Fronto-insula network activity explains emotional dysfunctions in juvenile myoclonic epilepsy: Combined evidence from pupillometry and fMRI

Multilayer brain network modeling and dynamic analysis of juvenile myoclonic epilepsy

Objective: It is indisputable that the functional connectivity of the brain network in juvenile myoclonic epilepsy (JME) patients is abnormal. As a mathematical extension of the traditional network model, the multilayer network can fully capture the fluctuations of brain imaging data with time, and capture subtle abnormal dynamic changes. This study assumed that the dynamic structure of JME patients is abnormal and used the multilayer network framework to analyze the change brain community structure in JME patients from the perspective of dynamic analysis.

Methods: First, functional magnetic resonance imaging (fMRI) data were obtained from 35 JME patients and 34 healthy control subjects. In addition, the communities of the two groups were explored with the help of a multilayer network model and a multilayer community detection algorithm. Finally, differences were described by metrics that are specific to the multilayer network.

Results: Compared with healthy controls, JME patients had a significantly lower modularity degree of the brain network. Furthermore, from the level of the functional network, the integration of the default mode network (DMN) and visual network (VN) in JME patients showed a significantly higher trend, and the flexibility of the attention network (AN) also increased significantly. At the node level, the integration of seven nodes of the DMN was significantly increased, the integration of five nodes of the VN was significantly increased, and the flexibility of three nodes of the AN was significantly increased. Moreover, through division of the core-peripheral system, we found that the left insula and left cuneus were core regions specific to the JME group, while most of the peripheral systems specific to the JME group were distributed in the prefrontal cortex and hippocampus. Finally, we found that the flexibility of the opercular part of the inferior frontal gyrus was significantly correlated with the severity of JME symptoms.

Conclusion: Our findings indicate that the dynamic community structure of JME patients is indeed abnormal. These results provide a new perspective for the study of dynamic changes in communities in JME patients.

Neurocomputational mechanisms of affected beliefs

The feedback people receive on their behavior shapes the process of belief formation and self-efficacy in mastering a particular task. However, the neural and computational mechanisms of how the subjective value of self-efficacy beliefs, and the corresponding affect, influence the learning process remain unclear. We investigated these mechanisms during self-efficacy belief formation using fMRI, pupillometry, and computational modeling, and by analyzing individual differences in affective experience. Biases in the formation of self-efficacy beliefs were associated with affect, pupil dilation, and neural activity within the anterior insula, amygdala, ventral tegmental area/ substantia nigra, and mPFC. Specifically, neural and pupil responses mapped the valence of the prediction errors in correspondence with individuals’ experienced affective states and learning biases during self-efficacy belief formation. Together with the functional connectivity dynamics of the anterior insula within this network, our results provide evidence for neural and computational mechanisms of how we arrive at affected beliefs.

Aberrant dynamic structure-function relationship of rich-club organization in treatment-naïve newly diagnosed juvenile myoclonic epilepsy

Neuroimaging studies have shown that juvenile myoclonic epilepsy (JME) is characterized by impaired brain networks. However, few studies have investigated the potential disruptions in rich‐club organization—a core feature of the brain networks. Moreover, it is unclear how structure–function relationships dynamically change over time in JME. Here, we quantify the anatomical rich‐club organization and dynamic structural and functional connectivity (SC–FC) coupling in 47 treatment‐naïve newly diagnosed patients with JME and 40 matched healthy controls. Dynamic functional network efficiency and its association with SC–FC coupling were also calculated to examine the supporting of structure–function relationship to brain information transfer. The results showed that the anatomical rich‐club organization was disrupted in the patient group, along with decreased connectivity strength among rich‐club hub nodes. Furthermore, reduced SC–FC coupling in rich‐club organization of the patients was found in two functionally independent dynamic states, that is the functional segregation state (State 1) and the strong somatomotor‐cognitive control interaction state (State 5); and the latter was significantly associated with disease severity. In addition, the relationships between SC–FC coupling of hub nodes connections and functional network efficiency in State 1 were found to be absent in patients. The aberrant dynamic SC–FC coupling of rich‐club organization suggests a selective influence of densely interconnected network core in patients with JME at the early phase of the disease, offering new insights and potential biomarkers into the underlying neurodevelopmental basis of behavioral and cognitive impairments observed in JME.

