Levels Of Apathy Research Articles

A Goal Intervention Improves Language Fluency: Evidence from Parkinson’s Disease and Healthy Aging

Background: Parkinson’s disease [PD] is associated with reduced motor and cognitive initiation, and decreased goal-directed behavior including language generation. The current study investigated a novel goal intervention for language generation impairments in PD patients. Methods: Twenty-one PD patients and 22 healthy controls, matched for gender, age, and education, completed a cognitive baseline and language generation tasks (complex scene descriptions and phonemic/semantic word fluency) with standard and adapted instructions, which implements a target ‘goal’. In addition, participants completed self-report questionnaires for apathy and mood. Results: PD patients performed more poorly on two of three language generation tasks. The goal intervention was effective in increasing both the PD patient and healthy control groups’ language generation. However, there was no differential benefit of increased goal specificity and difficulty for PD patients. As a group, PD patients reported higher levels of apathy and depression than healthy controls. Specifically, PD patients with executive apathy were more likely to have language generation impairments than PD patients without executive apathy and controls. Apathy subscales and goal benefit were unrelated. Conclusions: The goal intervention was effective for PD patients and older adults, suggesting that enhanced goal specificity and difficulty may benefit individuals with PD or those aging naturally.

Apathy and agitation in institutionalized older adults: an empirically derived classification.

Apathy and agitation are often recognized as the most problematic behavioural and psychological symptoms in care settings. In this study, we analyze the relationship between apathy and agitation symptoms other and their relationship with demographic, cognitive, and neuropsychiatric variables and psychotropic medication use. A retrospective study was conducted at a gerontological care centre in Láncara, Spain. Participants were 196 residents of the gerontological care centre, including 143 with a diagnosis of dementia. Apathy and agitation were assessed with the Apathy Scale for Institutionalized Patients with Dementia, Nursing Home version, and the Spanish version of the Cohen-Mansfield Agitation Inventory, respectively. Two-stage hierarchical cluster analysis (hierarchical cluster analysis in a first exploratory stage and K-means clustering to obtain the final solution in the second stage) was conducted to assign residents to different groups based on apathy and agitation scores. In cluster 1, a certain level of apathy, the highest levels of agitation, and the most frequent intake of atypical antipsychotics and clomethiazole were observed. The highest levels of apathy and the most frequent intake of memantine were seen in cluster 2. The lowest levels of agitation and apathy and the highest levels of cognitive performance were found in cluster 3. In this study, subjects with dementia were in a state of high agitation and eventual apathy, had low cognitive status, and were very old. Patients with this profile require well-designed non-pharmacological interventions.

Multidimensional Apathy: The Utility of the Dimensional Apathy Scale in Huntington's Disease.

Apathy is a disorder of motivation common to Huntington's disease (HD). Recent conceptual frameworks suggest that apathy is not unitary but consists of discrete subtypes ("dimensions"). Which of the proposed dimensions are preferentially affected in HD, and how these dimensions evolve with disease progression is unknown. The Dimensional Apathy Scale (DAS) separates apathy into Executive, Initiation and Emotional subscales. Using the DAS, we aimed to: 1) Determine the apathy subtypes prevalent in HD; 2) Compare the DAS against a unitary measure of apathy (Apathy Evaluation Scale, AES); 3) Assess the reliability of self- and observer-ratings; and 4) Determine the relationship between the DAS, and disease burden, total functional capacity (TFC) and the AES. Fifty pre-manifest, 51 manifest-HD, 87 controls, and 50 HD-observers completed the DAS, AES, and TFC. Manifest-HD participants had the highest levels of apathy across all dimensions (30.4% on Executive subscale, 34.8% on Initiation subscale, and 15.2% on Emotional subscale), relative to pre-manifest and control participants. Self- and observer-ratings on the DAS did not differ. Hierarchical regressions across the entire gene-expanded sample showed that scores on the Initiation subscale correlated with AES scores; higher Executive subscale scores were related to higher disease burden; and Emotional subscale scores with lower total functional capacity. In this first study of the DAS in HD, manifest-HD participants were more apathetic than pre-manifest and control participants across all apathy subtypes. The DAS may be a useful tool for measuring different aspects of apathy in people with HD.

