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Smith DE, Long NM. Successful retrieval is its own reward. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.26.605274. [PMID: 39211141 PMCID: PMC11360978 DOI: 10.1101/2024.07.26.605274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
The ability to successfully remember past events is critical to our daily lives, yet the neural mechanisms underlying the motivation to retrieve is unclear. Although reward-system activity and feedback-related signals have been observed during memory retrieval, whether this signal reflects intrinsic reward or goal-attainment is unknown. Adjudicating between these two alternatives is crucial for understanding how individuals are motivated to engage in retrieval and how retrieval supports later remembering. To test these two accounts, we conducted between-subjects recognition memory tasks on human participants undergoing scalp electroencephalography and varied test-phase goals (recognize old vs. detect new items). We used an independently validated feedback classifier to measure positive feedback evidence. We find positive feedback following successful retrieval regardless of task goals. Together, these results suggest that successful retrieval is intrinsically rewarding. Such a feedback signal may promote future retrieval attempts as well as bolster later memory for the successfully retrieved events.
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Kamp SM, Endemann R, Knopf L, Ferdinand NK. Subjective cognitive decline in healthy older adults is associated with altered processing of negative versus positive feedback in a probabilistic learning task. Front Psychol 2024; 15:1404345. [PMID: 39049950 PMCID: PMC11267478 DOI: 10.3389/fpsyg.2024.1404345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/27/2024] [Indexed: 07/27/2024] Open
Abstract
Older adults who worry about their own cognitive capabilities declining, but who do not show evidence of actual cognitive decline in neuropsychological tests, are at an increased risk of being diagnosed with dementia at a later time. Since neural markers may be more sensitive to early stages of cognitive decline, in the present study we examined whether event-related potential responses of feedback processing, elicited in a probabilistic learning task, differ between healthy older adults recruited from the community, who either did (subjective cognitive decline/SCD-group) or did not report (No-SCD group) worry about their own cognition declining beyond the normal age-related development. In the absence of group differences in learning from emotionally charged feedback in the probabilistic learning task, the amplitude of the feedback-related negativity (FRN) varied with feedback valence differently in the two groups: In the No-SCD group, the FRN was larger for positive than negative feedback, while in the SCD group, FRN amplitude did not differ between positive and negative feedback. The P3b was enhanced for negative feedback in both groups, and group differences in P3b amplitude were not significant. Altered sensitivity in neural processing of negative versus positive feedback may be a marker of SCD.
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Affiliation(s)
| | | | - Luisa Knopf
- Department of Psychology, Trier University, Trier, Germany
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Grabowska A, Zabielski J, Senderecka M. Machine learning reveals differential effects of depression and anxiety on reward and punishment processing. Sci Rep 2024; 14:8422. [PMID: 38600089 PMCID: PMC11366008 DOI: 10.1038/s41598-024-58031-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
Recent studies suggest that depression and anxiety are associated with unique aspects of EEG responses to reward and punishment, respectively; also, abnormal responses to punishment in depressed individuals are related to anxiety, the symptoms of which are comorbid with depression. In a non-clinical sample, we aimed to investigate the relationships between reward processing and anxiety, between punishment processing and anxiety, between reward processing and depression, and between punishment processing and depression. Towards this aim, we separated feedback-related brain activity into delta and theta bands to isolate activity that indexes functionally distinct processes. Based on the delta/theta frequency and feedback valence, we then used machine learning (ML) to classify individuals with high severity of depressive symptoms and individuals with high severity of anxiety symptoms versus controls. The significant difference between the depression and control groups was driven mainly by delta activity; there were no differences between reward- and punishment-theta activities. The high severity of anxiety symptoms was marginally more strongly associated with the punishment- than the reward-theta feedback processing. The findings provide new insights into the differences in the impacts of anxiety and depression on reward and punishment processing; our study shows the utility of ML in testing brain-behavior hypotheses and emphasizes the joint effect of theta-RewP/FRN and delta frequency on feedback-related brain activity.
