Prefrontal Cortical Activity During the Stroop Task: New Insights into the Why and the Who of Real-World Risky Sexual Behavior

Abstract

Background Research suggests that deficits in both executive functioning and trait impulsivity may play a role in risky sexual behavior. At the neural level, differences in regulation of the prefrontal cortex have been linked to impulsivity, measured neurocognitively and through self-report. The relationship between neurocognitive measures of executive control and trait impulsivity in predicting risky sexual behavior has not been investigated. Purpose To investigate the relationship between neural functioning during the Stroop task and risky sexual behavior, as well as the effect of individual differences in urgent (positive and negative) impulsivity on this relationship. Methods 105 sexually active men who have sex with men (MSM) completed the Stroop task during functional magnetic resonance imaging scanning. They also completed impulsivity inventories and self-reported their risky sexual behavior (events of condomless anal sex in the last 90 days). Results Risky participants had greater activation than safe participants during the color congruent condition of the Stroop task in anterior cingulate cortex/dorsomedial prefrontal cortex, dorsolateral prefrontal cortex, left frontal pole, and right insula. Across these regions, this neural activation mediated the link between (positive and/or negative) urgent impulsivity and risky sexual behavior. Conclusions Findings suggest that the brains of men who engage in risky sexual behavior may employ a different distribution of cognitive resources during tasks of executive functioning than men who practice safe sex, and that this may relate to differences in the prefrontal cortical/fronto-insular system responsible for impulse control.

Shared Neural Correlates Underlying Addictive Disorders and Negative Urgency

“…In studies with response inhibition tasks, the relationship between negative urgency and insula activation differed as a function of the presence of emotional stimuli, such that the relationship was negative during reward-related response inhibition [19], but positive during negative affect-related response inhibition [20]. Further, negative urgency is related to greater right insula activation during risky decision making in individuals engaging in risky sexual practices [21,22], adolescents who binge drink [23], and healthy young adults [24]. Negative urgency was also related to greater right insula activation in a decision making task when an individual made a risky decision as compared to when the individual previously made a safe decision [24].…”

“…Only those high in negative urgency showed greater activation in the dorsolateral PFC (dlPFC) and ventrolateral PFC (vlPFC) in response inhibition during a negative affect condition [20]. Further, negative urgency was related to greater right dlPFC activation during conscious maintenance of negative emotions in a whole sample of cocaine users and controls [33] and greater dlPFC activation during an easy cognitive control task among individuals engaged in risky sexual practices [21]. These findings suggest that lateral prefrontal regions are more intensely recruited during cognitive control when individuals are higher in negative urgency, suggesting these individuals utilize more cognitive resources for tasks involving cognitive control.…”

Risk proneness modulates the impact of impulsivity on brain functional connectivity

“…In a recent study, Barkley-Levenson et al (2018), using a Stroop task, observed that, in the congruent condition, risky participants showed greater activation of the ACC, DMPFC, dorsolateral prefrontal cortex, left frontal pole, and right insula in comparison with nonrisky participants. In a recent study, Barkley-Levenson et al (2018), using a Stroop task, observed that, in the congruent condition, risky participants showed greater activation of the ACC, DMPFC, dorsolateral prefrontal cortex, left frontal pole, and right insula in comparison with nonrisky participants.…”

“…Nonetheless, other factors appear to modulate the differences in the relation between impulsivity and connectivity, such as risk proneness. In a recent study, Barkley-Levenson et al (2018), using a Stroop task, observed that, in the congruent condition, risky participants showed greater activation of the ACC, DMPFC, dorsolateral prefrontal cortex, left frontal pole, and right insula in comparison with nonrisky participants. Further analysis suggested that, in the congruent condition, the activation of several of these regions mediates the association between urgency and risk behavior (risky category), which could be interpreted as indirectly supporting the idea that differences in the functioning of the frontoinsular system is responsible for the observed differences in impulse control between risky and nonrisky individuals.…”

Women at Greater Sexual Risk for STIs/HIV Have a Lower Mesolimbic and Affective Bias Response to Sexual Stimuli

“…These circuits allow an individual to evaluate choices and future consequences associated with a particular behavior (e.g., whether to have sex or not) and enable inhibition of behavior associated with risks (e.g., sex without a condom, Miller, 2000;Bechara and Van Der Linden, 2005;Ghazizadeh et al, 2012). Studies have shown, for example, that activation in the dorsolateral prefrontal cortex and other regulatory regions during inhibition of perseverative responses and cognitive interference is correlated with more sexual risk behaviors (Feldstein Ewing et al, 2015;Barkley-Levenson et al, 2018;Hansen et al, 2018; but see Goldenberg et al, 2013), with researchers suggesting a greater potential compensatory regulatory action to inhibit prepotent responses (Hansen et al, 2018), presumably driven by hyperactive reward and emotional brain regions.…”