Impact of an Intervention with Wii Video Games on the Autonomy of Activities of Daily Living and Psychological–Cognitive Components in the Institutionalized Elderly

As people age, the risk of disease increases and deterioration becomes more noticeable. These changes can increase the risk of cognitive impairment, with negative consequences for the quality of life and the ability to perform activities of daily living (ADLs) in older people, which translate into greater dependence and loss of wellness. This study aimed to determine the impact and effectiveness of the use of the Wii® game console (Nintendo Company Limited, Kyoto, Japan) on improving performance of basic and instrumental ADLs, as well as its relationship with cognitive impairment levels and mood in institutionalized older people. A longitudinal study was designed, whose study population consisted of people over 75 years of age who lived in a nursing-home or attended a day care center (n = 80; 45 women). Cognitive status was assessed using Lobo’s Mini-Cognitive Examination (MCE) and Global Deterioration Scale (FAST-GDS), while the psychological assessment used the Dementia Apathy Interview and Rating (DAIR), Yesavage scale for Geriatric Depression (EGD-15), and Goldberg Anxiety and Depression Scale (EADG). Differences from T1 to T2 in the control group (control; n = 40; 23 women; 83.25 ± 8.78 years; 76.35 ± 13.54 kg) and in the experimental group (Wii; n = 40; 22 women; 85.05 ± 8.63 years; 74.60 ± 13.01 kg) were evaluated using a paired Student’s t-test or Wilcoxon’s signed rank test, and a two-way repeated measures analysis of variance (ANOVA) test. Differences in Δ (%) and other tests at T1 and T2 were compared using the independent t-test or Mann–Whitney U test, with the treatment category as a fixed factor. The results showed that the Wii® video console had a positive influence for older people, increasing cognitive status and levels of ADLs, and psychological status. In addition, a positive correlation between performance of ADLs and cognitive status was observed, as well as a negative correlation with the psychological status. Through a rehabilitation program with a Wii® game console in the elderly, depression, anxiety and apathy levels were reduced, accompanied by an increase in memory and attention, as well as in performance of basic and instrumental ADLs.

Pengaruh Penerapan E-Voting Terhadap Tingkat Partisipasi Politik Masyarakat Pada Pemilihan Waliagari Batu Taba Kabupaten Agam Tahun 2019

This research is motivated by the level of community participation in Nagari Batu Taba where there are still many levels of public apathy about politics, especially in general elections. In 2019, Nagari Batu Taba held a general election using e-voting which previously was still conventional (based on ballot paper). The purpose of the study was to analyze regardless of the effect of the application of e-voting on the level of community political participation in the Election of Walinagari Batu Taba, Agam Regency in 2019. The method used in this study is a quantitative method. Respondents in this study are people who are registered in the Permanent Voters List who use their voting rights in walinagari elections and are taken using the Simple Random Sampling technique. The results showed that the e-voting variable had a significant effect on conventional (paper-based) community political participation, which had an Adjust R Square value of 0.706 or 71% and the remaining 29% was based on other variables not examined in this study. In this case, the application of e-voting has a significant effect on the level of community political participation in the 2019 Election of Walinagari Batu Taba, Agam Regency.

Pengaruh Penerapan E-Voting Terhadap Tingkat Partisipasi Politik Masyarakat Pada Pemilihan Waliagari Batu Taba Kabupaten Agam Tahun 2019

This research is motivated by the level of community participation in Nagari Batu Taba where there are still many levels of public apathy about politics, especially in general elections. In 2019, Nagari Batu Taba held a general election using e-voting which previously was still conventional (based on ballot paper). The purpose of the study was to analyze regardless of the effect of the application of e-voting on the level of community political participation in the Election of Walinagari Batu Taba, Agam Regency in 2019. The method used in this study is a quantitative method. Respondents in this study are people who are registered in the Permanent Voters List who use their voting rights in walinagari elections and are taken using the Simple Random Sampling technique. The results showed that the e-voting variable had a significant effect on conventional (paper-based) community political participation, which had an Adjust R Square value of 0.706 or 71% and the remaining 29% was based on other variables not examined in this study. In this case, the application of e-voting has a significant effect on the level of community political participation in the 2019 Election of Walinagari Batu Taba, Agam Regency.

Cognitive and Neuropsychiatric Profiles in Idiopathic Rapid Eye Movement Sleep Behavior Disorder and Parkinson's Disease.

