Repeating patterns: Predictive processing suggests an aesthetic learning role of the basal ganglia in repetitive stereotyped behaviors

Recurrent, unvarying, and seemingly purposeless patterns of action and
cognition are part of normal development, but also feature prominently in
several neuropsychiatric conditions. Repetitive stereotyped behaviors (RSBs)
can be viewed as exaggerated forms of learned habits and frequently
correlate with alterations in motor, limbic, and associative basal ganglia
circuits. However, it is still unclear how altered basal ganglia feedback
signals actually relate to the phenomenological variability of RSBs. Why do
behaviorally overlapping phenomena sometimes require different treatment
approaches−for example, sensory shielding strategies versus exposure
therapy for autism and obsessive-compulsive disorder, respectively? Certain
clues may be found in recent models of basal ganglia function that extend
well beyond action selection and motivational control, and have implications
for sensorimotor integration, prediction, learning under uncertainty, as
well as aesthetic learning. In this paper, we systematically compare three
exemplary conditions with basal ganglia involvement, obsessive-compulsive
disorder, Parkinson’s disease, and autism spectrum conditions, to gain
a new understanding of RSBs. We integrate clinical observations and
neuroanatomical and neurophysiological alterations with accounts employing
the predictive processing framework. Based on this review, we suggest
that basal ganglia feedback plays a central role in preconditioning cortical
networks to anticipate self-generated, movement-related perception. In this way, basal ganglia feedback appears ideally situated to adjust the salience
of sensory signals through precision weighting of (external) new sensory
information, relative to the precision of (internal) predictions based on prior
generated models. Accordingly, behavioral policies may preferentially rely on
new data versus existing knowledge, in a spectrum spanning between novelty
and stability. RSBs may then represent compensatory or reactive responses,
respectively, at the opposite ends of this spectrum. This view places an
important role of aesthetic learning on basal ganglia feedback, may account
for observed changes in creativity and aesthetic experience in basal ganglia
disorders, is empirically testable, and may inform creative art therapies in
conditions characterized by stereotyped behaviors.