Attentional Bias Predicts Increased Reward Salience and Risk Taking in Bipolar Disorder

TY - JOUR

T1 - Attentional Bias Predicts Increased Reward Salience and Risk Taking in Bipolar Disorder

AU - Mason, Liam

AU - Trujillo-Barreto, Nelson J.

AU - Bentall, Richard P.

AU - El-Deredy, Wael

PY - 2016/2/15

Y1 - 2016/2/15

N2 - BackgroundThere is amassing evidence that risky decision-making in bipolar disorder is related to reward-based differences in frontostriatal regions. However, the roles of early attentional and later cognitive processes remain unclear, limiting theoretical understanding and development of targeted interventions.MethodsTwenty euthymic bipolar disorder and 19 matched control participants played a Roulette task in which they won and lost money. Event-related potentials and source analysis were used to quantify predominantly sensory-attentional (N1), motivational salience (feedback-related negativities [FRN]), and cognitive appraisal (P300) stages of processing. We predicted that the bipolar disorder group would show increased N1, consistent with increased attentional orienting, and reduced FRN, consistent with a bias to perceive outcomes more favorably.ResultsAs predicted, the bipolar disorder group showed increased N1 and reduced FRN but no differences in P300. N1 amplitude was additionally associated with real-life risk taking, and N1 source activity was reduced in visual cortex but increased activity in precuneus, frontopolar, and premotor cortex, compared to those of controls.ConclusionsThese findings demonstrate an early attentional bias to reward that potentially drives risk taking by priming approach behavior and elevating reward salience in the frontostriatal pathway. Although later cognitive appraisals of these inputs may be relatively intact in remission, interventions targeting attention orienting may also be effective in long-term reduction of relapse.

AB - BackgroundThere is amassing evidence that risky decision-making in bipolar disorder is related to reward-based differences in frontostriatal regions. However, the roles of early attentional and later cognitive processes remain unclear, limiting theoretical understanding and development of targeted interventions.MethodsTwenty euthymic bipolar disorder and 19 matched control participants played a Roulette task in which they won and lost money. Event-related potentials and source analysis were used to quantify predominantly sensory-attentional (N1), motivational salience (feedback-related negativities [FRN]), and cognitive appraisal (P300) stages of processing. We predicted that the bipolar disorder group would show increased N1, consistent with increased attentional orienting, and reduced FRN, consistent with a bias to perceive outcomes more favorably.ResultsAs predicted, the bipolar disorder group showed increased N1 and reduced FRN but no differences in P300. N1 amplitude was additionally associated with real-life risk taking, and N1 source activity was reduced in visual cortex but increased activity in precuneus, frontopolar, and premotor cortex, compared to those of controls.ConclusionsThese findings demonstrate an early attentional bias to reward that potentially drives risk taking by priming approach behavior and elevating reward salience in the frontostriatal pathway. Although later cognitive appraisals of these inputs may be relatively intact in remission, interventions targeting attention orienting may also be effective in long-term reduction of relapse.

KW - Accumbens

KW - FRN

KW - mania

KW - N1

KW - P300

KW - Reward

KW - Risk taking

KW - Striatum

UR - http://www.scopus.com/inward/record.url?scp=84955211936&partnerID=8YFLogxK

U2 - 10.1016/j.biopsych.2015.03.014

DO - 10.1016/j.biopsych.2015.03.014

M3 - Article

AN - SCOPUS:84955211936

SN - 0006-3223

VL - 79

SP - 311

EP - 319

JO - Biological psychiatry

JF - Biological psychiatry

IS - 4

ER -