title: Neuronal correlates of risk-seeking attitudes to anticipated losses in binge drinkers.
abstract: BACKGROUND
  Abnormal decision making under risk is associated with a number of psychiatric disorders. Here, we focus on binge drinkers (BD), characterized by repeated episodes of heavy alcohol intoxication. Previous studies suggest a decreased sensitivity to aversive conditioning in BD. Here, we asked whether BD might be characterized by enhanced risk seeking related to decreased sensitivity to the anticipation of negative outcomes.
  
  
  METHODS
  Using an anticipatory risk-taking task (40 BD and 70 healthy volunteers) and an adapted version of this task for functional magnetic resonance imaging (21 BD and 21 healthy volunteers), we assessed sensitivity to reward and loss across risk probabilities.
  
  
  RESULTS
  In the behavioral task, BD showed a higher number of risky choices in high-risk losses. In the neuroimaging task, the high-risk attitude in the loss condition was associated with greater activity in dorsolateral prefrontal, lateral orbitofrontal, and superior parietal cortices in BD. Explicit exposure of BD to the probability and magnitude of loss, via introduction of feedback, resulted in a subsequent decrease in risky choices. This change in risk attitude in BD was associated with greater activity in inferior frontal gyrus, which also correlated with the percentage of decrease in risky choices after feedback presentation, suggesting a possible role for cognitive control toward risk-seeking attitudes.
  
  
  CONCLUSIONS
  Our findings suggest that a decrease in sensitivity to the anticipation of high-risk negative outcomes might underlie BD behavior. Presentation of explicit feedback of probability and loss in BD can potentially modify risk-taking attitudes, which have important public health implications and suggest possible therapeutic targets.
authors.affiliation: Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Yulia
authors.initials: Y
authors.lastname: Worbe
authors.affiliation: Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Irvine
authors.affiliation: Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Iris
authors.initials: I
authors.lastname: Lange
authors.affiliation: Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Prantik
authors.initials: P
authors.lastname: Kundu
authors.affiliation: Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Howell
authors.affiliation: Brighton and Sussex Medical School, University of Sussex, Brighton.
authors.forename: Neil A
authors.initials: NA
authors.lastname: Harrison
authors.affiliation: Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom; Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom; Cambridgeshire & Peterborough National Health Service Foundation Trust, Cambridge, United Kingdom; GlaxoSmithKline, Clinical Unit Cambridge, Cambridge, United Kingdom.
authors.forename: Edward T
authors.initials: ET
authors.lastname: Bullmore
authors.affiliation: Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Trevor W
authors.initials: TW
authors.lastname: Robbins
authors.affiliation: Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom; Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom. Electronic address: voonval@gmail.com.
authors.forename: Valerie
authors.initials: V
authors.lastname: Voon
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D063425:Binge Drinking / Q000473:pathology* / Q000523:psychology*; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D003657:Decision Making; D030141:Feedback, Psychological / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D010100:Oxygen / Q000097:blood; D011930:Reaction Time; D012309:Risk-Taking; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Binge drinking; feedback sensitivity; functional MRI; loss anticipation; risk-seeking behavior