The primary objective is to elucidate which circuits of the social decision making network are involved in IED and to what extent. Candidate mechanisms are the mesolimbic reward circuit and the social emotional cortical-amygdala connections. Our…
ID
Bron
Aandoening
Periodiek explosieve stoornis (intermittent explosive disorder), impulsieve agressie (impulsive aggression)
Ondersteuning
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
The main outcome measures will be drawn from functional magnetic resonance imaging (fMRI) scans, in which brain reactivity will be linked to the reaction time in rewarding vs. non-rewarding trials in a monetary incentive delay (MID) task, the number of avoidances in an approach-avoidance task (AAT), and emotional face processing.
Achtergrond van het onderzoek
Rationale:
Impulsive aggression is an approach-related impulsive response to a threatening or frustrating situation and can be marked as out of control in patients with intermittent explosive disorder (IED). The process of an aggressive reaction is based on the evaluation of threatening stimuli and regulation of behavioural outcome. The neural circuits underlying these processes involve the mesolimbic reward system and social-emotional cortical-amygdala connections, which are integrated in a larger social decision making network. Although knowledge about the involved brain regions is growing, little is known about their exact role in aggressive patients. Therefore, in the present study reward sensitivity, approach behaviour and emotional face processing in IED patients will be investigated and related to brain reactivity.
Objective:
The primary objective is to elucidate which circuits of the social decision making network are involved in IED and to what extent. Candidate mechanisms are the mesolimbic reward circuit and the social emotional cortical-amygdala connections. Our main question is whether an imbalance in the social decision network underlies increased reward sensitivity, decreased avoidance behaviour or increased reactivity to angry faces, or a combination of these mechanisms in IED patients. The main outcome measures will be drawn from structural and functional magnetic resonance imaging (fMRI) scans. In the functional scans brain reactivity will be linked to the reaction time in rewarding vs. non-rewarding trials in a monetary incentive delay (MID) task, the number of avoidances in an approach-avoidance task (AAT), and emotional face processing. Secondary outcome measures will be answers to the questionnaires and testosterone levels.
Doel van het onderzoek
The primary objective is to elucidate which circuits of the social decision making network are involved in IED and to what extent. Candidate mechanisms are the mesolimbic reward circuit and the social emotional cortical-amygdala connections. Our main question is whether an imbalance in the social decision network underlies increased reward sensitivity, decreased avoidance behaviour or increased reactivity to angry faces, or a combination of these mechanisms in IED patients.
Onderzoeksopzet
Day 1: Screening questionnaires
Aim within 2 weeks after screening: fMRI scan
Onderzoeksproduct en/of interventie
Observational study: participants perform some tasks in MRI scanner
Publiek
Department of Psychiatry, 966
PO Box 9101
Robbert J Verkes
Nijmegen 6500 HB
The Netherlands
+31 (0)24 3613970
r.verkes@psy.umcn.nl
Wetenschappelijk
Department of Psychiatry, 966
PO Box 9101
Robbert J Verkes
Nijmegen 6500 HB
The Netherlands
+31 (0)24 3613970
r.verkes@psy.umcn.nl
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
In order to be eligible to participate in this study, a subject must meet all of the following criteria:
- Age 18-50 years
- Male
- Native Dutch speakers
- Right-handed
- Normal or corrected to normal vision
IED patients should furthermore meet the following criteria:
- Score of ¡Ý 5 on the Social Dysfunction Aggression Scale (SDAS)
- Outpatient, meeting DSM-5 criteria or the integrated research criteria for Intermittent Explosive Disorder (IED-IR):
o Recurrent incidents of aggression manifest as either;
o Verbal or physical aggression towards other people, animals, or property occurring twice weekly on average for one month, or
o Three episodes involving physical assault against other people or destruction of property over one-year period
o The degree of aggressiveness expressed is grossly out of proportion to the provocation or any precipitating psychosocial stressors
o The aggressive behavior is generally not premeditated (e.g., is impulsive) and is not committed in order to achieve some tangible objective (e.g., money, power, intimidation, etc.)
o The aggressive behavior causes either marked distress in the individual or impairment in occupational or interpersonal functioning
o The aggressive behavior is not better accounted for by another mental disorder (e.g., Major Depressive/Manic/Psychotic Disorder; ADHD); General Medical Condition (e.g., Head Trauma, Senile Dementia Alzheimer¡¯s Type); or to the direct physiological effects of a substance
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
General exclusion criteria for fMRI: Metal implants or splinters, surgical clips, prostheses, artificial heart valves, claustrophobia, electronic equipment in body (such as a pacemaker), pregnancy, and epilepsy.
Furthermore, a potential subject who meets any of the following criteria will be excluded from participation in this study:
Psychiatric
• Current major depression, or ADHD
• Lifetime history of bipolar disorder, schizophrenia, delusional disorder, schizoaffective disorder, schizopheniform disorder or other psychotic disorders
• Schizoid or schizotypical personality disorder
• Current alcohol- or substance dependence
• Mental retardation (IQ<70 estimated)
Somatic
• History of trauma capitis
• Neurological disorders
Opzet
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In overige registers
| Register | ID |
|---|---|
| NTR-new | NL7364 |
| NTR-old | NTR7572 |
| CCMO | NL60848.091.17 |
| OMON | NL-OMON45615 |