Repeated measurement of the components of attention using two versions of the Attention Network Test (ANT): Stability, isolability, robustness, and reliability

Test-retest reliability of the attention network test from the perspective of intrinsic network organization

The attention network test (ANT), developed based on the triple-network taxonomy by Posner and colleagues, has been widely used to examine the efficacy of alerting, orienting and executive control in clinical and developmental neuroscience studies. Recent research suggests the imperfect reliability of the behavioural ANT and its variants. However, the classical ANT fMRI task's test-retest reliability has received little attention. Moreover, it remains ambiguous whether the attention-related intrinsic network components, especially the dorsal attention, ventral attention and frontoparietal network, manifest acceptable reliability. The present study approaches these issues by utilizing an openly available ANT fMRI dataset for participants with Parkinson's disease and healthy elderly. The reproducibility of group-level activations across sessions and participant groups and the test-retest reliability at the individual level were examined at the voxel, region and network levels. The intrinsic network was defined using the Yeo-Schaefer atlas. Our results reveal three critical facets: (1) the overlapping of the group-level contrast map between sessions and between participant groups was unsatisfactory; (2) the reliability of alerting, orienting and executive, defined as a contrast between conditions, was worse than estimates of specific conditions. (3) Dorsal attention, ventral attention, visual and somatomotor networks showed acceptable reliability for the congruent and incongruent conditions. Our results suggest that specific condition estimates might be used instead of the contrast map for individual or group-difference studies.

Molecular signatures of attention networks

Attention network theory proposes three distinct types of attention-alerting, orienting, and control-that are supported by separate brain networks and modulated by different neurotransmitters, that is, norepinephrine, acetylcholine, and dopamine. Here, we explore the extent of cortical, genetic, and molecular dissociation of these three attention systems using multimodal neuroimaging. We evaluated the spatial overlap between fMRI activation maps from the attention network test (ANT) and cortex-wide gene expression data from the Allen Human Brain Atlas. The goal was to identify genes associated with each of the attention networks in order to determine whether specific groups of genes were co-expressed with the corresponding attention networks. Furthermore, we analyzed publicly available PET-maps of neurotransmitter receptors and transporters to investigate their spatial overlap with the attention networks. Our analyses revealed a substantial number of genes (3871 for alerting, 6905 for orienting, 2556 for control) whose cortex-wide expression co-varied with the activation maps, prioritizing several molecular functions such as the regulation of protein biosynthesis, phosphorylation, and receptor binding. Contrary to the hypothesized associations, the ANT activation maps neither aligned with the distribution of norepinephrine, acetylcholine, and dopamine receptor and transporter molecules, nor with transcriptomic profiles that would suggest clearly separable networks. Independence of the attention networks appeared additionally constrained by a high level of spatial dependency between the network maps. Future work may need to reconceptualize the attention networks in terms of their segregation and reevaluate the presumed independence at the neural and neurochemical level.

The effect of considering eye movement time in evaluating the efficiency of attentional networks

The attention network test (ANT) is a tool for assessing the executive, alerting, and orienting components of attention. However, conflicting findings exist regarding the nature and correlation between attention networks. This study aims to investigate the influence of eye movement time on the assessment of attention network efficiency. Forty male students, with an average age of 20.8 ± 1.3 years, participated in the study. The revised attention network test was conducted concurrently with the recording of the electrooculogram signal. The electrooculogram signal was used to estimate eye placement time on target stimuli. Considering eye movement time for calculating the score of each network was proposed as a novel method. The study explored the nature of attention networks and their relationships, and revealed significant effects for attention networks with and without considering the eye movement time. Additionally, a significant correlation is observed between the alerting and orienting networks. However, no significant correlation is found between attention networks using the proposed method. Considering eye movement time alters the assessment of attention network efficiency and modifies the correlation among attention networks.

Implementation of an online spacing flanker task and evaluation of its test-retest reliability using measures of inhibitory control and the distribution of spatial attention

The flanker task (Eriksen & Eriksen, Perception & Psychophysics, 16(1), 143-149, 1974) has been highly influential and widely used in studies of visual attention. Its simplicity has made it popular to include it in experimental software packages and online platforms. The spacing flanker task (SFT), in which the distance between the target and flankers varies, is useful for studying the distribution of attention across space as well as inhibitory control. Use of the SFT requires that the viewing environment (e.g., stimulus size and viewing distance) be controlled, which is a challenge for online delivery. We implement and evaluate an online version of the SFT that includes two calibration pretests to provide the necessary control. Test-retest and split-half reliability of the online version was compared with a laboratory version on measures of inhibitory control and measures of the distribution of attention across space. Analyses show that the online SFT is comparable to laboratory testing on all measures. Results also identify two measures with good test-retest reliability that hold promise for studying performance in the SFT: the mean flanker effect (ICC = 0.745) and RTs on incongruent trials across distances (ICC = 0.65-0.71).

