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Mizuno et al: Low putamen activity associated with poor reward sensitivity in childhood CFS

Discussion in 'Latest ME/CFS Research' started by mango, Oct 1, 2016.

  1. mango

    mango Senior Member

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    Low putamen activity associated with poor reward sensitivity in childhood chronic fatigue syndrome

    Kei Mizuno, Ph.D.a, b, c, e, , , Junko Kawatanif, Kanako Tajimaa, b, Akihiro T. Sasakia, b, d, e, Tetsuya Yonedah, Masanori Komii, j, Toshinori Hiraik, l, Akemi Tomodam, Takako Joudoig, Yasuyoshi Watanabea, b, d, e

    NeuroImage: Clinical Volume 12, 2016, Pages 600–606
    http://dx.doi.org/10.1016/j.nicl.2016.09.016

    Highlights
    • Childhood chronic fatigue syndrome (CCFS) may have low neural reward processing.
    • Activity in the putamen was specifically decreased in low monetary reward.
    • Reduced activity of putamen was correlated with fatigue and reward from learning.
    • Low activity of the putamen is associated with poor reward sensitivity.
    • Decreased neural reward processing suggests dopamine dysfunction in CCFS patients.

    Abstract

    Motivational signals influence a wide variety of cognitive processes and components of behavioral performance. Cognitive dysfunction in patients with childhood chronic fatigue syndrome (CCFS) may be closely associated with a low motivation to learn induced by impaired neural reward processing. However, the extent to which reward processing is impaired in CCFS patients is unclear.

    The aim of the present functional magnetic resonance imaging (fMRI) study was to determine whether brain activity in regions related to reward sensitivity is impaired in CCFS patients.

    fMRI data were collected from 13 CCFS patients (mean age, 13.6 ± 1.0 years) and 13 healthy children and adolescents (HCA) (mean age, 13.7 ± 1.3 years) performing a monetary reward task. Neural activity in high- and low-monetary-reward conditions was compared between CCFS and HCA groups. Severity of fatigue and the reward obtained from learning in daily life were evaluated by questionnaires.

    Activity of the putamen was lower in the CCFS group than in the HCA group in the low-reward condition, but not in the high-reward condition. Activity of the putamen in the low-reward condition in CCFS patients was negatively and positively correlated with severity of fatigue and the reward from learning in daily life, respectively.

    We previously revealed that motivation to learn was correlated with striatal activity, particularly the neural activity in the putamen. This suggests that in CCFS patients low putamen activity, associated with altered dopaminergic function, decreases reward sensitivity and lowers motivation to learn.

    Keywords: Childhood chronic fatigue syndrome; Dopamine; fMRI; Motivation; Putamen; Reward sensitivity

    http://www.sciencedirect.com/science/article/pii/S2213158216301747
     
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  2. Woolie

    Woolie Senior Member

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    Sorry to say it, but another really rubbish fMRI study.

    The CCFS group (kids with CFS) and a group of controls did various online card gambling tasks where you could sometimes earn money by picking the right card - in one task, they got high rewards for picking the right card, in another they got low rewards, and in a third, they got no reward.

    There were no differences in CCFS and controls' response times on the tasks.

    They were looking for differences in activity in various subcortical structures which have been associated with reward processing. These included the caudate nucleus, the putamen (both part of the basal ganglia) and the thalamus. There were hardly any differences at all, even on fMRI, but the authors managed to find one: for the low reward condition, the CCFS group had significantly lower activity in the putamen than controls. No differences anywhere on the other conditions.

    The groups were small (14 CCFS, 13 control) and so were the differences observed. These differences also seemed to be driven by only two of the 14 CCFS kids.

    There does not seem to be any attempt to discuss why only the low reward condition yielded differences (the three levels), or what sort of pattern you might predict across the three different conditions.