Rapid eye movement (REM) sleep behavior disorder (RBD) is a risk factor for developing Parkinson’s disease (PD) and may represent its prodromal state. We compared neuropsychological and neuropsychiatric phenotypes of idiopathic (i) RBD, PD and healthy comparators (HC) in order to identify iRBD specific characteristics. Thirty-eight patients with iRBD, 38 PD patients with RBD (PD + RBD), 38 PD patients without RBD (PD-RBD) and 38 HC underwent a comprehensive neurological, neuropsychological and neuropsychiatric evaluation. iRBD, PD + RBD and PD-RBD performed worse than HC in short-term verbal memory, praxia, language and executive functions. iRBD had higher levels of anxiety, depression, apathy and alexithymia than HC. iRBD had higher levels of apathy than PD + RBD. Both PD groups had higher levels of anxiety and depression than HC. Surprisingly, iRBD performed better than all groups in long-term verbal memory. Patients diagnosed with iRBD are characterized by poor global cognitive performance, but better long-term memory and higher levels of depression, anxiety, alexithymia and apathy. Alexithymia and apathy in patients diagnosed with iRBD may be the expression of precocious derangement of emotional regulation, subsequently observed also in PD. Cognitive and neuropsychiatric symptoms of iRBD are early clinical manifestations of widespread neurodegeneration.

FACILITATING COMMUNITY PARTICIPATION THROUGH CROWDSOURCING IN URBAN PLANNING PROCESSES: AN EXPLORATORY STUDY

Fostering community participation by planners in South African municipalities poses a challenge during planning processes. Different levels of public apathy have been observed, and they continue to undermine the quest of municipalities to provide sustainable neighbourhoods. Also, value conflicts from different urban stakeholders resulting from this apathy can be ameliorated through improved participation of the communities in the planning processes. In bridging this gap, the paper seeks to explore different Crowdsourcing techniques to be employed in Mangaung to enable urban stakeholders’ participation in planning projects. As such, crowdsourcing, as a new web-based business model, is inclusive in the 4th Industrial Revolution and can be used as the best solution for community participation in planning projects. Based on the foregoing, this paper employs a case study research design and a coterie of techniques: semi-structured interviews and document reviews for data elicitation. Interviewees comprise of purposively recruited town planning and other municipal officials involved in planning projects. The emergent data will be analysed thematically. Expectedly, the findings hold immense implications for planning practitioners as well as other professionals and policymakers working within the urban planning and socio-economic development praxes in South African Municipalities.

Unraveling Apathy in Korsakoff Syndrome Patients Receiving Long-Term Care With and Without Cerebrovascular Comorbidity.

BackgroundKorsakoff syndrome (KS) is a severe neuropsychiatric disorder caused by acute deficiency of vitamin B1 and concomitant alcoholism. Patients with KS are particularly vulnerable for cerebrovascular comorbidity. KS is characterized by cognitive and neuropsychiatric symptoms, one of which is apathy. Apathy is a pathological lack of goal‐directed behaviors, goal‐directed cognitions, and goal‐directed emotions. Cerebrovascular accidents are known to carry a risk for developing apathy. Apathy has a dramatic effect on the autonomy and daily lives of patients suffering from this condition.MethodsWe assessed general apathy and related subconstructs in fifteen patients with KS, fifteen patients with KS and cerebrovascular comorbidity who reside in a 24‐hour care facility, and fifteen healthy controls.ResultsCompared with healthy controls, both KS patient groups showed higher levels of apathy as rated by a close informant. We found no difference between both KS patient groups and the healthy control group on the self‐report section of the Pleasant Activities List, suggesting that motivation is still intact in KS patients. It is important to note a discrepancy was found between self‐reporting and proxy reporting on this list. KS patients with cerebrovascular comorbidity showed more severe emotional blunting compared to both KS patients without cerebrovascular comorbidity and healthy controls. The competency to consent was lower in patients compared with healthy controls, but no difference was found between KS patients with cerebrovascular comorbidity and those without.ConclusionsOur results suggest that KS patients show increased levels of general apathy compared with healthy controls. Patients show a diminished competency to consent and increased emotional blunting, while motivation is not compromised. Cerebrovascular comorbidity in KS forms a high risk for emotional blunting. The results of this study suggest that apathy is a severe problem in KS. More attention in both the literature and clinical practice would benefit this complex patient population.