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Affiliation(s)
- Anna Grabowska
- Doctoral School in the Social Sciences, Jagiellonian University, Main Square 34, 30-010, Kraków, Poland.
- Institute of Philosophy, Jagiellonian University, Grodzka 52, 31-044, Kraków, Poland.
| | - Jakub Zabielski
- Institute of Philosophy, Jagiellonian University, Grodzka 52, 31-044, Kraków, Poland
| | - Magdalena Senderecka
- Institute of Philosophy, Jagiellonian University, Grodzka 52, 31-044, Kraków, Poland.
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Han S, Gao J, Hu J, Ye Y, Huang H, Liu J, Liu M, Ai H, Qiu J, Luo Y, Xu P. Disruptions of salience network during uncertain anticipation of conflict control in anxiety. Asian J Psychiatr 2023; 88:103721. [PMID: 37562270 DOI: 10.1016/j.ajp.2023.103721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/20/2023] [Accepted: 08/01/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Anxiety has been characterized by disrupted processing of conflict control, while little is known about anticipatory processing of conflicts in anxiety. Anticipation is the key factor in both anxiety and cognitive control, especially under uncertain conditions. The current study therefore examined neurocomputational mechanisms of uncertain anticipation of conflict control in anxiety. METHODS Twenty-six participants with high-trait anxiety and twenty-nine low-trait anxiety participants completed a cue-flanker task with functional magnetic resonance imaging. The hierarchical drift diffusion model (HDDM) was used to measure the cognitive computations during the task. To identify the neurocomputational mechanism of anticipatory control in anxiety, mediation analysis and dynamic causal modelling (DCM) analysis were conducted to examine the relationship between functional connectivity of brain networks and the parameters of HDDM. RESULTS We found influences of regulatory signals from the dorsolateral prefrontal cortex to dorsal anterior cingulate cortex on decision threshold in low-trait anxiety (LTA), but not in high-trait anxiety (HTA), especially for the condition with uncertain cues. The results indicate deficient top-down anticipatory control of upcoming conflicts in anxious individuals. DCM and HDDM analyses revealed that lower decision threshold was associated with higher intrinsic connectivity of salience network (SN) in anxious individuals, suggesting that dysfunctional SN disrupts anticipation of conflict control under uncertainty in anxiety. CONCLUSIONS Our results suggest hyperfunction of the SN underlies the deficient information accumulation during uncertain anticipation of upcoming conflicts in anxiety. Our findings shed new light on the mechanisms of anticipation processing and the psychopathology of anxiety.
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Affiliation(s)
- Shangfeng Han
- Department of Psychology and Center for Brain and Cognitive Sciences, School of Education, Guangzhou University, Guangzhou, China; Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
| | - Jie Gao
- School of Psychology, Chengdu Medical College, Chengdu, China
| | - Jie Hu
- School of Psychology, Chengdu Medical College, Chengdu, China
| | - Yanghua Ye
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
| | - Huiya Huang
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
| | - Jing Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Mingfang Liu
- Community Health Service Center of Beijing Normal University, China
| | - Hui Ai
- Institute of Applied Psychology, Tianjin University, Tianjin, China; Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Jianyin Qiu
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuejia Luo
- School of Psychology, Chengdu Medical College, Chengdu, China; Institute for Neuropsychological Rehabilitation, University of Health and Rehabilitation Sciences, Qingdao, China.
| | - Pengfei Xu
- The State Key Lab of Cognitive and Learning, Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (BNU), Faculty of Psychology, Beijing Normal University, Beijing, China; Center for Emotion and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China.
