The Anterior Cingulate Cortex, Risk-Taking, & Impulsivity: A closer look into Bipolar Disorder & ADHD

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Pope, Avery Claire
Brown, Thackery
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The documented presence of mental disorders has increased rapidly in the past few decades with over 51.5 million American adults diagnosed with a mental disorder in 2019 – a 1.5 million increase from 2018 (Substance, 2020). With the rise in these diagnoses, there is a greater need to understand both the neuroanatomy and symptomatology of mental illness and disorders. This study sets out to investigate one of the key behavioral deficits in both disorders-an increase in impulsivity and risk taking (Johnson et al., 2012; Lombardo et al., 2012; Najt et al., 2007; Reddy et al., 2014; Groen et al., 2013, Pollak et al., 2018). Previous research has shown the connection between gray-matter volume of the ACC, a brain area connected with impulse control, is correlated with increased potential for impulsivity; however, there are inconsistencies when considering risk-taking tasks and psychiatric disorders (Brown & Braver, 2007; Fukanaga et al., 2012; Matsuo et al., 2009). To address this gap in literature, this study offers an opportunity to further investigate the ACC’s relationship with impulsivity in the context of a formal assessment of decision-making using the Balloon Analogue Risk Task (BART). Using an extensive database from the UCLA Consortium for Neuropsychiatric Phenomics (Poldrack et al., 2016), participants with Bipolar Disorder (BD), Attention Deficit Hyperactivity Disorder (ADHD), and healthy controls were analyzed using voxel-based morphometry to determine the gray matter volumes of the anterior cingulate cortex. These scores were then compared to performance on the BART and scores on Barratt’s Impulsiveness Scale (BIS). The results indicate that risk-taking is correlated with decreased left ACC volume for healthy males only, whereas BIS scores, psychiatric conditions, and gender portrayed no correlations. Using this knowledge, other brain areas are likely involved in overriding ACC control for people diagnosed with psychiatric disorders. Females also seem to have a different area associated with impulse control instead of the ACC. Future studies could investigate other potential brain areas involved to develop more individualized and focused treatments for those who struggle with increased risk-taking and impulsivity.
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