Effects of stimulus-response compatibility in Parkinson’s disease: a psychophysiological analysis

Spatio-temporal dynamics of large-scale electrophysiological networks during cognitive action control in healthy controls and Parkinson's disease patients

Among the cognitive symptoms that are associated with Parkinson's disease (PD), alterations in cognitive action control (CAC) are commonly reported in patients. CAC enables the suppression of an automatic action, in favor of a goal-directed one. The implementation of CAC is time-resolved and arguably associated with dynamic changes in functional brain networks. However, the electrophysiological functional networks involved, their dynamic changes, and how these changes are affected by PD, still remain unknown. In this study, to address this gap of knowledge, 10 PD patients and 10 healthy controls (HC) underwent a Simon task while high-density electroencephalography (HD-EEG) was recorded. Source-level dynamic connectivity matrices were estimated using the phase-locking value in the beta (12-25 Hz) and gamma (30-45 Hz) frequency bands. Temporal independent component analyses were used as a dimension reduction tool to isolate the task-related brain network states. Typical microstate metrics were quantified to investigate the presence of these states at the subject-level. Our results first confirmed that PD patients experienced difficulties in inhibiting automatic responses during the task. At the group-level, we found three functional network states in the beta band that involved fronto-temporal, temporo-cingulate and fronto-frontal connections with typical CAC-related prefrontal and cingulate nodes (e.g., inferior frontal cortex). The presence of these networks did not differ between PD patients and HC when analyzing microstates metrics, and no robust correlations with behavior were found. In the gamma band, five networks were found, including one fronto-temporal network that was identical to the one found in the beta band. These networks also included CAC-related nodes previously identified in different neuroimaging modalities. Similarly to the beta networks, no subject-level differences were found between PD patients and HC. Interestingly, in both frequency bands, the dominant network at the subject-level was never the one that was the most durably modulated by the task. Altogether, this study identified the dynamic functional brain networks observed during CAC, but did not highlight PD-related changes in these networks that might explain behavioral changes. Although other new methods might be needed to investigate the presence of task-related networks at the subject-level, this study still highlights that task-based dynamic functional connectivity is a promising approach in understanding the cognitive dysfunctions observed in PD and beyond.

Functional brain imaging of speeded decision processing in Parkinson's disease and comparison with Schizophrenia

This study examined whether Parkinson's disease (PD¹) and schizophrenia (SCZ²) share a hypo dopaminergic dysfunction of the prefrontal cortex leading to cognitive impairments in decision processing. 24 medicated PD patients and 28 matched controls performed the Eriksen flanker two-choice reaction time (RT³) task while brain activity was measured throughout, using functional Magnetic Resonance Imaging (fMRI⁴). Results were directly compared to those of 30 SCZ patients and 30 matched controls. Significant differences between SCZ and PD were found, through directly comparing the z-score deviations from healthy controls across all behavioral measures, where only SCZ patients showed deviances from controls. Similarly a direct comparison of z-score activation deviations from controls indicated significant differences in prefrontal and cingulate cortical activation between SCZ and PD, where only SCZ patients showed hypo-activation of these areas compared to controls. The hypo-activation of the dorsolateral prefrontal cortex was related to larger RT variability (ex-Gaussian tau) in SCZ but not PD patients. Overall, the concluding evidence does not support a shared neural substrate of cognitive dysfunction, since the deficit in speeded decision processing and the related cortical hypo-activation observed in SCZ were absent in PD.

Conflict adaptation and related neuronal processing in Parkinson's disease

Non-motor symptoms like cognitive impairment are a huge burden for patients with Parkinson's disease. We examined conflict adaptation by using the congruency sequence effect as an index of adaptation in 17 patients with Parkinson's disease and 18 healthy controls with an Eriksen flanker task using functional magnet resonance imaging to reveal possible differences in executive function performance. We observed overall increased response times in patients with Parkinson's disease compared to healthy controls. A flanker interference effect and congruency sequence effect occurred in both groups. A significant interaction of current and previous trial type was revealed, but no effect of response sequence concerning left or right motor responses. Therefore, top-down conflict monitoring processes are likely the main contributors leading to the congruency sequence effect in our paradigm. In both groups incongruent flanker events elicited activation in the middle temporal gyrus, inferior parietal cortex, dorsolateral prefrontal cortex and the insula in contrast to congruent flanker events. A psychophysiological interactions analysis revealed increased functional connectivity of inferior parietal cortex as a seed to the left prefrontal thalamus during incongruent vs. congruent and neutral stimuli in patients with Parkinson's disease that may reflect compensatory facilitating action selection processes. We conclude that patients with Parkinson's disease exhibit conflict adaptation comparable to healthy controls when investigated while receiving their usual medication.

