Physiological activation of a cortical network during performance of the Wisconsin Card Sorting Test: a positron emission tomography study

The Role of the Human Cerebellum for Learning from and Processing of External Feedback in Non-Motor Learning: A Systematic Review

This review aimed to systematically identify and comprehensively review the role of the cerebellum in performance monitoring, focusing on learning from and on processing of external feedback in non-motor learning. While 1078 articles were screened for eligibility, ultimately 36 studies were included in which external feedback was delivered in cognitive tasks and which referenced the cerebellum. These included studies in patient populations with cerebellar damage and studies in healthy subjects applying neuroimaging. Learning performance in patients with different cerebellar diseases was heterogeneous, with only about half of all patients showing alterations. One patient study using EEG demonstrated that damage to the cerebellum was associated with altered neural processing of external feedback. Studies assessing brain activity with task-based fMRI or PET and one resting-state functional imaging study that investigated connectivity changes following feedback-based learning in healthy participants revealed involvement particularly of lateral and posterior cerebellar regions in processing of and learning from external feedback. Cerebellar involvement was found at different stages, e.g., during feedback anticipation and following the onset of the feedback stimuli, substantiating the cerebellum's relevance for different aspects of performance monitoring such as feedback prediction. Future research will need to further elucidate precisely how, where, and when the cerebellum modulates the prediction and processing of external feedback information, which cerebellar subregions are particularly relevant, and to what extent cerebellar diseases alter these processes.

Impaired cognitive flexibility and disrupted cognitive cerebellum in degenerative cerebellar ataxias

There is a clinically unmet need for a neuropsychological tool that reflects the pathophysiology of cognitive dysfunction in cerebellar degeneration. We investigated cognitive flexibility in degenerative cerebellar ataxia patients and aim to identify the pathophysiological correlates of cognitive dysfunction in relation to cerebellar cognitive circuits. We prospectively enrolled degenerative cerebellar ataxia patients with age-matched healthy controls who underwent 3 T 3D and resting-state functional MRI. All 56 participants were evaluated with the Scale for Assessment and Rating of Ataxia and neuropsychological tests including the Wisconsin Card Sorting Test, Trail Making Test, Montreal Cognitive Assessment and Mini-Mental State Examination. From MRI scans, we analysed the correlation of whole-brain volume and cortico-cerebellar functional connectivity with the Wisconsin Card Sorting Test performances. A total of 52 participants (29 ataxia patients and 23 healthy controls) were enrolled in this study. The Wisconsin Card Sorting Test scores (total error percentage, perseverative error percentage, non-perseverative error percentage and categories completed), Trail Making Test A and Montreal Cognitive Assessment were significantly impaired in ataxia patients (P < 0.05) compared to age-matched healthy controls. The Wisconsin Card Sorting Test error scores showed a significant correlation with the ataxia score (P < 0.05) controlling for age and sex. In volumetric analysis, the cerebellar right crus I, II, VIIb and VIII atrophy correlated with non-perseverative error percentage in the ataxia group. In functional connectivity analysis, the connectivity between crus I, II and VIIb of the cerebellum and bilateral superior parietal and superior temporal gyrus was significantly altered in ataxia patients. The functional connectivity between left crus II and VIIb of the cerebellum and dorsolateral prefrontal and superior frontal/parietal cortices showed a positive correlation with perseverative error percentage. The connectivity between left crus VIIb and pontine nucleus/middle cerebellar peduncle showed a significant negative correlation with non-perseverative error percentage in the ataxia group. The impaired cognitive flexibility represented by the Wisconsin Card Sorting Test was significantly impaired in degenerative cerebellar ataxia patients and correlated with disease severity. The Wisconsin Card Sorting Test performance reflects hypoactivity of the cognitive cerebellum and disrupted cortico-cerebellar connectivity in non-demented patients with degenerative cerebellar ataxia.

Longitudinal changes in global structural brain connectivity and cognitive performance in former hospitalized COVID-19 survivors: an exploratory study

BACKGROUND

Long-term sequelae of COVID-19 can result in reduced functionality of the central nervous system and substandard quality of life. Gaining insight into the recovery trajectory of admitted COVID-19 patients on their cognitive performance and global structural brain connectivity may allow a better understanding of the diseases' relevance.

OBJECTIVES

To assess whole-brain structural connectivity in former non-intensive-care unit (ICU)- and ICU-admitted COVID-19 survivors over 2 months following hospital discharge and correlate structural connectivity measures to cognitive performance.

METHODS

Participants underwent Magnetic Resonance Imaging brain scans and a cognitive test battery after hospital discharge to evaluate structural connectivity and cognitive performance. Multilevel models were constructed for each graph measure and cognitive test, assessing the groups' influence, time since discharge, and interactions. Linear regression models estimated whether the graph measurements affected cognitive measures and whether they differed between ICU and non-ICU patients.

RESULTS

Six former ICU and six non-ICU patients completed the study. Across the various graph measures, the characteristic path length decreased over time (β = 0.97, p = 0.006). We detected no group-level effects (β = 1.07, p = 0.442) nor interaction effects (β = 1.02, p = 0.220). Cognitive performance improved for both non-ICU and ICU COVID-19 survivors on four out of seven cognitive tests 2 months later (p < 0.05).

CONCLUSION

Adverse effects of COVID-19 on brain functioning and structure abate over time. These results should be supported by future research including larger sample sizes, matched control groups of healthy non-infected individuals, and more extended follow-up periods.

The neural correlates of value representation: From single items to bundles

One of the core questions in Neuro-economics is to determine where value is represented. To date, most studies have focused on simple options and identified the ventromedial prefrontal cortex (VMPFC) as the common value region. We report the findings of an fMRI study in which we asked participants to make pairwise comparisons involving options of varying complexity: single items (Control condition), bundles made of the same two single items (Scaling condition) and bundles made of two different single items (Bundling condition). We construct a measure of choice consistency to capture how coherent the choices of a participant are with one another. We also record brain activity while participants make these choices. We find that a common core of regions involving the left VMPFC, the left dorsolateral prefrontal cortex (DLPFC), regions associated with complex visual processing and the left cerebellum track value across all conditions. Also, regions in the DLPFC, the ventrolateral prefrontal cortex (VLPFC) and the cerebellum are differentially recruited across conditions. Last, variations in activity in VMPFC and DLPFC value-tracking regions are associated with variations in choice consistency. This suggests that value based decision-making recruits a core set of regions as well as specific regions based on task demands. Further, correlations between consistency and the magnitude of signal change with lateral portions of the PFC suggest the possibility that activity in these regions may play a causal role in decision quality.

A Scoping Review on Movement, Neurobiology and Functional Deficits in Dyslexia: Suggestions for a Three-Fold Integrated Perspective

Developmental dyslexia is a common complex neurodevelopmental disorder. Many theories and models tried to explain its symptomatology and find ways to improve poor reading abilities. The aim of this scoping review is to summarize current findings and several approaches and theories, focusing on the interconnectedness between motion, emotion and cognition and their connection to dyslexia. Consequently, we present first a brief overview of the main theories and models regarding dyslexia and its proposed neural correlates, with a particular focus on cerebellar regions and their involvement in this disorder. After examining different types of intervention programs and remedial training, we highlight the effects of a specific structured sensorimotor intervention named Quadrato Motor Training (QMT). QMT utilizes several cognitive and motor functions known to be relevant in developmental dyslexia. We introduce its potential beneficial effects on reading skills, including working memory, coordination and attention. We sum its effects ranging from behavioral to functional, structural and neuroplastic, especially in relation to dyslexia. We report several recent studies that employed this training technique with dyslexic participants, discussing the specific features that distinguish it from other training within the specific framework of the Sphere Model of Consciousness. Finally, we advocate for a new perspective on developmental dyslexia integrating motion, emotion and cognition to fully encompass this complex disorder.

