title: The neural basis of decision-making and reward processing in adults with euthymic bipolar disorder or attention-deficit/hyperactivity disorder (ADHD).
abstract: BACKGROUND
  Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) share DSM-IV criteria in adults and cause problems in decision-making. Nevertheless, no previous report has assessed a decision-making task that includes the examination of the neural correlates of reward and gambling in adults with ADHD and those with BD.
  
  
  RESULTS
  We used the Iowa gambling task (IGT), a task of rational decision-making under risk (RDMUR) and a rapid-decision gambling task (RDGT) which elicits behavioral measures as well as event-related potentials (ERPs: fERN and P3) in connection to the motivational impact of events. We did not observe between-group differences for decision-making under risk or ambiguity (RDMUR and IGT); however, there were significant differences for the ERP-assessed RDGT. Compared to controls, the ADHD group showed a pattern of impaired learning by feedback (fERN) and insensitivity to reward magnitude (P3). This ERP pattern (fERN and P3) was associated with impulsivity, hyperactivity, executive function and working memory. Compared to controls, the BD group showed fERN- and P3-enhanced responses to reward magnitude regardless of valence. This ERP pattern (fERN and P3) was associated with mood and inhibitory control. Consistent with the ERP findings, an analysis of source location revealed reduced responses of the cingulate cortex to the valence and magnitude of rewards in patients with ADHD and BD.
  
  
  CONCLUSIONS
  Our data suggest that neurophysiological (ERPs) paradigms such as the RDGT are well suited to assess subclinical decision-making processes in patients with ADHD and BD as well as for linking the cingulate cortex with action monitoring systems.
authors.affiliation: Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive Neurology, Favaloro University, Buenos Aires, Argentina. aibanez@neurologiacognitiva.org
authors.forename: Agustin
authors.initials: A
authors.lastname: Ibanez
authors.forename: Marcelo
authors.initials: M
authors.lastname: Cetkovich
authors.forename: Agustin
authors.initials: A
authors.lastname: Petroni
authors.forename: Hugo
authors.initials: H
authors.lastname: Urquina
authors.forename: Sandra
authors.initials: S
authors.lastname: Baez
authors.forename: Maria Luz
authors.initials: ML
authors.lastname: Gonzalez-Gadea
authors.forename: Juan Esteban
authors.initials: JE
authors.lastname: Kamienkowski
authors.forename: Teresa
authors.initials: T
authors.lastname: Torralva
authors.forename: Fernando
authors.initials: F
authors.lastname: Torrente
authors.forename: Sergio
authors.initials: S
authors.lastname: Strejilevich
authors.forename: Julia
authors.initials: J
authors.lastname: Teitelbaum
authors.forename: Esteban
authors.initials: E
authors.lastname: Hurtado
authors.forename: Raphael
authors.initials: R
authors.lastname: Guex
authors.forename: Margherita
authors.initials: M
authors.lastname: Melloni
authors.forename: Alicia
authors.initials: A
authors.lastname: Lischinsky
authors.forename: Mariano
authors.initials: M
authors.lastname: Sigman
authors.forename: Facundo
authors.initials: F
authors.lastname: Manes
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology*; D001714:Bipolar Disorder / Q000503:physiopathology*; D003657:Decision Making / Q000502:physiology*; D005715:Gambling / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000502:physiology*; D006801:Humans; D007858:Learning / Q000502:physiology; D008959:Models, Neurological; D009483:Neuropsychological Tests; D012054:Reinforcement, Psychology; D012201:Reward; D012306:Risk