A systematic review of resting-state and task-based fmri in juvenile myoclonic epilepsy

Functional neuroimaging modalities have enhanced our understanding of juvenile myoclonic epilepsy (JME) underlying neural mechanisms. Due to its non-invasive, sensitive and analytical nature, functional magnetic resonance imaging (fMRI) provides valuable insights into relevant functional brain networks and their segregation and integration properties. We systematically reviewed the contribution of resting-state and task-based fMRI to the current understanding of the pathophysiology and the patterns of seizure propagation in JME Altogether, despite some discrepancies, functional findings suggest that corticothalamo-striato-cerebellar network along with default-mode network and salience network are the most affected networks in patients with JME. However, further studies are required to investigate the association between JME's main deficiencies, e.g., motor and cognitive deficiencies and fMRI findings. Moreover, simultaneous electroencephalography-fMRI (EEG-fMRI) studies indicate that alterations of these networks play a role in seizure modulation but fall short of identifying a causal relationship between altered functional properties and seizure propagation. This review highlights the complex pathophysiology of JME, which necessitates the design of more personalized diagnostic and therapeutic strategies in this group.

Reduced structural covariance connectivity of defaut mode network and salience network in MRI-normal focal epilepsy

Neuroimaging studies have found altered functional connectivity of default mode network (DMN) and salience network (SN) in patients with focal epilepsy (FE). However, the structural basis underlying the functional connectivity disturbance in the patients is still unclear. Sixteen MRI-normal FE and 22 healthy controls were included in the current study. The T1 structural image of each participant was obtained. Seed-based structural covariance connectivity was employed to investigate changes of structural covariance connectivity of DMN and SN in FE patients. We further evaluated gray matter volume changes of brain areas showing altered structural connectivity in the patients. We found that patients with FE showed reduced connectivity of posterior cingulate cortex and left medial prefrontal cortex, hippocampus and orbitofrontal cortex, and reduced connectivity of right fronto-insula cortex with left insula, orbitofrontal cortex, opercum part of inferior frontal cortex and right medial prefrontal cortex compared with healthy controls. Moreover, those brain areas showing significant reduced structural covariance connectivity in patients with FE also had a loss of gray matter volume, indicating that reduced structural connectivity of DMN and SN might be associated with gray matter atrophy in the patients. Those results highlight the crucial role of DMN and SN in the pathology of patients with FE, and provided structural basis for the functional disturbance of the two networks in this disease.

Impulsiveness, personality traits and executive functioning in patients with juvenile myoclonic epilepsy

PURPOSE

To evaluate impulsiveness in adult patients with JME and its relationship with personality traits and executive functioning.

METHODS

Patients completed psychiatric evaluation (DSM IV), Barratt Impulsiveness Scale (BIS-11), Neo Revised Personality Inventory (NEO PI-R) and executive functioning evaluation comprising Controlled Oral Word Association (COWA), Digit Span, Trail Making Tests (TMT), Stroop Test (ST) and Wisconsin Card Sorting Test (WSCT). Healthy controls (63 % female, mean age 35.7 yrs. (±8.37)) were examined to allow calculation of z-scores.

