有精神病史的常郁型双相障碍患者的强化学习障碍。

IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY
Sandra Chi Yiu Wong, Heidi Ka Ying Lo, Anson Kai Chun Chau, Mary Chung Mun Ng, Joe Kwun Nam Chan, Ryan Sai Ting Chu, Catherine Zhiqian Fang, Christy Lai Ming Hui, Sherry Kit Wa Chan, Edwin Ho Ming Lee, Simon Sai Yu Lui, Wing Chung Chang
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引用次数: 0

摘要

强化学习(RL)障碍是双相情感障碍(BD)功能预后的重要决定因素。本研究采用计算机化的RL范式,对38名从首发躁狂症伴精神病开始3年内接受治疗的16-40岁的正常心境双相i型障碍(BD-I)患者和40名人口统计学匹配的健康对照进行了RL检测,研究了快速和渐进学习、奖励驱动和惩罚驱动学习。评估症状严重程度和认知功能。我们的研究结果显示,BD-I个体比对照组表现出更低的损失转移得分(p = 0.03)。其他快速RL测量没有组间差异。对于总RL,重复测量方差分析显示组的主效应(F1,76 = 6.5, p = 0.03;对照组优于患者),阻滞(f2.87、218.45 = 43.7,p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reinforcement learning impairment in individuals with euthymic bipolar I disorder with a history of psychosis.

Reinforcement-learning (RL) impairment is an important determinant of functional outcome in bipolar-disorder (BD). This study examined RL in 38 euthymic bipolar-I-disorder (BD-I) individuals aged 16-40 years who were treated within three years from first-episode mania with psychosis and 40 demographically-matched healthy-controls using a computerized RL-paradigm, which investigated rapid and gradual learning, and reward-driven and punishment-driven learning. Symptom severity and cognitive functions were assessed. Our results showed that BD-I individuals displayed lower lose-shift scores than controls (p = 0.03). There were no group differences in other rapid RL measures. Regarding overall RL, a repeated-measures ANOVA revealed main effect of group (F1,76 = 6.5, p = 0.03; controls performed better than patients), block (F2.87,218.45 = 43.7, p < 0.001; performance improving over time) and probability (F1,76 = 15.6, p < 0.001; better performance in 90% than in 80% condition). Post-hoc analysis revealed that controls performed better than BD-I individuals on loss-avoidance stimuli (p = 0.02). Better performance of controls relative to BD-I individuals on gain stimuli approached statistical significance (p = 0.06). No correlations of RL measures with symptoms, cognition or antipsychotic dose were observed. In conclusion, this study is among the few to examine RL impairment in euthymic BD-I with history of psychosis at a relatively early illness stage, and indicates that BD-I individuals displayed punishment-driven learning (i.e., negative RL) deficits compared with controls. Diminished punishment-sensitivity may indicate vulnerability to maladaptive behaviors, particularly in response to negative events or stress, and poorer functional impairment. Further research is required to clarify longitudinal trajectory of punishment-insensitivity and its relationship with psychosis and functional outcomes in the early-stage of BD.

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来源期刊
CiteScore
8.80
自引率
4.30%
发文量
154
审稿时长
6-12 weeks
期刊介绍: The original papers published in the European Archives of Psychiatry and Clinical Neuroscience deal with all aspects of psychiatry and related clinical neuroscience. Clinical psychiatry, psychopathology, epidemiology as well as brain imaging, neuropathological, neurophysiological, neurochemical and moleculargenetic studies of psychiatric disorders are among the topics covered. Thus both the clinician and the neuroscientist are provided with a handy source of information on important scientific developments.
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