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Woelk SP, Garfinkel SN. Dissociative Symptoms and Interoceptive Integration. Curr Top Behav Neurosci 2024. [PMID: 38755513 DOI: 10.1007/7854_2024_480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Dissociative symptoms and disorders of dissociation are characterised by disturbances in the experience of the self and the surrounding world, manifesting as a breakdown in the normal integration of consciousness, memory, identity, emotion, and perception. This paper aims to provide insights into dissociative symptoms from the perspective of interoception, the sense of the body's internal physiological state, adopting a transdiagnostic framework.Dissociative symptoms are associated with a blunting of autonomic reactivity and a reduction in interoceptive precision. In addition to the central function of interoception in homeostasis, afferent visceral signals and their neural and mental representation have been shown to shape emotional feeling states, support memory encoding, and contribute to self-representation. Changes in interoceptive processing and disrupted integration of interoceptive signals into wider cognition may contribute to detachment from the body and the world, blunted emotional experience, and altered subjective recall, as experienced by individuals who suffer from dissociation.A better understanding of the role of altered interoceptive integration across the symptom areas of dissociation could thus provide insights into the neurophysiological mechanisms underlying dissociative disorders. As new therapeutic approaches targeting interoceptive processing emerge, recognising the significance of interoceptive mechanisms in dissociation holds potential implications for future treatment targets.
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Affiliation(s)
- Sascha P Woelk
- Institute of Cognitive Neuroscience, University College London, London, UK.
| | - Sarah N Garfinkel
- Institute of Cognitive Neuroscience, University College London, London, UK
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2
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Corcoran AW, Perrykkad K, Feuerriegel D, Robinson JE. Body as First Teacher: The Role of Rhythmic Visceral Dynamics in Early Cognitive Development. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023:17456916231185343. [PMID: 37694720 DOI: 10.1177/17456916231185343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Embodied cognition-the idea that mental states and processes should be understood in relation to one's bodily constitution and interactions with the world-remains a controversial topic within cognitive science. Recently, however, increasing interest in predictive processing theories among proponents and critics of embodiment alike has raised hopes of a reconciliation. This article sets out to appraise the unificatory potential of predictive processing, focusing in particular on embodied formulations of active inference. Our analysis suggests that most active-inference accounts invoke weak, potentially trivial conceptions of embodiment; those making stronger claims do so independently of the theoretical commitments of the active-inference framework. We argue that a more compelling version of embodied active inference can be motivated by adopting a diachronic perspective on the way rhythmic physiological activity shapes neural development in utero. According to this visceral afferent training hypothesis, early-emerging physiological processes are essential not only for supporting the biophysical development of neural structures but also for configuring the cognitive architecture those structures entail. Focusing in particular on the cardiovascular system, we propose three candidate mechanisms through which visceral afferent training might operate: (a) activity-dependent neuronal development, (b) periodic signal modeling, and (c) oscillatory network coordination.
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Affiliation(s)
- Andrew W Corcoran
- Monash Centre for Consciousness and Contemplative Studies, Monash University
- Cognition and Philosophy Laboratory, School of Philosophical, Historical, and International Studies, Monash University
| | - Kelsey Perrykkad
- Cognition and Philosophy Laboratory, School of Philosophical, Historical, and International Studies, Monash University
| | | | - Jonathan E Robinson
- Cognition and Philosophy Laboratory, School of Philosophical, Historical, and International Studies, Monash University
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3
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Tanaka Y, Ito Y, Terasawa Y, Umeda S. Modulation of heartbeat-evoked potential and cardiac cycle effect by auditory stimuli. Biol Psychol 2023; 182:108637. [PMID: 37490801 DOI: 10.1016/j.biopsycho.2023.108637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 06/29/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
Interoception has been proposed as a factor that influences various psychological processes (Khalsa et al., 2018). Afferent signals from the cardiovascular system vary across cardiac cycle phases. Heartbeat-evoked potentials (HEP) and event-related potentials (ERP) were measured to examine whether interoceptive signals differed between cardiac cycle phases. Simultaneously, participants performed an auditory oddball task in which the timing of the presenting stimulus was synchronized with the heartbeat. Pure tones were presented at 10 ms (late diastole condition), 200 ms (systole condition), or 500 ms after the R wave (diastole condition). Greater HEP amplitudes were observed when the tone was presented during diastole than during systole or late diastole. ERP showed the same tendency: a greater amplitude was observed during diastole than systole or late diastole. These results suggest that the processing of interoception reflected by HEP and exteroception reflected by ERP share attentional resources when both stimuli coincide. When the tone was presented during systole, attention to the internal state decreased compared with when the tone was presented during diastole, and attention was distributed to both exteroception and interoception. Our study suggests that HEP may be considered an indication of a relative amount of resources to process the interoception.
