The neural basis of decision-making and reward processing in adults with euthymic bipolar disorder or attention-deficit/hyperactivity disorder (ADHD)

Agustin Ibanez*, Marcelo Cetkovich, Agustin Petroni, Hugo Urquina, Sandra Baez, Maria Luz Gonzalez-Gadea, Juan Esteban Kamienkowski, Teresa Torralva, Fernando Torrente, Sergio Strejilevich, Julia Teitelbaum, Esteban Hurtado, Raphael Guex, Margherita Melloni, Alicia Lischinsky, Mariano Sigman, Facundo Manes

*Corresponding author for this work

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) share DSM-IV criteria in adults and cause problems in decision-making. Nevertheless, no previous report has assessed a decision-making task that includes the examination of the neural correlates of reward and gambling in adults with ADHD and those with BD. Methodology/Principal Findings: We used the Iowa gambling task (IGT), a task of rational decision-making under risk (RDMUR) and a rapid-decision gambling task (RDGT) which elicits behavioral measures as well as event-related potentials (ERPs: fERN and P3) in connection to the motivational impact of events. We did not observe between-group differences for decision-making under risk or ambiguity (RDMUR and IGT); however, there were significant differences for the ERP-assessed RDGT. Compared to controls, the ADHD group showed a pattern of impaired learning by feedback (fERN) and insensitivity to reward magnitude (P3). This ERP pattern (fERN and P3) was associated with impulsivity, hyperactivity, executive function and working memory. Compared to controls, the BD group showed fERN- and P3-enhanced responses to reward magnitude regardless of valence. This ERP pattern (fERN and P3) was associated with mood and inhibitory control. Consistent with the ERP findings, an analysis of source location revealed reduced responses of the cingulate cortex to the valence and magnitude of rewards in patients with ADHD and BD. Conclusions/Significance: Our data suggest that neurophysiological (ERPs) paradigms such as the RDGT are well suited to assess subclinical decision-making processes in patients with ADHD and BD as well as for linking the cingulate cortex with action monitoring systems.

Original languageEnglish
Article numbere37306
Pages (from-to)1-11
Number of pages11
JournalPLoS ONE
Volume7
Issue number5
DOIs
Publication statusPublished - 18 May 2012
Externally publishedYes

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