| 1. |
- Taylor, Peter N, et al.
(författare)
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C-peptide and metabolic outcomes in trials of disease modifying therapy in new-onset type 1 diabetes: an individual participant meta-analysis
- 2023
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Ingår i: The Lancet Diabetes and Endocrinology. - : Elsevier. - 2213-8587 .- 2213-8595. ; 11:12, s. 915-925
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Tidskriftsartikel (refereegranskat)abstract
- Background: Metabolic outcomes in type 1 diabetes remain suboptimal. Disease modifying therapy to prevent β-cell loss presents an alternative treatment framework but the effect on metabolic outcomes is unclear. We, therefore, aimed to define the relationship between insulin C-peptide as a marker of β-cell function and metabolic outcomes in new-onset type 1 diabetes.Methods: 21 trials of disease-modifying interventions within 100 days of type 1 diabetes diagnosis comprising 1315 adults (ie, those 18 years and older) and 1396 children (ie, those younger than 18 years) were combined. Endpoints assessed were stimulated area under the curve C-peptide, HbA1c, insulin use, hypoglycaemic events, and composite scores (such as insulin dose adjusted A1c, total daily insulin, U/kg per day, and BETA-2 score). Positive studies were defined as those meeting their primary endpoint. Differences in outcomes between active and control groups were assessed using the Wilcoxon rank test.Findings: 6 months after treatment, a 24·8% greater C-peptide preservation in positive studies was associated with a 0·55% lower HbA1c (p<0·0001), with differences being detectable as early as 3 months. Cross-sectional analysis, combining positive and negative studies, was consistent with this proportionality: a 55% improvement in C-peptide preservation was associated with 0·64% lower HbA1c (p<0·0001). Higher initial C-peptide levels and greater preservation were associated with greater improvement in HbA1c. For HbA1c, IDAAC, and BETA-2 score, sample size predictions indicated that 2-3 times as many participants per group would be required to show a difference at 6 months as compared with C-peptide. Detecting a reduction in hypoglycaemia was affected by reporting methods.Interpretation: Interventions that preserve β-cell function are effective at improving metabolic outcomes in new-onset type 1 diabetes, confirming their potential as adjuncts to insulin. We have shown that improvements in HbA1c are directly proportional to the degree of C-peptide preservation, quantifying this relationship, and supporting the use of C-peptides as a surrogate endpoint in clinical trials.
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| 2. |
- Chowdhury, Rumana, et al.
(författare)
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Dopamine restores reward prediction errors in old age
- 2013
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Ingår i: Nature Neuroscience. - : Springer Science and Business Media LLC. - 1097-6256 .- 1546-1726. ; 16:5, s. 648-653
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Tidskriftsartikel (refereegranskat)abstract
- Senescence affects the ability to utilize information about the likelihood of rewards for optimal decision-making. Using functional magnetic resonance imaging in humans, we found that healthy older adults had an abnormal signature of expected value, resulting in an incomplete reward prediction error (RPE) signal in the nucleus accumbens, a brain region that receives rich input projections from substantia nigra/ventral tegmental area (SN/VTA) dopaminergic neurons. Structural connectivity between SN/VTA and striatum, measured by diffusion tensor imaging, was tightly coupled to inter-individual differences in the expression of this expected reward value signal. The dopamine precursor levodopa (L-DOPA) increased the task-based learning rate and task performance in some older adults to the level of young adults. This drug effect was linked to restoration of a canonical neural RPE. Our results identify a neurochemical signature underlying abnormal reward processing in older adults and indicate that this can be modulated by L-DOPA.
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| 3. |
- de Boer, Lieke, et al.
(författare)
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Attenuation of dopamine-modulated prefrontal value signals underlies probabilistic reward learning deficits in old age
- 2017
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Ingår i: eLIFE. - : ELIFE SCIENCES PUBLICATIONS LTD. - 2050-084X. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Probabilistic reward learning is characterised by individual differences that become acute in aging. This may be due to age-related dopamine (DA) decline affecting neural processing in striatum, prefrontal cortex, or both. We examined this by administering a probabilistic reward learning task to younger and older adults, and combining computational modelling of behaviour, fMRI and PET measurements of DA D1 availability. We found that anticipatory value signals in ventromedial prefrontal cortex (vmPFC) were attenuated in older adults. The strength of this signal predicted performance beyond age and was modulated by D1 availability in nucleus accumbens. These results uncover that a value-anticipation mechanism in vmPFC declines in aging, and that this mechanism is associated with DA D1 receptor availability.
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| 4. |
- Durkin, Rachael, et al.
(författare)
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Anacrusis : Upbeat
- 2022
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Ingår i: The Routledge Companion to Music and Modern Literature. - Abingdon : Routledge. - 9780367237240 - 9781032232874 - 9780367237288 ; , s. 1-3
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Bokkapitel (refereegranskat)
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| 5. |
- Guitart-Masip, Marc, et al.
(författare)
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Action versus valence in decision making
- 2014
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Ingår i: Trends in cognitive sciences. - : Elsevier BV. - 1364-6613 .- 1879-307X. ; 18:4, s. 194-202
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Forskningsöversikt (refereegranskat)abstract
- The selection of actions, and the vigor with which they are executed, are influenced by the affective valence of predicted outcomes. This interaction between action and valence significantly influences appropriate and inappropriate choices and is implicated in the expression of psychiatric and neurological abnormalities, including impulsivity and addiction. We review a series of recent human behavioral, neuroimaging, and pharmacological studies whose key design feature is an orthogonal manipulation of action and valence. These studies find that the interaction between the two is subject to the critical influence of dopamine. They also challenge existing views that neural representations in the striatum focus on valence, showing instead a dominance of the anticipation of action.