Neurophysiological mechanisms underlying motor feature binding processes and representations

Coherent, voluntary action requires an integrated representation of these actions and their defining features. Although theories delineate how action integration requiring binding between different action features may be accomplished, the underlying neurophysiological mechanisms are largely elusive. The present study examined the neurophysiological mechanisms underlying binding processes in actions. To this end, we conducted EEG recordings and applied standard event-related potential analyses, temporal EEG signal decomposition and multivariate pattern analyses (MVPA). According to the code occupation account, an overlap between a planned and a to-be-performed action impairs performance. The level, to which performance is attenuated depends on the strength of binding of action features. This binding process then determines the representation of them, the so-called action files. We show that code occupation and bindings between action features specifically modulate processes preceding motor execution as showed by the stimulus-locked lateralized readiness potential (LRP). Conversely, motor execution processes reflected by the response-locked LRP were not modulated by action file binding. The temporal decomposition of the EEG signal, further distinguished between action file related processes: the planned response determining code occupation was reflected in general (voluntary) response selection but not in involuntary (response priming-related) activation. Moreover, MVPA on temporally decomposed neural signals indicated that action files are represented as a continuous chain of activations. Within this chain, inhibitory and response re-activation patterns can be distinguished. Taken together, the neurophysiological correlates of action file binding suggest that parallel, stimulus- and response-related pre-motor processes are responsible for the code occupation in the human motor system.

Tourette syndrome as a motor disorder revisited - Evidence from action coding

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Feature Binding/integration in the motor domain in Tourette Syndrome (TS) is examined.

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Motor binding processes and interleaved action are intact in TS.

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Binding processes are differentially modulated in the motor domain and sensori-motor processes.

Because tics are the defining clinical feature of Tourette syndrome, it is conceptualized predominantly as a motor disorder. There is some evidence though suggesting that the neural basis of Tourette syndrome is related to perception–action processing and binding between perception and action. However, binding processes have not been examined in the motor domain in these patients. If it is particularly perception–action binding but not binding processes within the motor system, this would further corroborate that Tourette syndrome it is not predominantly, or solely, a motor disorder.

Here, we studied N = 22 Tourette patients and N = 24 healthy controls using an established action coding paradigm derived from the Theory of Event Coding framework and concomitant EEG-recording addressing binding between a planned but postponed, and an interleaved immediate reaction with different levels of overlap of action elements. Behavioral performance during interleaved action coding was normal in Tourette syndrome. Response locked lateralized readiness potentials reflecting processes related to motor execution were larger in Tourette syndrome, but only in simple conditions. However, pre-motor processes including response preparation and configuration reflected by stimulus-locked lateralized readiness potentials were normal. This was supported by a Bayesian data analysis providing evidence for the null hypothesis. The finding that processes integrating different action-related elements prior to motor execution are normal in Tourette syndrome suggests that Tourette it is not solely a motor disorder. Considering other recent evidence, the data show that changes in “binding” in Tourette syndrome are specific for perception–action integration but not for action coding.

The arrow of time: Advancing insights into action control from the arrow version of the Eriksen flanker task

Since its introduction by B. A. Eriksen and C. W. Eriksen (Perception & Psychophysics, 16, 143-49, 1974), the flanker task has emerged as one of the most important experimental tasks in the history of cognitive psychology. The impact of a seemingly simple task design involving a target stimulus flanked on each side by a few task-irrelevant stimuli is astounding. It has inspired research across the fields of cognitive neuroscience, psychophysiology, neurology, psychiatry, and sports science. In our tribute to Charles W. ("Erik") Eriksen, we (1) review the seminal papers originating from his lab in the 1970s that launched the paradigmatic task and laid the foundation for studies of action control, (2) describe the inception of the arrow version of the Eriksen flanker task, (3) articulate the conceptual and neural models of action control that emerged from studies of the arrows flanker task, and (4) illustrate the influential role of the arrows flanker task in disclosing developmental trends in action control, fundamental deficits in action control due to neuropsychiatric disorders, and enhanced action control among elite athletes.

