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Impulsivity, reward sensitivity, and decision-making in subarachnoid hemorrhage survivors

Published online by Cambridge University Press:  08 September 2006

CLAIRE H. SALMOND ,
ELISE E. DEVITO ,
LUKE CLARK ,
DAVID K. MENON ,
DORIS A. CHATFIELD ,
JOHN D. PICKARD ,
PETER J. KIRKPATRICK  and
BARBARA J. SAHAKIAN
CLAIRE H. SALMOND
Affiliation:
Wolfson Brain Imaging Centre, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
ELISE E. DEVITO
Affiliation:
Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom Department of Neurosurgery, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
LUKE CLARK
Affiliation:
Experimental Psychology, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
DAVID K. MENON
Affiliation:
Wolfson Brain Imaging Centre, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom Department of Anaesthetics, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
DORIS A. CHATFIELD
Affiliation:
Department of Anaesthetics, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
JOHN D. PICKARD
Affiliation:
Wolfson Brain Imaging Centre, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom Department of Neurosurgery, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
PETER J. KIRKPATRICK
Affiliation:
Department of Neurosurgery, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
BARBARA J. SAHAKIAN
Affiliation:
Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
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Abstract

Subarachnoid hemorrhage (SAH) survivors often report psychosocial and emotional changes, including a diminished capacity for decision making. However, systematic investigations into the nature of the changes have been limited to those patients surviving SAH secondary to aneurysms of the anterior communicating artery. This study aimed to explore the nature of decision making in survivors of SAH secondary to aneurysms of the middle cerebral or posterior communicating artery using a series of computerized tasks. Twenty SAH survivors and 20 matched controls completed a battery of computerized decision-making tasks. These included tasks examining an individual's ability to make probabilistic choices and risk-taking behavior, as well as tasks examining aspects of impulsivity. The results revealed two key patterns of abnormal decision-making behavior in the SAH survivors: altered sensitivity to both reward and punishment, and impulsive responding. These complex deficits may contribute to difficulties in daily living resulting from apathy, poor judgment, or inhibition in SAH survivors. (JINS, 2006, 12, 697–706.)

Keywords

Intracranial aneurysmCognitionAffective symptomsRisk takingImpulsive behaviorMotivation
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 12 , Issue 5 , September 2006 , pp. 697 - 706
Copyright
© 2006 The International Neuropsychological Society