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Xia L, Gu R, Lin Y, Qin J, Luo W, Luo YJ. Explaining reversal learning deficits in anxiety with electrophysiological evidence. J Psychiatr Res 2023; 164:270-280. [PMID: 37390622 DOI: 10.1016/j.jpsychires.2023.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/02/2023]
Abstract
Reversal learning is a crucial aspect of behavioral flexibility that plays a significant role in environmental adaptation and development. While previous studies have established a link between anxiety and impaired reversal learning ability, the underlying mechanisms behind this association remain unclear. This study employed a probabilistic reversal learning task with electroencephalographic recording to investigate these mechanisms. Participants were divided into two groups based on their scores on Spielberger's State-Trait Anxiety Inventory: high trait-anxiety (HTA) and low trait-anxiety (LTA), consisting of 50 individuals in each group. The results showed that the HTA group had poorer reversal learning performance than the LTA group, including a lower tendency to shift to the new optimal option after rule reversals (reversal-shift). The study also examined event-related potentials elicited by reversals and found that although the N1 (related to attention allocation), feedback-related negativity (FRN: related to belief updating), and P3 (related to response inhibition) were all sensitive to the grouping factor, only the FRN elicited by reversal-shift mediated the relationship between anxiety and the number/reaction time of reversal-shift. From these findings, we suggest that abnormalities in belief updating may contribute to the impaired reversal learning performance observed in anxious individuals. In our opinion, this study sheds light on potential targets for interventions aimed at improving behavioral flexibility in anxious individuals.
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Affiliation(s)
- Lisheng Xia
- School of Psychology, Guizhou Normal University, Guiyang, 550025, China
| | - Ruolei Gu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Yongling Lin
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
| | - Jianqiang Qin
- School of Psychology, Guizhou Normal University, Guiyang, 550025, China
| | - Wenbo Luo
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, 116029, China; Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Dalian, 116029, China.
| | - Yue-Jia Luo
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China; School of Social Development and Management, University of Health and Rehabilitation Sciences, Qingdao, 266113, China
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Hidalgo-Muñoz AR, Jallais C, Evennou M, Fort A. Driving anxiety and anxiolytics while driving: Their impacts on behaviour and cognition behind the wheel. Heliyon 2023; 9:e16008. [PMID: 37305507 PMCID: PMC10256919 DOI: 10.1016/j.heliyon.2023.e16008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction The interaction between road safety and drivers' mental health is an important issue to take into consideration on transportation and safety research. The present review deals specifically with the link between anxiety and driving activity from two complementary points of view. Method A systematic review into primary studies, following the PRISMA statement, was carried out in four databases: Scopus, Web of Science, Transport Research International Documentation and Pubmed. A total of 29 papers were retained. On the one hand, we present a systematic review of research articles exploring the cognitive and behavioural effects of driving anxiety, regardless its onset, when concerned people have to drive. The second goal of the review is to compile the available literature on the influence of legal drugs, which are used to fight against anxiety, on actual driving tasks. Results Eighteen papers have been retained for the first question, whose main findings show that exaggerated cautious driving, negative feelings and avoidance are associated with driving anxiety. Most of the conclusions were drawn from self-reported questionnaires and little is known about the effects in situ. Concerning the second question, benzodiazepines are the most studied legal drugs. They affect different attentional processes and could slow reaction times down depending on the population and treatment features. Conclusions The two standpoints included in the present work allow us to propose some possible lines of research to study certain aspects that have not been explored in depth about people who either feel apprehensive about driving or who drive under the effects of anxiolytics. Practical applications The study on driving anxiety may be crucial to estimate the consequences for traffic safety. Furthermore, it is relevant to design effective campaigns to raise awareness about the issues discussed. To propose standard evaluations of driving anxiety and exhaustive research works to find out the extent of anxiolytics use are also important to be considered for traffic policies.
