Hypoactivation in the precuneus and posterior cingulate cortex during ambiguous decision making in individuals with HIV

Abstract

People with human immunodeficiency virus (HIV) often have neurocognitive impairment. People with HIV make riskier decisions when the outcome probabilities are known, and have abnormal neural architecture underlying risky decision making. However, ambiguous decision making, when the outcome probabilities are unknown, is more common in daily life, but the neural architecture underlying ambiguous decision making in people with HIV is unknown. Eighteen people with HIV and 20 controls completed a decision making task while undergoing functional magnetic resonance imaging scanning. Participants chose between a certain reward and uncertain reward with a known (risky) or unknown (ambiguous) probability of winning. There were three levels of risk: high, medium, and low. Ambiguous > risky brain activity was compared between groups. Ambiguous > risky brain activity was correlated with emotional/psychiatric functioning in people with HIV. Both groups were similarly ambiguity-averse. People with HIV were more risk-averse than controls and chose the high-risk uncertain option less often. People with HIV had hypoactivity in the precuneus, posterior cingulate cortex (PCC), and fusiform gyrus during ambiguous > medium risk decision making. Ambiguous > medium risk brain activity was negatively correlated with emotional/psychiatric functioning in individuals with HIV. To make ambiguous decisions, people with HIV underrecruit key regions of the default mode network, which are thought to integrate internally and externally derived information to come to a decision. These regions and related cognitive processes may be candidates for interventions to improve decision-making outcomes in people with HIV.

Ambiguity aversion: bibliometric analysis and literature review of the last 60 years

“…Moreover, research on ambiguity aversion could benefit from agent-based simulations (Georgalos 2018 ). Another promising tool to analyze if people are indeed ambiguity-averse is functional magnetic resonance imaging (fMRI) from neuroeconomics (Camerer et al 2007 ; Hall et al 2021 ).…”

Frequency-dependent functional alterations in people living with HIV with early stage of HIV-associated neurocognitive disorder

“…It shows the highest metabolic rate at rest, has rich anatomical and functional connections with a wide range of brain regions, and participates in multiple complex cognitive functions, such as visuospatial imagination, episodic memory retrieval, and self-task processing ( Cavanna and Trimble, 2006 ). Damage to this brain region was supported by Hall et al with a task-based functional MRI showing hypoactivation in the precuneus during ambiguous decision-making in PLWH ( Hall et al, 2021 ). In a magnetic resonance spectroscopy study, glutamate reduction in the precuneus of PLWH was reported, and this reduction was associated with information processing speed ( Mohamed et al, 2018 ).…”

Gray matter volumes discriminate cognitively impaired and unimpaired people with HIV

“…These markers of AD currently include neurodegenerative metrics obtained from MRI (e.g., less GMV) and PET (e.g., abnormal amyloid and tau depositions; Jack et al, 2018 ). Potential future directions might be to combine the Frascati criteria with emerging neuroimaging markers of HAND, including GMV as demonstrated in the present study, as well as functional MRI ( Ances et al, 2009 , Nguchu et al, 2021 , Plessis et al, 2014 , Hall et al, 2021 , Minosse et al, 2021 ) and magnetoencephalography ( Spooner et al, 2020 , Lew et al, 2018 , Wiesman et al, 2018 , Wilson et al, 2017. , Becker et al, 2012a , Becker et al, 2012b ).…”