PREOPTEREĆENOST UČENIKA ŠKOLSKIM OBAVEZAMA / STUDENTS OVERLOAD WITH SCHOOL DUTIES

School in the modern society should provide an environment for students to feel safe and motivated for learning. There should be an optimal student workload with the schoolwork as well as with the homework. Unfortunately, student overload at all levels of education has been evident. Their overloaded schedule presents a significant challenge and may cause fatigue, exhaustion, distraction, mope, high levels of stress, apathy, superficially and campaign learning, and general lack of motivation. Due to the topicality of the issue, the authors of this paper have tried to offer a review of the sources of the student overload. Different sources, as well as negative consequences of student overload have been determined based on a significant number of empirical works so far. The article also suggests measures to relieve students. Psychologists, in cooperation with the students’ parents and experts from other branches of the education sector, can contribute in finding a way to prevent and reduce consequences of the overload. Empirical studies about sources of student overload are also necessary to determine evidence based guidelines for the education reform.

PENGARUH LITERASI POLITIK TERHADAP PARTISIPASI POLITIK PEMILIH PEMULA PADA PEMILUKADA KOTA PARIAMAN TAHUN 2018

The aim of this study is to analyze the effect of political literacy on political participation of Novice voters in the 2018 regional elections for Pariaman city. The not optimal participation of Novice voters in regional elections and the relatively high level of apathy for first-time voters and minimal knowledge of politics makes first-time voters vulnerable to mobilization, this is a reason for researchers to make novice voters the object of research. The method used in this research uses a quantitative approach with a survey method. The population in this study were adolescents or people aged 17-23 years who were registered as voters by the KPU of Pariaman City. Determination of sample using Simple Random Sampling technique resulted in 100 samples. Data collection uses a liker scale. The data obtained were analyzed using simple regression. The results showed that the political literacy variable simultaneously had a significant effect on the political participation of first-time voters in Kota Pariaman in 2018.

A-255 Severe Psychological Dysfunction in a Neurologically Complex Patient during a Pre-Surgical Evaluation for Normal Pressure Hydrocephalus Shunt Implantation

Abstract Objective Psychological syndromes like depression and anxiety are common in neurological conditions and lead to poorer quality of life and disability. However, these syndromes are often under-recognized in neurologic patients and are thus under-diagnosed due to overlapping symptomatology. Here, we report on a patient with a complex neurological history as well as clinically significant affective symptoms. Participants The patient is a 69-year-old Caucasian female recently diagnosed with normal pressure hydrocephalus. Relevant medical history was significant for focal epilepsy with complex seizures, obstructive sleep apnea, and cerebrovascular accident. She underwent neuropsychological evaluation as part of a pre-surgical workup for shunt implantation. Results The patient’s neurocognitive profile was marked by significant impairments in most cognitive domains and she was not independent in activities of daily living. On self-report measures of current emotional functioning, she reported clinically severe levels of depression, anxiety, apathy, executive dysfunction, and disinhibition. During the clinical interview, she reported experiencing passive suicidal ideation as well as a significant history of traumatic experiences. Conclusion The psychological symptoms the patient was experiencing undoubtedly impacted her neurocognitive status and functioning abilities, though she was receiving no treatment for these symptoms. Addressing symptoms resulting from psychological syndromes in patients with neurological conditions is an important role for neuropsychologists, as accurate diagnosis of psychological syndromes can inform treatment recommendations and improve patient outcomes. This case illustrates the importance of documenting a thorough clinical history, including past psychiatric history, as well as a detailed examination of self-reported current psychological functioning as part of a comprehensive neuropsychological case formulation.

Effects of a virtual group cycling experience on people living with dementia: A mixed method pilot study.

