Empathy under arrest?:functional and structural neural correlates of empathy in psychopathy

Om interacties met anderen goed te laten verlopen, is het belangrijk dat we begrijpen wat zij doen en ervaren. Uit onderzoek is gebleken dat een van de mogelijke mechanismen hierachter ligt in het ‘heractiveren’van hersengebieden - die we gebruiken om acties uit te voeren en emoties en aanrakingen te ervaren - wanneer we anderen waarnemen die deze handelingen uitvoeren of emoties en aanrakingen ervaren. Deze ‘heractivatie’ van hersengebieden zou ons een soort privé ervaring van het gevoel van een ander kunnen geven. Neem als voorbeeld van de pijn die we zelf voelen, wanneer we iemand anders zien die zich in de vinger snijdt. In dit proefschrift onderzochten we het neurale mechanisme dat hieraan ten grondslag ligt bij een groep mensen gediagnosticeerd met psychopathie. Een belangrijk kenmerk van deze mentale stoornis is het verminderd vermogen om mee te voelen met de emoties van anderen en deze te herkennen. Wij hebben in dit onderzoek bekeken of dit samenhangt met een vermindere activatie van de hersengebieden voor emoties, acties en sensaties, wanneer mensen met psychopathie kijken naar andere mensen die iets meemaken. De resultaten van dit proefschrift suggereren dat psychopathie niet zozeer een onvermogen is om deze gebieden te activeren, maar wel dat zij dit spontaan minder sterk doen. Aangezien het de eerste keer is dat soortgelijk onderzoek is uitgevoerd bij deze doelgroep, zullen de resultaten nog moeten worden geverifieerd in vervolgonderzoek. Deze informatie zou dan mogelijk kunnen leiden tot alternatieve therapeutische strategieën

Dysfunctional Social Reinforcement Processing in Disruptive Behavior Disorders: An Functional Magnetic Resonance Imaging Study.

ObjectivePrior functional magnetic resonance imaging (fMRI) work has revealed that children/adolescents with disruptive behavior disorders (DBDs) show dysfunctional reward/non-reward processing of non-social reinforcements in the context of instrumental learning tasks. Neural responsiveness to social reinforcements during instrumental learning, despite the importance of this for socialization, has not yet been previously investigated.MethodsTwenty-nine healthy children/adolescents and 19 children/adolescents with DBDs performed the fMRI social/non-social reinforcement learning task. Participants responded to random fractal image stimuli and received social and non-social rewards/non-rewards according to their accuracy.ResultsChildren/adolescents with DBDs showed significantly reduced responses within the caudate and posterior cingulate cortex (PCC) to non-social (financial) rewards and social non-rewards (the distress of others). Connectivity analyses revealed that children/adolescents with DBDs have decreased positive functional connectivity between the ventral striatum (VST) and the ventromedial prefrontal cortex (vmPFC) seeds and the lateral frontal cortex in response to reward relative to non-reward, irrespective of its sociality. In addition, they showed decreased positive connectivity between the vmPFC seed and the amygdala in response to non-reward relative to reward.ConclusionThese data indicate compromised reinforcement processing of both non-social rewards and social non-rewards in children/adolescents with DBDs within core regions for instrumental learning and reinforcement-based decision- making (caudate and PCC). In addition, children/adolescents with DBDs show dysfunctional interactions between the VST, vmPFC, and lateral frontal cortex in response to rewarded instrumental actions potentially reflecting disruptions in attention to rewarded stimuli

Neurodevelopmental Changes in Social Reinforcement Processing: A Functional Magnetic Resonance Imaging Study.