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References

REFERENCES

Alexander, M.P. & Freedman, M. (1984). Amnesia after anterior communicating artery aneurysm rupture. Neurology, 34, 752–757.Google Scholar
Bar-On, R., Tranel, D., Denburg, N.L., & Bechara, A. (2003). Exploring the neurological substrate of emotional and social intelligence. Brain, 126(Pt 8), 1790–1800.Google Scholar
Bechara, A., Damasio, A.R., Damasio, H., & Anderson, S.W. (1994). Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50, 7–15.CrossRefGoogle Scholar
Bechara, A., Damasio, H., Damasio, A.R., & Lee, G.P. (1999). Different contributions of the human amygdala and ventromedial prefrontal cortex to decision-making. Journal of Neuroscience, 19, 5473–5481.Google Scholar
Bechara, A., Tranel, D., & Damasio, H. (2000). Characterization of the decision-making deficit of patients with ventromedial prefrontal cortex lesions. Brain, 123, 2189–2202.Google Scholar
Beck, A. (1970). Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press.
Beck, A.T. & Steer, R.A. (1987). Beck Depression Inventory. San Antonio: Psychological Corporation.
Clark, L., Robbins, T.W., Ersche, K.D., Imeson, L., Islam, S., Sonuga-Barke, E.J.S., & Sahakian, B.J. (2006). Reduced reflection during decision-making in chronic and former drug users. Biological Psychiatry, Electronic publication before print.Google Scholar
Cools, R., Barker, R.A., Sahakian, B.J., & Robbins, T.W. (2003). L-Dopa medication remediates cognitive inflexibility, but increases impulsivity in patients with Parkinson's disease. Neuropsychologia, 41, 1431–1441.CrossRefGoogle Scholar
Cummings, J.L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D.A., & Gornbein, J. (1994). The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.Google Scholar
Damasio, A.R., Graff-Radford, N.R., Eslinger, P.J., Damasio, H., & Kassell, N. (1985). Amnesia following basal forebrain lesions. Archives of Neurology, 42, 263–271.CrossRefGoogle Scholar
Deakin, J., Aitken, M., Robbins, T., & Sahakian, B.J. (2004). Risk taking during decision-making in normal volunteers changes with age. Journal of the International Neuropsychological Society, 10, 590–598.Google Scholar
Elliott, R., Friston, K.J., & Dolan, R.J. (2000). Dissociable neural responses in human reward systems. Journal of Neuroscience, 20, 6159–6165.Google Scholar
Elliott, R., Sahakian, B.J., Herrod, J.J., Robbins, T.W., & Paykel, E.S. (1997). Abnormal response to negative feedback in unipolar depression: Evidence for a diagnosis specific impairment. Journal of Neurology, Neurosurgery, and Psychiatry, 63, 74–82.Google Scholar
Eslinger, P.J. & Damasio, A.R. (1985). Severe disturbance of higher cognition after bilateral frontal lobe ablation: Patient EVR. Neurology, 35, 1731–1741.CrossRefGoogle Scholar
Evenden, J.L. (1999). The pharmacology of impulsive behaviour in rats V: The effects of drugs on responding under a discrimination task using unreliable visual stimuli. Psychopharmacology (Berl), 143, 111–122.CrossRefGoogle Scholar
Fiorillo, C.D., Tobler, P.N., & Schultz, W. (2003). Discrete coding of reward probability and uncertainty by dopamine neurons. Science, 299, 1898–1902.CrossRefGoogle Scholar
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Frank, M.J., Seeberger, L.C., & O'Reilly R, C. (2004). By carrot or by stick: Cognitive reinforcement learning in parkinsonism. Science, 306, 1940–1943.CrossRefGoogle Scholar
Gade, A. (1982). Amnesia after operations on aneurysms of the anterior communicating artery. Surgical Neurology, 18, 46–49.CrossRefGoogle Scholar
Gonzalez, C., Dana, J., Koshino, H., & Just, M. (2005). The framing effect and risky decisions: Examining cognitive functions with fMRI. Journal of Economic Psychology, 26, 1–20.Google Scholar
Howell, D.C. (2002). Statistical methods for psychology (5th ed.). Pacific Grove, CA: Duxbury.
Hutter, B.O., Gilsbach, J.M., & Kreitschmann, I. (1995). Quality of life and cognitive deficits after subarachnoid haemorrhage. British Journal of Neurosurgery, 9, 465–475.Google Scholar
Kagan, J. (1966). Reflection-impulsivity: The generality and dynamics of conceptual tempo. Journal of Abnormal Psychology, 71, 17–24.CrossRefGoogle Scholar
Kassell, N.F., Torner, J.C., Jane, J.A., Haley, E.C., Jr., & Adams, H.P. (1990). The International Cooperative Study on the Timing of Aneurysm Surgery. Part 2: Surgical results. Journal of Neurosurgery, 73, 37–47.Google Scholar