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| 6. |
- Guitart-Masip, Marc, et al.
(författare)
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Anxiety associated with perceived uncontrollable stress enhances expectations of environmental volatility and impairs reward learning
- 2023
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Ingår i: Scientific Reports. - 2045-2322. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Unavoidable stress can lead to perceived lack of control and learned helplessness, a risk factor for depression. Avoiding punishment and gaining rewards involve updating the values of actions based on experience. Such updating is however useful only if action values are sufficiently stable, something that a lack of control may impair. We examined whether self-reported stress uncontrollability during the first wave of the COVID-19 pandemic predicted impaired reward-learning. In a preregistered study during the first-wave of the COVID-19 pandemic, we used self-reported measures of depression, anxiety, uncontrollable stress, and COVID-19 risk from 427 online participants to predict performance in a three-armed-bandit probabilistic reward learning task. As hypothesised, uncontrollable stress predicted impaired learning, and a greater proportion of probabilistic errors following negative feedback for correct choices, an effect mediated by state anxiety. A parameter from the best-fitting hidden Markov model that estimates expected beliefs that the identity of the optimal choice will shift across images, mediated effects of state anxiety on probabilistic errors and learning deficits. Our findings show that following uncontrollable stress, anxiety promotes an overly volatile representation of the reward-structure of uncertain environments, impairing reward attainment, which is a potential path to anhedonia in depression.
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| 7. |
- Guitart-Masip, Marc, et al.
(författare)
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Differential, but not opponent, effects of L-DOPA and citalopram on action learning with reward and punishment
- 2014
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Ingår i: Psychopharmacology. - : Springer Science and Business Media LLC. - 0033-3158 .- 1432-2072. ; 231:5, s. 955-966
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Tidskriftsartikel (refereegranskat)abstract
- Decision-making involves two fundamental axes of control namely valence, spanning reward and punishment, and action, spanning invigoration and inhibition. We recently exploited a go/no-go task whose contingencies explicitly decouple valence and action to show that these axes are inextricably coupled during learning. This results in a disadvantage in learning to go to avoid punishment and in learning to no-go to obtain a reward. The neuromodulators dopamine and serotonin are likely to play a role in these asymmetries: Dopamine signals anticipation of future rewards and is also involved in an invigoration of motor responses leading to reward, but it also arbitrates between different forms of control. Conversely, serotonin is implicated in motor inhibition and punishment processing. To investigate the role of dopamine and serotonin in the interaction between action and valence during learning. We combined computational modeling with pharmacological manipulation in 90 healthy human volunteers, using levodopa and citalopram to affect dopamine and serotonin, respectively. We found that, after administration of levodopa, action learning was less affected by outcome valence when compared with the placebo and citalopram groups. This highlights in this context a predominant effect of levodopa in controlling the balance between different forms of control. Citalopram had distinct effects, increasing participants' tendency to perform active responses independent of outcome valence, consistent with a role in decreasing motor inhibition. Our findings highlight the rich complexities of the roles played by dopamine and serotonin during instrumental learning.
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| 8. |
- Loh, Eleanor, et al.
(författare)
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Parsing the Role of the Hippocampus in Approach-Avoidance Conflict
- 2017
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Ingår i: Cerebral Cortex. - : Oxford University Press (OUP). - 1047-3211 .- 1460-2199. ; 27:1, s. 201-215
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Tidskriftsartikel (refereegranskat)abstract
- The hippocampus plays a central role in the approach-avoidance conflict that is central to the genesis of anxiety. However, its exact functional contribution has yet to be identified. We designed a novel gambling task that generated approach-avoidance conflict while controlling for spatial processing. We fit subjects' behavior using a model that quantified the subjective values of choice options, and recorded neural signals using functional magnetic resonance imaging (fMRI). Distinct functional signals were observed in anterior hippocampus, with inferior hippocampus selectively recruited when subjects rejected a gamble, to a degree that covaried with individual differences in anxiety. The superior anterior hippocampus, in contrast, uniquely demonstrated value signals that were potentiated in the context of approach-avoidance conflict. These results implicate the anterior hippocampus in behavioral avoidance and choice monitoring, in a manner relevant to understanding its role in anxiety. Our findings highlight interactions between subregions of the hippocampus as an important focus for future study.
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| 9. |
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The Routledge Companion to Music and Modern Literature
- 2022
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Samlingsverk (redaktörskap) (refereegranskat)abstract
- Modern literature has always been obsessed by music. It cannot seem to think about itself without obsessing about music. And music has returned the favour. The Routledge Companion to Music and Modern Literature addresses this relationship as a significant contribution to the burgeoning field of word and music studies. The 37 chapters within consider the partnership through four lenses—the universal, opera and literature, musical and literary forms, and popular music and literature—and touch upon diverse and pertinent themes for our modern times, ranging from misogyny to queerness, racial inequality to the claimed universality of whiteness. This Companion therefore offers an essential resource for all who try to decode the musico-literary exchange.
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