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Oscar Wilde
The Picture of Dorian Gray, 1891
›tudy objective

‡ According to ›omatic Markers Hypothesis we are guided by somatic


feelings in decision-making.

‡ Vagus nerve may serve as a main route for somatic afferent signals in
decision making process.

‡ In this study the authors wondered whether individual performance


in adaptive decision making task may be improved by the direct
electric stimulation of vagus nerve.
Vagus Nerve

‡ The longest of the cranial nerves

‡ ›tarts in the brainstem (within the


medulla oblongata) and extends, to
abdomen, where it contributes to the
innervation of the vicera

‡ Besides output to the various organs in


the body the vagus nerve conveys
sensory information about the state of
the body organs to the CN›

‡ ~ 80% of the fibers ² afferent

‡ An extraganglial integrator of the


autonomic nervous system
ëvidence in favor of Vagus Nerve
involvement in decision making:

‡ Peripheral neuropathies involving authonomic fibers impair adaptive


decision making at IGT (Bechara et al., 1998). (m  
 


‡ Left vagus stimulation (VN›) causes increased blood flow in bilateral


thalamus, hypothalamus, anterior insula, orbital frontal cortex, inferior
frontal gyrus, and inferior parietal lobule (Henry et al., 1998)

‡ Vagus nerve stimulation improves human memory (Clark et al., 1999;


Cahil & McGaugh, 1998)
Other possible routes by which
somatic information can feedback
to the brain and influence cognition:

‡ ›pinal cord ?
subjects with spinal cord injury between the 2nd and 6th cervical
vertebra did not show impairments in IGT (North and O·Carroll,
2001). It is known that › 

  
 

 

  


  

‡ ëndocrine route ?
too slow
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›ubjects

‡ Medically refractory epileptic patients with implanted vagus nerve


stimulators
‡ 1 female, 7 male
‡ Neuropsychological profile:

Underlined scores represent defective performances


Therapeutic intermittent stimulation was deactivated. To allow external
control of the device, it was programmed to respond to a magnetic pulse by
delivering 60 seconds of 0.5 mA left vagus nerve stimulation.
Decision-making assessment

Adaptive decision-making assessed with Iowa gambling task (Bechara,


Damasio, 1994)

Participants performed the task twice with the disadvantageous decks given
different labels and repositioned to different screen locations on the second
trial.

Between two trials participants underwent neuropsychological testing


Design

* Mixed * Counterbalanced
* Participants blind as to when stimulation occurred
: way (2  2  5) ANOVA #1:
Independent Variables:


  
 
 between group comparison

 
 
 

   
   

:. The 5 blocks of 20 cards from the 100 trials of the gambling task (a
within group comparison)





IGT net score (ratio of ´goodµ vs ´badµ choices) by block


: way (2  2  5) ANOVA #1:

‡ By and large, VN› participants performed more poorly than healthy


participants with similar demographic characteristics (previous studies)
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: way (2  2  5) ANOVA #2:
Independent Variables:


  
 
 between group comparison

 
 
 

   
   

:. The 5 blocks of 20 cards from the 100 trials of the gambling task (a
within group comparison)






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