RESULTS

50 patients (70 % female; mean age 32.5 yrs. (±9.2)) presented higher scores of Total (z=-0.37; p = 0.005) and Motor Impulsiveness (z=-0.79; p < 0.001) on BIS-11. Motor Impulsiveness was associated with higher rates of mild psychiatric disorders (depression and anxiety) (p = 0.035) and worse myoclonic seizure control (p = 0.007). NEO PI-R showed differences on Neuroticism (z=-0.60; p < 0.001), Openness (z = 0.38; p = 0.043), Agreeableness (z=-0.38; p = 0.033) and Conscientiousness (z=-0.53; p = 0.003). There were positive correlations between BIS-11 and Neuroticism with Total, Motor and Non-Planning Impulsiveness, on the other hand, Conscientiousness was negatively correlated with these as well as with Attentive Impulsiveness. Patients performance was worse than that of controls on COWA (z=-0.43; p = 0.009) and WCST's Total Number of Completed Categories (z=-2.08; p = 0.005), Trials Taken to Complete First Category (z=-1.56; p = 0.013), Percentage of Total Errors (z=-1.56; p < 0.001), Perseverative Errors (z=-0.73; p = 0.002), Non-Perseverative Errors (z=-1.05; p = 0.003) and Conceptual Level Responses (z=-1.52; p < 0.001). Non-Planning Impulsiveness correlated with Performance (ST and TMT).

CONCLUSION

Patients with JME present with impulsive behavior, personality features and executive dysfunction which are linked and may lead to lack of commitment in treatment and affect other aspects of life.

Altered dynamic effective connectivity of the default mode network in newly diagnosed drug-naïve juvenile myoclonic epilepsy

Juvenile myoclonic epilepsy (JME) has been repeatedly revealed to be associated with brain dysconnectivity in the default mode network (DMN). However, the implicit assumption of stationary and nondirectional functional connectivity (FC) in most previous resting-state fMRI studies raises an open question of JME-related aberrations in dynamic causal properties of FC. Here, we introduces an empirical method incorporating sliding-window approach and a multivariate Granger causality analysis to investigate, for the first time, the reorganization of dynamic effective connectivity (DEC) in DMN for patients with JME. DEC was obtained from resting-state fMRI of 34 patients with newly diagnosed and drug-naïve JME and 34 matched controls. Through clustering analysis, we found two distinct states that characterize the DEC patterns (i.e., a less frequent, strongly connected state (State 1) and a more frequent, weakly connected state (State 2)). Patients showed altered ECs within DMN subnetworks in the State 2, whereas abnormal ECs between DMN subnetworks were found in the State 1. Furthermore, we observed that the causal influence flows of the medial prefrontal cortex and angular gyrus were altered in a manner of state specificity, and associated with disease severity of patients. Overall, our findings extend the dysconnectivity hypothesis in JME from static to dynamic causal FC and demonstrate that aberrant DEC may underlie abnormal brain function in JME at early phase of illness.

Revisiting personality in epilepsy: Differentiation of personality in two epilepsies starting in adolescence

PURPOSE

The purpose of this study was to investigate personality characteristics and clinical parameters in two well-defined epilepsies: mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE/HS) and juvenile myoclonic epilepsy (JME) through NEO Revised Personality Inventory (NEO-PI-R) and Neurobehavior Inventory (NBI) standardized instruments.

METHODS

One hundred patients undergoing corticoamygdalohippocampectomy (CAH), 100 patients with JME, and 100 control subjects answered the personality measures. Clinical parameters such as psychiatric symptoms, seizure frequency, duration of epilepsy, and side of the lesion in MTLE/HS group were investigated. Statistical analysis consisted of the mean and standard deviation (SD) of each variable. Student's t-test or Fisher exact test were used according to the variable studied.

RESULTS

The three groups were within the average range of NEO-PI-R and NBI, although 'tendencies' and differences were demonstrated. The MTLE/HS and control subjects had a similar profile: low scores in Neuroticism and high in Conscientiousness (r = -0.330; p < 0.001/r = -0.567; p < 0.001, respectively) in opposition to what occurred in JME, low in Conscientiousness and high in Neuroticism (r = -0.509; p = 0.005). The NBI 'sense of personal destiny' trait was higher (3.15; p = 0.003) in MTLE/HS than in JME and controls. The JME 'law and order' scores were lower than in other groups (p = 0.024). A tendency towards specific NBI traits differentiates MTLE/HS (Factor 3) from JME (Factor 1) groups. Psychiatric symptoms and seizure frequency were correlated with worse scores in NBI and, especially, in Neuroticism domain of NEO-PI-R.

CONCLUSION

Specific personality features were linked to each epileptic disease. These findings highlight the importance of considering unique features linked to epilepsy conditions in daily clinical observation to develop support programmes.

