Insula and putamen centered functional connectivity networks reflect healthy agers' subjective experience of cognitive fatigue in multiple tasks

Vision-based estimation of fatigue and engagement in cognitive training sessions

Computerized cognitive training (CCT) is a scalable, well-tolerated intervention that has promise for slowing cognitive decline. The effectiveness of CCT is often affected by a lack of effective engagement. Mental fatigue is a the primary factor for compromising effective engagement in CCT, particularly in older adults at risk for dementia. There is a need for scalable, automated measures that can constantly monitor and reliably detect mental fatigue during CCT. Here, we develop and validate a novel Recurrent Video Transformer (RVT) method for monitoring real-time mental fatigue in older adults with mild cognitive impairment using their video-recorded facial gestures during CCT. The RVT model achieved the highest balanced accuracy (79.58%) and precision (0.82) compared to the prior models for binary and multi-class classification of mental fatigue. We also validated our model by significantly relating to reaction time across CCT tasks (Waldχ2=5.16,p=0.023). By leveraging dynamic temporal information, the RVT model demonstrates the potential to accurately measure real-time mental fatigue, laying the foundation for future CCT research aiming to enhance effective engagement by timely prevention of mental fatigue.

The neural substrates responsible for punishment sensitivity association with procrastination: Left putamen connectivity with left middle temporal gyrus

Procrastination has adverse consequences across cultural contexts. Behavioral research found a positive correlation between punishment sensitivity and procrastination. However, little is known about the neural substrates underlying the association between them. We employed voxel-based morphometry (VBM) and resting-state functional connectivity (RSFC) methods to address this issue with two independent samples. In Sample 1, behavioral results found that punishment sensitivity was positively related to procrastination. The VBM analysis showed that punishment sensitivity was negatively correlated with gray matter volume in left putamen. Subsequently, the RSFC results revealed that left putamen - left middle temporal gyrus (MTG) connectivity was positively associated with punishment sensitivity. More crucially, mediation analysis indicated that left putamen - left MTG connectivity mediated the relationship between punishment sensitivity and procrastination. The aforementioned results were validated in Sample 2. Altogether, left putamen - left MTG connectivity might be the neural signature of the association between punishment sensitivity and procrastination.

Brain abnormalities in survivors of COVID-19 after 2-year recovery: a functional MRI study

Background

A variety of symptoms, particularly cognitive, psychiatric and neurological symptoms, may persist for a long time among individuals recovering from COVID-19. However, the underlying mechanism of these brain abnormalities remains unclear. This study aimed to investigate the long-term neuroimaging effects of COVID-19 infection on brain functional activities using resting-state functional magnetic resonance imaging (rs-fMRI).

Methods

Fifty-two survivors 27 months after infection (mild-moderate group: 25 participants, severe-critical: 27 participants), from our previous community participants, along with 35 healthy controls, were recruited to undergo fMRI scans and comprehensive cognitive function measurements. Participants were evaluated by subjective assessment of Cognitive Failures Questionnaire-14 (CFQ-14) and Fatigue Scale-14 (FS-14), and objective assessment of Montreal Cognitive Assessment (MoCA), N-back, and Simple Reaction Time (SRT). Each had rs-fMRI at 3T. Measures such as the amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) were calculated.

Findings

Compared with healthy controls, survivors of mild-moderate acute symptoms group and severe-critical group had a significantly higher score of cognitive complains involving cognitive failure and mental fatigue. However, there was no difference of cognitive complaints between two groups of COVID-19 survivors. The performance of three groups was similar on the score of MoCA, N-back and SRT. The rs-fMRI results showed that COVID-19 survivors exhibited significantly increased ALFF values in the left putamen (PUT.L), right inferior temporal gyrus (ITG.R) and right pallidum (PAL.R), while decreased ALFF values were observed in the right superior parietal gyrus (SPG.R) and left superior temporal gyrus (STG.L). Additionally, decreased ReHo values in the right precentral gyrus (PreCG.R), left postcentral gyrus (PoCG.L), left calcarine fissure and surrounding cortex (CAL.L) and left superior temporal gyrus (STG.L). Furthermore, significant negative correlations between the ReHo values in the STG.L, and CFQ-14 and mental fatigue were found.

Interpretation

This long-term study suggests that individuals recovering from COVID-19 continue to experience cognitive complaints, psychiatric and neurological symptoms, and brain functional alteration. The rs-fMRI results indicated that the changes in brain function in regions such as the putamen, temporal lobe, and superior parietal gyrus may contribute to cognitive complaints in individuals with long COVID even after 2-year infection.

Funding

The National Programs for Brain Science and Brain-like Intelligence Technology of China, the National Natural Science Foundation of China, Natural Science Foundation of Beijing Municipality of China, and the National Key Research and Development Program of China.