Association of Intrinsic Functional Connectivity between the Locus Coeruleus and Salience Network with Attentional Ability

The locus coeruleus (LC) is a brainstem region associated with broad neural arousal because of norepinephrine production, but it has increasingly been associated with specific cognitive processes. These include sustained attention, with deficits associated with various neuropsychological disorders. Neural models of attention deficits have focused on interrupted dynamics between the salience network (SAL) with the frontoparietal network, which has been associated with task-switching and processing of external stimuli, respectively. Conflicting findings for these regions suggest the possibility of upstream signaling leading to attention dysfunction, and recent research suggests LC involvement. In this study, resting-state functional connectivity and behavioral performance on an attention task was examined within 584 individuals. Analysis revealed significant clusters connected to LC activity in the SAL. Given previous findings that attention deficits may be caused by SAL network switching dysfunctions, findings here further suggest that dysfunction in LC-SAL connectivity may impair attention.

The ANTI-Vea-UGR Platform: A Free Online Resource to Measure Attentional Networks (Alertness, Orienting, and Executive Control) Functioning and Executive/Arousal Vigilance

The Attentional Networks Test for Interactions and Vigilance-executive and arousal components (ANTI-Vea) is a computerized task of 32 min duration in the standard format. The task simultaneously assesses the main effects and interactions of the three attentional networks (i.e., phasic alertness, orienting, and executive control) and two dissociated components of vigilance with reasonable reliability (executive and arousal vigilance). We present this free and publicly accessible resource (ANTI-Vea-UGR; https://anti-vea.ugr.es/) developed to easily run, collect, and analyze data with the ANTI-Vea (or its subtasks measuring some attentional and/or vigilance components embedded in the ANTI-Vea). Available in six different languages, the platform allows for the adaptation of stimulus timing and procedure to facilitate data collection from different populations (e.g., clinical patients, children). Collected data can be freely downloaded and easily analyzed with the provided scripts and tools, including a Shiny app. We discuss previous evidence supporting that attention and vigilance components can be assessed in typical lab conditions as well as online and outside the laboratory. We hope this tutorial will help researchers interested in measuring attention and vigilance with a tool useful to collect data from large sample sizes and easy to use in applied contexts.

Event-related potentials associated with attentional networks evidence changes in executive and arousal vigilance

Attention is regulated by three independent but interacting networks, that is, alerting, comprising phasic alertness and vigilance, orienting, and executive control. Previous studies analyzing event-related potentials (ERPs) associated with attentional networks have focused on phasic alertness, orienting, and executive control, without an independent measure of vigilance. ERPs associated with vigilance have been instead measured in separate studies and via different tasks. The present study aimed to differentiate ERPs associated with attentional networks by simultaneously measuring vigilance along with phasic alertness, orienting, and executive control. Forty participants (34 women, age: M = 25.96; SD = 4.96) completed two sessions wherein the electroencephalogram was recorded while they completed the Attentional Networks Test for Interactions and Vigilance-executive and arousal components, a task that measures phasic alertness, orienting, and executive control along with executive (i.e., detection of infrequent critical signals) and arousal (i.e., sustaining a fast reaction to environmental stimuli) vigilance. ERPs previously associated with attentional networks were replicated here: (a) N1, P2, and contingent negative variation for phasic alertness; (b) P1, N1, and P3 for orienting; and (c) N2 and slow positivity for executive control. Importantly, different ERPs were associated with vigilance: while the executive vigilance decrement was associated with an increase in P3 and slow positivity across time-on-task, arousal vigilance loss was associated with reduced N1 and P2 amplitude. The present study shows that attentional networks can be described by different ERPs simultaneously observed in a single session, including independent measures of executive and arousal vigilance on its assessment.

The direction of attention in second language phonological contrast learning

This study attempted to describe why some individuals are more successful when learning to perceive the sounds of a second language by analyzing the role attention plays in perceptual learning. Fifty-seven monolingual English-speaking adults completed the study. The participants underwent a perceptual learning paradigm presenting the novel contrast, the voicing contrast between Thai /b/ and /p/. The experiment consisted of a 40-item pretest, 480-trial learning phase, and 40-item posttest. Approximately half of the participants (n = 30) were given explicit instruction to listen for the specific contrast prior to the learning phase; other participants were not told the nature of the contrast. The Attention Network Test (ANT) from Fan, McCandliss, Sommer, Raz, and Posner [(2002). J. Cogn. Neurosci. 14(3), 340-347] was used to assess attentional networks. Generalized linear models and linear mixed effect models (LME) were fit to predict the participants' post-test scores based on ANT subscores, experimental group, and learning block (LME only). The results showed a correlation between attentional control and the ability to learn non-native phoneme contrasts regardless of instruction. In addition, there was a positive interaction between attentional control and the provision of explicit instructions during the learning process, such that individuals with high attentional control learned better when they received explicit instruction prior to training.