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Affiliation(s)
- Antonio R. Hidalgo-Muñoz
- Department of Basic Psychology, Psychobiology and Methodology of Behavioural Science, University of Salamanca, Salamanca, Spain
- Instituto de Neurociencias de Castilla y León, University of Salamanca, Salamanca, Spain
| | - Christophe Jallais
- University Gustave Eiffel, University Lyon, TS2-LESCOT, F-69675 Lyon, France
| | - Myriam Evennou
- University Gustave Eiffel, University Lyon, TS2-LESCOT, F-69675 Lyon, France
| | - Alexandra Fort
- University Gustave Eiffel, University Lyon, TS2-LESCOT, F-69675 Lyon, France
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Isheqlou LK, Soltanlou M, Zarean M, Saeedi MT, Heysieattalab S. Feedback-related negativity in perfectionists: An index of performance outcome evaluation. Behav Brain Res 2023; 444:114358. [PMID: 36822512 DOI: 10.1016/j.bbr.2023.114358] [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: 09/30/2022] [Revised: 02/11/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023]
Abstract
It has been suggested that maladaptive perfectionists are more prone to concern over their performance outcomes than adaptive perfectionists. Performance outcome evaluation is reflected in the amplitude of feedback-related negativity (FRN) in brain electroencephalography (EEG). Hence, the amplitude of the FRN after receiving unfavorable feedback indicating a negative performance outcome may reflect personality characteristics. In other words, EEG could be a better marker of personality characteristics than self-report measures. However, the FRN component has not yet been investigated between different types of perfectionists. In the present study, group differences in the FRN were examined between two groups of adaptive and maladaptive perfectionists and a group of non-perfectionists during a monetary gambling task. We observed a larger FRN amplitude for adaptive perfectionists than for maladaptive perfectionists. This finding is consistent with previous reports that reward prediction error is reflected in the amplitude of the FRN. This difference in FRN could be interpreted as the pessimistic outcome expectation biases in maladaptive perfectionists.
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Affiliation(s)
- Leyla Karami Isheqlou
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
| | - Mojtaba Soltanlou
- School of Psychology, University of Surrey, Guildford, UK; Faculty of Education, University of Johannesburg, Johannesburg, South Africa
| | - Mostafa Zarean
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
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Baumel WT, Mills JA, Schroeder HK, Specht AM, Rothenberg R, Peris TS, Strawn JR. Executive Functioning in Pediatric Anxiety and Its Relationship to Selective Serotonin Reuptake Inhibitor Treatment Response: A Double-Blind, Placebo-Controlled Trial. J Child Adolesc Psychopharmacol 2022; 32:215-223. [PMID: 35532982 PMCID: PMC9145261 DOI: 10.1089/cap.2022.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To characterize executive function in adolescents with generalized anxiety disorder (GAD) and its relationship to treatment. Methods: Using data from a double-blind, placebo-controlled trial of escitalopram in adolescents (N = 51) 12-17 years of age with GAD, we used the self-report version of the Behavior Rating Inventory of Executive Function (BRIEF-SR) to assess executive function, at baseline, and examined its relationship to treatment response as measured by the Pediatric Anxiety Rating Scale (PARS). Results: For all baseline subscores of the BRIEF-SR, T-scores were significantly elevated in adolescents with GAD compared to an age- and sex-matched normative healthy sample. In escitalopram-treated patients, baseline BRIEF-SR scores for Emotional Control (β = 0.256, 95% credibility interval [CrI]: 0.367 to 0.146, p < 0.001), Working Memory (β = 0.204, CrI: 0.2952 to 0.1134, p < 0.001), Planning/Organizing (β = -0.223, CrI: -0.1021 to -0.3436, p = 0.004), and Task Completion (β = -0.152, CrI: 0.075 to 0.228, p = 0.002) predicted the trajectory of improvement in PARS score over the 8-week trial. For youth who received placebo, only the Inhibit score was significantly, but weakly, associated with response trajectory (β = -0.081, CrI: -0.0167 to -0.1461, p = 0.015). For adolescents who had clinically significant impairment in Emotional Control, Working Memory, Planning/Organizing, and Task Completion (i.e., T-score >65), the trajectory of improvement significantly differed from patients without scores in the clinically significant range. Conclusions: Taken together, these findings point to the potential value of assessing executive function in youth with anxiety disorders as one strategy for guiding treatment selection. These data suggest that executive function may predict treatment response to psychopharmacologic treatment and point to numerous avenues for further personalizing treatment.