Alterations in Resting-State MR Functional Connectivity of the Central Autonomic Network in Multiple System Atrophy and Relationship with Disease Severity

BACKGROUND

The central autonomic network (CAN) plays a critical role in the body's sympathetic and parasympathetic control. However, functional connectivity (FC) changes of the CAN in patients with multiple system atrophy (MSA) remain unknown.

PURPOSE

To investigate FC alterations of CAN in MSA patients.

STUDY TYPE

Prospective.

POPULATION

Eighty-two subjects (47 patients with MSA [44.7% female, 60.5 ± 6.9 years], 35 age- and sex-matched healthy controls [HC] [57.1% female, 62.5 ± 6.6 years]).

FIELD STRENGTH/SEQUENCE

3-T, resting-state functional magnetic resonance imaging (rs-fMRI) using gradient echo-planar imaging (EPI), T1-weighted three-dimensional magnetization-prepared rapid gradient echo (3D MPRAGE) structural MRI.

ASSESSMENT

FC alterations were explored by using core modulatory regions of CAN as seeds, including midcingulate cortex, insula, amygdala, and ventromedial prefrontal cortex. Bartlett factor score (BFS) derived from a factor analysis of clinical assessments on disease severity was used as a grouping factor for moderate MSA (mMSA: BFS < 0) and severe MSA (sMSA: BFS > 0).

STATISTICAL TESTS

For FC analysis, the one-way ANCOVA with cluster-level family-wise error correction (statistical significance level of P < 0.025), and post hoc t-testing with Bonferroni correction or Tamhane's T2 correction (statistical significance level of adjusted-P < 0.05) were adopted. Correlation was assessed using Pearson correlation or Spearman correlation (statistical significance level of P < 0.05).

RESULTS

Compared with HC, patients with MSA exhibited significant FC aberrances between the CAN and brain areas of sensorimotor control, limbic network, putamen, and cerebellum. For MSA patients, most FC alterations of CAN, especially concerning FC between the right anterior insula and right primary sensorimotor cortices, were found to be significantly correlated with disease severity. FC changes were found to be more significant in sMSA group than in mMSA group when compared with HCs.

DATA CONCLUSION

MSA shows widespread FC changes of CAN, suggesting that abnormal functional integration of CAN may be involved in disease pathogenesis of MSA.

LEVEL OF EVIDENCE

2 TECHNICAL EFFICACY: Stage 3.

A Multi-Dimensional Model of Fatigue in Old Age: Implications for Brain Aging

As the most reported symptom in old age, fatigue is understudied in terms of both mechanisms and measures. Population heterogeneity and methodological inconsistency makes understanding the relationship between fatigue and brain aging challenging. The present article comprehensively reviews existing conceptual and operational frameworks of fatigue, as well as mechanistic heterogeneities of fatigue that exist in the aging literature. Then, I propose a Multi-Dimensional Model of fatigue to provide theoretical cohesion to the study of fatigue in old age, along with a "fatigue circuit" addressing brain profiles across dimensions of fatigue. The potential relationships between fatigue dimensions, the fatigue circuit, and brain aging are discussed to inform the direction of future research.

Structural Basal Ganglia Correlates of Subjective Fatigue in Middle-Aged and Older Adults

OBJECTIVE

Fatigue is among the most common complaints in community-dwelling older adults, yet its etiology is poorly understood. Based on models implicating frontostriatal pathways in fatigue pathogenesis, we hypothesized that smaller basal ganglia volume would be associated with higher levels of subjective fatigue and reduced set-shifting in middle-aged and older adults without dementia or other neurologic conditions.

METHODS

Forty-eight non-demented middle-aged and older adults (M_age = 68.1, SD = 9.4; M_MMSE = 27.3, SD = 1.9) completed the Fatigue Symptom Inventory, set-shifting measures, and structural MRI as part of a clinical evaluation for subjective cognitive complaints. Associations were examined cross-sectionally.

RESULTS

Linear regression analyses showed that smaller normalized basal ganglia volumes were associated with more severe fatigue (β = -.29, P = .041) and poorer Trail Making Test B-A (TMT B-A) performance (β = .30, P = .033) controlling for depression, sleep quality, vascular risk factors, and global cognitive status. Putamen emerged as a key structure linked with both fatigue (r = -.43, P = .003) and TMT B-A (β = .35, P = .021). The link between total basal ganglia volume and reduced TMT B-A was particularly strong in clinically fatigued patients.

CONCLUSION

This study is among the first to show that reduced basal ganglia volume is an important neurostructural correlate of subjective fatigue in physically able middle-aged and older adults without neurological conditions. Findings suggest that fatigue and rapid set-shifting deficits may share common neural underpinnings involving the basal ganglia, and provide a framework for studying the neuropathogenesis and treatment of subjective fatigue.