Progressive Recruitment of the Frontoparietal Multiple-demand System with Increased Task Complexity, Time Pressure, and Reward

A distributed, frontoparietal "multiple-demand" (MD) network is involved in tasks of many different kinds. Integrated activity across this network may be needed to bind together the multiple features of a mental control program (Duncan, 2013). Previous data suggest that, especially with low cognitive load, there may be some differentiation between MD regions (e.g., anterior vs. posterior regions of lateral frontal cortex), but with increasing load, there is progressive recruitment of the entire network. Differentiation may reflect preferential access to different task features, whereas co-recruitment may reflect information exchange and integration. To examine these patterns, we used manipulations of complexity, time pressure, and reward while participants solved a spatial maze. Complexity was manipulated by combining two simple tasks. Time pressure was added by fading away the maze during route planning, and on some of these trials, there was the further possibility of a substantial reward. Simple tasks evoked activity only in posterior MD regions, including posterior lateral frontal cortex, pre-supplementary motor area/anterior cingulate, and intraparietal sulcus. With increasing complexity, time pressure, and reward, increases in activity were broadly distributed across the MD network, though with quantitative variations. Across the MD network, the results show a degree of functional differentiation, especially at low load, but strong co-recruitment with increased challenge or incentive.

How does social information affect charitable giving?: Empathic concern promotes support for underdog recipient

Charitable giving represents a unique cooperative characteristic of humans. In today's environment with social media, our charitable decisions seem to be influenced by social information such as a project's popularity. Here we report three experiments that examined people's reactions to social information about a charitable endeavor and their psychophysiological underpinnings. Participants were first solicited to make donations to either the Africa or Syria project of UNICEF. Then participants were provided an opportunity to learn social information (i.e., how much each project had raised from previous participants) and change their decision if desired. Contrary to expectation, participants who learned that their initial preferences were consistent with the majority of previous participants' choices exhibited a sizable tendency to switch to the less popular project in their final choices. This anti-conformity pattern was robust across the three experiments. Eye-tracking data (gaze bias and pupil dilation) indicated that these "Changers" were more physiologically aroused and formed more differential valuations between the two charity projects, compared to "Keepers" who retained their initial preferences after viewing the social information. These results suggest that social information about relative popularity may evoke empathic concern for the worse-off target, in line with the human tendency to avoid unequal distributions.

Juvenile myoclonic epilepsy has hyper dynamic functional connectivity in the dorsolateral frontal cortex

PURPOSE

Characterize the static and dynamic functional connectivity for subjects with juvenile myoclonic epilepsy (JME) using a quantitative data-driven analysis approach.

METHODS

Whole-brain resting-state functional MRI data were acquired on a 3 T whole-body clinical MRI scanner from 18 subjects clinically diagnosed with JME and 25 healthy control subjects. 2-min sliding-window approach was incorporated in the quantitative data-driven data analysis framework to assess both the dynamic and static functional connectivity in the resting brains. Two-sample t-tests were performed voxel-wise to detect the differences in functional connectivity metrics based on connectivity strength and density.

RESULTS

The static functional connectivity metrics based on quantitative data-driven analysis of the entire 10-min acquisition window of resting-state functional MRI data revealed significantly enhanced functional connectivity in JME patients in bilateral dorsolateral prefrontal cortex, dorsal striatum, precentral and middle temporal gyri. The dynamic functional connectivity metrics derived by incorporating a 2-min sliding window into quantitative data-driven analysis demonstrated significant hyper dynamic functional connectivity in the dorsolateral prefrontal cortex, middle temporal gyrus and dorsal striatum. Connectivity strength metrics (both static and dynamic) can detect more extensive functional connectivity abnormalities in the resting-state functional networks (RFNs) and depict also larger overlap between static and dynamic functional connectivity results.