Social isolation and sedentary behaviour are common in residential aged care facilities (also known as nursing homes or long-term care). Use of new technologies such as virtual and augmented reality are currently under investigation for their potential to provide exciting and engaging activities for older people in residential aged care facilities. However, there is limited evidence on whether these technologies can promote physical activity in a small group setting for people with cognitive impairment. Using mixed methods, we examined the use of a virtual cycling experience in a sample of 10 participants with cognitive impairment living in residential aged care facilities. In a randomised crossover design, participants engaged in a 25-minute, self-paced, facilitated seated virtual cycling experience and a time-matched seated physical activity session in groups of five. All participants completed a brief pre- and post-intervention mood questionnaire. Video analysis was used for both conditions to compare levels of environmental stimulation, apathy and engagement using both the Person-Environment Apathy Rating Scale and the Engagement of a Person with Dementia Scale. A thematic analysis of semi-structured interviews following the virtual cycling experience was also performed. No differences were observed between conditions for all outcomes except for environmental stimulation, where there was a lower response in the intervention than the control condition (p = 0.032). This was primarily driven by lower scores for the virtual cycling experience than control in physical accessibility (p = 0.012). Participants reported the virtual cycling experience to be immersive and challenging and reminisced about cycling earlier in life. The activity manager observed that the virtual cycling experience was an overall positive experience and emphasised benefits of safety screening and preparation prior to the activities. The findings of this study support the use of the virtual cycling experience as an immersive and engaging alternative to usual activities, which might encourage higher levels of physical activity in residential aged care facilities.

Factors related to post-stroke depression during the first 2 weeks after stroke

Introduction This study aimed to clarify factors associated with post-stroke depression in patients with acute stroke within 2 weeks of onset. Method Eighty-eight patients with stroke were divided into post-stroke depression ( n = 49) and non-post-stroke depression ( n = 39) groups based on their Hamilton Depression Rating Scale scores. We evaluated stroke severity, upper limb function, activities of daily living, frontal lobe/cognitive function, and level of apathy. Activity levels were measured using an ActiGraph GT9X Link system. Mann–Whitney U-tests were used to determine differences between the two groups. Spearman’s rank correlation and logistic regression analyses were also performed. Results The post-stroke depression and non-post-stroke depression groups exhibited significant differences in National Institutes of Health Stroke Scale scores at admission and discharge; Functional Independence Measure exercise items, cognitive items, and total items at admission; Fugl-Meyer Assessment scores; and Apathy Rating Scale scores. Logistic regression indicated that Fugl-Meyer Assessment scores were associated with post-stroke depression. Conclusion Stroke severity, paralysis, and physical function/activities of daily living ability are associated with post-stroke depression in the acute phase. Our findings suggest that increases in physical impairment severity are associated with increased post-stroke depression risks. Rehabilitation professionals should focus on identifying post-stroke depression in early post-stroke stages.

REGIONAL SPECIFICS OF FORMATION OF VALUES OF CIVIL SOCIETY IN RUSSIAN FEDERATION (on the example of the Kabardino-Balkar Republic)

Features and problems of the development of civil society are some of the most topical issues of modern Russia’s social and political life. In early 21st ct. the idea of Eurasianism gained popularity. Its advocates claim that Russia is a unique independent civilization in itself, with its own unique cultural code. Social and cultural Russian specifics precondition significant regional differences in the level of development of civil society. Experts report that the values of civil society became widespread in the most economically developed regions. Citizens create and active participate in NGOs, promote charity, actively defend their rights. In less economically developed regions, located on the periphery of the social and economic development of the country, the level of development of civil society is quite low. The paper considers the specifics of the development of civil society values in one of the Southern regions of Russia – the Kabardino-Balkar Republic. The study is based on the systemic and interdisciplinary approaches. The research method used is a questionnaire survey. The sample size is 550 people. The study has revealed that residents of Kabardino-Balkaria more often use family ties and corruption to solve their life problems. At the same time, a small proportion of citizens resort to the services of NGOs, law enforcement agencies and the judicial system, which indicates a low level of legal awareness of the regional population. Despite the fact that younger people grew up in post-Soviet Russia, modeled after democratic countries, this sociodemographic population group shows higher level of social apathy and rejection of civil society values than the population of Kabardino-Balkaria on average.

