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Related Experiment Video

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Investigating Pain-Related Avoidance Behavior using a Robotic Arm-Reaching Paradigm

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Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories.

Laurel S Morris^1,2, Benjaman To³, Kwangyeol Baek³

¹Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, United Kingdom.

Neuroimage. Clinical

|September 1, 2017

Summary

This summary is machine-generated.

Functional neurological disorder (FND) patients showed impaired learning to avoid negative outcomes, despite heightened sensitivity to negative information. This suggests negative contexts may hinder adaptive behaviors in FND.

Keywords:

Amygdala Avoidance learning Conversion disorder Functional neurological disorder

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Area of Science:

Neuroscience
Psychiatry
Cognitive Science

Background:

Functional neurological disorder (FND) presents with unexplained neurological symptoms, altered cognitive processing, and negative affect, often linked to amygdala reactivity.
Understanding the impact of negative affect on cognitive function in FND is crucial for developing effective interventions.

Purpose of the Study:

To investigate the effect of negative conditioning on cognitive function and amygdala reactivity in FND patients.
To examine whether FND patients exhibit enhanced harm avoidance in response to negative stimuli.

Main Methods:

Functional magnetic resonance imaging (fMRI) was used to assess brain activity during an instrumental associative learning task in 25 FND patients and 20 healthy volunteers (HV).
Participants underwent negative or neutral conditioning before performing a task to avoid monetary losses, with multi-echo resting state fMRI also collected.
Reinforcement learning models and computational analyses were employed to analyze behavioral and neural data.

Main Results:

FND patients demonstrated heightened sensitivity to negative conditioned stimuli but were generally impaired in learning to avoid losses.
Behavioral and neural analyses revealed FND patients persisted in choosing options leading to negative outcomes.
FND patients exhibited enhanced amygdala and reduced dorsolateral prefrontal cortex (dlPFC) responses to negative feedback, with increased resting-state functional connectivity between these regions.

Conclusions:

FND patients exhibit impaired instrumental avoidance learning, consistent with difficulties in action-outcome binding.
Despite enhanced behavioral and neural sensitivity to negative information, FND patients did not show improved avoidance learning.
The findings do not support the harm avoidance theory in FND and suggest negative contexts may interfere with adaptive behaviors.