Flanker Task-Elicited Event-Related Potential Sources Reflect Human Recombinant Erythropoietin Differential Effects on Parkinson's Patients

We used EEG source analysis to identify which cortical areas were involved in the automatic and controlled processes of inhibitory control on a flanker task and compared the potential efficacy of recombinant-human erythropoietin (rHuEPO) on the performance of Parkinson's Disease patients. The samples were 18 medicated PD patients (nine of them received rHuEPO in addition to their usual anti-PD medication through random allocation and the other nine patients were on their regular anti-PD medication only) and 9 age and education-matched healthy controls (HCs) who completed the flanker task with simultaneous EEG recordings. N1 and N2 event-related potential (ERP) components were identified and a low resolution tomography (LORETA) inverse solution was employed to localize the neural generators. Reaction times and errors were increased for the incongruent flankers for PD patients compared to controls. EEG source analysis identified an effect of rHuEPO on the lingual gyri for the early N1 component. N2-related sources in middle cingulate and precuneus were associated with the inhibition of automatic responses evoked by incongruent stimuli differentiated PD and HCs. From our results rHuEPO seems to mediate an effect on N1 sources in lingual gyri but not on behavioural performance. N2-related sources in middle cingulate and precuneus were evoked by incongruent stimuli differentiated PD and HCs.

Preserved but Less Efficient Control of Response Interference After Unilateral Lesions of the Striatum

Previous research on the neural basis of cognitive control processes has mainly focused on cortical areas, while the role of subcortical structures in cognitive control is less clear. Models of basal ganglia function as well as clinical studies in neurodegenerative diseases suggest that the striatum (putamen and caudate nucleus) modulates the inhibition of interfering responses and thereby contributes to an important aspect of cognitive control, namely response interference control. To further investigate the putative role of the striatum in the control of response interference, 23 patients with stroke-induced lesions of the striatum and 32 age-matched neurologically healthy controls performed a unimanual version of the Simon task. In the Simon task, the correspondence between stimulus location and response location is manipulated so that control over response interference can be inferred from the reaction time costs in incongruent trials. Results showed that stroke patients responded overall slower and more erroneous than controls. The difference in response times (RTs) between incongruent and congruent trials (known as the Simon effect) was smaller in the ipsilesional/-lateral hemifield, but did not differ significantly between groups. However, in contrast to controls, stroke patients exhibited an abnormally stable Simon effect across the reaction time distribution indicating a reduced efficiency of the inhibition process. Thus, in stroke patients unilateral lesions of the striatum did not significantly impair the general ability to control response interference, but led to less efficient selective inhibition of interfering responses.

On the effects of tyrosine supplementation on interference control in a randomized, double-blind placebo-control trial

Exerting cognitive control is an effortful endeavor that is strongly modulated by the availability of dopamine (DA) and norepinephrine (NE), which are both synthesized from the amino acid precursor tyrosine. Supplementing tyrosine may increase the synthesis of both catecholamines. This has been suggested to improve executive functioning and potentially even counteract depletion effects in this domain. Yet, it has remained unclear whether tyrosine also improves interference control and whether subliminally and consciously triggered response conflicts are subject to the same modulation. We investigated this question in a double-blind intra-individual study design. N = 26 young healthy subjects performed two consecutive cognitive control tasks that triggered automatic incorrect response tendencies; once with tyrosine supplementation and once with a placebo. The results show that tyrosine decreased the size of consciously perceived conflicts in a Simon Task, but not a Flanker task, thus suggesting that stimulus-response conflicts might be modulated differently from stimulus-stimulus conflicts. At the same time, tyrosine supplementation increased the size of subliminally triggered conflicts whenever a different, consciously perceived conflict was also present. This suggests that control-related DA and NE release may increase visuo-motor priming, especially when no conflict-specific top-down control may be triggered to counteract subliminal priming effects. Also, these subliminal conflicts might be aggravated by concurrent control investments in other kinds of conflict. Taken together, our data suggest that beneficial effects of tyrosine supplementation do not require depletion effects, but may be limited to situations where we consciously perceive a conflict and the associated need for conflict-specific control.

RLS patients show better nocturnal performance in the Simon task due to diminished visuo-motor priming

OBJECTIVE

The restless legs syndrome (RLS) is characterized by sensory-motor symptoms which usually occur predominantly at rest in the evening and at night. It is assumed that this circadian rhythm is caused by low dopamine levels in the evening. Yet, it has never been investigated whether RLS patients show diurnal variations in cognitive functions modulated by dopamine and what neurophysiological and functional neuroanatomical processes underlie such modulations.

METHODS

We used a Simon task combined with EEG and source localization to investigate whether top-down response selection and/or automatic visuo-motor priming are subject to diurnal changes in RLS patients, as compared to matched healthy controls.