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Affiliation(s)
- Yuto Tanaka
- Global Research Institute, Keio University, 2-15-45 Mita, Minato-ku, Tokyo 108-8345, Japan.
| | - Yuichi Ito
- Department of Psychological Sciences, Kwansei Gakuin University, 1-155 Uegahara Ichibancho, Nishinomiya, Hyogo 662-8501, Japan
| | - Yuri Terasawa
- Department of Psychology, Keio University, 2-15-45 Mita, Minato-ku, Tokyo 108-8345, Japan
| | - Satoshi Umeda
- Department of Psychology, Keio University, 2-15-45 Mita, Minato-ku, Tokyo 108-8345, Japan
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4
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Finke JB, Zhang X, Plein D, Schilling TM, Schächinger H, Larra MF. Combining mental and physical stress: Synergy or interference? Physiol Behav 2021; 233:113365. [PMID: 33600808 DOI: 10.1016/j.physbeh.2021.113365] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 12/23/2022]
Abstract
Both cognitive stressors (such as mental arithmetic tasks) and physical stressors (such as the cold pressor test, CP) are among the most widely employed tools in acute stress research, and there is growing evidence for a high degree of stimulus-response specificity, rather than uniformity, in the human stress response. However, little is known about potential synergistic or interfering effects during concurrent administration. While cognitive tasks have been hypothesized to attenuate pain perception during CP, they are also thought to enhance physiological reactivity. Conversely, physical stress might interfere with effective stress induction by cognitive challenges. To address these questions, 56 participants underwent either the CP (3-min ice-water immersion of feet) or a warm-water control condition. In half of the sample, the Paced Auditory Serial Addition Task (PASAT) was performed simultaneously (fully crossed interventions). Salivary cortisol, cardiovascular parameters, and subjective ratings as well as voice pitch (F0) were assessed. Results show that cortisol responses, self-reported pain and subjective arousal were mainly driven by cold exposure, which also led to increased F0. The PASAT incrementally enhanced cardiovascular reactions, but did not affect pain ratings nor cortisol responses to the CP. However, intra-individual concordance between elevated blood pressure and other reactivity measures was enhanced by PASAT administration during the CP. Importantly, performance decrements in the mental-arithmetic task were not associated with diminished stress responses. In conclusion, our results speak against any strong interference when administering cognitive and painful physical stressors simultaneously, pointing rather to specific additive effects, particularly regarding cardiovascular reactivity.
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Affiliation(s)
- Johannes B Finke
- Department of Clinical Psychology, University of Siegen, Siegen, Germany
| | - Xinwei Zhang
- Institute of Psychobiology, Department of Clinical Psychophysiology, University of Trier, Trier, Germany
| | - Debora Plein
- Institute of Psychobiology, Department of Clinical Psychophysiology, University of Trier, Trier, Germany
| | - Thomas M Schilling
- Institute of Psychobiology, Department of Clinical Psychophysiology, University of Trier, Trier, Germany
| | - Hartmut Schächinger
- Institute of Psychobiology, Department of Clinical Psychophysiology, University of Trier, Trier, Germany
| | - Mauro F Larra
- IfADo - Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
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5
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Disentangling sensorimotor and cognitive cardioafferent effects: A cardiac-cycle-time study on spatial stimulus-response compatibility. Sci Rep 2020; 10:4059. [PMID: 32132629 PMCID: PMC7055319 DOI: 10.1038/s41598-020-61068-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 02/21/2020] [Indexed: 11/10/2022] Open
Abstract
Cardiac-cycle-time effects are attributed to variations in baroreceptor (BR) activity and have been shown to impinge on subcortical as well as cortical processes. However, cognitive and sensorimotor processes mediating voluntary responses seem to be differentially affected. We sought to disentangle cardiac-cycle-time effects on subcortical and cortical levels as well as sensorimotor and cognitive processes within a spatial stimulus-response-compatibility paradigm employing startling stimuli of different modalities. Air-puffs and white noise-bursts were presented unilaterally during either cardiac systole or diastole while bilateral startle EMG responses were recorded. Modality, laterality and cardiac-cycle-time were randomly varied within-subjects. Cognitive and sensorimotor stimulus-response-compatibility was orthogonally varied between-subjects: Participants (N = 80) responded to the stimuli via left/right button-push made with either the contra- or ipsilateral hand (sensorimotor compatibility) on either the ipsi- or contralateral button (cognitive compatibility). We found that sensorimotor compatible reactions were speeded during systole whereas sensorimotor incompatible ones were prolonged. This effect was independent of cognitive compatibility and restricted to auditory stimuli. Startle was inhibited during systole irrespective of modality or compatibility. Our results demonstrate how differential cardiac-cycle-time effects influence performance in conflict tasks and further suggest that stimulus-response-compatibility paradigms offer a viable method to uncover the complex interactions underlying behavioral BR effects.