Working Memory and Manual Dexterity in Dyslexic Children: A Systematic Review and Meta-Analysis

Dyslexic children have impairments in working memory and manual dexterity. Studies have shown that when cognitive development has deficits, motor development is often impaired, indicating a strong interconnection between both domains, and the possibility of interference with each other's proper functioning. Thus, a new literature review is necessary to understand which components of working memory and manual dexterity are affected in dyslexic children and the possible relationship between them. This review aimed to perform a systematic review and meta-analysis to analyze both skills in dyslexic children. The protocol was carried out according to the criteria established by PRISMA being registered at PROSPERO under number CRD 42021238901. Six literature databases were searched to locate studies published between 2001 and 2021: EMBASE, ERIC, ISI Web of Science, PubMed, PsycINFO, and Scopus. 21 studies met the inclusion criteria. The findings suggest that dyslexic children have significantly poorer visuospatial and verbal working memory with more impairments in the phonological loop. No significant differences were found in manual dexterity.

Flight training changes the brain functional pattern in cadets

Introduction

To our knowledge, this is the first study to use MRI (Magnetic Resonance Imaging) before and after an intensive flight training. This study aimed to investigate the effectiveness of flight training in civil flying cadets.

Methods

The civil flying cadets and controls completed two study visits. Visit 1 was performed in 2019, and high spatial resolution structural image and resting-state functional MRI data were collected. The second visit was completed in 2022. In addition to the MRI data mentioned above, participants completed the cognitive function assessment at the second visit.

Results

Mixed-effect regression model analysis found that flight training enhanced the degree centrality (DC) values of the left middle frontal gyrus and left lingual gyrus. The subsequent correlation calculation analysis suggested a possible relationship between these alterations and cognitive function.

Discussion

These results suggest that flight training might promote the DC value of the prefrontal and occipital cortices and, in turn, enhance their executive function.

Relationship Between Gross Motor Skills and Inhibitory Control in Preschool Children: A Pilot Study

Purpose

Gross motor skills (GMS) and inhibitory control (IC) which are both development in preschool stage is significant for preschooler to healthy growth. However, the evidence of relationship between them in preschoolers are still insufficient, most of studies only focus on youth. Thus, the aim of this research is to examine the association between GMS and IC in preschool children.

Methods

This cross-sectional study used baseline data from a previous intervention study of preschoolers conducted in 2018. GMS were assessed by using the Test for Gross Motor Development (2nd edition) in preschoolers, which includes two subtests of locomotor and object control skills. Total GMS is calculated from the sum of these two subtests. The Fish Flanker task was used to evaluate both accuracy and reaction time of IC. Multivariate linear regression models were established to analyze the relationships between GMS and IC.

Results

A total of 123 preschool-age children (55 girls, 68 boys) were included in the final analysis. After adjusting for confounders, GMS (β = −8.27 ms, 95%CI: −14.2, −2.34), locomotor (β = −11.2 ms, 95%CI: −21.43, −0.97), and object control skills (β = −12.15 ms, 95%CI: −22.07, −2.23) were all negatively related with reaction time of IC.

Conclusion

There was a significant negative correlation between gross motor skills and the reaction time of inhibitory control in preschool children. Further research is needed to verify this finding in prospective and experimental studies.

The effectiveness of high-frequency left DLPFC-rTMS on depression, response inhibition, and cognitive flexibility in female subjects with major depressive disorder

BACKGROUND

The purpose of the present study was to investigate the effect of high-frequency repetitive transcranial magnetic stimulation on depression severity, response inhibition, and cognitive flexibility in subjects with major depressive disorder.

METHODS

Twenty-eight female subjects with major depressive disorder were randomly divided into experimental and control groups. High frequency (20 Hz) rTMS stimulation at 85% of the MT consisted of 25 trains of 5 s duration, a total of 2500 pulses/session or sham stimulation was applied over the left DLPFC for five consecutive days per week, for two weeks. Depression severity, response inhibition, and cognitive flexibility of subjects were assessed by Beck Depression Inventory, Go/NoGo, and Wisconsin sort cards (WCST) tests, respectively, pre- and post-TMS intervention.

RESULTS

rTMS over the left DLPFC significantly decreased the depression severity at the Beck Depression Inventory, enhanced accuracy, and decreased reaction time at the Go/NoGo task. In the Wisconsin Card Sort Test, perseverative and non-perseverative errors and failure to maintain a set index significantly decreased following rTMS treatment.

CONCLUSIONS

Findings indicate that 20-Hz rTMS treatment on the left DLPFC has a positive effect on depression severity, response inhibition, and cognitive flexibility in depressed subjects.

The Relationship between Executive Functions and Gross Motor Skills in Rural Children Aged 8–10 Years

Considering that cognitive and motor dimensions of human beings grow together, and that primary school age is one of the most important stages of children’s cognitive and motor development, the aim of this study was to investigate the relationship between executive functions and gross motor skills in rural children aged 8–10 years. This descriptive and correlational research was conducted with 93 Iranian rural primary school children aged 8 to 10 years. A Behavior Rating Inventory of Executive Function (BRIEF) questionnaire and the Test of Gross Motor Development, second edition (TGMD-2) were used to collect data on executive functions and gross motor skills, respectively. The results showed that most of the correlations between criterion and predictor variables were moderate. In the regression results we observed that among the components of executive functions, inhibition, working memory, planning/organizing, and organization had a significant relationship with gross motor skills, but no relationship was found between other components and motor skills. As a result, it can be said that in predicting cognitive development and specifically mentioned executive functions, gross motor skills are an important and effective factor among rural children and, given the importance of cognitive development and executive functions in childhood, it seems that by helping to develop their gross motor skills, executive functions will also be strengthened. Finally, possible future studies are addressed, which could investigate the effect of different aspects of motor skill classifications on executive functions.

Relationship between motor learning and gambling propensity in Parkinson's disease

INTRODUCTION

The basal ganglia and related dopaminergic cortical areas are important neural systems underlying motor learning and are also implicated in impulse control disorders (ICDs). Motor learning impairments and ICDs are frequently observed in Parkinson's disease (PD). Nevertheless, the relationship between motor learning ability and ICDs has not been elucidated.

METHODS

We examined the relationship between motor learning ability and gambling propensity, a possible symptom for prodromal ICDs, in PD patients. Fifty-nine PD patients without clinical ICDs and 43 normal controls (NC) were administered a visuomotor rotation perturbation task and the Iowa Gambling Task (IGT) to evaluate motor learning ability and gambling propensity, respectively. Participants also performed additional cognitive assessments and underwent brain perfusion SPECT imaging.

