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Decision-making under risk and ambiguity in adults with Tourette syndrome

Published online by Cambridge University Press:  28 July 2022

Cyril Atkinson-Clement Open the ORCID record for Cyril Atkinson-Clement [Opens in a new window] ,
Mael Lebreton ,
Leïla Patsalides ,
Astrid de Liege ,
Yanica Klein ,
Emmanuel Roze ,
Emmanuelle Deniau ,
Andreas Hartmann ,
Stefano Palminteri  and
Yulia Worbe
Cyril Atkinson-Clement*
Affiliation:
Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France Movement Investigation and Therapeutics Team, Paris, France School of Medicine, University of Nottingham, Nottingham, UK
Mael Lebreton
Affiliation:
Paris School of Economics, Paris, France Swiss Center for Affective Science, University of Geneva, Geneva, Switzerland Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
Leïla Patsalides
Affiliation:
Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France Movement Investigation and Therapeutics Team, Paris, France
Astrid de Liege
Affiliation:
Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France Movement Investigation and Therapeutics Team, Paris, France National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France
Yanica Klein
Affiliation:
Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France Movement Investigation and Therapeutics Team, Paris, France National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France
Emmanuel Roze
Affiliation:
Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France Movement Investigation and Therapeutics Team, Paris, France Department of Neurology, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France
Emmanuelle Deniau
Affiliation:
Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France Movement Investigation and Therapeutics Team, Paris, France National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France
Andreas Hartmann
Affiliation:
Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France Movement Investigation and Therapeutics Team, Paris, France National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France
Stefano Palminteri
Affiliation:
Laboratoire de Neurosciences Cognitives et Computationnelles, INSERM, Paris, France Département d'Etudes Cognitives, ENS, PSL Research University, Paris, France Institute for Cognitive Neuroscience, HSE, Moscow, Russian Federation
Yulia Worbe*
Affiliation:
Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Sorbonne University, 75005 Paris, France Movement Investigation and Therapeutics Team, Paris, France National Reference Center for Tourette Syndrome, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France Department of Neurophysiology, Saint Antoine Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
*
Authors for correspondence: Cyril Atkinson-Clement, E-mail: Cyril.Atkinson-Clement@nottingham.ac.uk; Yulia Worbe, E-mail: yulia.worbe@aphp.fr
Authors for correspondence: Cyril Atkinson-Clement, E-mail: Cyril.Atkinson-Clement@nottingham.ac.uk; Yulia Worbe, E-mail: yulia.worbe@aphp.fr
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Abstract

Background

Tourette syndrome (TS) as well as its most common comorbidities are associated with a higher propensity for risky behaviour in everyday life. However, it is unclear whether this increased risk propensity in real-life contexts translates into a generally increased attitude towards risk. We aimed to assess decision-making under risk and ambiguity based on prospect theory by considering the effects of comorbidities and medication.

Methods

Fifty-four individuals with TS and 32 healthy controls performed risk and ambiguity decision-making tasks under both gains and losses conditions. Behavioural and computational parameters were evaluated using (i) univariate analysis to determine parameters difference taking independently; (ii) supervised multivariate analysis to evaluate whether our parameters could jointly account for between-group differences (iii) unsupervised multivariate analysis to explore the potential presence of sub-groups.

Results

Except for general ‘noisier’ (less consistent) decisions in TS, we showed no specific risk-taking behaviour in TS or any relation with tics severity or antipsychotic medication. However, the presence of comorbidities was associated with distortion of decision-making. Specifically, TS with obsessive–compulsive disorder comorbidity was associated with a higher risk-taking profile to increase gain and a higher risk-averse profile to decrease loss. TS with attention-deficit hyperactivity disorder comorbidity was associated with risk-seeking in the ambiguity context to reduce a potential loss.

Conclusions

Impaired valuation of risk and ambiguity was not related to TS per se. Our findings are important for clinical practice: the involvement of individuals with TS in real-life risky situations may actually rather result from other factors such as psychiatric comorbidities.

Keywords

Aripiprazoledecision makingimpulsivitypsychiatryrisk-taking
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 11 , August 2023 , pp. 5256 - 5266
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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