S82. REINFORCEMENT LEARNING IMPAIRMENT IN PATIENTS WITH EARLY-STAGE PSYCHOTIC BIPOLAR DISORDER

Background Abnormal reward sensitivity is a biosignature to mood disorders spectrum. Recent data suggested either elevated or preserved positive but impaired negative reinforcement learning in patients with bipolar disorder. Functional MRI studies provided extra evidence on heightened reward sensitivity in manic patients. Of note, these investigations mostly rest on chronically ill samples, conditions of whom may have been confounded by prolonged exposure to medications. This study aims to examine reinforcement learning performance and its relationship with symptomology in patients with early-stage psychotic bipolar disorder (BDP). Methods This study is based on 38 patients with early-stage BDP (defined by having received psychiatric treatment for first-episode BDP within 3 years since service entry) who have been euthymic for at least eight weeks and 40 demographically-matched controls. Reinforcement learning performance was evaluated using Gain-vs-Loss-Avoidance Task (GLAT), which measured the correct responses in both gain and loss-avoidance pairs with reinforcement probability at either 90% or 80% across four blocks in the training phase and one block in the test/transfer phase. Comparison analyses on reinforcement learning performance were conducted on two groups. Associations of reinforcement learning measures with symptom scores, cognitive functions and functioning measures were also tested. Results There was no group difference in gender, age or education level. Repeated-measures analysis of variance (ANOVA) showed significant main effects of group (F=6.52, p=0.013), block (F=43.71, p<0.001), probability (F= 5.58, p<0.001), and block x group (F=2.87, p=0.040) interaction. Post-hoc tests revealed that controls performed better than patients across blocks (p<0.05). Patients also showed a lower lose-shift rate (t= 2.21, p=0.03) and punishment-driven learning accuracy rates (t=2.42, p=0.018) than controls. Marginally significant main effect of stimulus pair (F=3.98, p=0.05) was revealed in the test phase, with controls showing a significantly higher preference in Frequent Winner vs Frequent Loser (FWFL) pair than patients (t=-2.25, p=0.028). No significant correlations between learning measures and any of the symptom dimensions in patient sample. Discussion Our preliminary findings provided a brief evidence on the negative reinforcement learning impairment in early-stage BDP patients. Further investigation is required to verify and confirm our results of impaired negative reinforcement learning in the initial course of bipolar disorder.

It Is What You Have, Not What You Lose: Effects of Perceived Gains and Losses on Goal Orientation Across Adulthood

Objectives Goal orientation tends to shift from predominantly striving for gains to maintenance and loss avoidance across adulthood. A dominant hypothesis states that age-related increases in losses drive the motivational shift. The present study tests this hypothesis and an alternative, namely that perceived accumulation of resources/assets and discrepancy between the actual and desired state underlie the stronger maintenance and loss-avoidance orientation in older than younger adults. Methods Data from N = 182 U.S. adult participants on Amazon Mechanical Turk (preregistered; 50.0% female; 19–77 years, M = 45.1, SD = 15.86) comprise measures of demographics, goal orientation in 16 selected life domains as well as perceived accumulation, losses, actual-desired discrepancy in the same domains. Results Multilevel modeling analyses showed that, as expected and confirming prior research, gain orientation decreased and maintenance orientation increased with age. Moreover, both perceived losses and accumulation of resources/assets increased with age, while the actual-desired discrepancy decreased. Larger perceived accumulation and smaller actual-desired discrepancies were associated with stronger maintenance orientation. Regardless of age, a smaller actual-desired discrepancy was also associated with stronger loss-avoidance orientation. Contrary to predictions, perceived losses were negatively associated with gain orientation, but not significantly associated with maintenance or loss-avoidance orientation. Discussion Results replicate the shift in goal orientation across adulthood. Speaking against the loss hypothesis, perceived accumulation of resources/assets and actual-desired discrepancy seem to play an important role in determining goal orientation over adulthood, while the role of perceived losses may be less significant than commonly assumed.

Prediction of white matter integrity pattern in overweight and obese adults

IntroductionObesity has been associated with lower white matter integrity (WMI) in limbic brain regions, including the fornix. Both early decrease of WMI in the fornix (WMIf) and midlife obesity have been related to dementia incidence with advancing age. No studies have explored early cognitive predictors of WMIf in overweight-obese (OO) adults. Aim of this study was to compare OO and normal-weight (NW) participants with respect to (a) WMIf in adulthood and (b) the relationship between cognitive performance at school-age and in adolescence with WMIf in adulthood.MethodsParticipants were part of a cohort followed since infancy who underwent magnetic resonance imaging studies in adulthood (22.3 ± 1.3 years). Diffusion tensor imaging was performed and Tract Based Spatial Statistics (TBSS) was used to obtain fractional anisotropy (FA) skeleton; increased FA relates to greater WMI. A mask for the fornix was created (JHU-ICBM DTI-81 Atlas) and then used to extract the average FA for each individual. Participants also performed neurocognitive tasks: (a) school-age (10.3 ± 1.0 years): the trail making test comprises two conditions and time difference between conditions reflects cognitive flexibility; (b) adolescence (15.6 ± 0.5 years): incentive task that test the effect of incentives (reward, loss avoidance or neutral) on inhibitory control performance (correct responses latency). In adulthood, BMI was categorized as NW (≥ 18.5 to < 25.0 kg/m2) and OO (≥ 25.0 kg/m2) groups. A t-test and univariate GLM were conducted. Analysis were adjusted by sex and age-specific BMI z-scores.ResultsParticipants were 27 NW (41% female) and 41 OO (49% female). Compared to NW, OO participants showed decreased FA in the fornix (0.585 vs. 0.618, p < 0.05), i.e. lower WMIf. Differences were apparent in the relationship between cognitive flexibility at school-age (F = 2.9, p = 0.06) and loss avoidance latency in adolescence (F = 3.5, p < 0.05) with FA in the fornix in adulthood. Increased cognitive flexibility at school-age (β = 0.335, p < 0.05) and decreased loss avoidance latency in adolescence (β = -0.581, p < 0.001) were related to higher FA in the fornix in OO adults. No relationship resulted significant in NW adults.DiscussionPerformance in neurocognitive tasks at earlier developmental stages were related with WMIf only in OO adults, group characterized by decreased WMIf. Our results provide evidence regarding specific neurocognitive tasks with predictive value for WMIf alterations. Further, they could contribute to the understanding of neural mechanisms underlying obesity and also provide insight relative to neurodegenerative risk with advancing age.SupportFondecyt 11160671 and NIH HD33487.