RESULTS

Better motor learning ability was significantly correlated with lower IGT scores, i.e., higher gambling propensity, in PD patients but not in NC. The higher scores on assessments reflecting prefrontal lobe function and well-preserved blood perfusion in prefrontal areas were correlated with lower IGT scores along with better motor learning ability.

CONCLUSIONS

Our findings suggest that better motor learning ability and higher gambling propensity are based on better prefrontal functions, which are in accordance with the theory that the prefrontal cortex is one of the common essential regions for both motor learning and ICDs.

Regional difference in prefrontal oxygenation before and during overground walking in humans: a wearable multichannel NIRS study

Using wireless multichannel near-infrared spectroscopy, regional difference in cortical activity over the prefrontal cortex (PFC) was examined before and during overground walking and in response to changes in speed and cognitive demand. Oxygenated-hemoglobin concentration (Oxy-Hb) as index of cortical activity in ventrolateral PFC (VLPFC), dorsolateral PFC (DLPFC), and frontopolar cortex (FPC) was measured in 14 subjects, whereas heart rate was measured as estimation of exercise intensity in six subjects. The impact of mental imagery on prefrontal Oxy-Hb was also explored. On both sides, Oxy-Hb in VLPFC, DLPFC, and lateral FPC was increased before the onset of normal-speed walking, whereas Oxy-Hb in medial FPC did not respond before walking onset. During the walking, Oxy-Hb further increased in bilateral VLPFC, whereas Oxy-Hb was decreased in DLPFC and lateral and medial FPC. Increasing walking speed did not alter the increase in Oxy-Hb in VLPFC but counteracted the decrease in Oxy-Hb in DLPFC (but not in lateral and medial FPC). Treadmill running evoked a greater Oxy-Hb increase in DLPFC (n = 5 subjects). Furthermore, increasing cognitive demand during walking, by deprivation of visual feedback, counteracted the decrease in Oxy-Hb in DLPFC and lateral and medial FPC, but it did not affect the increase in Oxy-Hb in VLPFC. Taken together, the profound and localized Oxy-Hb increase is a unique response for the VLPFC. The regional heterogeneity of the prefrontal Oxy-Hb responses to natural overground walking was accentuated by increasing walking speed or cognitive demand, suggesting functional distinction within the PFC.

Application of integrative physiological approach to evaluate human physiological responses to the inhalation of essential oils of Japanese citrus fruits iyokan (Citrus iyo) and yuzu (Citrus junos)

This study investigated the effects of essential oil odors from Japanese citrus fruits, iyokan (Citrus iyo) and yuzu (Citrus junos), on human psychology and both the autonomic and central nervous systems. The inhalation of both essential oils significantly increased miosis rate and fingertip temperature and could induce parasympathetic dominance by suppressing sympathetic nerve activity. Oxyhemoglobin concentration in the prefrontal cortex increased after the inhalation of yuzu essential oil and decreased after the inhalation of iyokan essential oil. Subjectively, the inhalation of both essential oils reduced the feelings of fatigue and improved the feelings of refreshment, suggesting that the effect of autonomic nervous activity might involve in these psychological changes directly. Moreover, we observed that task performance improved after inhaling yuzu essential oil, which may be due to the increase in oxyhemoglobin concentration in the prefrontal cortex.

Evaluation of the transient hypofrontality theory in the context of exercise: A systematic review with meta-analysis

Accumulating research suggests that, as a result of reduced neural activity in the prefrontal cortex (PFC), higher-order cognitive function may be compromised while engaging in high-intensity acute exercise, with this phenomenon referred to as the transient hypofrontality effect. However, findings in this field remain unclear and lack a thorough synthesis of the evidence. Therefore, the purpose of this meta-analysis was to evaluate the effects of in-task acute exercise on cognitive function, and further, to examine whether this effect is moderated by the specific type of cognition (i.e., PFC-dependent vs. non-PFC-dependent). Studies were identified by electronic databases in accordance with the PRISMA guidelines. In total, 22 studies met our inclusion criteria and intercept only meta-regression models with robust variance estimation were used to calculate the weighted average effect sizes across studies. Acute exercise at all intensities did not influence cognitive function (β = -0.16, 95% CI = [-0.58, 0.27], p = .45) when exercise occurred during the cognitive task, and no significant moderation effects emerged. However, there was evidence that cognitive task type (PFC-dependent vs. non-PFC-dependent) moderated the effect of high-intensity acute exercise on a concomitant cognitive performance (β = -0.81, 95% CI = [-1.60, -0.02], p = .04). Specifically, our findings suggest that PFC-dependent cognition is impaired while engaging in an acute bout of high-intensity exercise, providing support for the transient hypofrontality theory. We discuss these findings in the context of reticular-activating and cognitive-energetic perspectives.

Internal manipulation of perceptual representations in human flexible cognition: A computational model

Executive functions represent a set of processes in goal-directed cognition that depend on integrated cortical-basal ganglia brain systems and form the basis of flexible human behaviour. Several computational models have been proposed for studying cognitive flexibility as a key executive function and the Wisconsin card sorting test (WCST) that represents an important neuropsychological tool to investigate it. These models clarify important aspects that underlie cognitive flexibility, particularly decision-making, motor response, and feedback-dependent learning processes. However, several studies suggest that the categorisation processes involved in the solution of the WCST include an additional computational stage of category representation that supports the other processes. Surprisingly, all models of the WCST ignore this fundamental stage and they assume that decision making directly triggers actions. Thus, we propose a novel hypothesis where the key mechanisms of cognitive flexibility and goal-directed behaviour rely on the acquisition of suitable representations of percepts and their top-down internal manipulation. Moreover, we propose a neuro-inspired computational model to operationalise this hypothesis. The capacity of the model to support cognitive flexibility was validated by systematically reproducing and interpreting the behaviour exhibited in the WCST by young and old healthy adults, and by frontal and Parkinson patients. The results corroborate and further articulate the hypothesis that the internal manipulation of representations is a core process in goal-directed flexible cognition.

Recovery of consciousness and cognition after general anesthesia in humans

Understanding how the brain recovers from unconsciousness can inform neurobiological theories of consciousness and guide clinical investigation. To address this question, we conducted a multicenter study of 60 healthy humans, half of whom received general anesthesia for 3 hr and half of whom served as awake controls. We administered a battery of neurocognitive tests and recorded electroencephalography to assess cortical dynamics. We hypothesized that recovery of consciousness and cognition is an extended process, with differential recovery of cognitive functions that would commence with return of responsiveness and end with return of executive function, mediated by prefrontal cortex. We found that, just prior to the recovery of consciousness, frontal-parietal dynamics returned to baseline. Consistent with our hypothesis, cognitive reconstitution after anesthesia evolved over time. Contrary to our hypothesis, executive function returned first. Early engagement of prefrontal cortex in recovery of consciousness and cognition is consistent with global neuronal workspace theory.