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Kimura K. Cardiac cycle modulates reward feedback processing: An ERP study. Neurosci Lett 2019; 711:134473. [PMID: 31479723 DOI: 10.1016/j.neulet.2019.134473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/16/2019] [Accepted: 08/30/2019] [Indexed: 10/26/2022]
Abstract
The present study aimed to investigate whether the evaluative processing of action feedback is influenced by the cardiac cycle. To this aim, we examined the influence of the cardiac cycle on an event-related brain potential (ERP) effect that indexed the evaluative processing of action feedback [i.e., an ERP effect that interpreted as a feedback-related negativity (FRN) elicited by "bad" action feedback or a reward positivity (RewP) elicited by "good" action feedback]. Participants performed a gambling task in which they chose one of two stimuli and received an action feedback that indicated monetary gain or loss. Each trial was retrospectively classified into systole and diastole trials; systole trials were defined as those where monetary outcomes were presented during systole, and the diastole trials as those where monetary outcomes were presented during diastole. The results showed that the FRN/RewP was larger for the systole trials than for the diastole trials, which was due to the modulation of gain rather than loss ERPs. These results provide evidence that the natural fluctuation of cardiac afferent signals can modulate the evaluative processing of feedback.
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Affiliation(s)
- Kenta Kimura
- National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan.
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Waselius T, Wikgren J, Penttonen M, Nokia MS. Breathe out and learn: Expiration‐contingent stimulus presentation facilitates associative learning in trace eyeblink conditioning. Psychophysiology 2019; 56:e13387. [DOI: 10.1111/psyp.13387] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 03/22/2019] [Accepted: 04/08/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Tomi Waselius
- Department of Psychology University of Jyvaskyla Jyvaskyla Finland
| | - Jan Wikgren
- Department of Psychology University of Jyvaskyla Jyvaskyla Finland
- Centre for Interdisciplinary Brain Research University of Jyvaskyla Jyvaskyla Finland
| | - Markku Penttonen
- Department of Psychology University of Jyvaskyla Jyvaskyla Finland
| | - Miriam S. Nokia
- Department of Psychology University of Jyvaskyla Jyvaskyla Finland
- Neuroscience Center Helsinki Institute of Life Science, University of Helsinki Helsinki Finland
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Waselius T, Wikgren J, Halkola H, Penttonen M, Nokia MS. Learning by heart: cardiac cycle reveals an effective time window for learning. J Neurophysiol 2018; 120:830-838. [PMID: 29742028 DOI: 10.1152/jn.00128.2018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cardiac cycle phase is known to modulate processing of simple sensory information. This effect of the heartbeat on brain function is likely exerted via baroreceptors, the neurons sensitive for changes in blood pressure. From baroreceptors, the signal is conveyed all the way to the forebrain and the medial prefrontal cortex. In the two experiments reported, we examined whether learning, as a more complex form of cognition, can be modulated by the cardiac cycle phase. Human participants ( experiment 1) and rabbits ( experiment 2) were trained in trace eyeblink conditioning while neural activity was recorded. The conditioned stimulus was presented contingently with either the systolic or diastolic phase of the cycle. The tone used as the conditioned stimulus evoked amplified responses in both humans (electroencephalogram from "vertex," Cz) and rabbits (hippocampal CA1 local field potential) when its onset was timed at systole. In humans, the cardiac cycle phase did not affect learning, but rabbits trained at diastole learned significantly better than those trained at a random phase of the cardiac cycle. In summary, our results suggest that neural processing of external stimuli and also learning can be affected by targeting stimuli on the basis of cardiac cycle phase. These findings might be useful in applications aimed at maximizing or minimizing the effects of external stimulation. NEW & NOTEWORTHY It has been shown that rapid changes in bodily states modulate neural processing of external stimulus in brain. In this study, we show that modulation of neural processing of external stimulus and learning about it depends on the phase of the cardiac cycle. This is a novel finding that can be applied to optimize associative learning.