RESULTS

We found that RLS patients showed better task performance due to reduced visuo-motor priming in the evening, as reflected by smaller early lateralized readiness potential (e-LRP) amplitudes and decreased activation of the superior parietal cortex and premotor cortex. Top-down response selection and early attentional processing were unaffected by RLS.

CONCLUSIONS

Counterintuitively, RLS patients show enhanced task performance in the evening, i.e. when experiencing dopaminergic deficiency. Yet, this may be explained by deficits in visuo-motor priming that lead to reduced false response tendencies.

SIGNIFICANCE

This study reveals a counterintuitive circadian variation of cognitive functions in RLS patients.

Neurophysiological mechanisms of circadian cognitive control in RLS patients - an EEG source localization study

The circadian variation of sensory and motor symptoms with increasing severity in the evening and at night is a key diagnostic feature/symptom of the restless legs syndrome (RLS). Even though many neurological diseases have shown a strong nexus between motor and cognitive symptoms, it has remained unclear whether cognitive performance of RLS patients declines in the evening and which neurophysiological mechanisms are affected by the circadian variation. In the current study, we examined daytime effects (morning vs. evening) on cognitive performance in RLS patients (n = 33) compared to healthy controls (n = 29) by analyzing flanker interference effects in combination with EEG and source localization techniques. RLS patients showed larger flanker interference effects in the evening than in the morning (p = .023), while healthy controls did not display a comparable circadian variation. In line with this, the neurophysiological data showed smaller N1 amplitudes in RLS patients compared to controls in the interfering task condition in the evening (p = .042), but not in the morning. The results demonstrate diurnal cognitive changes in RLS patients with intensified impairments in the evening. It seems that not all dopamine-regulated cognitive processes are altered in RLS and thus show daytime-dependent impairments. Instead, the daytime-related cognitive impairment emerges from attentional selection processes within the extra-striate visual cortex, but not from later cognitive processes such as conflict monitoring and response selection.

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RLS patients have larger flanker interference effect in the evening.

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RLS patients have enhanced impairment of attentional selection in the evening.

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Nocturnal attentional impairment relies on the extra-striate visual cortex.

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Conflict monitoring and response selection are not affected by RLS.

The norepinephrine system shows information-content specific properties during cognitive control - Evidence from EEG and pupillary responses

The ability to exert cognitive control is a major function of the prefrontal cortex, the efficiency of which depends on the phasic release of norepinephrine (NE) at particular time points. However, different aspects of information are simultaneously processed at any given moment. This raises the question of whether the norepinephrine system is also capable of specifically modulating selected aspects of all ongoing information processing, especially when several of those processes are carried out by the same functional neuroanatomical structure at the same time. We examine this question in humans using a flanker paradigm by integrating neurophysiological (EEG) and pupil diameter data using novel signal processing techniques including Residue Iteration Decomposition (RIDE) and source localization. We show that during conflict monitoring, motor response-related processes are more strongly modulated by the NE system than stimulus-related processes or central decision processes between stimulus and response. This was the case even though these processes occurred at the same time point and were mediated by overlapping medial frontal cortical structures. The results indicate that the NE system exerts specific modulatory effects for different informational contents that are simultaneously processed in the medial frontal cortex.

Reversal of alcohol-induced effects on response control due to changes in proprioceptive information processing

Recent research has drawn interest to the effects of binge drinking on response selection. However, choosing an appropriate response is a complex endeavor that usually requires us to process and integrate several streams of information. One of them is proprioceptive information about the position of limbs. As to now, it has however remained elusive how binge drinking affects the processing of proprioceptive information during response selection and control in healthy individuals. We investigated this question using neurophysiological (EEG) techniques in a response selection task, where we manipulated proprioceptive information. The results show a reversal of alcohol-induced effects on response control due to changes in proprioceptive information processing. The most likely explanation for this finding is that proprioceptive information does not seem to be properly integrated in response selection processes during acute alcohol intoxication as found in binge drinking. The neurophysiological data suggest that processes related to the preparation and execution of the motor response, but not upstream processes related to conflict monitoring and spatial attentional orienting, underlie these binge drinking-dependent modulations. Taken together, the results show that even high doses of alcohol have very specific effects within the cascade of neurophysiological processes underlying response control and the integration of proprioceptive information during this process.