False recognitions in short-term memory - Age-differences in neural activity

While the knowledge on age-related differences in susceptibility to episodic false memories is extensive, little is known about this phenomenon in visual short-term memory (STM). Our previous behavioural research indicated that older adults are more confident of their erroneous STM recognitions than young adults. However, unlike in episodic memory, we did not find support for older adults' higher rate of false alarms. To further understand this specific age-difference, here we investigated its neural correlates. First, the pattern of behavioural results replicated the one from our previous experiment. Second, younger adults, when compared to older adults, exhibited higher false recognition-related activity of the visual cortex, the anterior cingulate cortex, the frontal operculum/insular cortex as well as regions within the anterior and dorsolateral prefrontal cortex. No age-differences were observed in hippocampal activity. Third, younger but not older adults presented higher activity in the anterior cingulate cortex and the frontal operculum/insular cortex for false recognitions when compared to highly confident correct rejections. Finally, frontal activity was influenced by both the individuals' performance and their metacognitive abilities. The results suggest that age-related differences in confidence of STM false recognitions may arise from age-differences in performance monitoring and uncertainty processing rather than in hippocampal-mediated binding.

Cognition and Frailty in Patients With Heart Failure: A Systematic Review of the Association Between Frailty and Cognitive Impairment

Background/Aim: Pathological processes associated with aging increase the risk of cognitive deficits. Frailty syndrome may significantly accelerate these pathological processes in elderly patients with heart failure. The objective of this review was to better understand the association between frailty syndrome and co-occurring cognitive decline in patients with heart failure. Methods: We conducted a systematic review based on PubMed/MEDLINE, Scopus, EMBASE, and CINAHL as databases. The search followed the method described by Webb and Roe. For inclusions, the studies were selected employing cross-sectional and longitudinal designs. The included studies had to evaluate frailty syndrome and cognitive impairments among participants with heart failure. As we were interested in older adults, the search was limited to individuals >65 years of age. The search was limited to primary research articles written in English published since the year 2000. Results: Of the 1,245 studies retrieved by the systematic review, 8 relevant studies were enclosed for the full-text review. Our review revealed that most studies of patients with HF demonstrated evidence of an association between greater frailty and cognitive impairment. In particular, six studies reported evidence for the significant association between higher levels of frailty and cognitive impairment in patients with heart failure. The remaining two studies failed to find an association between frailty and cognitive impairment. Conclusions: The development of frailty and cognitive impairment in heart failure is particularly important because this cardiovascular disease is a common cause of both morbidity and mortality in the world. The results of this review fill the existing gap in the literature related to the identification of clinical factors linked with frailty syndrome that contribute to cognitive impairment in patients with a diagnosis of heart failure. The prevalence of overlapping frailty and cognitive impairment in patients with heart failure, therefore, necessitates a routine assessment of these components in the care of patients with cardiovascular disease.

Theta activity from frontopolar cortex, mid-cingulate cortex and anterior cingulate cortex shows different roles in cognitive planning performance

Cognitive planning, the ability to develop a sequenced plan to achieve a goal, plays a crucial role in human goal-directed behavior. However, the specific role of frontal structures in planning is unclear. We used a novel and ecological task, that allowed us to separate the planning period from the execution period. The spatio-temporal dynamics of EEG recordings showed that planning induced a progressive and sustained increase of frontal-midline theta activity (FMθ) over time. Source analyses indicated that this activity was generated within the prefrontal cortex. Theta activity from the right mid-Cingulate Cortex (MCC) and the left Anterior Cingulate Cortex (ACC) were correlated with an increase in the time needed for elaborating plans. On the other hand, left Frontopolar cortex (FP) theta activity exhibited a negative correlation with the time required for executing a plan. Since reaction times of planning execution correlated with correct responses, left FP theta activity might be associated with efficiency and accuracy in making a plan. Associations between theta activity from the right MCC and the left ACC with reaction times of the planning period may reflect high cognitive demand of the task, due to the engagement of attentional control and conflict monitoring implementation. In turn, the specific association between left FP theta activity and planning performance may reflect the participation of this brain region in successfully self-generated plans.

Slow electroencephalographic oscillations and behavioral measures as predictors of high executive processing in early postmenopausal females: A discriminant analysis approach

Decline in cognitive function is frequent in early postmenopause. There are postmenopausal females who show high performance while others display low performance in executive function, modulated by the prefrontal cortex. These differences have led to confusing and inconclusive results, which have not been explained entirely by the decline in estrogens, which affect the prefrontal cortex functions. An analysis of brain function and the application of a discriminant analysis can help to clarify the deficits in executive function shown by some postmenopausal females. The objective was to examine electroencephalographic recording during the performance of an executive function test in early postmenopausal females, ten with a high level of performance and ten with a low level of performance. Absolute power of delta, theta, alpha1, alpha2, beta1 and beta2 and the numbers of completed categories, trials, perseverative errors and overall errors were submitted to stepwise discriminant analysis to identify predictor variables. Four predictors emerged as significant of group membership based on cognitive performance, with the high-performance group characterized by more completed categories, more delta power, less theta power and more alpha1 power. These findings suggest that postmenopausal females classified in the high-performance group displayed appropriate temporary activation in slow oscillations during executive processing.

The effect of bilateral high frequency repetitive transcranial magnetic stimulation on cognitive functions in schizophrenia

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Despite their major effects on positive symptoms, antipsychotics do not have a significant effect on cognition in schizophrenia

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Bilateral high frequency rTMS targeting dorsolateral prefrontal cortices has been effective on working memory

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Bilateral 20 Hz rTMS improved attention and verbal working memory in schizophrenia patients,

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It also improved the competence of switching the perceptional set up under a disruptive effect towards new instructions, in this study

Dynamic Changes in EEG Power Spectral Densities During NIH-Toolbox Flanker, Dimensional Change Card Sort Test and Episodic Memory Tests in Young Adults

Much is known about electroencephalograph (EEG) patterns during sleep, but until recently, it was difficult to study EEG patterns during conscious, awake behavior. Technological advances such as powerful wireless EEG systems have led to a renewed interest in EEG as a clinical and research tool for studying real-time changes in the brain. We report here the first normative study of EEG activity while healthy young adults completed a series of cognitive tests recently published by the National Institutes of Health Toolbox Cognitive Battery (NIH-TCB), a commonly-used standardized measure of cognition primarily used in clinical populations. In this preliminary study using a wireless EEG system, we examined power spectral density (PSD) in four EEG frequency bands. During baseline and cognitive testing, PSD activity for the lower frequency bands (theta and alpha) was greater, relative to the higher frequency bands (beta and gamma), suggesting participants were relaxed and mentally alert. Alpha, beta and gamma activity was increased during a memory test compared to two other, less demanding executive function tests. Gamma activity was also inversely correlated with performance on the memory test, consistent with the neural efficiency hypothesis which proposes that better cognitive performance may link with lower cortical energy consumption. In summary, our study suggests that cognitive performance is related to the dynamics of EEG activity in a normative young adult population.

