Resting state predicts neural activity during reward-guided decision making: An fMRI study on Balloon Analogue Risk Task.

In our previous work [8], we have shown that resting state (RS) functional connectivity metrics are significantly related with behavioural performance at Balloon Analogue Risk Task (BART). In the present study we investigated the hypothesis of an association between RS metrics and neural activity evoked by BART execution. A group-level whole-brain regression was run to assess whether RS metrics predict brain activation during the BART, in a sample of 35 young healthy adults (mean age 23 ± 2 years, 25 F). Results complete the previous findings showing that RS is also significantly associated with the neural activity during BART execution. Specifically, ALFF is positively associated with the activity of both the right inferior parietal lobule and the left caudate. These new results are coherent with previous evidence indicating RS abnormalities in clinical conditions characterised by symptoms of impulse control disorders, and further suggest that RS might be a stable predictor of both behavioural indices and neural correlates of impulsivity and of reward-guided decision-making.

Doubling the Dose of Bevacizumab Beyond Progression in Metastatic Colorectal Cancer-the Experience of a Tertiary Cancer Center.

Background: Colorectal cancer (CRC) is the third most common cancer in Europe, with an annual increase in incidence ranging between 0.4 and 3.6% in various countries. Although the development of CRC was extensively studied, limited number of new therapies were developed in the last few years. Bevacizumab is frequently used as first- and second-line therapy for management of metastatic CRC (mCRC). The aim of this study is to present our experience with using bevacizumab beyond disease progression at different dosage levels in mCRC patients, in terms of overall survival, progression-free survival, time to treatment failure, and toxicities. Methods: We performed a consecutive retrospective analysis of patients with confirmed mCRC who were treated with bevacizumab at "Prof Dr. Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania. We included patients who had received bevacizumab as first- or second-line therapy and further stratified them according to the dose administered as a second-line (either standard dose of 5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks, or double dose of 10 mg/kg every 2 weeks or 15 mg/kg every 3 weeks-depending on the classical chemotherapy partner). All patients had received bevacizumab beyond progression (BYP) which is defined as continuing bevacizumab administration through second-line treatment despite disease progression. In each group, we evaluated the prognostic factors that influenced survival and treatment outcome. Results: One hundred and fifty-one (151) patients were included in the study. Themedian age of patients receiving double dose bevacizumab (DDB) and standard dose bevacizumab (SDB) was 58 years (range 41-71) and 57 years (range 19-75), respectively. The median overall survival in the DDB group was 41 months (range 27-49) compared to 25 months (range 23-29) in the SDB group (p = 0.01 log-rank test). First-line oxaliplatin-based treatment was used more frequently regardless of group, while irinotecan-based more frequently used as a second-line treatment (p = 0.014). Both oxaliplatin- and irinotecan-based regimens were found to be suitable partners for BYP. Statistical analysis revealed that dose intensity, primary tumor location, and cumulative exposure to BYP had significant influence on survival. Conclusion: Doubling the dose of bevacizumab after first progression may improve survival in mCRC patients. Increasing bevacizumab dose intensity could override the prognostic impact of primary tumor location in patients receiving double the dose of bevacizumab after first disease progression.

You do not have to act to be impulsive: Brain resting-state activity predicts performance and impulsivity on the Balloon Analogue Risk Task.

OBJECTIVE: Impulsivity is a key, trait-like feature of the decision-making process. As personality traits are stable over time, we hypothesized that resting-state (RS) neural activity would predict individual impulsivity. METHODS: Thirty-five healthy individuals underwent fMRI scan during RS and subsequently performed the Balloon Analogue Risk Task (BART). In BART, impulsivity was inversely correlated to monetary earnings. A group-level whole-brain regression assessed the relationship between earnings at BART and RS evaluated by the Hurst Exponent, regional homogeneity; low frequency oscillation (LFO), (including the Amplitude of Low Frequency Fluctuations - ALFF- and the fractional Amplitude of Low Frequency Fluctuations -fALFF) and the Default Mode Network (DMN) functional connectivity. RESULTS: ALFF significantly correlates with total earnings in the ventral part of the ACC/MPFC (FWE corrected p < 0.05 (uncorrected p value <0.0005; cluster size: ≥10 voxels), while H significantly correlates with total earnings in the anterior insula and the part opercularis of the inferior frontal gyrus. CONCLUSIONS: These results suggest that impulsivity and ability to change strategies according to external cues are trait characteristics shaped in the RS's functional architecture that can be detected also when individuals are not engaged in decision-making tasks.