    There's a lot of hand waving about pro-inflammatory cytokines and the possible effects of neuroinflamamtion and oxidative stress on activity in the putamen. Then some talk about how levodopa (used in Parskinson's) might alleviate our fatigue. But then it ends with this:
    I rest my case.
     
    Last edited: Oct 2, 2016
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  3. Sidereal

    Sidereal Senior Member

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    The recent metabolomics data suggested problems with dopamine synthesis. CBT won't do squat to normalise 'reward processing' when the enzymes needed to make the relevant neurotransmitter are underfunctioning due to low energy.
     
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  4. Hutan

    Hutan Senior Member

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    New Zealand
    These poor sick kids, and by extension all children with ME/CFS, have been labelled as having a reduced motivation to learn which causes reduced cognitive performance:
    This was the questionnaire the team of this paper used to measure motivation:
    Here are the results
    Looking at the P values, you can see that there really isn't any significant difference between the two groups. But they make a big deal of the different Reward Scores. So, they are saying that the healthy and CFS kids both feel that they make the same amount of learning effort but the CFS kids feel that they get less reward.

    It's very interesting (appalling) to see how crude that LERI questionnaire is and how inappropriate it is for sick kids.
    Here's the questions used for the Reward score:
    (from this source - it may not be exactly the same as the Fukuda one which is behind a pay wall - http://successforkidswithhearingloss.com/wp-content/uploads/2011/08/Fatigue-and-Learning-Scale.pdf) ETA - it is different - it has 5 questions rather than the 4 used in this study

    A 'yes' is scored 2 points and a 'no' is scored 1 point and the points are totalled. How this is supposed to be an accurate measure of learning reward for a sick child (probably not attending school and uncertain about the future), I do not know.

    Look back on the mean scores: 6.4 +-1.1 for the control group vs 5.5 +-1.2 for the CFS group. Frankly, I'm amazed there was only a difference of 0.9 between the means given those questions.

    (BTW, that source where I got the questions suggested that the typical mean for boys in grades 7 to 9 is 5.7 and the mean for girls is 5.6. So, assuming the two questionnaires are the same, the CFS group's results are perfectly normal.)

    Then they try to tie together this so called abnormal reward from learning with the level of activity in a bit of the brain.

    Tiny study, clutching at straws.
     
    Last edited: Oct 2, 2016
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  5. trishrhymes

    trishrhymes Senior Member

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    Thanks everyone who has commented. I now understand better just what a crap and indeed dangerous study this is. :aghhh::aghhh::aghhh:
     
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  6. Woolie

    Woolie Senior Member

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    @Hutan, it gets worse. The authors who published the LERI (self report effort-reward scale), used it as an independent measure. That is, they predicted that people who thought they needed to expend a lot of effort to get rewards in their school learning were more likely to have fatigue!

    The questions in the LERI were:
     
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  7. Dolphin

    Dolphin Senior Member

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  8. dreampop

    dreampop Senior Member

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    I think the Japanese researchers, many of whom were involved in the neuroinflammation and metabolic study (watanabe was involved in this one and the metabolic one) have believed in the past CFS is psycho-social illness. Their research is a mix of crap like this and interesting biological stuff too. I wonder what they really think.
     
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  9. Woolie

    Woolie Senior Member

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    Yes, @dreampop, that's the impression I get. They almost say something bold, then they retreat to psychosocial crap. This paper read like someone (a reviewer? co-author?) had asked them to put in something about CBT and GET at the last minute.

    I don't think its useful to look at what's going on at the topmost level until we know more about what's going on downstream. Just feeling unwell and exhausted could very well affect our brain activity on all kinds of tasks, and those differences probably have little to say about mechanisms underlying MECFS.
     
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  10. Effi

    Effi Senior Member

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    Europe
    I also wonder what the politics are re: ME in Japan. Does anyone know?
     
  11. dreampop

    dreampop Senior Member

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    Or their cultural stance. Surprised we have no one from Japan on here.
     

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