Reduced future-oriented decision making in individuals with subjective cognitive decline: A functional MRI study

Xiaochen Hu; Franziska Uhle; Klaus Fliessbach; Michael Wagner; Ying Han; Bernd Weber; Frank Jessen

doi:10.1016/j.dadm.2017.02.005

Reduced future-oriented decision making in individuals with subjective cognitive decline: A functional MRI study

Alzheimers Dement (Amst). 2017 Mar 14:6:222-231. doi: 10.1016/j.dadm.2017.02.005. eCollection 2017.

Authors

Xiaochen Hu¹, Franziska Uhle², Klaus Fliessbach³, Michael Wagner³, Ying Han⁴, Bernd Weber⁵, Frank Jessen²

Affiliations

¹ Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany; Department of Psychiatry and Psychotherapy, University Hospital of Bonn, Bonn, Germany.
² Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
³ Department of Psychiatry and Psychotherapy, University Hospital of Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
⁴ Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China.
⁵ Department of Epileptology, University Hospital of Bonn, Bonn, Germany; Center for Economics and Neuroscience, University of Bonn, Bonn, Germany.

Abstract

Introduction: Subjective cognitive decline (SCD) refers to an at-risk state of Alzheimer's disease and subtle cognitive deficits that have been observed in this condition. Currently, it is unknown whether complex cognitive processes relevant to everyday life, such as future-oriented choice behavior, are also altered in SCD.

Methods: Twenty SCD participants and 24 control (CO) participants took part in a functional magnetic resonance imaging task on intertemporal decisions, with and without simultaneous episodic future imagination.

Results: SCD participants showed reduced future-oriented choices. Future imagination increased future-oriented choices and was associated with increased brain activation in medial frontal polar cortex, right insular cortex, and anterior cingulate cortex in CO only, not SCD. In addition, more future-oriented choices were associated with hippocampal activation during choice processing in CO only.

Discussion: Subtle neuronal network disruptions in SCD may underlie their myopic future decisions and lack of modulation of choice behavior by episodic future imagination.

Keywords: Alzheimer's disease; Delay discounting; Episodic future imagination; Intertemporal decision making; Subjective cognitive decline.