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Impaired Adaptive Learning in Chronic Pain Contributes to Apathy.

Xinyuan Yan1,2, Crina M Peterson1, Lisa M Schmidt3

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Summary
This summary is machine-generated.

Individuals with chronic temporomandibular disorder (TMD) show impaired adaptive learning and struggle to reduce uncertainty. This cognitive deficit is linked to motivational issues like apathy in chronic pain patients.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Computational Psychiatry

Background:

  • Chronic pain, particularly temporomandibular disorder (TMD), is linked to motivational deficits.
  • The precise cognitive mechanisms underlying this link are not well understood.

Purpose of the Study:

  • To investigate the cognitive mechanisms connecting chronic pain (TMD) to motivational symptoms.
  • To identify computational signatures of learning and decision-making deficits in individuals with TMD.

Main Methods:

  • Utilized a probabilistic reward task with a novel volatile Kalman filter model.
  • Analyzed behavioral data from 26 TMD participants and 39 matched controls.
  • Assessed trial-wise updates in uncertainty, volatility, and learning rates.

Main Results:

  • No significant difference in surface-level task performance between TMD patients and controls.
  • Model-based analysis revealed TMD participants failed to reduce uncertainty and adapt learning rates over time.
  • TMD participants reported higher apathy, depression, pain catastrophizing, and lower quality of life.

Conclusions:

  • Disrupted uncertainty adaptation is a computational signature in individuals with TMD.
  • Impaired belief-updating partially mediates the relationship between TMD and apathy.
  • Findings suggest a mechanistic link between chronic pain and motivational dysfunction via deficits in adapting to uncertainty.