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Affiliation(s)
- W. Thomas Baumel
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jeffrey A. Mills
- Department of Economics, Lindner College of Business, University of Cincinnati, Cincinnati, Ohio, USA
| | - Heidi K. Schroeder
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Ashley M. Specht
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Richard Rothenberg
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Tara S. Peris
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
| | - Jeffrey R. Strawn
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Child and Adolescent Psychiatry, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Division of Clinical Pharmacology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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Giannopoulos AE, Zioga I, Papageorgiou P, Pervanidou P, Makris G, Chrousos GP, Stachtea X, Capsalis C, Papageorgiou C. Evaluating the Modulation of the Acoustic Startle Reflex in Children and Adolescents via Vertical EOG and EEG: Sex, Age, and Behavioral Effects. Front Neurosci 2022; 16:798667. [PMID: 35464323 PMCID: PMC9019526 DOI: 10.3389/fnins.2022.798667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/28/2022] [Indexed: 11/15/2022] Open
Abstract
Acoustic startle reflex (ASR) constitutes a reliable, cross-species indicator of sensorimotor and inhibitory mechanisms, showing distinct signature in cognitive aging, sex, and psychopathological characterization. ASR can be modulated by the prepulse inhibition (PPI) paradigm, which comprises the suppression of reactivity to a startling stimulus (pulse) following a weak prepulse (30- to 500-ms time difference), being widely linked to inhibitory capabilities of the sensorimotor system. If the prepulse–pulse tones are more clearly separated (500–2,000 ms), ASR amplitude is enhanced, termed as prepulse facilitation (PPF), reflecting sustained or selective attention. Our study aimed to investigate early-life sensorimotor sex/age differences using Electroencephalographic recordings to measure muscular and neural ASR in a healthy young population. Sixty-three children and adolescents aged 6.2–16.7 years (31 females) took part in the experiment. Neural ASR was assessed by two different analyses, namely, event-related potentials (ERPs) and first-derivative potentials (FDPs). As expected, PPF showed enhanced responses compared with PPI, as indicated by eyeblink, ERP and FDP measures, confirming the gating effect hypothesis. Sex-related differences were reflected in FDPs, with females showing higher ASR than males, suggesting increased levels of poststartle excitability. Intragroup age effects were evaluated via multipredictor regression models, noticing positive correlation between age versus eyeblink and ERP responses. Attention-related ERPs (N100 and P200) showed distinct patterns in PPI versus PPF, potentially indicative for alternative attentional allocation and block-out of sensory overload. Screening measures of participants’ neurodevelopmental (assessed by Wechsler Intelligence Scale for Children) and behavioral (assessed by Child Behavior Checklist) markers were also associated with increased N100/P200 responses, presumably indexing synergy between perceptual consistency, personality profiling, and inhibitory performance. Conclusively, modulation of ASR by PPI and PPF is associated with biological sex and internal/external personality traits in childhood and adolescence, potentially useful to guide symptomatology and prevention of psychopathology.
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Affiliation(s)
- Anastasios E. Giannopoulos
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
- *Correspondence: Anastasios E. Giannopoulos,
| | - Ioanna Zioga
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
- First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Panos Papageorgiou
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, “Aghia Sophia” Children’s Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerasimos Makris
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, “Aghia Sophia” Children’s Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George P. Chrousos
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, “Aghia Sophia” Children’s Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Xanthi Stachtea
- Neurosciences and Precision Medicine Research Institute “COSTAS STEFANIS” (UMHRI), University Mental Health, Athens, Greece
| | - Christos Capsalis
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Charalabos Papageorgiou
- Neurosciences and Precision Medicine Research Institute “COSTAS STEFANIS” (UMHRI), University Mental Health, Athens, Greece
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