Computational modelling and neural correlates of reinforcement learning following three-week escitalopram: a double-blind, placebo-controlled semi-randomised study

Abstract Reinforcement learning is a fundamental aspect of adaptive behaviour, since it involves the acquisition and updating of associations between actions and their outcomes based on the rewarding or punishing consequences. Acute experimental manipulations of serotonin have provided compelling ev...

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Main Authors: Christelle Langley, Graham K. Murray, Sophia Armand, Franziska Knolle, Rudolf N. Cardinal, Annette Johansen, Peter S. Jensen, Jianfeng Feng, Dea S. Stenbæk, Gitte M. Knudsen, Patrick M. Fisher, Barbara J. Sahakian
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Language:English
Published: Nature Publishing Group 2025-05-01
Series:Translational Psychiatry
Online Access:https://doi.org/10.1038/s41398-025-03392-6
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author Christelle Langley
Graham K. Murray
Sophia Armand
Franziska Knolle
Rudolf N. Cardinal
Annette Johansen
Peter S. Jensen
Jianfeng Feng
Dea S. Stenbæk
Gitte M. Knudsen
Patrick M. Fisher
Barbara J. Sahakian
author_facet Christelle Langley
Graham K. Murray
Sophia Armand
Franziska Knolle
Rudolf N. Cardinal
Annette Johansen
Peter S. Jensen
Jianfeng Feng
Dea S. Stenbæk
Gitte M. Knudsen
Patrick M. Fisher
Barbara J. Sahakian
author_sort Christelle Langley
collection DOAJ
description Abstract Reinforcement learning is a fundamental aspect of adaptive behaviour, since it involves the acquisition and updating of associations between actions and their outcomes based on the rewarding or punishing consequences. Acute experimental manipulations of serotonin have provided compelling evidence for its role in reinforcement learning. However, it remains unknown how more chronic manipulation of serotonin, which holds greater clinical relevance, affects reinforcement learning and the underlying neural mechanisms. Consequently, we aimed to investigate the effect of a three-week administration of the SSRI, escitalopram, on a reinforcement learning paradigm during functional magnetic resonance imaging. The study used a double-blind, placebo-controlled design with 64 healthy volunteers. Participants were semi-randomised, ensuring matched groups for age, sex and intelligence quotient (IQ), to receive either 20 mg of escitalopram (n = 32) or placebo (n = 32) for at least 21 days. We analysed group differences in reinforcement learning using both analysis of covariance as well as innovative hierarchical Bayesian modelling of the reinforcement learning task. Escitalopram reduced learning from punishment during punishment trials. A key novel finding was that there was decreased activation of the intraparietal sulcus in the escitalopram group when compared to the placebo group during reward trials. The involvement of the intraparietal sulcus suggests that escitalopram affects the encoding of value outcome, which may lead to reduced reinforcement sensitivity, and thereby impacting adaptive learning from feedback. Understanding these mechanisms may help to optimize SSRI treatment to mitigate clinical symptoms and improve quality of life for neuropsychiatric patients, by elucidating serotonin’s effects on affect, cognition, and behaviour.
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spelling doaj-art-0c4764f7e8a84a7eade8e5d0610734552025-08-20T02:29:46ZengNature Publishing GroupTranslational Psychiatry2158-31882025-05-011511810.1038/s41398-025-03392-6Computational modelling and neural correlates of reinforcement learning following three-week escitalopram: a double-blind, placebo-controlled semi-randomised studyChristelle Langley0Graham K. Murray1Sophia Armand2Franziska Knolle3Rudolf N. Cardinal4Annette Johansen5Peter S. Jensen6Jianfeng Feng7Dea S. Stenbæk8Gitte M. Knudsen9Patrick M. Fisher10Barbara J. Sahakian11Department of Psychiatry, University of CambridgeDepartment of Psychiatry, University of CambridgeNeurobiology Research Unit, Copenhagen University Hospital RigshospitaletDepartment of Psychiatry, University of CambridgeDepartment of Psychiatry, University of CambridgeNeurobiology Research Unit, Copenhagen University Hospital RigshospitaletNeurobiology Research Unit, Copenhagen University Hospital RigshospitaletInstitute of Science and Technology for Brain-Inspired Intelligence, Fudan UniversityNeurobiology Research Unit, Copenhagen University Hospital RigshospitaletNeurobiology Research Unit, Copenhagen University Hospital RigshospitaletNeurobiology Research Unit, Copenhagen University Hospital RigshospitaletDepartment of Psychiatry, University of CambridgeAbstract Reinforcement learning is a fundamental aspect of adaptive behaviour, since it involves the acquisition and updating of associations between actions and their outcomes based on the rewarding or punishing consequences. Acute experimental manipulations of serotonin have provided compelling evidence for its role in reinforcement learning. However, it remains unknown how more chronic manipulation of serotonin, which holds greater clinical relevance, affects reinforcement learning and the underlying neural mechanisms. Consequently, we aimed to investigate the effect of a three-week administration of the SSRI, escitalopram, on a reinforcement learning paradigm during functional magnetic resonance imaging. The study used a double-blind, placebo-controlled design with 64 healthy volunteers. Participants were semi-randomised, ensuring matched groups for age, sex and intelligence quotient (IQ), to receive either 20 mg of escitalopram (n = 32) or placebo (n = 32) for at least 21 days. We analysed group differences in reinforcement learning using both analysis of covariance as well as innovative hierarchical Bayesian modelling of the reinforcement learning task. Escitalopram reduced learning from punishment during punishment trials. A key novel finding was that there was decreased activation of the intraparietal sulcus in the escitalopram group when compared to the placebo group during reward trials. The involvement of the intraparietal sulcus suggests that escitalopram affects the encoding of value outcome, which may lead to reduced reinforcement sensitivity, and thereby impacting adaptive learning from feedback. Understanding these mechanisms may help to optimize SSRI treatment to mitigate clinical symptoms and improve quality of life for neuropsychiatric patients, by elucidating serotonin’s effects on affect, cognition, and behaviour.https://doi.org/10.1038/s41398-025-03392-6
spellingShingle Christelle Langley
Graham K. Murray
Sophia Armand
Franziska Knolle
Rudolf N. Cardinal
Annette Johansen
Peter S. Jensen
Jianfeng Feng
Dea S. Stenbæk
Gitte M. Knudsen
Patrick M. Fisher
Barbara J. Sahakian
Computational modelling and neural correlates of reinforcement learning following three-week escitalopram: a double-blind, placebo-controlled semi-randomised study
Translational Psychiatry
title Computational modelling and neural correlates of reinforcement learning following three-week escitalopram: a double-blind, placebo-controlled semi-randomised study
title_full Computational modelling and neural correlates of reinforcement learning following three-week escitalopram: a double-blind, placebo-controlled semi-randomised study
title_fullStr Computational modelling and neural correlates of reinforcement learning following three-week escitalopram: a double-blind, placebo-controlled semi-randomised study
title_full_unstemmed Computational modelling and neural correlates of reinforcement learning following three-week escitalopram: a double-blind, placebo-controlled semi-randomised study
title_short Computational modelling and neural correlates of reinforcement learning following three-week escitalopram: a double-blind, placebo-controlled semi-randomised study
title_sort computational modelling and neural correlates of reinforcement learning following three week escitalopram a double blind placebo controlled semi randomised study
url https://doi.org/10.1038/s41398-025-03392-6
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