■建立对人类行为的动机影响对于理解健康和疾病中的选择和决策至关重要。在这里,我们使用了基于价值的决策测试,操纵预测和经验奖励值,以评估健康青少年和强迫症(OCD)患者对目标导向行动的动机控制。
■在对两个动作-两个结果概率任务进行仪器训练后,青少年(n=21)使用不同的刺激进行巴甫洛夫调节,预测工具性结果,第三个结果,或者什么都没有。然后,我们在选择测试期间评估功能磁共振成像,在这些测试中,我们改变了预测值,使用特定和通用的巴甫洛夫-工具转移,和经验的价值,使用结果贬值。建立功能意义,我们测试了一组匹配的青少年强迫症患者(n=20).
■在健康的青少年中,预测值和经验值都会影响目标导向行动的表现,由不同的眶额-纹状体回路介导,涉及外侧眶额皮质(OFC)和内侧OFC,分别。然而,在患有强迫症的青少年中,选择对预测值或经验值的变化不敏感。这些损伤与特定的巴甫洛夫-器械转移和前前额叶皮层活动不足期间外侧OFC的活动不足和内侧OFC的活动过度有关,尾状核,以及它们在贬值测试中的连通性。
■我们发现,预测和经验值通过不同的眶额和前额叶纹状体回路对青少年目标导向动作的表现产生了强大的影响。此外,这些动机过程的影响在强迫症中被严重钝化,包括内侧和外侧OFC的电路的功能隔离,产生失调的行动控制。
UNASSIGNED: Establishing the motivational influences on human action is essential for understanding choice and decision making in health and disease. Here we used tests of value-based decision making, manipulating both predicted and experienced reward values to assess the motivational control of goal-directed action in healthy adolescents and those with obsessive-compulsive disorder (OCD).
UNASSIGNED: After instrumental training on a two action-two outcome probabilistic task, adolescents (n = 21) underwent Pavlovian conditioning using distinct stimuli predicting either the instrumental outcomes, a third outcome, or nothing. We then assessed functional magnetic resonance imaging during choice tests in which we varied the predicted value, using specific and general Pavlovian-instrumental transfer, and the experienced value, using outcome devaluation. To establish functional significance, we tested a matched cohort of adolescents with OCD (n = 20).
UNASSIGNED: In healthy adolescents, both predicted and experienced values influenced the performance of goal-directed actions, mediated by distinct orbitofrontal-striatal circuits involving the lateral orbitofrontal cortex (OFC) and medial OFC, respectively. However, in adolescents with OCD, choice was insensitive to changes in either predicted or experienced values. These impairments were related to hypoactivity in the lateral OFC and hyperactivity in the medial OFC during specific Pavlovian-instrumental transfer and hypoactivity in the anterior prefrontal cortex, caudate nucleus, and their connectivity in the devaluation test.
UNASSIGNED: We found that predicted and experienced values exerted a potent influence on the performance of goal-directed actions in adolescents via distinct orbitofrontal- and prefrontal-striatal circuits. Furthermore, the influence of these motivational processes was severely blunted in OCD, as was the functional segregation of circuits involving medial and lateral OFC, producing dysregulated action control.