Impulsive oculomotor action selection in Parkinson's disease

The effects of Parkinson's disease (PD) on the dynamics of impulsive action selection and suppression have recently been studied using distributional analyses, but with mixed results, especially for selection. Furthermore, some authors have suggested that impulsivity, regarded as a personality trait, shares common features with behavioral tasks' measures. The current study was designed to clarify the impact of PD on impulsive action selection and suppression, and investigate the link between cognitive action control and self-reported impulsivity. We administered an oculomotor version of the Simon task to 32 patients with PD and 32 matched healthy controls (HC), and conducted distributional analyses in accordance with the activation-suppression model. Patients and HC also filled out the Barratt Impulsiveness Scale (BIS) questionnaire. Results showed that patients with PD were faster overall and exhibited a greater congruence effect than HC. They also displayed enhanced impulsive action selection. By contrast, the suppression of impulsive responses was similar across both groups. Furthermore, patients had higher impulsivity scores, which were correlated with higher impulsive action selection and higher suppression. Our study yielded two interesting findings. First, PD resulted in a higher number of fast errors. The activation-suppression model suggests that patients with PD are more susceptible to the impulsive action selection induced by the irrelevant stimulus dimension. Second, impulsive action selection and suppression were both associated with trait impulsivity, as measured by the BIS, indicating that these two aspects of impulsivity share common features.

Blunted neural response to errors as a trait marker of melancholic depression

Identification of biomarkers of vulnerability for Major Depressive Disorder is a high priority, but heterogeneity of the diagnosis can hinder research. Biomarkers of vulnerability should also be present in the absence of the diagnosis. The present study examined the magnitude of the error-related negativity (ERN), an event-related potential component following errors in a sample with remitted melancholic depression (N=17), remitted non-melancholic depression (N=33), and healthy controls (N=55). Remitted melancholic depression was uniquely characterized by a blunted ERN relative to the other two groups. Individuals with remitted non-melancholic depression did not differ from controls in the magnitude of the ERN. This was the case despite the fact that the melancholic and non-melancholic groups did not differ in course or severity of their past illnesses, or in their current functioning. Results suggest that the blunted ERN may be a viable vulnerability marker for melancholia.

Speed pressure in conflict situations impedes inhibitory action control in Parkinson's disease

The current study investigated the effects of Parkinson's disease (PD) on the ability to resolve conflicts when performance emphasized speed vs. response accuracy. PD patients and healthy controls (HC) completed a Simon task, and a subset of participants provided movement-related potential (MRP) data to investigate motor cortex activation and inhibition associated with conflict resolution. Both groups adjusted performance strategically with speed or accuracy instructions. The groups experienced similar susceptibility to making fast errors in conflict trials, but PD patients were less proficient compared to HC at suppressing incorrect responses, especially under speed pressure. Analysis of MRPs showed attenuated inhibition of the motor cortex controlling the conflicting response in PD patients compared to HC. These results confirm the detrimental effects of PD on inhibitory control mechanisms with speed pressure and also suggest that a downstream effect of inhibitory dysfunction in PD might be due to diminished inhibition of the motor cortex.

Immediate effects of rhythmic auditory stimulation with tempo changes on gait in stroke patients

[Purpose] The aim of this study was to investigate the effects of tempo changes in rhythmic auditory stimulation (RAS) on gait in stroke patients. [Subjects] Forty-one chronic stroke patients who had had a stroke with more than 6 months previously were recruited for this study. [Methods] All participants were asked to walk under 5 different conditions in random order: (1) no RAS (baseline); (2) baseline-matched RAS (0%); and (3) −10%, (4) +10%, and (5) +20% of the baseline. A GAITRite system was used to evaluate the spatial and temporal parameters of gait. [Results] Compared with under the RAS 0% conditions, the gait velocity, cadence, and stride length on the affected side were significantly decreased under the RAS −10% conditions. Gait velocity and cadence were significantly improved, but gait symmetry was significantly decreased under the RAS +10% and +20% conditions compared with under the RAS 0% conditions. [Conclusion] A faster RAS tempo significantly improved gait velocity and cadence, and applying RAS significantly improved the gait symmetry of stroke patients.

Deep brain stimulation of the subthalamic nucleus, but not dopaminergic medication, improves proactive inhibitory control of movement initiation in Parkinson's disease

Slowness in movement initiation is a cardinal feature of Parkinson's disease (PD) that is still poorly understood and unsuccessfully alleviated by standard therapies. Here, we raise this major clinical issue within the framework of a novel theoretical model that allows a better understanding of the basic mechanisms involved in movement initiation. This model assumes that movement triggering is inhibited by default to prevent automatic responses to unpredictable events. We investigated to which extent the top-down control necessary to release this locking state before initiating actions is impaired in PD and restored by standard therapies. We used a cue-target reaction time task to test both the ability to initiate fast responses to targets and the ability to refrain from reacting to cues. Fourteen patients with dopaminergic (DA) medication and 11 with subthalamic nucleus (STN) stimulation were tested on and off treatment, and compared with 14 healthy controls. We found evidence that patients withdrawn from treatment have trouble voluntarily releasing proactive inhibitory control; while DA medication broadly reduces movement initiation latency, it does not reinstate a normal pattern of movement initiation; and stimulation of the STN specifically re-establishes the efficiency of the top-down control of proactive inhibition. These results suggest that movement initiation disorders that resist DA medication are due to executive, not motor, dysfunctions. This conclusion is discussed with regard to the role the STN may play as an interface between non-DA executive and DA motor systems in cortico-basal ganglia loops.