"Placebo by Proxy" and "Nocebo by Proxy" in Children: A Review of Parents' Role in Treatment Outcomes

The "placebo (effect) by proxy" (PbP) concept, introduced by Grelotti and Kaptchuk (1), describes a positive effect of a patient's treatment on persons in their surrounding such as family members or healthcare providers, who feel better because the patient is being treated. The PbP effect is a complex dynamic phenomenon which attempts to explain a change in treatment outcome arising from an interaction between a patient and an effect from proxies such as parents, caregivers, physicians or even the media. By extension the effect of the proxy can also have a negative or adverse effect whereby a proxy feels worse when a patient is treated, giving rise to the possibility of a "nocebo (effect) by proxy" (NbP), and by extension can influence a patient's treatment response. While this has yet to be systematically investigated, such an effect could occur when a proxy observes that a treatment is ineffective or is perceived as causing adverse effects leading the patient to experience side effects. In this narrative review, we take these definitions one step further to include the impact of PbP/NbP as they transform to affect the treatment outcome for the patient or child being treated, not just the people surrounding the individual being treated. Following a systematic search of literature on the subject using the Journal of Interdisciplinary Placebo Studies (JIPS) database (https://jips.online) and PubMed (NCBI) resulted in very few relevant studies, especially in children. The effect of PbP per se has been studied in parents and their children for temper tantrums, acupuncture for postoperative symptoms, as well as for neuroprotection in very preterm-born infants. This paper will review the PbP/NbP concepts, show evidence for its presence in children's treatment outcome and introduce clinical implications. We will also offer suggestions for future research to further our understanding of the role of the proxy in promoting or distracting from treatment benefit in children. Increasing an appreciation of the PbP and NbP phenomena and the role of the proxy in children's treatment should improve research study design and ultimately harness them to improve clinical child healthcare.

Sequence Variation Associated with SLC12A5 Gene Expression Is Linked to Brain Structure and Function in Healthy Adults

A single-nucleotide polymorphism in the promoter region of the Matrix Metalloproteinase-9 (MMP9) gene, rs3918242, has been shown to affect MMP9 expression in macrophages and was associated with schizophrenia by two independent groups. However, rs3918242's effects on MMP9 expression were not replicable in cell lines or brain tissue. Additionally, publically available data indicate that rs3918242 genotype is related not to MMP9 expression, but rather to expression of SLC12A5, a nearby gene coding for a K+/Cl- cotransporter, whose expression has also been related to schizophrenia. Here, we studied brain structure and function in healthy participants stratified by rs3918242 genotype using structural MRI (N = 298), functional MRI during an N-back working memory task (N = 554), and magnetoencephalography (MEG) during the same task (N = 190). We found rs3918242 was associated with gray matter volume (GMV) in the insula and dorsolateral prefrontal cortex bilaterally, closely replicated in discovery and replication samples; and with inferior parietal lobule (IPL) GMV when the samples were meta-analytically combined. Additionally, using both fMRI and MEG, rs3918242 was associated with right IPL working memory-related activation, replicated in two cohorts and across imaging modalities. These convergent results provide further impetus for examinations of the relationship of SLC12A5 with brain structure and function in neuropsychiatric disease.

Beyond consensus: Embracing heterogeneity in curated neuroimaging meta-analysis

Coordinate-based meta-analysis can provide important insights into mind-brain relationships. A popular approach for curated small-scale meta-analysis is activation likelihood estimation (ALE), which identifies brain regions consistently activated across a selected set of experiments, such as within a functional domain or mental disorder. ALE can also be utilized in meta-analytic co-activation modeling (MACM) to identify brain regions consistently co-activated with a seed region. Therefore, ALE aims to find consensus across experiments, treating heterogeneity across experiments as noise. However, heterogeneity within an ALE analysis of a functional domain might indicate the presence of functional sub-domains. Similarly, heterogeneity within a MACM analysis might indicate the involvement of a seed region in multiple co-activation patterns that are dependent on task contexts. Here, we demonstrate the use of the author-topic model to automatically determine if heterogeneities within ALE-type meta-analyses can be robustly explained by a small number of latent patterns. In the first application, the author-topic modeling of experiments involving self-generated thought (N = 179) revealed cognitive components fractionating the default network. In the second application, the author-topic model revealed that the left inferior frontal junction (IFJ) participated in multiple task-dependent co-activation patterns (N = 323). Furthermore, the author-topic model estimates compared favorably with spatial independent component analysis in both simulation and real data. Overall, the results suggest that the author-topic model is a flexible tool for exploring heterogeneity in ALE-type meta-analyses that might arise from functional sub-domains, mental disorder subtypes or task-dependent co-activation patterns. Code for this study is publicly available (https://github.com/ThomasYeoLab/CBIG/tree/master/stable_projects/meta-analysis/Ngo2019_AuthorTopic).

The Relationship between Mismatch Negativity and the COMTVal108/158Met Genotype in Schizophrenia

Mismatch negativity (MMN) is a component of auditory event-related potentials that reflects automatic change detection in the brain, showing qualities of endophenotypes in schizophrenia. MMN deficiency is one of the robust findings in patients, and it reflects both cognitive and functional decline. Catechol-o-methyltransferase (COMT) is a key enzyme involved in regulating dopamine transmission within the prefrontal cortex. A preliminary study suggested that the COMTVal108/158Met genotype (rs4680) is related to cognitive function in schizophrenia. Both the COMTVal108/158Met genotype and MMN are related to cognitive function, but no studies have reported on the relationship between MMN and the COMTVal108/158Met genotype in schizophrenia. This study therefore examined the relationship between COMTVal108/158Met genotype and MMN. The duration of MMN was measured, and the COMTVal108/158Met polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism in 49 Japanese schizophrenia patients (Val/Val, n = 21; Met carriers, n = 28). Amplitude and latency of MMN were compared between Val/Val and Met carriers.

PET imaging of dopamine release in the frontal cortex of manganese-exposed non-human primates

Humans and non-human primates exposed to excess levels of manganese (Mn) exhibit deficits in working memory and attention. Frontal cortex and fronto-striatal networks are implicated in working memory and these circuits rely on dopamine for optimal performance. Here, we aimed to determine if chronic Mn exposure alters in vivo dopamine release (DAR) in the frontal cortex of non-human primates. We used [¹¹ C]-FLB457 positron emission tomography with amphetamine challenge to measure DAR in Cynomolgus macaques. Animals received [¹¹ C]-FLB457 positron emission tomography scans with and without amphetamine challenge prior to Mn exposure (baseline), at different time points during the Mn exposure period, and after 10 months of Mn exposure cessation. Four of six Mn-exposed animals expressed significant impairment of frontal cortex in vivo DAR relative to baseline. One Mn animal had no change in DAR and another Mn animal expressed increased DAR relative to baseline. In the reversal studies, one Mn-exposed animal exhibited complete recovery of DAR while the second animal had partial recovery. In both animals, frontal cortex Mn concentrations normalized after 10 months of exposure cessation based on T1-weighted magnetic resonance imaging. D1-dopamine receptor (D1R) autoradiography in frontal cortex tissue indicates that Mn animals that experienced cessation of Mn exposure expressed D1R levels that were approximately 50% lower than Mn animals that did not experience cessation of Mn exposure or control animals. The present study provides evidence of Mn-induced alterations in frontal cortex DAR and D1R that may be associated with working memory and attention deficits observed in Mn-exposed subjects.

