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Functional MRI and delay discounting in patients infected with hepatitis C

  • Holly McCready
  • Milky Kohno
  • Michael Kolessar
  • Laura Dennis
  • Daniel Kriz
  • Hannah Luber
  • Renee Anderson
  • Michael Chang
  • Anna Sasaki
  • Kenneth Flora
  • Arthur Vandenbark
  • Suzanne H. Mitchell
  • Jennifer M. Loftis
  • William F. Hoffman
  • Marilyn Huckans
Article
  • 13 Downloads

Abstract

Hepatitis C virus-infected (HCV+) adults evidence increased rates of psychiatric and cognitive difficulties. This is the first study to use functional magnetic resonance imaging (fMRI) to examine brain activation in untreated HCV+ adults. To determine whether, relative to non-infected controls (CTLs), HCV+ adults exhibit differences in brain activation during a delay discounting task (DDT), a measure of one’s tendency to choose smaller immediate rewards over larger delayed rewards—one aspect of impulsivity. Twenty adults with HCV and 26 CTLs completed an fMRI protocol during the DDT. Mixed effects regression analyses of hard versus easy trials of the DDT showed that, compared with CTLs, the HCV+ group exhibited less activation in the left lateral occipital gyrus, precuneus, and superior frontal gyrus. There were also significant interactive effects for hard–easy contrasts in the bilateral medial frontal gyrus, left insula, left precuneus, left inferior parietal lobule, and right temporal occipital gyrus; the CTL group evidenced a positive relationship between impulsivity and activation, while the HCV+ group exhibited a negative relationship. Within the HCV+ group, those with high viral load chose immediate rewards more often than those with low viral load, regardless of choice difficulty; those with low viral load chose immediate rewards more often on hard choices relative to easy choices. Results show that HCV+ patients exhibit greater impulsive behavior when presented with difficult choices, and impulsivity is negatively related to activation in regions important for cognitive control. Thus, interventions that decrease impulsive choice may be warranted with some HCV+ patients.

Keywords

Hepatitis Neuroimaging fMRI Impulsivity Delay discounting Cognition 

Notes

Acknowledgments

The authors would like to thank Jonathan Woodhouse and Adriana Seelye for their help with study start-up and data collection; Betsy Zucker, Patricia Taylor-Young, and the other providers of the VAPORHCS Hepatology Clinic for their continued collaboration and support of this research program; Janice Voukidis and the other providers of the Oregon Clinic’s Gastroenterology Clinic for help with recruitment and data collection; and Diane Howieson, Daniel Storzbach, Alexander Stevens, and Peter Hauser for their mentorship and essential input into initial study design.

Funding information

This material was supported in part by the U.S. Department of Veterans Affairs VA Career Development Award Program (MH, JL) and IK2CX001790 (MK), Clinical Sciences Research and Development Merit Review Program CX001558-01A1 (WH), Biomedical Laboratory Research and Development Merit Review Program I01 BX002061 (JL), DOJ 2010-DD-BX0517 (WH), NIDA P50DA18165 (MH, WH, JL), NIDA T32 DA007262 (MK), NIAAA T32 AA007468 (MK), Collins Medical Trust (MK) and the Medical Research Foundation (MK). HM, MK, LD, DK, HL, and RA were employed as Research Assistants, MK, JL, and AV as Research Scientists, MC and AS as Staff Hepatologists, WF as a Staff Psychiatrist, and MH as a Staff Psychologist and Neuropsychologist at the Veterans Affairs Portland Health Care System, Portland, Oregon. Contents do not represent the view of the U.S. Department of Veterans Affairs or the United States Government.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection  2018

Authors and Affiliations

  • Holly McCready
    • 1
    • 2
    • 3
  • Milky Kohno
    • 1
    • 2
    • 3
  • Michael Kolessar
    • 1
    • 4
  • Laura Dennis
    • 1
    • 2
    • 3
  • Daniel Kriz
    • 1
  • Hannah Luber
    • 1
  • Renee Anderson
    • 1
  • Michael Chang
    • 1
    • 5
  • Anna Sasaki
    • 1
    • 5
  • Kenneth Flora
    • 6
  • Arthur Vandenbark
    • 1
    • 7
    • 8
  • Suzanne H. Mitchell
    • 2
    • 3
    • 9
  • Jennifer M. Loftis
    • 1
    • 3
    • 5
  • William F. Hoffman
    • 1
    • 2
    • 3
    • 10
  • Marilyn Huckans
    • 1
    • 3
    • 5
    • 10
  1. 1.Research and DevelopmentVA Portland Health Care SystemPortlandUSA
  2. 2.Department of Behavioral Neuroscience, School of MedicineOregon Health and Science UniversityPortlandUSA
  3. 3.Department of Psychiatry, School of MedicineOregon Health and Science UniversityPortlandUSA
  4. 4.Department of PM&R and PsychiatryUniversity of Texas Southwestern Medical CenterDallasUSA
  5. 5.The Northwest Hepatitis C Resource CenterVA Portland Health Care SystemPortlandUSA
  6. 6.Department of GastroenterologyThe Oregon ClinicPortlandUSA
  7. 7.Department of Neurology, School of MedicineOregon Health and Science UniversityPortlandUSA
  8. 8.Department of Molecular Microbiology and Immunology, School of MedicineOregon Health and Science UniversityPortlandUSA
  9. 9.Oregon Institute of Occupational Health Sciences, School of MedicineOregon Health and Science UniversityPortlandUSA
  10. 10.Behavioral Health & Clinical Neurosciences DivisionVA Portland Health Care SystemPortlandUSA

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