The executive functions in frontal and temporal lobes: a flanker task intracerebral recording study

The occurrence of the local generators of P3-like potentials elicited by a noise-compatibility flanker test was used to study the processing of executive functions, particularly in the frontal and temporal cortices. The test performed with arrows comprised a simpler congruent and a more difficult incongruent task. The two tasks activated the attention and several particular executive functions, i.e., working memory, time perception, initiation, and motor control of executed task. The incongruent task increased demand on executive functions, and besides the functions common for both tasks, an inhibition of automatic responses, the reversal of incorrect response tendency, the internal ordering of the correct response, and the initiation of the target-induced correct response were involved. In seven epilepsy surgery candidates (four men and three women), ranging in age from 26 to 38 years, multicontact depth electrodes were implanted in 590 cortical sites. In the two tasks, the P3-like potential sources were displayed in the mesial temporal structures, the lateral temporal neocortex, the anterior and posterior cingulate, the orbitofrontal cortex, and dorsolateral prefrontal cortex. The P3-like potentials occurred more frequently with the incongruent than with congruent stimuli in all these areas. This more frequent occurrence of P3 sources elicited by the incongruent task appeared significant in temporal lateral neocortex and orbitofrontal cortex. The executive functions are processed in a widespread frontotemporal neurocognitive network. This study confirms the involvement of the temporal neocortex in the executive functions.

Predictive information processing in the brain: errors and response monitoring

The monitoring of one's own actions is essential for adjusting behavior. In particular, response errors are important events that require behavioral adjustments. Correct and incorrect responses, as well as feedback to responses, are followed by brain activity originating mainly in the anterior cingulate, which can be measured with fMRI and event-related potential (ERP) techniques. After each response a small negativity (Nc or CRN) is elicited in the ERP, which is strongly enhanced in incorrect trials (Ne or ERN). Following feedback stimuli that signal a negative outcome of an action, a similar negativity, the feedback-related negativity (FRN) is elicited. Recently it has been shown that these neurophysiological correlates of response monitoring and evaluation can be classified even on the single-trial level in the EEG and thus could be utilized not only to distinguish between correct and erroneous actions, but also can be used online for a wide range of applications such as prediction of clinical outcomes or brain computer interfaces.

Freezing of Gait in Parkinson Disease Is Associated With Impaired Conflict Resolution

Background. Freezing of gait (FOG) in Parkinson disease (PD) may involve executive dysfunction. This study examined whether executive functioning and attention are more affected in patients with FOG compared with those without and determined whether these processes are influenced by anti-Parkinson medication. Methods. A total of 11 PD patients with FOG, 11 without FOG, and 10 healthy control subjects, matched for age, gender, and education, participated. General motor, mental and cognitive screening tests, as well as specific neuropsychological assessment of executive functions and the Attention Network Test (ANT) were administered. The ANT was conducted in both ON and OFF phases in a counterbalanced design to determine medication-specific effects. Results. FOG showed a clear association with impairment in the executive control network for conflict resolution (inhibition of unwanted responses and impaired response selection), compared with nonfreezers and healthy controls, F(2, 28) = 5.41, P = .01. Orienting and alerting function did not differ between groups, F < 1. Other executive functions, such as abstract problem solving and mental flexibility were not associated with FOG ( P > .10). Anti-Parkinson medication did not ameliorate conflict resolution ( P > .10), although orienting attention improved with medication, F(1, 17) = 9.81, P < .01. Conclusions. This study shows an association between impaired conflict resolution and FOG, important in understanding the interplay between cognitive and motor problems, which can lead to specific rehabilitation strategies.