Cerebellar Gray Matter Volume, Executive Function, and Insomnia: Gender Differences in Adolescents

The cerebellum is an important region responsible for adolescent cognitive function and sleep, and their correlation is expected to show different patterns depending on age and gender. We examined the regional cerebellar gray matter volume (GMV), executive function (EF) and insomnia symptoms to identify their correlation and gender differences in adolescents. Data for a total of 55 subjects' (M = 31, F = 24, 14.80 ± 1.39 years old) were analyzed. The correlations between cerebellar regional GMV and Wisconsin card sorting test (WCST) subcategories showed that EF was better with larger GMV both in males and females. Far more overall correlations with cerebellar regions were observed in boys, with corresponding correlation strength being higher, and differences in localization were also observed in contrast to girls. Larger cerebellar GMV corresponded to better EF in adolescents. Insomnia did not influence the correlations between cerebellar regional GMV and EF, but more severe insomnia in boys correlated to smaller GMV in the right flocculonodular lobe. These results might implicate that the adolescent cerebellum is involved differently in EF dependent on gender.

Model-based lesion mapping of cognitive control using the Wisconsin Card Sorting Test

The role of the frontal lobes in cognition and behavior has long been enigmatic. Over the past decade, computational models have provided a powerful approach to understanding cognition and decision-making. Here, we used a model-based approach to analyze data from a classical task used to assess frontal lobe function, the Wisconsin Card Sorting Test. We applied computational modeling and voxel-based lesion-symptom mapping in 328 patients with focal lesions, to uncover cognitive processes and neural correlates of test scores. Our results reveal that lesions in the right prefrontal cortex are associated with elevated perseverative errors and reductions in the model parameter of sensitivity to punishment. These findings indicate that the capacity to flexibly switch between task sets requires the detection of contingency changes, which are enabled by a sensitivity to punishment that reduces perseverative errors. We demonstrate the power of model-based approaches in understanding patterns of deficits on classical neuropsychological tasks.

The frontal cortex is involved in cognitive control, e.g. cognitive flexibility and behavioral inhibition, but the roles of frontal subdivisions are unclear. Here, the authors used computational modelling of cognitive control task performance to map lesions responsible for impairments in specific cognitive operations.

NMDA receptors of blood lymphocytes anticipate cognitive performance variations in healthy volunteers

Working memory (WM) system, temporarily stores information and uses this information for complex cognitive tasks. WM connects memory, emotional feelings and perception. Evidence compelling that N-methyl d-aspartate receptor (NMDAR) expression relatively affect WM performance in animal models. It has been suggested some peripheral blood lymphocyte's (PBL) receptors are similar with neuronal receptors in the brain, so we measured PBL's receptors changes as a marker of the neuronal receptor. In this study, we examined one hundred adult men with Wisconsin Card Sorting Test (WCST) as a tool for primary screening for executive function (EF) which include WM. Then, we selected fifty individuals with high and low WCST scores. With digit span and symmetry span tasks, we screened 20 samples for high WM group and 19 samples for low WM group. After separating PBL, we measured mRNA expression level changes in NMDAR subunits with Reverse transcription-polymerase chain reaction method. We demonstrated that GluN2D increased and GluN3A decreased in individuals with high WM compared with the low WM (P < .01 and P < .001, respectively). The expression levels of GluN2A, GluN2B, and GluN3B were not altered between two groups (P > .05). Modifying the PBL receptors could be future approaches to defend memory loss and concentrate the senses over WM-related processes in physiological and pathological statuses. We hypothesized that increasing in GluN2 subunits and decreasing in GluN3 subunits led to improving current via NMDAR and subsequently affect WM.

The neurocognitive nature of children with ADHD comorbid sluggish cognitive tempo: Might SCT be a disorder of vigilance?

Sluggish Cognitive Tempo (SCT) refers to a clinical construct including several symptoms such as sluggishness, absentmindedness, low energy. In the present study, we compared neurocognitive laboratory outcomes of ADHD children with or without SCT.

METHOD

The CNS Vital Signs Battery was utilized to measure neurocognitive measure of the participants. The SCT+ADHD group comprised of 42 subjects, ADHD group was 41 subjects and control group was 24 subjects.

RESULTS

The cognitive flexibility score was found to be more severely impaired in ADHD children with SCT in comparison to the ADHD-only. Additionally, greater deficits in the Shifting Attention Test (p = 0.014) and the Continuous Performance Test (reaction time score, p < 0.01) were found in the SCT+ADHD group relative to ADHD group. Processing speed, visual/auditory memory, psychomotor speed and reaction time were not found to more impaired in those comorbid with SCT.

CONCLUSION

Impairments in the cognitive flexibility and more specifically shifting attention and continuous performance may be indicative of vigilance and orientation problems rather than executive functions for the SCT construct.

Age-related decline in cognitive flexibility in female chimpanzees

Data on cognitive aging in chimpanzees are extremely sparse, yet can provide an invaluable phylogenetic perspective, especially because Alzheimer disease (AD)-like neuropathology has recently been described in the oldest chimpanzee brains. This finding underscores the importance of data on cognitive aging in this fellow hominin, our closest biological relative. We tested 30 female chimpanzees, 12-56 years old, on a computerized analog of the Wisconsin Card Sort test. This test assesses cognitive flexibility, which is severely impaired in normal aging and AD. Subjects selected stimuli according to color or shape; the rewarded dimension (i.e., color or shape) switched without warning and the chimpanzee had to adapt her responses accordingly. We found that increasing age was associated with an increased number of perseverative errors and an increased number of trials to reach criterion in each switching dimension. The number of aborted trials was similar across age groups. These data show that similar to humans, chimpanzees show a clear age-related decline in cognitive flexibility that is already observed at middle age.

Bilateral Transcranial Magnetic Stimulation on DLPFC Changes Resting State Networks and Cognitive Function in Patients With Bipolar Depression

Introduction: Bipolar patients have abnormalities in cognitive functions and emotional processing. Two resting state networks (RSNs), the default mode network (DMN) and the sensorimotor network (SMN), play a decisive role in these two functions. Dorsolateral prefrontal cortex (DLPFC) is one of the main areas in the central executive network (CEN), which is linked to the activities of each of the two networks. Studies have found DLPFC abnormalities in both hemispheres of patients with bipolar depression. We hypothesized that the bilateral repetitive transcranial magnetic stimulation (rTMS) of DLPFC would produce changes in the activity of both the SMN and DMN as well as relevant cognitive function in patients with bipolar depression that responded to treatment.

Methods: 20 patients with bipolar depression underwent 10 sessions of 1 Hz rTMS on right DLPFC with subsequent 10 Hz rTMS on left DLPFC. Changes in electroencephalography resting networks between pre and post rTMS were evaluated utilizing low-resolution electromagnetic tomography (eLORETA). Depression symptom was assessed using the Beck Depression Inventory (BDI-II) and cognitive function was assessed by Verbal Fluency Test (VFT), Rey Auditory Verbal Learning Test (RAVLT), Stroop Test, and Wisconsin Card Sorting Test (WCST).

Results: Responders to rTMS showed significantly lower DMN activity at baseline and a significant decrease in SMN connectivity after treatment. Non-responders did not significantly differ from the control group at the baseline and they showed higher activity in the SMN, visual network, and visual perception network compared to control group following treatment. Bilateral rTMS resulted in significant changes in the executive functions, verbal memory, and depression symptoms. No significant changes were observed in selective attention and verbal fluency.

Conclusion: Bilateral stimulation of DLPFC, as the main node of CEN, results in changes in the activity of the SMN and consequently improves verbal memory and executive functions in patients with bipolar depression.