CONCLUSION

Incorporating a 2-min sliding window into quantitative data-driven analysis of resting-state functional MRI data can reveal additional information on the temporally fluctuating RFNs of the human brain, which indicate that RFNs involving dorsolateral prefrontal cortex have temporal varying hyper dynamic characteristics in JME patients. Assessing dynamic along with static functional connectivity may provide further insights into the abnormal function connectivity underlying the pathological brain functioning in JME.

Nicotinic receptor abnormalities as a biomarker in idiopathic generalized epilepsy

PURPOSE

Mutations of cholinergic neuronal nicotinic receptors have been identified in the autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE), associated with changes on PET images using [¹⁸F]-F-85380-A (F-A-85380), an α4β2 nicotinic receptor ligand. The aim of the present study was to evaluate potential changes in nicotinic receptor availability in other types of epilepsy.

METHODS

We included 34 male participants, 12 patients with idiopathic generalized epilepsy (IGE), 10 with non-lesional diurnal focal epilepsy, and 12 age-matched healthy controls. All patients underwent PET/CT using F-A-85380 and [¹⁸F]-fluorodeoxyglucose (FDG), 3D T1 MRI and diffusion tensor imaging (DTI). F-A-85380 and FDG images were compared with the control group using a voxel-wise (SPM12) and a volumes of interest (VOI) analysis.

RESULTS

In the group of patients with IGE, the voxel-wise and VOI analyses showed a significant increase of F-A-85380 ratio index of binding potential (BP_RI, corresponding to the receptor availability) in the anterior cingulate cortex (ACC), without structural changes on MRI. At an individual level, F-A-85380 BP_RI increase in the ACC could distinguish IGE patients from controls and from patients with focal epilepsy with good accuracy.

CONCLUSIONS

We observed focal changes of density/availability of nicotinic receptors in IGE, namely an increase in the ACC. These data suggest that the modulation of α4β2 nicotinic receptors plays a role not only in ADNFLE, but also in other genetic epileptic syndromes such as IGE and could serve as a biomarker of epilepsy syndromes with a genetic background.

Disentangling brain activity related to the processing of emotional visual information and emotional arousal

Processing of emotional visual information engages cognitive functions and induces arousal. We aimed to examine the modulatory role of emotional valence on brain activations linked to the processing of visual information and those linked to arousal. Participants were scanned and their pupil size was measured while viewing negative and neutral images. The visual noise was added to the images in various proportions to parametrically manipulate the amount of visual information. Pupil size was used as an index of physiological arousal. We show that arousal induced by the negative images, as compared to the neutral ones, is primarily related to greater amygdala activity while increasing visibility of negative content to enhanced activity in the lateral occipital complex (LOC). We argue that more intense visual processing of negative scenes can occur irrespective of the level of arousal. It may suggest that higher areas of the visual stream are fine-tuned to process emotionally relevant objects. Both arousal and processing of emotional visual information modulated activity within the ventromedial prefrontal cortex (vmPFC). Overlapping activations within the vmPFC may reflect the integration of these aspects of emotional processing. Additionally, we show that emotionally-evoked pupil dilations are related to activations in the amygdala, vmPFC, and LOC.

Microstructural white matter changes and their relation to neuropsychological deficits in patients with juvenile myoclonic epilepsy

OBJECTIVE

Juvenile myoclonic epilepsy (JME) is the most common idiopathic generalized epilepsy syndrome. Neuropsychological, electrophysiological, and neuroimaging studies have led to the hypothesis that JME is related to dysfunction of frontal brain regions and mainly frontal thalamocortical networks.

METHODS

We investigated possible microstructural white matter abnormalities of 20 patients with JME as compared with 20 healthy control subjects using diffusion tensor imaging (DTI). We analyzed whole-head DTI scans without an a-priori hypothesis using Tract-Based Spatial Statistics (TBSS). To analyze associated gray matter changes, we applied voxel-based morphometry (VBM) to a 3D T1 magnetization prepared rapid gradient echo (MPRAGE) sequence. Neuropsychological testing and personality trait tests were performed to bridge the gap between structure and function.