Variations in the TNF-α Gene (TNF-α -308G→A) Affect Attention and Action Selection Mechanisms in a Dissociated Fashion

There is growing interest to understand the molecular basis of complex cognitive processes. While neurotransmitter systems have frequently been examined, other, for example neuroimmunological factors have attracted much less interest. Recent evidence suggests that the A allele of the tumor necrosis factor alpha (TNF-α) 308G→A single nucleotide polymorphism (SNP; rs1800629) enhances cognitive functions. However, it is also known that TNF-α exerts divergent, region-specific effects on neuronal functioning. Thus the finding that the A allele is associated with enhanced cognitive performance may be due to regionally specific effects of TNF-α. In this study, associations between the TNF-α −308G→A single nucleotide polymorphism (rs1800629) and cognitive function in an event-related potential (ERP) study in healthy participants ( n = 96) are investigated. We focus on subprocesses of stimulus-response compatibility that are known to be mediated by different brain systems. The results show a dissociative effect of the TNF- 308G→A SNP on ERPs reflecting attentional (N1) versus conflict and action selection processes [N2 and early-lateralized readiness potential (e-LRP)] between the AA/AG and the GG genotypes. Compared with the GG genotype group, attentional processes (N1) were enhanced in the combined AA/AG genotype group, while conflict processing functions (N2) and the selection of actions (LRP) were reduced. The results refine the picture of the effects of the TNF-α −308G→A SNP on cognitive functions and emphasize the known divergent effects of TNF-α on brain functions.

The effect of Parkinson's disease on the dynamics of on-line and proactive cognitive control during action selection

Processing irrelevant visual information sometimes activates incorrect response impulses. The engagement of cognitive control mechanisms to suppress these impulses and make proactive adjustments to reduce the future impact of incorrect impulses may rely on the integrity of frontal-basal ganglia circuitry. Using a Simon task, we investigated the effects of basal ganglia dysfunction produced by Parkinson's disease (PD) on both on-line (within-trial) and proactive (between-trial) control efforts to reduce interference produced by the activation of an incorrect response. As a novel feature, we applied distributional analyses, guided by the activation-suppression model, to differentiate the strength of incorrect response activation and the proficiency of suppression engaged to counter this activation. For situations requiring on-line control, PD (n = 52) and healthy control (n = 30) groups showed similar mean interference effects (i.e., Simon effects) on reaction time (RT) and accuracy. Distributional analyses showed that although the strength of incorrect response impulses was similar between the groups PD patients were less proficient at suppressing these impulses. Both groups demonstrated equivalent and effective proactive control of response interference on mean RT and accuracy rates. However, PD patients were less effective at reducing the strength of incorrect response activation proactively. Among PD patients, motor symptom severity was associated with difficulties in on-line, but not in proactive, control of response impulses. These results suggest that basal ganglia dysfunction produced by PD has selective effects on cognitive control mechanisms engaged to resolve response conflict, with primary deficits in the on-line suppression of incorrect responses occurring in the context of a relatively spared ability to adjust control proactively to minimize future conflict.

Effects of aging, Parkinson's disease, and dopaminergic medication on response selection and control

We examined effects of short-term and long-term dopaminergic medication in Parkinson's disease on conflict monitoring or response selection processes. These processes were examined using event-related potentials (ERPs), while subjects performed a stimulus-response (S-R) compatibility task. An extended sample of young and elderly controls, Parkinson's disease patients with a medication history (PDs) and initially diagnosed, drug-naïve de novo PD patients (de novo PDs) were enrolled. Both PD groups were measured twice (on and off-medication or before and 8 weeks after medication onset). The results show that dopaminergic intervention selectively reduced the pathologically enhanced response selection in compatible S-R relations. This medication effect was already evident after short-term treatment, not differing from long-term treatment and performance in elderly controls. Contrary, age-related attenuations of the N2 in incompatible S-R relations, probably reflecting impaired conflict processing or response control, are unaffected by medication. The results suggest that compatible and incompatible S-R relations demand different neuronal mechanisms within the basal ganglia, as only the former are affected by agonizing the dopaminergic system.

The effect of speed-accuracy strategy on response interference control in Parkinson's disease

Studies that used conflict paradigms such as the Eriksen Flanker task show that many individuals with Parkinson's disease (PD) have pronounced difficulty resolving the conflict that arises from the simultaneous activation of mutually exclusive responses. This finding fits well with contemporary views that postulate a key role for the basal ganglia in action selection. The present experiment aims to specify the cognitive processes that underlie action selection deficits among PD patients in the context of variations in speed-accuracy strategy. PD patients (n=28) and healthy controls (n=17) performed an arrow version of the flanker task under task instructions that either emphasized speed or accuracy of responses. Reaction time (RT) and accuracy rates decreased with speed compared to accuracy instructions, although to a lesser extent for the PD group. Differences in flanker interference effects among PD and healthy controls depended on speed-accuracy strategy. Compared to the healthy controls, PD patients showed larger flanker interference effects under speed stress. RT distribution analyses suggested that PD patients have greater difficulty suppressing incorrect response activation when pressing for speed. These initial findings point to an important interaction between strategic and computational aspects of interference control in accounting for cognitive impairments of PD. The results are also compatible with recent brain imaging studies that demonstrate basal ganglia activity to co-vary with speed-accuracy adjustments.