Structural alterations within cerebellar circuitry are associated with general liability for common mental disorders

Accumulating mental-health research encourages a shift in focus toward transdiagnostic dimensional features that are shared across categorical disorders. In support of this shift, recent studies have identified a general liability factor for psychopathology-sometimes called the 'p factor'- that underlies shared risk for a wide range of mental disorders. Identifying neural correlates of this general liability would substantiate its importance in characterizing the shared origins of mental disorders and help us begin to understand the mechanisms through which the 'p factor' contributes to risk. Here we believe we first replicate the 'p factor' using cross-sectional data from a volunteer sample of 1246 university students, and then using high-resolution multimodal structural neuroimaging, we demonstrate that individuals with higher 'p factor' scores show reduced structural integrity of white matter pathways, as indexed by lower fractional anisotropy values, uniquely within the pons. Whole-brain analyses further revealed that higher 'p factor' scores are associated with reduced gray matter volume in the occipital lobe and left cerebellar lobule VIIb, which is functionally connected with prefrontal regions supporting cognitive control. Consistent with the preponderance of cerebellar afferents within the pons, we observed a significant positive correlation between the white matter integrity of the pons and cerebellar gray matter volume associated with higher 'p factor' scores. The results of our analyses provide initial evidence that structural alterations in corticocerebellar circuitry supporting core functions related to the basic integration, coordination and monitoring of information may contribute to a general liability for common mental disorders.

Lose-Shift Responding in Humans Is Promoted by Increased Cognitive Load

The propensity of animals to shift choices immediately after unexpectedly poor reinforcement outcomes is a pervasive strategy across species and tasks. We report here on the memory supporting such lose-shift responding in humans, assessed using a binary choice task in which random responding is the optimal strategy. Participants exhibited little lose-shift responding when fully attending to the task, but this increased by 30%–40% in participants that performed with additional cognitive load that is known to tax executive systems. Lose-shift responding in the cognitively loaded adults persisted throughout the testing session, despite being a sub-optimal strategy, but was less likely as the time increased between reinforcement and the subsequent choice. Furthermore, children (5–9 years old) without load performed similarly to the cognitively loaded adults. This effect disappeared in older children aged 11–13 years old. These data provide evidence supporting our hypothesis that lose-shift responding is a default and reflexive strategy in the mammalian brain, likely mediated by a decaying memory trace, and is normally suppressed by executive systems. Reducing the efficacy of executive control by cognitive load (adults) or underdevelopment (children) increases its prevalence. It may therefore be an important component to consider when interpreting choice data, and may serve as an objective behavioral assay of executive function in humans that is easy to measure.

D2/D3 dopamine receptor binding with [F-18]fallypride correlates of executive function in medication-naïve patients with schizophrenia

Converging evidence indicates that the prefrontal cortex is critically involved in executive control and that executive dysfunction is implicated in schizophrenia. Reduced dopamine D2/D3 receptor binding potential has been reported in schizophrenia, and the correlations with neuropsychological test scores have been positive and negative for different tasks. The aim of this study was to examine the relation between dopamine D2/D3 receptor levels with frontal and temporal neurocognitive performance in schizophrenia. Resting-state ¹⁸F-fallypride positron emission tomography was performed on 20 medication-naïve and 5 previously medicated for brief earlier periods patients with schizophrenia and 19 age- and sex-matched healthy volunteers. Striatal and extra-striatal dopamine D2/D3 receptor levels were quantified as binding potential using fallypride imaging. Magnetic resonance images in standard Talairach position and segmented into gray and white matter were co-registered to the fallypride images, and the AFNI stereotaxic atlas was applied. Two neuropsychological tasks known to activate frontal and temporal lobe function were chosen, specifically the Wisconsin Card Sorting Test (WCST) and the California Verbal Learning Test (CVLT). Images of the correlation coefficient between fallypride binding and WCST and CVLT performance showed a negative correlation in contrast to positive correlations in healthy volunteers. The results of this study demonstrate that lower fallypride binding potential in patients with schizophrenia may be associated with better performance. Our findings are consistent with previous studies that failed to find cognitive improvements with typical dopamine-blocking medications.

Frontal lobe metabolic alterations in autism spectrum disorder: a 1H-magnetic resonance spectroscopy study

PURPOSE

Recently, neuroimaging studies were performed using ¹H-magnetic resonance spectroscopy (¹H-MRS), revealing a quantitative alteration of neurochemicals (such as neurotransmitters and metabolites) in several brain regions of patients with autism spectrum disorder (ASD). The involvement of the frontal lobe in the neurobiology of ASD has long been documented in the literature. Therefore, the aim of this study was to analyze the alterations of N-acetylaspartate/creatine (NAA/Cr) and choline/Cr (Cho/Cr) ratios in the frontal lobe subcortical white matter (WM) in ASD patients, in order to reveal any alteration of metabolites that might be the expression of specific clinical features of the disorder.

PATIENTS AND METHODS

An ¹H-MRS study of the frontal lobe subcortical WM was performed in 75 children with ASD and in 50 age-matched controls to evaluate the functional activity of this brain region.

RESULTS

NAA/Cr and Cho/Cr ratios were significantly altered in ASD, compared to control subjects. Moreover, in the ASD group, NAA/Cr was significantly lower in patients with a cognitive impairment.

CONCLUSION

Results from this study confirm the existence of brain metabolites' alterations in frontal lobe WM in children with ASD, supporting the relevance of this brain region in the clinical expressions of this disorder, including its role in the cognitive impairment. Further ¹H-MRS investigations will allow to comprehensively explain the relationship between metabolic alteration in a specific brain region and specific clinical features of ASD.

Cognitive, Emotional, and Auto-Activation Dimensions of Apathy in Parkinson's Disease

Apathy is one of the most frequent non-motor manifestations in Parkinson's disease (PD) that can lead to a whole range of deleterious outcomes. In 2006, Levy and Dubois proposed a model that distinguishes three different apathy aetiologies in PD divided into three subtypes of disrupted processing: “emotional-affective,” “cognitive,” and “auto-activation.” These three dimensions associated with dopamine depletion present in the pathology would lead to the emergence of apathy in PD. The aim of this mini-review was to describe and discuss studies that have explore links between apathy and the three subtypes of disrupted processing proposed by Levy and Dubois (2006) and as well as the links between these dimensions and dopamine depletion in Parkinson's disease. The lack of consensus regarding the emotional-affective correlates of apathy and the lack of evidence supporting the hypothesis of the auto-activation deficit, do not clearly confirm the validity of Levy and Dubois's model. Furthermore, the suggested association between dopaminergic depletion and apathy must also be clarified.