ObjectiveIn the current study we investigated neurodevelopmental changes in response to social and non-social reinforcement.MethodsFifty-three healthy participants including 16 early adolescents (age, 10-15 years), 16 late adolescents (age, 15-18 years), and 21 young adults (age, 21-25 years) completed a social/non-social reward learning task while undergoing functional magnetic resonance imaging. Participants responded to fractal image stimuli and received social or non-social reward/non-rewards according to their accuracy. ANOVAs were conducted on both the blood oxygen level dependent response data and the product of a context-dependent psychophysiological interaction (gPPI) analysis involving ventromedial prefrontal cortex (vmPFC) and bilateral insula cortices as seed regions.ResultsEarly adolescents showed significantly increased activation in the amygdala and anterior insula cortex in response to non-social monetary rewards relative to both social reward/non-reward and monetary non-rewards compared to late adolescents and young adults. In addition, early adolescents showed significantly more positive connectivity between the vmPFC/bilateral insula cortices seeds and other regions implicated in reinforcement processing (the amygdala, posterior cingulate cortex, insula cortex, and lentiform nucleus) in response to non-reward and especially social non-reward, compared to late adolescents and young adults.ConclusionIt appears that early adolescence may be marked by: (i) a selective increase in responsiveness to non-social, relative to social, rewards; and (ii) enhanced, integrated functioning of reinforcement circuitry for non-reward, and in particular, with respect to posterior cingulate and insula cortices, for social non-reward

The Autism Diagnostic Observation Schedule, Module 4:Application of the Revised Algorithms in an Independent, Well-Defined, Dutch Sample (n=93)

This study examined the discriminative ability of the revised Autism Diagnostic Observation Schedule module 4 algorithm (Hus and Lord in J Autism Dev Disord 44(8):1996-2012, 2014) in 93 Dutch males with Autism Spectrum Disorder (ASD), schizophrenia, psychopathy or controls. Discriminative ability of the revised algorithm ASD cut-off resembled the original algorithm ASD cut-off: highly specific for psychopathy and controls, lower sensitivity than Hus and Lord (2014; i.e. ASD .61, AD .53). The revised algorithm AD cut-off improved sensitivity over the original algorithm. Discriminating ASD from schizophrenia was still challenging, but the better-balanced sensitivity (.53) and specificity (.78) of the revised algorithm AD cut-off may aide clinicians' differential diagnosis. Findings support using the revised algorithm, being conceptually conform the other modules, thus improving comparability across the lifespan

Neural Responses to Fluoxetine in Youths with Disruptive Behavior and Trauma Exposure: A Pilot Study

Objective: A preliminary investigation of the impact of a serotonergic agent (fluoxetine) on symptom profile and neural response in youths with disruptive behavior disorders (DBDs) and a history of trauma exposure. Methods: There were three participant groups: (i) Youths with DBDs and trauma exposure who received fluoxetine treatment for 8 weeks (n = 11); (ii) A matched group of youths with DBDs and trauma exposure who received routine regular follow-up in an outpatient clinic (n = 10); and (iii) Typically developing youths (n = 18). All participants conducted an expression processing functional magnetic resonance imaging task twice, 8 weeks apart: (pretreatment and post-treatment for youths with DBDs). Results: Youths with DBDs and trauma exposure who received fluoxetine treatment compared to the other two groups showed: (i) significant improvement in externalizing, oppositional defiant disorder, irritability, anxiety-depression, and trauma-related symptoms; (ii) as a function of fearful expression intensity, significantly decreased amygdala response and increased recruitment of regions implicated in top-down attention control (insula cortex, inferior parietal lobule, and postcentral gyrus) and emotional regulation (ventromedial prefrontal cortex [vmPFC]); and (iii) correlation between DBD/irritability symptom improvement and increased activation of top-down attention control areas (inferior parietal lobule, insula cortex, and postcentral gyrus) and an emotion regulation area (vmPFC). Conclusions: This study provides preliminary evidence that a serotonergic agent (fluoxetine) can reduce disruptive behavior and mood symptoms in youths with DBDs and trauma exposure and that this may be mediated by enhanced activation of top-down attention control and emotion regulation areas (inferior parietal lobule, insula cortex, and vmPFC)

Diagnosing Autism Spectrum Disorders in Adults: the Use of Autism Diagnostic Observation Schedule (ADOS) Module 4

Autism Diagnostic Observation Schedule (ADOS) module 4 was investigated in an independent sample of high-functioning adult males with an autism spectrum disorder (ASD) compared to three specific diagnostic groups: schizophrenia, psychopathy, and typical development. ADOS module 4 proves to be a reliable instrument with good predictive value. It can adequately discriminate ASD from psychopathy and typical development, but is less specific with respect to schizophrenia due to behavioral overlap between autistic and negative symptoms. However, these groups differ on some core items and explorative analyses indicate that a revision of the algorithm in line with Gotham et al. (J Autism Dev Disord 37: 613–627, 2007) could be beneficial for discriminating ASD from schizophrenia