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Affiliation(s)
- Tomi Waselius
- Department of Psychology, University of Jyväskylä , Jyväskylä , Finland
| | - Jan Wikgren
- Department of Psychology, University of Jyväskylä , Jyväskylä , Finland.,Centre for Interdisciplinary Brain Research, University of Jyväskylä , Jyväskylä , Finland
| | - Hanna Halkola
- Department of Psychology, University of Jyväskylä , Jyväskylä , Finland
| | - Markku Penttonen
- Department of Psychology, University of Jyväskylä , Jyväskylä , Finland
| | - Miriam S Nokia
- Department of Psychology, University of Jyväskylä , Jyväskylä , Finland
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Murphy J, Brewer R, Catmur C, Bird G. Interoception and psychopathology: A developmental neuroscience perspective. Dev Cogn Neurosci 2017; 23:45-56. [PMID: 28081519 PMCID: PMC6987654 DOI: 10.1016/j.dcn.2016.12.006] [Citation(s) in RCA: 198] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 12/15/2022] Open
Abstract
Interoception refers to the perception of the physiological condition of the body, including hunger, temperature, and heart rate. There is a growing appreciation that interoception is integral to higher-order cognition. Indeed, existing research indicates an association between low interoceptive sensitivity and alexithymia (a difficulty identifying one's own emotion), underscoring the link between bodily and emotional awareness. Despite this appreciation, the developmental trajectory of interoception across the lifespan remains under-researched, with clear gaps in our understanding. This qualitative review and opinion paper provides a brief overview of interoception, discussing its relevance for developmental psychopathology, and highlighting measurement issues, before surveying the available work on interoception across four stages of development: infancy, childhood, adolescence and late adulthood. Where gaps in the literature addressing the development of interoception exist, we draw upon the association between alexithymia and interoception, using alexithymia as a possible marker of atypical interoception. Evidence indicates that interoceptive ability varies across development, and that this variance correlates with established age-related changes in cognition and with risk periods for the development of psychopathology. We suggest a theory within which atypical interoception underlies the onset of psychopathology and risky behaviour in adolescence, and the decreased socio-emotional competence observed in late adulthood.
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Affiliation(s)
- Jennifer Murphy
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Rebecca Brewer
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; School of Psychology, The University of East London, London, UK
| | - Caroline Catmur
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Geoffrey Bird
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Institute of Cognitive Neuroscience, UCL, London, UK; Dept of Experimental Psychology, University of Oxford, Oxford, UK
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10
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Cardiac afferent activity modulates the expression of racial stereotypes. Nat Commun 2017; 8:13854. [PMID: 28094772 PMCID: PMC5247580 DOI: 10.1038/ncomms13854] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 11/04/2016] [Indexed: 12/31/2022] Open
Abstract
Negative racial stereotypes tend to associate Black people with threat. This often leads to the misidentification of harmless objects as weapons held by a Black individual. Yet, little is known about how bodily states impact the expression of racial stereotyping. By tapping into the phasic activation of arterial baroreceptors, known to be associated with changes in the neural processing of fearful stimuli, we show activation of race-threat stereotypes synchronized with the cardiovascular cycle. Across two established tasks, stimuli depicting Black or White individuals were presented to coincide with either the cardiac systole or diastole. Results show increased race-driven misidentification of weapons during systole, when baroreceptor afferent firing is maximal, relative to diastole. Importantly, a third study examining the positive Black-athletic stereotypical association fails to demonstrate similar modulations by cardiac cycle. We identify a body–brain interaction wherein interoceptive cues can modulate threat appraisal and racially biased behaviour in context-dependent ways. Black individuals are racially stereotyped as threatening but how bodily signals may affect these misperceptions is not known. Here Azevedo and colleagues show that these race-driven responses are affected by the cardiac cycle, being more biased when arterial baroreceptor activation is maximal.