Functional imaging of cognition in an old-old population: A case for portable functional near-infrared spectroscopy

In this study, functional near-infrared spectroscopy (fNIRS) was used to record brain activation during cognitive testing in older individuals (88±6yo; N = 19) living in residential care communities. This population, which is often associated with loss of personal independence due to physical or cognitive decline associated with aging, is also often under-represented in neuroscience research because of a limited means to participate in studies which often take place in large urban or university centers. In this study, we demonstrate the feasibility and initial results using a portable 8-source by 4-detector fNIRS system to measure brain activity from participants within residential care community centers. Using fNIRS, brain signals were recorded during a series of computerized cognitive tests, including a Symbol Digit Coding test (SDC), Stroop Test (ST), and Shifting Attention Test (SAT). The SDC and SAT elicited greater activity in the left middle frontal region of interest. Three components of the ST produced increases in the right middle frontal and superior frontal, and left superior frontal regions. An association between advanced age and increased activation in the right middle frontal region was observed during the incongruent ST. Although none of the participants had clinical dementia based on the short portable mental status questionnaire, the group performance was slightly below age-normed values on these cognitive tests. These results demonstrate the capability for obtaining functional neuroimaging measures in residential settings, which ultimately may aid in prognosis and care related to dementia in older adults.

Plasticity of prefrontal cortex connectivity in schizophrenia in response to antisaccade practice

People with schizophrenia exhibit difficulties in cognitive control that are often attributed to deficits in prefrontal cortex (PFC) circuitry. Practice paradigms have been used to improve these PFC-mediated deficits. The neural consequences of practice on task-based PFC activation have been addressed. Effects on task-based PFC connectivity, however, are largely unknown. We recruited people with schizophrenia and controls to practice antisaccades, a measure of PFC-mediated cognitive control that is disrupted in people with schizophrenia. Subjects performed antisaccades during functional magnetic resonance imaging (fMRI) before and after eight days of antisaccade practice. A group (schizophrenia, controls) × time (pre-, post-test) repeated measures ANOVA on the results of a psychophysiological interaction (PPI) analysis was used to evaluate changes in PFC connectivity; a similar model was used to evaluate changes in antisaccade behavior. After practice, antisaccade behavior improved and PFC connectivity with insular/temporal regions (involved in bottom-up orienting processes) increased in the schizophrenia group. The level of connectivity at post-test in the schizophrenia group was similar to that seen at pre-test in controls and positively correlated with antisaccade performance. Increases in connectivity between bottom-up and top-down regions may underlie behavioral improvements in people with schizophrenia after cognitive control practice.

Frontal lobe executive dysfunction and cerebral perfusion study in alcohol dependence syndrome

BACKGROUND

Long-term alcohol use leading to frontal lobe impairment has been a cause of concern for many decades. However, there are very few studies from India of evaluation of frontal lobe executive dysfunction among alcoholics. Hence, this study was undertaken to evaluate the frontal executive dysfunction using Wisconsin Card Sorting Test (WCST) and perfusion deficits by Single-Photon Emission Computerized Tomography (SPECT) among alcohol-dependent patients.

AIM

The aim of this study is to evaluate the frontal executive dysfunction using WCST and frontal lobe perfusion deficits by SPECT among alcohol-dependent patients.

MATERIALS AND METHODS

This was a cross-sectional study involving 20 alcohol dependence syndrome patients in a tertiary care center. After ethical clearance and informed consent, all were evaluated using WCST and SPECT.

RESULTS

About 45% patients had impairment on WCST, and it was related to the duration of drinking. About 55% showed reduced frontal lobe perfusion on SPECT scan and they had a long duration of drinking compared to controls. Among the patients showing impairment on WCST subscores, more than 50% had reduced frontal lobe perfusion on SPECT.

CONCLUSION

This study not only confirmed the executive function impairment and frontal lobe perfusion deficits in alcohol-dependent patients but also showed a concomitant presence of both in patients with chronic alcohol abuse.

Protocol for the Reconstructing Consciousness and Cognition (ReCCognition) Study

Important scientific and clinical questions persist about general anesthesia despite the ubiquitous clinical use of anesthetic drugs in humans since their discovery. For example, it is not known how the brain reconstitutes consciousness and cognition after the profound functional perturbation of the anesthetized state, nor has a specific pattern of functional recovery been characterized. To date, there has been a lack of detailed investigation into rates of recovery and the potential orderly return of attention, sensorimotor function, memory, reasoning and logic, abstract thinking, and processing speed. Moreover, whether such neurobehavioral functions display an invariant sequence of return across individuals is similarly unknown. To address these questions, we designed a study of healthy volunteers undergoing general anesthesia with electroencephalography and serial testing of cognitive functions (NCT01911195). The aims of this study are to characterize the temporal patterns of neurobehavioral recovery over the first several hours following termination of a deep inhaled isoflurane general anesthetic and to identify common patterns of cognitive function recovery. Additionally, we will conduct spectral analysis and reconstruct functional networks from electroencephalographic data to identify any neural correlates (e.g., connectivity patterns, graph-theoretical variables) of cognitive recovery after the perturbation of general anesthesia. To accomplish these objectives, we will enroll a total of 60 consenting adults aged 20-40 across the three participating sites. Half of the study subjects will receive general anesthesia slowly titrated to loss of consciousness (LOC) with an intravenous infusion of propofol and thereafter be maintained for 3 h with 1.3 age adjusted minimum alveolar concentration of isoflurane, while the other half of subjects serves as awake controls to gauge effects of repeated neurobehavioral testing, spontaneous fatigue and endogenous rest-activity patterns.

Cognitive persistence: Development and validation of a novel measure from the Wisconsin Card Sorting Test

The Wisconsin Card Sorting Test (WCST) has long been used as a neuropsychological assessment of executive function abilities, in particular, cognitive flexibility or "set-shifting". Recent advances in scoring the task have helped to isolate specific WCST performance metrics that index set-shifting abilities and have improved our understanding of how prefrontal and parietal cortex contribute to set-shifting. We present evidence that the ability to overcome task difficulty to achieve a goal, or "cognitive persistence", is another important prefrontal function that is characterized by the WCST and that can be differentiated from efficient set-shifting. This novel measure of cognitive persistence was developed using the WCST-64 in an adult lifespan sample of 230 participants. The measure was validated using individual variation in cingulo-opercular cortex function in a sub-sample of older adults who had completed a challenging speech recognition in noise fMRI task. Specifically, older adults with higher cognitive persistence were more likely to demonstrate word recognition benefit from cingulo-opercular activity. The WCST-derived cognitive persistence measure can be used to disentangle neural processes involved in set-shifting from those involved in persistence.

Patterns of brain and cardiovascular activation while solving rule-discovery and rule-application numeric tasks

It is known that solving mental tasks leads to tonic increase in cardiovascular activity. Our previous research showed that tasks involving rule application (RA) caused greater tonic increase in cardiovascular activity than tasks requiring rule discovery (RD). However, it is not clear what brain mechanisms are responsible for this difference. The aim of two experimental studies was to compare the patterns of brain and cardiovascular activity while both RD and the RA numeric tasks were being solved. The fMRI study revealed greater brain activation while solving RD tasks than while solving RA tasks. In particular, RD tasks evoked greater activation of the left inferior frontal gyrus and selected areas in the parietal, and temporal cortices, including the precuneus, supramarginal gyrus, angular gyrus, inferior parietal lobule, and the superior temporal gyrus, and the cingulate cortex. In addition, RA tasks caused larger increases in HR than RD tasks. The second study, carried out in a cardiovascular laboratory, showed greater increases in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) while solving RA tasks than while solving RD tasks. The results support the hypothesis that RD and RA tasks involve different modes of information processing, but the neuronal mechanism responsible for the observed greater cardiovascular response to RA tasks than to RD tasks is not completely clear.