Modulating Neurocognitive Processes of Learning to Trust and Distrust in Aging

Much of human interaction is based on trust. Aging has been associated with deficits in trust-related decision making, likely further exacerbated in age-associated neurodegenerative disease (Alzheimer's disease/AD), possibly underlying the dramatically growing public health problem of elder fraud. Optimal trust-related decision making and avoiding exploitation require the ability to learn about the trustworthiness of social partners across multiple interactions, but the role that learning plays in determining age deficits in trust decisions is currently unknown. The proposed work is conceptually embedded in the Changes in Integration for Social Decisions in Aging (CISDA) framework. This framework describes how the integration of decision-relevant information is impacted by trajectories of change in theory of mind, memory systems, and social-emotional processing with age. Two innovative trust-learning paradigms - the Social Iowa Gambling Task (sIGT) and the FLorida-Arizona Gambling Task (FLAG) - will be leveraged to test CISDA predictions. Aim: Probe the malleability of the underlying neurocircuitry of trust-learning deficits in aging. This study will utilize real-time fMRI neurofeedback to train healthy older adults in anterior cingulate cortex up-regulation toward enhanced trust-related learning in aging and confirm critical mechanisms of experience-dependent social decisions in aging. Grant R01AG072658 Aim 3: Test the malleability of trust-learning neurocircuitry toward optimized trust-related decision making in aging.

This study will apply rtfMRI neurofeedback training as an intervention method, to demonstrate that healthy older adults can be trained in volitional up-regulation of ACC activity, reducing their trust-learning deficits. The study will compromise 4 MRI sessions: 1 pre-training scan, 2 training scans, and 1 post-training scan. Number and duration of scans are based on our feasibility data showing that older adults were able to up-regulate ROI activity after two 1-h training sessions. After the post-training scan, the effects of neurofeedback training on far transfer to phishing susceptibility and exploitation risks will be assessed using PEST and our survey measures.

Real-time functional magnetic resonance imaging guided neurofeedback is a non-invasive procedure that provides a visual of participants' current blood oxygen-level-dependent (BOLD) signal in response to a specific task or stimulus in a targeted brain region relative to a control region. Participants use real-time neurofeedback to modulate targeted BOLD signals in their own brain. This technique is used in Study 3. The study does not assess change in a health condition. It evaluates the effect of real-time functional magnetic resonance imaging guided neurofeedback (vs. sham neurofeedback) on trust-related learning in older adults.

Sham control is the neurofeedback that was previously recorded from a patient, a non-invasive procedure used as a placebo

Measures of neural activity are obtained using functional magnetic resonance imaging during administration of computerized learning tasks, with contrasting groups and conditions

Inclusion Criteria: Able to provide verbal and written informed consent Fluent English speaker At least 8th grade education Age between 60-85 years On stable medication regimen Exclusion Criteria: Pregnancy Magnetic resonance imaging contraindications (e.g., certain metallic objects in body, claustrophobia) Current major depression defined as scores >14 on the Beck Depression Inventory-II Impaired scores on the Telephone Interview for Cognitive Status (TICS; cut-off of >30) Current use of medications with significant anticholinergic properties due to potential influence on memory ("memory enhancing"; e.g., Aricept or Namenda) Current use of anticonvulsant, neuroleptic, sedatives, or other medications known to affect cognition Uncorrected visual and hearing impairments Neurologic conditions affecting the brain (e.g., stroke, epilepsy, traumatic brain injury with >30-minute loss of consciousness) Impaired scores on a cognitive screening measure, the Montreal Cognitive Assessment (MoCA); for older adults the cutoff will be age and education corrected Unstable medical illness (e.g., metastatic cancer) Significant cardiovascular conditions (e.g., major heart attack) Will not exclude participants who are taking anti-depressant medications. Use of antidepressants (particularly SSRI's) and anxiolytic medications will be recorded and included in post-hoc analyses