Ansiedad, depresión y apatía en relación a la situación de fragilidad

Esta investigación descriptiva transversal estudia la relación de la situación de fragilidad en adultos mayores institucionalizados y la ansiedad, depresión y apatía en los mismos con una muestra de 193 personas mayores institucionalizadas en cuatro residencias para personas mayores.La fragilidad se mide con la herramienta Short Physical Performance Battery; la ansiedad y la depresión con la escala Goldberg; y la apatía con la escala Dementhia Apathy Interview and Rating.Se trata de un estudio transversal y descriptivo que no realiza ningún tipo de intervención sobre las personas participantes y pretende establecer si existe o no relación entre las variables, pero no una relación de causalidad entre ellas.Se observa que las tres variables correlacionan con la puntuación total de la escala de fragilidad y con cada una de sus subescalas; de manera que, a mayor situación de fragilidad y/o dependencia, mayores niveles de ansiedad, depresión y apatía.Aparecen además diferencias significativas entre el grupo de personas frágiles y prefrágiles en lo referente a la apatía; y entre los grupos dependiente y prefrágil en relación a la ansiedad y la depresión.

Using Virtual Reality to Improve Apathy in Residential Aged Care: Mixed Methods Study

BackgroundApathy is a common symptom in neurological disorders, including dementia, and is associated with a faster rate of cognitive decline, reduced quality of life, and high caregiver burden. There is a lack of effective pharmacological treatments for apathy, and nonpharmacological interventions are a preferred first-line approach to treatment. Virtual reality (VR) using head-mounted displays (HMDs) is being successfully used in exposure- and distraction-based therapies; however, there is limited research on using HMDs for symptoms of neurological disorders.ObjectiveThis feasibility study aimed to assess whether VR using HMDs could be used to deliver tailored reminiscence therapy and examine the willingness to participate, response rates to measures, time taken to create tailored content, and technical problems. In addition, this study aimed to explore the immediate effects between verbal fluency and apathy after exposure to VR.MethodsA mixed methods study was conducted in a sample of older adults residing in aged care, and 17 participants were recruited. Apathy was measured using the Apathy Evaluation Scale (AES), and verbal fluency was used as a proxy measure of improvements in apathy and debriefing interviews to assess feedback from participants. Side effects that can occur from using HMDs were also measured.ResultsWe recruited participants from a high socioeconomic status setting with a high education level, and the participation rate was 85% (17/20); most responses to measures were positive. Access to a wide range of freely available content and the absence of technical difficulties made the delivery of a VR reminiscence intervention highly feasible. Participants had improved semantic scores (t14=−3.27; P=.006) but not phonemic fluency scores (t14=0.55; P=.59) immediately after the intervention. Those with higher levels of apathy demonstrated the greatest cognitive improvements after a VR reminiscence experience, which was indicated by a strong positive relationship between the AES and semantic verbal fluency change scores postminus pre-VR (r=0.719; 95% CI 0.327 to 0.900; P=.003). All participants enjoyed the experience despite 35% (6/17) of participants experiencing temporary side effects.ConclusionsThis study provides initial evidence that it is feasible to use VR with HMDs for therapy to treat symptoms of apathy in older adults in residential aged care. However, there is a need to closely monitor the side effects of HMD use in older adults. Further research is needed using an active control group to compare the use of VR with traditional forms of reminiscence therapy.

Психологическая помощь студентам в адаптации к вузовской жизни

The paper deals with the problems of socio-psychological adaptation of junior students of higher education institutions to higher education. Students who did not cope with the difficulties of the adaptation period are distinguished by indifference to study and social life, deviant behavior, doubts about the correctness of the chosen professional path, difficulties in relations with classmates and mentors. As a result, these students have a high level of emotional stress, increased anxiety, low self-esteem, apathy, pessimism, and depressive disorders that hinder their professional and personal development. In this regard, the study of socio-psychological problems of first-year students in order to provide them with quality assistance is relevant, since it helps to increase their self-esteem, spiritual and professional growth of the individual, and therefore the effectiveness of the higher education system as a whole. The paper summarizes the theoretical research in the field of psychological science and presents the results of applying a comprehensive program of psychological assistance to first-year students in the framework of the psychological support service existing on the basis of Lobachevsky State University.

M137. HIGH CONFIDENCE FOR VISUOMOTOR ACTION RECRUITS THE VENTRAL STRIATUM – A METACOGNITIVE APPROACH FOR UNDERSTANDING NEGATIVE SYMPTOMS?