The effect of Parkinson's disease on interference control during action selection

Basal ganglia structures comprise a portion of the neural circuitry that is hypothesized to coordinate the selection and suppression of competing responses. Parkinson's disease (PD) may produce a dysfunction in these structures that alters this capacity, making it difficult for patients with PD to suppress interference arising from the automatic activation of salient or overlearned responses. Empirical observations thus far have confirmed this assumption in some studies, but not in others, due presumably to considerable inter-individual variability among PD patients. In an attempt to help resolve this controversy, we measured the performance of 50 PD patients and 25 healthy controls on an arrow version of the Eriksen flanker task in which participants were required to select a response based on the direction of a target arrow that was flanked by arrows pointing in the same (congruent) or opposite (incongruent) direction. Consistent with previous findings, reaction time (RT) increased with incongruent flankers compared to congruent or neutral flankers, and this cost of incongruence was greater among PD patients. Two novel findings are reported. First, distributional analyses, guided by dual-process models of conflict effects and the activation-suppression hypothesis, revealed that PD patients are less efficient at suppressing the activation of conflicting responses, even when matched to healthy controls on RT in a neutral condition. Second, this reduced efficiency was apparent in half of the PD patients, whereas the remaining patients were as efficient as healthy controls. These findings suggest that although poor suppression of conflicting responses is an important feature of PD, it is not evident in all medicated patients.

Action monitoring in boys with attention-deficit/hyperactivity disorder, their nonaffected siblings, and normal control subjects: evidence for an endophenotype

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is a very common and highly heritable child psychiatric disorder associated with dysfunctions in fronto-striatal networks that control attention and response organization. The aim of this study was to investigate whether features of action monitoring related to dopaminergic functions represent endophenotypes that are brain functions on the pathway from genes and environmental risk factors to behavior.

METHODS

Action monitoring and error processing as indicated by behavioral and electrophysiological parameters during a flanker task were examined in boys with ADHD combined type according to DSM-IV (n = 68), their nonaffected siblings (n = 18), and healthy control subjects with no known family history of ADHD (n = 22).

RESULTS

Boys with ADHD displayed slower and more variable reaction-times. Error negativity (Ne) was smaller in boys with ADHD compared with healthy control subjects, whereas nonaffected siblings displayed intermediate amplitudes following a linear model predicted by genetic concordance. The three groups did not differ on error positivity (Pe). The N2 amplitude enhancement due to conflict (incongruent flankers) was reduced in the ADHD group. Nonaffected siblings also displayed intermediate N2 enhancement.

CONCLUSIONS

Converging evidence from behavioral and event-related potential findings suggests that action monitoring and initial error processing, both related to dopaminergically modulated functions of anterior cingulate cortex, might be an endophenotype related to ADHD.

Stimulus-Response Compatibility in Huntington's Disease: A Cognitive-Neurophysiological Analysis

The basal ganglia are assumed to be of importance in action/response selection, but results regarding the importance are contradictive. We investigate these processes in relation to attentional processing using event-related potentials (ERPs) in Huntington's disease (HD), an autosomal genetic disorder expressed by degeneration of the basal ganglia, using a flanker task. A symptomatic HD group, a presymptomatic HD group (pHD), and healthy controls were examined. In the behavioral data, we found a general response slowing in HD while the compatibility effect was the same for all groups. The ERP data show a decrease of the N1 on the flanker in HD and pHD; this suggests deficient attentional processes. The N1 on the target was unaffected, suggesting that the attentional system in HD is not entirely deficient. The early lateralized readiness potential (LRP), reflecting automatic response activation due to the flankers, was unchanged, whereas the late LRP, reflecting controlled response selection due to the target information, was delayed in HD. Thus levels of action-selection processes are differentially affected in HD with automatic processes seeming to be more robust against neurodegeneration. The N2, usually associated with conflict processing, was reduced in the HD but not in the pHD and the control groups. Because the N2 was related to the LRP and reaction times in all groups, the N2 may generally not be related to conflict but rather to controlled response selection, which is impaired in HD. Overall, the results suggest alterations in attentional control, conflict processing, and controlled response selection in HD but not in automatic response selection.