Neural Research on Depth Perception and Stereoscopic Visual Fatigue in Virtual Reality

Virtual reality (VR) technology provides highly immersive depth perception experiences; nevertheless, stereoscopic visual fatigue (SVF) has become an important factor currently hindering the development of VR applications. However, there is scant research on the underlying neural mechanism of SVF, especially those induced by VR displays, which need further research. In this paper, a Go/NoGo paradigm based on disparity variations is proposed to induce SVF associated with depth perception, and the underlying neural mechanism of SVF in a VR environment was investigated. The effects of disparity variations as well as SVF on the temporal characteristics of visual evoked potentials (VEPs) were explored. Point-by-point permutation statistical with repeated measures ANOVA results revealed that the amplitudes and latencies of the posterior VEP component P2 were modulated by disparities, and posterior P2 amplitudes were modulated differently by SVF in different depth perception situations. Cortical source localization analysis was performed to explore the original cortex areas related to certain fatigue levels and disparities, and the results showed that posterior P2 generated from the precuneus could represent depth perception in binocular vision, and therefore could be performed to distinguish SVF induced by disparity variations. Our findings could help to extend an understanding of the neural mechanisms underlying depth perception and SVF as well as providing beneficial information for improving the visual experience in VR applications.

Investigate the Neuro Mechanisms of Stereoscopic Visual Fatigue

Stereoscopic visual fatigue (SVF) due to prolonged immersion in the virtual environment can lead to negative user experience, thus hindering the development of virtual reality (VR) industry. Previous studies have focused on investigating the evaluation indicators associated with SVF, while few studies have been conducted to reveal the underlying neural mechanism, especially in VR applications. In this paper, a modified Go/NoGo paradigm was adopted to induce SVF in VR environment with Go trials for maintaining participants' attention to experimental viewing tasks and NoGo trials for investigating the neural effects under SVF. Random dot stereograms (RDSs) with 11 disparities and 2 types of shapes (arrow and rectangle) were presented to evoke the depth-related visual evoked potentials (DVEPs) during 64-channel EEG recordings. EEG datasets collected from 15 participants in NoGo trials were selected to conduct individual processing and group analysis, in which the characteristics of the DVEPs components for various fatigue degrees were compared with one-way repeated-measurement ANOVA and independent components were clustered to explore the original cortex areas related to SVF. Point-by-point permutation statistics revealed that DVEPs sample points from 230ms to 280ms in most brain areas changed significantly with SVF. More specifically, we found that amplitudes of component P2 changed significantly when SVF increased. Additionally, independent component analysis (ICA) identified that component P2 which originated from posterior cingulate cortex and precuneus, was associated statistically with SVF. We believe that SVF is rather a conscious status concerning the changes of self-awareness or self-location awareness than the performance reduction of retinal image processing. Moreover, we suggest that indicators representing higher conscious state may be a better indicator for SVF evaluation in VR environments.

Neural and computational mechanisms of momentary fatigue and persistence in effort-based choice

From a gym workout, to deciding whether to persevere at work, many activities require us to persist in deciding that rewards are ‘worth the effort’ even as we become fatigued. However, studies examining effort-based decisions typically assume that the willingness to work is static. Here, we use computational modelling on two effort-based tasks, one behavioural and one during fMRI. We show that two hidden states of fatigue fluctuate on a moment-to-moment basis on different timescales but both reduce the willingness to exert effort for reward. The value of one state increases after effort but is ‘recoverable’ by rests, whereas a second ‘unrecoverable’ state gradually increases with work. The BOLD response in separate medial and lateral frontal sub-regions covaried with these states when making effort-based decisions, while a distinct fronto-striatal system integrated fatigue with value. These results provide a computational framework for understanding the brain mechanisms of persistence and momentary fatigue.

The willingness to exert effort into demanding tasks often declines over time through fatigue. Here the authors provide a computational account of the moment-to-moment dynamics of fatigue and its impact on effort-based choices, and reveal the neural mechanisms that underlie such computations.

Few Structural Brain Changes Associated With Moderate-Intensity Interval Training and Low-Intensity Continuous Training in a Randomized Trial of Fitness and Older Adults

This study utilized a randomized control trial to examine whether structural changes in the precuneus, insula, caudate, hippocampus, and putamen were related to exercise. A total of 197 healthy older adults with no evidence of dementia participated in moderate-intensity interval training or low-intensity continuous training for 16 weeks. Size decreased in the right hippocampus such that the effect of time was significant but the interaction with condition was not. For the left hippocampus, size decreased in the low-intensity continuous training condition but increased in the moderate-intensity continuous training plus interval training condition at the trend level. Finally, there was a significant time-by-condition interaction such that the thickness of the left insula increased for low-intensity continuous training and decreased for moderate-intensity continuous training plus interval training. Few structural changes were associated with the exercise intervention. Future studies should examine the effects of exercise on brain structure in high-risk or clinical populations for a longer period of time.