Empathy under arrest? : functional and structural neural correlates of empathy in psychopathy

Om interacties met anderen goed te laten verlopen, is het belangrijk dat we begrijpen wat zij doen en ervaren. Uit onderzoek is gebleken dat een van de mogelijke mechanismen hierachter ligt in het ‘heractiveren’van hersengebieden - die we gebruiken om acties uit te voeren en emoties en aanrakingen te ervaren - wanneer we anderen waarnemen die deze handelingen uitvoeren of emoties en aanrakingen ervaren. Deze ‘heractivatie’ van hersengebieden zou ons een soort privé ervaring van het gevoel van een ander kunnen geven. Neem als voorbeeld van de pijn die we zelf voelen, wanneer we iemand anders zien die zich in de vinger snijdt. In dit proefschrift onderzochten we het neurale mechanisme dat hieraan ten grondslag ligt bij een groep mensen gediagnosticeerd met psychopathie. Een belangrijk kenmerk van deze mentale stoornis is het verminderd vermogen om mee te voelen met de emoties van anderen en deze te herkennen. Wij hebben in dit onderzoek bekeken of dit samenhangt met een vermindere activatie van de hersengebieden voor emoties, acties en sensaties, wanneer mensen met psychopathie kijken naar andere mensen die iets meemaken. De resultaten van dit proefschrift suggereren dat psychopathie niet zozeer een onvermogen is om deze gebieden te activeren, maar wel dat zij dit spontaan minder sterk doen. Aangezien het de eerste keer is dat soortgelijk onderzoek is uitgevoerd bij deze doelgroep, zullen de resultaten nog moeten worden geverifieerd in vervolgonderzoek. Deze informatie zou dan mogelijk kunnen leiden tot alternatieve therapeutische strategieën. Emotions of other people are very contagious. Imagine you are a scientist, giving a lecture about the results of your work. While walking up and down the stage, enthusiastically explaining your findings, you forget to pay attention to your feet, stumble, and disappear behind the table. A case-study, completed by the author of this thesis, revealed that gasps will immediately emerge from the audience and when you get up and peer out over the table, many of those that were sitting in the front row will by now have walked a few steps towards you to check whether you are ok (data not published). The example above indicates that emotions and feelings of others can touch us in a very real way: when someone you see is feeling hurt, there is a big chance that some of this hurt spills over to you as well. In the neuroscientific literature, this phenomenon has been shown at the neural level: When you observe other people perform actions or experience emotions or sensations, this activates brain regions that you would normally use to perform these actions and experience these emotions and sensations yourself. In this thesis, we examined the mechanism behind this sharing at the neural level, using functional and structural Magnetic Resonance Imaging. More specifically, we were interested in a group of people with a documented lack of responses to emotions of others, namely individuals diagnosed with a disorder called psychopathy. Results from this thesis suggest that psychopathy is not so much an inability to empathize with other people, but a reduced propensity to do so. This information may lead to alternative therapeutic strategies, given that they can be replicated and extended in future research.

BOLD data representing activation and connectivity for rare no-go versus frequent go cues

The neural circuitry underlying response control is often studied using go/no-go tasks, in which participants are required to respond as fast as possible to go cues and withhold from responding to no-go stimuli. In the current task, response control was studied using a fully counterbalanced design in which blocks with a low frequency of no-go cues (75% go, 25% no-go) were alternated with blocks with a low frequency of go cues (25% go, 75% no-go); see also “Segregating attention from response control when performing a motor inhibition task: Segregating attention from response control” [1]. We applied a whole brain corrected, paired t-test to the data assessing for regions differentially activated by low frequency no-go cues relative to high frequency go cues. In addition, we conducted a generalized psychophysiological interaction analysis on the data using a right inferior frontal gyrus seed region. This region was identified through the BOLD response t-test and was chosen because right inferior gyrus is highly implicated in response inhibition. Keywords: Cognitive control, Go/No-go, fMRI, Generalized psychophysiological interactions, Inhibitio