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Limongi R, Silva AM. Temporal Prediction Errors Affect Short-Term Memory Scanning Response Time. Exp Psychol 2016; 63:333-342. [DOI: 10.1027/1618-3169/a000339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The Sternberg short-term memory scanning task has been used to unveil cognitive operations involved in time perception. Participants produce time intervals during the task, and the researcher explores how task performance affects interval production – where time estimation error is the dependent variable of interest. The perspective of predictive behavior regards time estimation error as a temporal prediction error (PE), an independent variable that controls cognition, behavior, and learning. Based on this perspective, we investigated whether temporal PEs affect short-term memory scanning. Participants performed temporal predictions while they maintained information in memory. Model inference revealed that PEs affected memory scanning response time independently of the memory-set size effect. We discuss the results within the context of formal and mechanistic models of short-term memory scanning and predictive coding, a Bayes-based theory of brain function. We state the hypothesis that our finding could be associated with weak frontostriatal connections and weak striatal activity.
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Affiliation(s)
- Roberto Limongi
- Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
- Instituto Venezolano de Investigaciones Lingüísticas y Literarias Andres Bello, Laboratorio de Lenguaje y Cognición, Caracas, Venezuela
| | - Angélica M. Silva
- Escuela de Pedagogía, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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Pramme L, Larra MF, Schächinger H, Frings C. Cardiac cycle time effects on selection efficiency in vision. Psychophysiology 2016; 53:1702-1711. [PMID: 27450530 DOI: 10.1111/psyp.12728] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 06/12/2016] [Indexed: 01/19/2023]
Abstract
The effect of cardiac cycle time on attentional selection was investigated in an experiment in which participants classified target letters in a visual selection task. Stimulus onsets were aligned to the R wave of the electrocardiogram and stimuli presented either during the ventricular systole or diastole. Selection efficiency was operationalized as difference in target selection performance under conditions of homogeneous and heterogeneous distractors. Differences in performance (i.e., the impact selection difficulty had on the ability to select the target) were attenuated for stimuli presented during the ventricular systole compared to the diastole. Increased baroafferent signal transmission during the systole appears to reduce interference of highly distracting stimuli on visual selection efficiency.
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Affiliation(s)
- Lisa Pramme
- Cognitive Psychology, Trier University, Trier, Germany.
| | - Mauro F Larra
- Clinical Psychophysiology, Trier University, Trier, Germany
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Pramme L, Schächinger H, Frings C. Baroreceptor activity impacts upon controlled but not automatic distractor processing. Biol Psychol 2015; 110:75-84. [PMID: 26134892 DOI: 10.1016/j.biopsycho.2015.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 05/28/2015] [Accepted: 06/14/2015] [Indexed: 10/23/2022]
Abstract
Changes within the cardiovascular system have been shown to alter sensorimotor and memory performance, pain perception as well as cortical arousal. This influence is assumed to be mediated by afferent feedback of baroreceptors that when stimulated exert inhibitory effects on cortical structures. Mainly responsible for short-term regulation of blood pressure, afferents of the baroreceptors are widely connected to subcortical and cortical structures like the insular cortex. A putative impact on cognitive control processes remains an open question, however. Using a sequential distractor priming task, the present study investigated whether inhibitory influences of baroreceptor activation apply to selective information processing in the presence of irrelevant information. In particular, we assessed distractor-response binding and Negative Priming as indices of automatic and controlled distractor processing, respectively. Baroreceptor activation was experimentally manipulated by the systematic variation of body position. The results showed that only Negative Priming but not distractor-response binding was modulated by body position suggesting that controlled but not automatic processing of distractors is affected by baroreceptor activity.
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Affiliation(s)
- Lisa Pramme
- Cognitive Psychology Department, Institute of Psychology, University of Trier, Germany.
| | - Hartmut Schächinger
- Clinical Psychophysiology Department, Institute of Psychobiology, University of Trier, Germany
| | - Christian Frings
- Cognitive Psychology Department, Institute of Psychology, University of Trier, Germany
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