BackgroundMetacognition refers to the ability to discriminate between one’s own correct and incorrect decisions, thus representing a key function for goal-oriented behavior. The neurobiological underpinnings of metacognition have mainly been studied in perceptual decision-making and memory-related processes; therefore, mechanisms and neural correlates underlying metacognitive processes during visuomotor actions are still poorly characterized and the specific role of confidence remains to be elucidated. This is of particular interest as deficits in goal-directed behavior and insight both are a hallmark of the negative symptoms of schizophrenia.MethodsWe examined 31 healthy controls who were asked to draw straight reaching trajectories towards a visual target, while measuring their brain activity with functional Magnetic Resonance Imaging (fMRI). Deviations were introduced in 70% of the trajectories seen on the screen. Participants then reported awareness of deviations (first-order), followed by (second-order) confidence in their response. The amount of deviation was titrated to reach a 71% average detection rate using an adaptive staircase procedure. Metacognition was measured using the M-Ratio, which estimates the ratio of first-order information available for confidence computation (Maniscalco & Lau, 2012). Whole brain activity was analyzed via a parametric general linear model (GLM).ResultsParticipants showed good metacognitive abilities at evaluating the correctness of their first-order responses (M-Ratio: 0.98±0.25). Movements were decomposed into two phases based on peaks in the variance of the trajectory deviation and actual joystick position. We found that confidence ratings after deviated trials were explained by a combination of the trajectory deviation in the initial phase (p=0.006; linear mixed model) and the amount of motor correction in the final phase of the movement (p<0.001). At the neural level, as expected, conscious detection of deviation engages strongly the visual cortex, whereas higher visuomotor corrections engage primarily the primary motor cortex. Importantly, we show that high confidence specifically recruits the ventral striatum bilaterally (p<0.05 corrected for multiple comparisons), suggesting a role for confidence in motivating action.DiscussionTaken together, these results show for the first time in healthy controls that confidence for visuomotor action strongly engages motivational regions in line with a key role of metacognition in goal directed behavior and accurate insight into self-performed actions. These results in healthy controls are currently being tested in a cohort of schizophrenia patients and our hypothesis is that patients with higher level of apathy will display lower metacognitive confidence and lower ventral striatum activity

M142. INCREASED VENTRAL STRIATAL FUNCTIONAL CONNECTIVITY IN PATIENTS WITH SCHIZOPHRENIA DURING REWARD ANTICIPATION

BackgroundRecent studies have pointed at the ventral striatum as one of the main candidates underlying motivational dysfunctions in schizophrenia. Patients with negative symptoms show decreased BOLD activity in the ventral striatum and this activity strongly correlates with apathy scores during reward anticipation.While in patients with schizophrenia blunted ventral striatal activation during reward anticipation has been widely reported, little is known about abnormal striatal functional connectivity during reward anticipation. In this study, we performed generalized whole-brain psychophysiological interaction (gPPI) analyses using the right and left ventral striatum as seeds in schizophrenia patients with apathy and reduced ventral striatal activation from two published fMRI studies (Kirschner et al., 2016; Stepien et al., 2018).MethodsForty-four healthy controls (18 females, mean age = 31.1) and 40 patients with schizophrenia (10 females, mean age = 32.5) performed a variant of the Monetary Incentive Delay task within an fMRI design. Negative symptoms were assessed with the Brief Negative Symptoms Scale (BNSS). GPPI analyses were done using the PPPI toolbox on SPM 8. To examine potential difference in striatal functional connectivity, we performed two sample t-tests between patients with schizophrenia and healthy controls using the contrast [High Reward Anticipation – No Reward Anticipation].ResultsPatients with schizophrenia showed increased functional connectivity between the right ventral striatum and the anterior cingulate cortex, posterior cingulate cortex, cerebellum, motor cortex, parietal cortex, temporo-parietal junction and thalamus compared to controls (cluster-level FDR p<0.05). No higher connectivity was found in controls compared to patients.For the regions with increased functional connectivity, we performed correlations between the patients’ gPPI signal and apathy. We found significant correlations between apathy and functional connectivity between the right ventral striatum and the right posterior cingulate cortex (r=0.40, p<.05) and right parietal cortex (r=0.39, p<.05).DiscussionOur preliminary results indicate that physiological changes in the ventral striatum lead to dysfunctional connectivity with a cortex-wide network, affecting both cortico-striatal-thalamic-cortical and cortico-striatal-thalamic-cerebellar pathways. In addition, we show that some of these changes are related to apathy levels. This work provides novel insights in cortico-striatal network dysfunction during reward processing in patients with schizophrenia.