Modulatory effects of cognitive exertion on regional functional connectivity of the salience network in women with ME/CFS: A pilot study

BACKGROUND

A common symptom of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is post-exertional malaise (PEM). Various brain abnormalities have been observed in patients with ME/CFS, especially in insular and limbic areas, but their link with ME/CFS symptoms is still unclear. This pilot study aimed at investigating the association between PEM in ME/CFS and changes in functional connectivity (FC) of two main networks: the salience network (SN) and the default-mode network (DMN).

METHODS

A total of 16 women, 6 with and 10 without ME/CFS, underwent clinical and MRI assessment before and after cognitive exertion. Resting-state FC maps of 7 seeds (3 for the SN and 4 for the DMN) and clinical measures of fatigue, pain and cognition were analysed with repeated-measure models. FC-symptom change associations were also investigated.

RESULTS

Exertion induced increases in fatigue and pain in patients with ME/CFS compared to the control group, while no changes were found in cognitive performance. At baseline, patients showed altered FC between some DMN seeds and frontal areas and stronger FC between all SN seeds and left temporal areas and the medulla. Significantly higher FC increases in patients than in controls were found only between the right insular seed and frontal and subcortical areas; these increases correlated with worsening of symptoms.

CONCLUSIONS

Cognitive exertion can induce worsening of ME/CFS-related symptoms. These changes were here associated with strengthening of FC of the right insula with areas involved in reward processing and cognitive control.

Adult Age Differences in the Effects of Chronic Mental Fatigue on Task-Related Fatigue, Appraisals, and Performance

Engagement in potentially beneficial activities is assumed to be based partially on perceived costs and benefits. Mental fatigue may be one factor that affects perceived costs. We examined age differences in both chronic and situational mental fatigue, and their relation to task perceptions and engagement levels. Younger (M _age = 32.6) and older (M _age = 73.1) adults completed questionnaires measuring subjective mental fatigue, physical and mental health, and motivational states, along with several assessments of cognitive ability. In addition, assessments of effort expenditure (systolic blood pressure) and task difficulty were collected during performance of a cognitively demanding memory-scan task. Two components of chronic mental fatigue (CMF) relating to affect and motivation were identified. Although the structure of CMF did not vary with age, CMF was differentially predictive of engagement and appraisal levels across groups. As CMF-Affect levels increased, older adults' task-difficulty appraisals increased more than those of younger adults. In addition, CMF-Affect was positively associated with levels of engagement in the young, but negatively associated in the old as memory load increased. Older adults also exhibited higher levels of situational fatigue than did the young, as evidenced by increased levels of effort expenditure as both time on task and objective demands increased. However, little relationship existed between chronic and situational mental fatigue in either age group. These findings suggest that the affective aspect of CMF is particularly consequential in older adults, with both task appraisals and engagement levels being negatively affected when fatigue is high.

Cognitive Fatigue Is Associated with Altered Functional Connectivity in Interoceptive and Reward Pathways in Multiple Sclerosis

Cognitive fatigue is common and debilitating among persons with multiple sclerosis (pwMS). Neural mechanisms underlying fatigue are not well understood, which results in lack of adequate treatment. The current study examined cognitive fatigue-related functional connectivity among 26 pwMS and 14 demographically matched healthy controls (HCs). Participants underwent functional magnetic resonance imaging (fMRI) scanning while performing a working memory task (n-back), with two conditions: one with higher cognitive load (2-back) to induce fatigue and one with lower cognitive load (0-back) as a control condition. Task-independent residual functional connectivity was assessed, with seeds in brain regions previously implicated in cognitive fatigue (dorsolateral prefrontal cortex (DLPFC), ventromedial prefrontal cortex (vmPFC), dorsal anterior cingulate cortex (dACC), insula, and striatum). Cognitive fatigue was measured using the Visual Analogue Scale of Fatigue (VAS-F). Results indicated that as VAS-F scores increased, HCs showed increased residual functional connectivity between the striatum and the vmPFC (crucial in reward processing) during the 2-back condition compared to the 0-back condition. In contrast, pwMS displayed increased residual functional connectivity from interoceptive hubs—the insula and the dACC—to the striatum. In conclusion, pwMS showed a hyperconnectivity within the interoceptive network and disconnection within the reward circuitry when experiencing cognitive fatigue.