RESULTS

In patients, DTI revealed microstructural white matter changes in anterior parts of the Corpus callosum, anterior parts of the cingulate gyrus, and widespread frontal white matter bilaterally as well as in anterior parts of the right thalamus, which were not accompanied by gray matter changes in VBM. Microstructural changes in the cingulum correlated with personality traits. Neuropsychological test results showed impaired attention and executive functions and reduced short-term memory in the patient group. Also, there was a tendency toward alexithymia and significantly higher scores on depression.

SIGNIFICANCE

The present study results showed neuropsychological deficits including frontal lobe cognitive performance and a tendency toward alexithymia as well as accompanying microstructural neuroimaging changes in patients with JME, which all point to alterations in frontal brain regions and frontal thalamocortical networks in these patients.

Mindfulness meditation regulates anterior insula activity during empathy for social pain

Mindfulness has been shown to reduce stress, promote health, and well-being, as well as to increase compassionate behavior toward others. It reduces distress to one's own painful experiences, going along with altered neural responses, by enhancing self-regulatory processes and decreasing emotional reactivity. In order to investigate if mindfulness similarly reduces distress and neural activations associated with empathy for others' socially painful experiences, which might in the following more strongly motivate prosocial behavior, the present study compared trait, and state effects of long-term mindfulness meditation (LTM) practice. To do so we acquired behavioral data and neural activity measures using functional magnetic resonance imaging (fMRI) during an empathy for social pain task while manipulating the meditation state between two groups of LTM practitioners that were matched with a control group. The results show increased activations of the anterior insula (AI) and anterior cingulate cortex (ACC) as well as the medial prefrontal cortex and temporal pole when sharing others' social suffering, both in LTM practitioners and controls. However, in LTM practitioners, who practiced mindfulness meditation just prior to observing others' social pain, left AI activation was lower and the strength of AI activation following the mindfulness meditation was negatively associated with trait compassion in LTM practitioners. The findings suggest that current mindfulness meditation could provide an adaptive mechanism in coping with distress due to the empathic sharing of others' suffering, thereby possibly enabling compassionate behavior. Hum Brain Mapp 38:4034-4046, 2017. © 2017 Wiley Periodicals, Inc.

Clinical trial of modulatory effects of oxytocin treatment on higher-order social cognition in autism spectrum disorder: a randomized, placebo-controlled, double-blind and crossover trial

BACKGROUND

Autism spectrum disorders are neurodevelopmental conditions with severe impairments in social communication and interaction. Pioneering research suggests that oxytocin can improve motivation, cognition and attention to social cues in patients with autism spectrum disorder. The aim of this clinical trial is to characterize basic mechanisms of action of acute oxytocin treatment on neural levels and to relate these to changes in different levels of socio-affective and -cognitive functioning.

METHODS

This clinical study is a randomized, double-blind, cross-over, placebo-controlled, multicenter functional magnetic resonance imaging study with two arms. A sample of 102 male autism spectrum disorder patients, diagnosed with Infantile Autistic Disorder (F84.0 according to ICD-10), Asperger Syndrome (F84.5 according to ICD-10), or Atypical Autism (F84.1 according to ICD-10) will be recruited and will receive oxytocin and placebo nasal spray on two different days. Autism spectrum disorder patients will be randomized to determine who receives oxytocin on the first and who on the second visit. Healthy control participants will be recruited and case-control matched to the autism spectrum disorder patients. The primary outcome will be neural network activity, measured with functional magnetic resonance imaging while participants perform socio-affective and -cognitive tasks. Behavioral markers such as theory of mind accuracy ratings and response times will be assessed as secondary outcomes in addition to physiological measures such as skin conductance. Trait measures for alexithymia, interpersonal reactivity, and social anxiety will also be evaluated. Additionally, we will analyze the effect of oxytocin receptor gene variants and how these potentially influence the primary and secondary outcome measures. Functional magnetic resonance imaging assessments will take place at two time points which will be scheduled at least two weeks apart to ensure a sufficient wash-out time after oxytocin treatment. The study has been approved by an ethical review board and the competent authority.

DISCUSSION

Revealing the mechanisms of acute oxytocin administration, especially on the socio-affective and -cognitive domains at hand, will be a further step towards novel therapeutic interventions regarding autism.

