Modulation of feedback related activity in the rostral anterior cingulate cortex during trial and error exploration

The present functional magnetic resonance imaging (fMRI) experiment aims at clarifying the role of the rostral anterior cingulate cortex (rACC) in the evaluation of feedback in a deterministic environment. We tested, in particular, the response of the rACC to the detection of different types of feedback, and to varying levels of outcome expectancy. We used a problem-solving task in which subjects had to discover, in successive trials, which one of the four presented stimuli was associated with a positive feedback, the other ones being associated with error feedback. In this task, two periods alternated: 1. an exploratory period in which error feedback indicated to adapt the following response appropriately (and continue to explore), and first positive feedback indicated to change strategy (i.e. to shift from explorative to exploitative behavior), and 2. an exploitative period in which subjects had to repeat the correct choice. The rACC is recruited in the exploratory period during the analysis of both error and first correct positive feedback. In addition, the rACC activity was modulated by positive reward prediction error values (i.e. the difference between obtained and expected feedback). Altogether, these results reveal the critical role of the rACC in the evaluation of salient feedback for learning optimal strategies.     

The screen for cognitive impairment in psychiatry (SCIP) is associated with disease severity and cognitive complaints in major depression

Objective: To assess the relationship between the Screen for Cognitive Impairment in Psychiatry (SCIP) score and illness severity, subjective cognition and functioning in a cohort of major depressive disorder (MDD) patients.

Methods: Patients (n?=?40) diagnosed with MDD (DSM-IV-TR) completed the SCIP, a brief neuropsychological test, and a battery of self-administered questionnaires evaluating functioning (GAF, SDS, WHODAS 2.0, EDEC, PDQ-D5). Disease severity was evaluated with the Hamilton Depression Rating Scale (HDRS) and the Clinical Global Impression (CGI).

Results: Age and sex were associated with performance in the SCIP. The SCIP-Global index score was associated with disease severity (r?=??0.316, p?<?.05), the SDS, a patient self-assessment of daily functioning (r?=??0.368, p?<?.05), and the EDEC subscales of patient-reported cognitive deficits (r?=??0.388, p?<?.05) and their functional impacts (r?=??0.335, p?<?.05). Multivariate analysis adjusted for age and sex confirmed these tests are independent predictors of performance in the SCIP (CGI-S, F_[3,34]?=?4.478, p?=?.009; SDS, F_[3,34]?=?3.365, p?=?.030; EDEC-perceived cognitive deficits, F_[3,34]?=?5.216, p?=?.005; EDEC-perceived impacts of functional impairment, F_[3,34]?=?5.154, p?=?.005).

Conclusions: This study confirms that the SCIP can be used during routine clinical evaluation of MDD, and that cognitive deficits objectively assessed in the SCIP are associated with disease severity and self-reported cognitive dysfunction and impairment in daily life.     

Determinants of Low Birth Weight in Ghana: Does Quality of Antenatal Care Matter?

Maternal and Child Health Journal - Low birth weight is a public health issue that contributes to perinatal and infant mortality, especially in limited-resource settings, but there is limited...