# Subjective Valuation of Physical Effort in Health and Disease

> **NIH NIH R01** · HUGO W. MOSER RES INST KENNEDY KRIEGER · 2020 · $405,076

## Abstract

PROJECT SUMMARY
A major hurdle to compliance with rehabilitation therapies is poor effort on the part of patients, caused by
fatigue and feelings of insurmountable effort. If a physical exercise feels very effortful one may be unwilling to
exert the effort required, whereas if an exercise feels less effortful one may be more likely to persevere.
Despite the ubiquity of effort-based judgments, and their disruption in a variety of neurological conditions, the
mechanisms responsible for the subjective valuation of physical effort have received limited investigation. The
central hypothesis of this proposal is that an individual's subjective valuation of effort is reflected in her inherent
excitability of motor cortex, and that this metric is sensitive to disease state. We will perform experiments in
healthy human participants; and a group of participants with multiple sclerosis (MS). We have developed a
novel effort-based choice paradigm that allows us to obtain a precise objective measure of an individual's
subjective valuation of effort. We will use this approach, in combination with computational modeling, functional
magnetic resonance imaging (fMRI), and noninvasive brain stimulation, to investigate the mechanisms
responsible for the subjective valuation of effort. In Aim 1 we will study how motor physiology influences
subjective effort valuation in healthy participants. We will use transcranial magnetic stimulation (TMS) to non
invasively probe the physiological properties of participants' motor cortex; and we will have the same
participants make decisions about effort while they are scanned with fMRI, and use this data to computationally
model their subjective valuation of effort and associated brain activity. These experiments will allow us to test
the relationships between an individual's representations of effort value and motor physiology. In Aim 2 we will
identify the mechanisms of subjective effort valuation in patients with MS. We will use TMS and fMRI to
investigate the neural and behavioral representations of effort value in MS. These experiments will shed light
on the neural circuits that are disrupted in individuals with MS, suffering from feelings of fatigue. Our studies
will have a broad impact on the fields of decision-making and motor control by dissecting the fundamental
mechanisms responsible for physical effort valuation. This work will provide an understanding of the neural
mechanisms underlying disrupted feelings of effort in MS, and may eventually reveal neurobehavioral markers
and neuromodulatory interventions to aid in the prediction and treatment of rehabilitation non-compliance.

## Key facts

- **NIH application ID:** 9984486
- **Project number:** 5R01HD097619-02
- **Recipient organization:** HUGO W. MOSER RES INST KENNEDY KRIEGER
- **Principal Investigator:** Vikram S Chib
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $405,076
- **Award type:** 5
- **Project period:** 2019-09-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9984486

## Citation

> US National Institutes of Health, RePORTER application 9984486, Subjective Valuation of Physical Effort in Health and Disease (5R01HD097619-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9984486. Licensed CC0.

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