we know, the better chances we have to improve treatments for people.

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unless you’re left-handed, then things are reversed.

References:

1. Sihvonen AJ, Ripollés P, Leo V, Rodríguez-Fornells A, Soinila S, & Särkämö T. (24 Aug 2016). Neural Basis of Acquired Amusia and Its Recovery after Stroke. Journal of Neuroscience, 36(34):8872-8881. PMID: 27559169, DOI: 10.1523/JNEUROSCI.0709-16.2016. ARTICLE  | FULLTEXT PDF

2.Bates E, Wilson SM, Saygin AP, Dick F, Sereno MI, Knight RT, & Dronkers NF (May 2003). Voxel-based lesion-symptom mapping. Nature Neuroscience, 6(5):448-50. PMID: 12704393, DOI: 10.1038/nn1050. ARTICLE

By Neuronicus, 9 November 2016

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Autism cure by gene therapy

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Nothing short of an autism cure is promised by this hot new research paper.

Among many thousands of proteins that a neuron needs to make in order to function properly there is one called SHANK3 made from the gene shank3. (Note the customary writing: by consensus, a gene’s name is written using small caps and italicized, whereas the protein’s name that results from that gene expression is written with caps).

This protein is important for the correct assembly of synapses and previous work has shown that if you delete its gene in mice they show autistic-like behavior. Similarly, some people with autism, but by far not all, have a deletion on Chromosome 22, where the protein’s gene is located.

The straightforward approach would be to restore the protein production into the adult autistic mouse and see what happens. Well, one problem with that is keeping the concentration of the protein at the optimum level, because if the mouse makes too much of it, then the mouse develops ADHD and bipolar.

So the researchers developed a really neat genetic model in which they managed to turn on and off the shank3 gene at will by giving the mouse a drug called tamoxifen (don’t take this drug for autism! Beside the fact that is not going to work because you’re not a genetically engineered mouse with a Cre-dependent genetic switch on your shank3, it is also very toxic and used only in some form of cancers when is believed that the benefits outweigh the horrible side effects).

In young adult mice, the turning on of the gene resulted in normalization of synapses in the striatum, a brain region heavily involved in autistic behaviors. The synapses were comparable to normal synapses in some aspects (from the looks, i.e. postsynaptic density scaffolding, to the works, i.e. electrophysiological properties) and even more so in others (more dendritic spines than normal, meaning more synapses, presumably). This molecular repair has been mirrored by some behavioral rescue: although these mice still had more anxiety and more coordination problems than the control mice, their social aversion and repetitive behaviors disappeared. And the really really cool part of all this is that this reversal of autistic behaviors was done in ADULT mice.

Now, when the researchers turned the gene on in 20 days old mice (which is, roughly, the equivalent of the entering the toddling stage in humans), all four behaviors were rescued: social aversion, repetitive, coordination, and anxiety. Which tells us two things: first, the younger you intervene, the more improvements you get and, second and equally important, in adult, while some circuits seem to be irreversibly developed in a certain way, some other neural pathways are still plastic enough as to be amenable to change.

Awesome, awesome, awesome. Even if only a very small portion of people with autism have this genetic problem (about 1%), even if autism spectrum disorders encompass such a variety of behavioral abnormalities, this research may spark hope for a whole range of targeted gene therapies.

Reference: Mei Y, Monteiro P, Zhou Y, Kim JA, Gao X, Fu Z, Feng G. (Epub 17 Feb 2016). Adult restoration of Shank3 expression rescues selective autistic-like phenotypes. Nature. doi: 10.1038/nature16971. Article | MIT press release

By Neuronicus, 19 February 2016

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