Linn, F.H.H., Rinkel, G.J.E., Algra, A., & van Gijn, J. (1996). Incidence of subarachnoid hemorrhage. Role of region, year and rate of computed tomography: A meta-analysis. Stroke, 26, 625–629.Google Scholar
Ljunggren, B., Sonesson, B., Saveland, H., & Brandt, L. (1985). Cognitive impairment and adjustment in patients without neurological deficits after aneurysmal SAH and early operation. Journal of Neurosurgery, 62, 673–679.Google Scholar
Logue, V., Durward, M., Pratt, R.T., Piercy, M., & Nixon, W.L. (1968). The quality of survival after rupture of an anterior cerebral aneurysm. British Journal of Psychiatry, 114, 137–160.Google Scholar
Martin, J.H. (1996). Neuroanatomy: Text and atlas. Stamford, Connecticut: Appleton & Lange.
Mavaddat, N., Kirkpatrick, P.J., Rogers, R.D., & Sahakian, B.J. (2000). Deficits in decision-making in patients with aneurysms of the anterior communicating artery. Brain, 123(Pt. 10), 2109–2117.Google Scholar
Nelson, H.E. (1982). National Adult Reading Test Manual. Windsor, UK: NFER-Nelson.
Ogden, J.A., Mee, E.W., & Henning, M. (1994). A prospective study of psychosocial adaptation following subarachnoid haemorrhage. Neuropsychological Rehabilitation, 4, 7–30.Google Scholar
Okawa, M., Maeda, S., Nukui, H., & Kawafuchi, J. (1980). Psychiatric symptoms in ruptured anterior communicating aneurysms: Social prognosis. Acta Psychiatria Scandanavica, 61, 306–312.Google Scholar
Powell, J., Kitchen, N., Heslin, J., & Greenwood, R. (2002). Psychosocial outcomes at three and nine months after good neurological recovery from aneurysmal subarachnoid haemorrhage: Predictors and prognosis. Journal of Neurology, Neurosurgery, and Psychiatry, 72, 772–781.Google Scholar
Powell, J., Kitchen, N., Heslin, J., & Greenwood, R. (2004). Psychosocial outcomes at 18 months after good neurological recovery from aneurysmal subarachnoid haemorrhage. Journal of Neurology, Neurosurgery, and Psychiatry, 75, 1119–1124.CrossRefGoogle Scholar
Rogers, R.D., Everitt, B.J., Baldacchino, A., Blackshaw, A.J., Swainson, R., Wynne, K., Baker, N.B., Hunter, J., Carthy, T., Booker, E., London, M., Deakin, J.F., Sahakian, B.J., & Robbins, T.W. (1999a). Dissociable deficits in the decision-making cognition of chronic amphetamine abusers, opiate abusers, patients with focal damage to prefrontal cortex, and tryptophan-depleted normal volunteers: Evidence for monoaminergic mechanisms. Neuropsychopharmacology, 20, 322–339.Google Scholar
Rogers, R.D., Owen, A.M., Middleton, H.C., Williams, E.J., Pickard, J.D., Sahakian, B.J., & Robbins, T.W. (1999b). Choosing between small, likely rewards and large, unlikely rewards activates inferior and orbital prefrontal cortex. Journal of Neuroscience, 19, 9029–9038.Google Scholar
Rogers, R.D., Ramnani, N., Mackay, C., Wilson, J.L., Jezzard, P., Carter, C.S., & Smith, S.M. (2004). Distinct portions of anterior cingulate cortex and medial prefrontal cortex are activated by reward processing in separable phases of decision-making cognition. Biological Psychiatry, 55, 594–602.CrossRefGoogle Scholar
Salmond, C.H., Chatfield, D.A., Menon, D.K., Pickard, J.D., & Sahakian, B.J. (2005). Cognitive Sequelae of head injury: Involvement of basal forebrain and associated structures. Brain, 128, 189–200.Google Scholar
Saveland, H., Sonesson, B., Ljunggren, B., Brandt, L., Uski, T., Zygmunt, S., & Hindfelt, B. (1986). Outcome evaluation following subarachnoid hemorrhage. Journal of Neurosurgery, 64, 191–196.CrossRefGoogle Scholar
Smith, B. (1963). Cerebral pathology in subarachnoid haemorrhage. Journal of Neurology, Neurosurgery, and Psychiatry, 26, 535–539.Google Scholar
Swainson, R., Hodges, J.R., Galton, C.J., Semple, J., Michael, A., Dunn, B.D., Iddon, J.L., Robbins, T.W., & Sahakian, B.J. (2001). Early detection and differential diagnosis of Alzheimer's disease and depression with neuropsychological tasks. Dementia and Geriatric Cognitive Disorders, 12, 265–280.CrossRefGoogle Scholar
Teissier du Cros, J. & Lhermitte, F. (1984). Neuropsychological analysis of ruptured saccular aneurysms of the anterior communicating artery after radical therapy (32 cases). Surgical Neurology, 22, 353–359.CrossRefGoogle Scholar
Vilkki, J. (1985). Amnesic syndromes after surgery of anterior communicating artery aneurysms. Cortex, 21, 431–444.Google Scholar
Weir, B. (1998). Anatomic features of aneurysms. In B. Weir (Ed.), Subarachnoid hemorrhage: Causes and cures (pp. 46–62). New York: Oxford University Press.