Purpose: Limited data are available on immunologic responses to primary pandemic H1N1 (2009) vaccination in recipients of allogeneic hematopoietic stem cell transplantation (HSCT) recipients. In 2009 serologic responses to either pandemic H1N1 (2009) vaccine (n = 36)

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The COVID-19 outbreak introduced unprecedented health-risks, as well as pressure on the financial, social, and psychological well-being due to the response to the outbreak1–4. Here, we examined the manifestations of the COVID-19 outbreak on the brain structure in the healthy population, following the initial phase of the pandemic in Israel. We pre-registered our hypothesis that the intense experience of the outbreak potentially induced stress-related brain modifications5–8. Volumetric changes in n = 50 participants scanned before and after the COVID-19 outbreak and lockdown, were compared with n = 50 control participants that were scanned twice prior to the pandemic. The pandemic provided a rare opportunity to examine brain plasticity in a natural experiment. We found volumetric increases in bilateral amygdalae, putamen, and the anterior temporal cortices. Changes in the amygdalae diminished as time elapsed from lockdown relief, suggesting that the intense experience associated with the pandemic outbreak induced volumetric changes in brain regions commonly associated with stress and anxiety9–11.

The dual-process theory of action control postulates that there are two competitive and complementary mechanisms that control our behavior: a goal-directed system that executes deliberate actions, explicitly aimed toward a particular outcome, and a habitual system that autonomously execute well-learned actions, typically following an encounter with a previously associated cue. In line with dual-process theory, animal studies have provided convincing evidence for dissociable neural mechanisms, mainly manifested in cortico-striatal regions, involved in goal-directed and habitual action control. While substantial progress has been made in characterizing the neural mechanism underlying habit learning in animals, we still lack knowledge on how habits are formed and maintained in the human brain. Thus far only one study, conducted more than a decade ago by Tricomi et al. (2009), has been able to induce habitual behavior in humans via extensive training. This study also implicated the posterior putamen in the process, using functional magnetic resonance imaging (fMRI). However, recent attempts to replicate the behavioral results of this study were not successful. This leaves the research of human habits, and particularly the research of their formation through extensive repetition, as well as their neural basis, limited and far behind the animal research in the field. This motivated us to (1) attempt to replicate the behavioral and imaging main findings of Tricomi et al., (2) identify further functional and microstructural neural modifications associated with habit formation and manifestation, and (3) investigate the relationships between functional and structural plasticity and individual differences in habit expression. To this end, in this registered report we used Tricomi et al.'s free-operant task along with multi-modal MRI methods in a well-powered sample (n=123). In this task participants' sensitivity to outcome devaluation (an index of goal-directed/habitual action control) is tested following either short or extensive training. In contrast to our hypothesis, we were not able to demonstrate habit formation as a function of training duration nor were we able to relate any functional or microstructural plasticity in the putamen with individual habit expression. We found that a pattern of increased activations in the left head of caudate that re-occurred across each day's training is associated with goal directed behavior and that increased processing of devalued cues in low-level visual regions was indicative of goal-directed behavior (and vice versa). In a follow-up exploratory analysis comparing habitual and goal-directed subgroups within each experimental group, we found that elevated activations in frontoparietal regions during early stages of training, as well as increased reactivity towards still-valued cues in somatosensory and superior parietal regions were found in individuals that were more inclined to perform goal-directed behavior (compared with more habitual individuals). Taken together, regions commonly implicated in goal-directed behavior were most predictive of individual habit expression. Finally, we also found that differential patterns of training-related microstructural plasticity, as measured with diffusion MRI, in midbrain dopaminergic regions were associated with habit expression. This work provides new insights into the neural dynamics involved in individual habit formation/expression and encourages the development and testing of new, more sensitive, procedures for experimental habit induction in humans.

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