TRIAL REGISTRATION

German Clinical Trial Register DRKS00010053 . The trial was registered on the 8^th of April 2016.

Evidence from pupillometry and fMRI indicates reduced neural response during vicarious social pain but not physical pain in autism

Autism spectrum disorder (ASD) is characterized by substantial social deficits. The notion that dysfunctions in neural circuits involved in sharing another's affect explain these deficits is appealing, but has received only modest experimental support. Here we evaluated a complex paradigm on the vicarious social pain of embarrassment to probe social deficits in ASD as to whether it is more potent than paradigms currently in use. To do so we acquired pupillometry and fMRI in young adults with ASD and matched healthy controls. During a simple vicarious physical pain task no differences emerged between groups in behavior, pupillometry, and neural activation of the anterior insula (AIC) and anterior cingulate cortex (ACC). In contrast, processing complex vicarious social pain yielded reduced responses in ASD on all physiological measures of sharing another's affect. The reduced activity within the AIC was thereby explained by the severity of autistic symptoms in the social and affective domain. Additionally, behavioral responses lacked correspondence with the anterior cingulate and anterior insula cortex activity found in controls. Instead, behavioral responses in ASD were associated with hippocampal activity. The observed dissociation echoes the clinical observations that deficits in ASD are most pronounced in complex social situations and simple tasks may not probe the dysfunctions in neural pathways involved in sharing affect. Our results are highly relevant because individuals with ASD may have preserved abilities to share another's physical pain but still have problems with the vicarious representation of more complex emotions that matter in life.

Cortical localization of phase and amplitude dynamics predicting access to somatosensory awareness

Neural dynamics leading to conscious sensory perception have remained enigmatic in despite of large interest. Human functional magnetic resonance imaging (fMRI) studies have revealed that a co-activation of sensory and frontoparietal areas is crucial for conscious sensory perception in the several second time-scale of BOLD signal fluctuations. Electrophysiological recordings with magneto- and electroencephalography (MEG and EEG) and intracranial EEG (iEEG) have shown that event related responses (ERs), phase-locking of neuronal activity, and oscillation amplitude modulations in sub-second timescales are greater for consciously perceived than for unperceived stimuli. The cortical sources of ER and oscillation dynamics predicting the conscious perception have, however, remained unclear because these prior studies have utilized MEG/EEG sensor-level analyses or iEEG with limited neuroanatomical coverage. We used a somatosensory detection task, magnetoencephalography (MEG), and cortically constrained source reconstruction to identify the cortical areas where ERs, local poststimulus amplitudes and phase-locking of neuronal activity are predictive of the conscious access of somatosensory information. We show here that strengthened ERs, phase-locking to stimulus onset (SL), and induced oscillations amplitude modulations all predicted conscious somatosensory perception, but the most robust and widespread of these was SL that was sustained in low-alpha (6-10 Hz) band. The strength of SL and to a lesser extent that of ER predicted conscious perception in the somatosensory, lateral and medial frontal, posterior parietal, and in the cingulate cortex. These data suggest that a rapid phase-reorganization and concurrent oscillation amplitude modulations in these areas play an instrumental role in the emergence of a conscious percept.

Neural pathways of embarrassment and their modulation by social anxiety

While being in the center of attention and exposed to other's evaluations humans are prone to experience embarrassment. To characterize the neural underpinnings of such aversive moments, we induced genuine experiences of embarrassment during person-group interactions in a functional neuroimaging study. Using a mock-up scenario with three confederates, we examined how the presence of an audience affected physiological and neural responses and the reported emotional experiences of failures and achievements. The results indicated that publicity induced activations in mentalizing areas and failures led to activations in arousal processing systems. Mentalizing activity as well as attention towards the audience were increased in socially anxious participants. The converging integration of information from mentalizing areas and arousal processing systems within the ventral anterior insula and amygdala forms the neural pathways of embarrassment. Targeting these neural markers of embarrassment in the (para-)limbic system provides new perspectives for developing treatment strategies for social anxiety disorders.