The change of attention network functions and physiological adaptation during high-altitude hypoxia and reoxygenation

Previous studies have not reached a definitive conclusion regarding the effect of high-altitude hypoxia and reoxygenation on attention. To clarify the influence of altitude and exposure time on attention and the relations between physiological activity and attention, we conducted a longitudinal study to track attention network functions in 26 college students. The scores on the attention network test and physiological data, including heart rate, percutaneous arterial oxygen saturation (SpO₂), blood pressure, and vital capacity in pulmonary function measurement, were collected at five time-points: two weeks before arriving at high altitude (baseline), within 3 days after arriving at high altitude (HA3), 21 days after arriving at high altitude (HA21), 7 days after returning to sea level (POST7) and 30 days after returning to sea level (POST30). The alerting scores at POST30 were significantly higher than those at baseline, HA3 and HA21; the orienting scores at HA3 were lower than those at POST7 and POST30; the executive control scores at POST7 were significantly lower than those at baseline, HA3, HA21, and POST30; and the executive control scores at HA3 were significantly higher than those at POST30. The change in SpO₂ during high-altitude acclimatization (from HA3 to HA21) was positively correlated with the orienting score at HA21. Vital capacity changes during acute deacclimatization positively correlated with orienting scores at POST7. Attention network functions at the behavioral level did not decline after acute hypoxia exposure compared with baseline. Attention network functions after returning to sea level were improved compared with those during acute hypoxia; additionally, alerting and executive function scores were improved compared with those at baseline. Thus, the speed of physiological adaptation could facilitate the recovery of orienting function during acclimatization and deacclimatization.

Warning signals only support the first action in a sequence

Acting upon target stimuli from the environment becomes faster when the targets are preceded by a warning (alerting) cue. Accordingly, alerting is often used to support action in safety-critical contexts (e.g., honking to alert others of a traffic situation). Crucially, however, the benefits of alerting for action have been established using laboratory tasks assessing only simple choice reactions. Real-world actions are considerably more complex and mainly consist of sensorimotor sequences of several sub-actions. Therefore, it is still unknown if the benefits of alerting for action transfer from simple choice reactions to such sensorimotor sequences. Here, we investigated how alerting affected performance in a sequential action task derived from the Trail-Making-Test, a well-established neuropsychological test of cognitive action control (Experiment 1). In addition to this task, participants performed a classic alerting paradigm including a simple choice reaction task (Experiment 2). Results showed that alerting sped up responding in both tasks, but in the sequential action task, this benefit was restricted to the first action of a sequence. This was the case, even when multiple actions were performed within a short time (Experiment 3), ruling out that the restriction of alerting to the first action was due to its short-lived nature. Taken together, these findings reveal the existence of an interface between phasic alertness and action control that supports the next action.

Context-specific effects of threatening faces on alerting, orienting, and executive control: A fNIRS study

Real-world threatening faces possess both useful and irrelevant attributes with respect to the current goal. How these attributes interact and affect attention, which comprises at least three processes hypothesized to engage the frontal lobes (alerting, orienting, and executive control), remains poorly understood. Here, the neurocognitive effects of threatening facial expressions on the three processes of attention were examined through the emotional Attention Network Test (ANT) and functional near-infrared spectroscopy (fNIRS). Forty-seven (20M, 27F) young adults performed a blocked version of the arrow flanker task with neutral and angry facial cues applied in three cue conditions (no, center, and spatial). Hemodynamic changes occurring in participants' frontal cortices during task performance were recorded by multichannel fNIRS. Behavioral results indicated that alerting, orienting, and executive control processes existed in both the neutral and angry conditions. However, depending on the context, angry facial cues affected these processes differently compared with neutral facial cues. Specifically, the angry face disrupted the classical decrease in reaction time from the no-cue to center-cue condition specifically during the congruent condition. Additionally, fNIRS results revealed significant frontal cortical activation during the incongruent vs. congruent task; neither cue nor emotion significantly affected frontal activation. Thus, the findings suggest that the angry face affects all three attentional processes while exerting context-specific effects on attention. They also imply that during the ANT, the frontal cortex is most involved in executive control. The present study offers essential insights into how various attributes of threatening faces interact and alter attention.

Happy and sad music acutely modulate different types of attention in older adults

Of the three subtypes of attention outlined by the attentional subsystems model, alerting (vigilance or arousal needed for task completion) and executive control (the ability to inhibit distracting information while completing a goal) are susceptible to age-related decline, while orienting remains relatively stable. Yet, few studies have investigated strategies that may acutely maintain or promote attention in typically aging older adults. Music listening may be one potential strategy for attentional maintenance as past research shows that listening to happy music characterized by a fast tempo and major mode increases cognitive task performance, likely by increasing cognitive arousal. The present study sought to investigate whether listening to happy music (fast tempo, major mode) impacts alerting, orienting, and executive control attention in 57 middle and older-aged adults (M = 61.09 years, SD = 7.16). Participants completed the Attention Network Test (ANT) before and after listening to music rated as happy or sad (slow tempo, minor mode), or no music (i.e., silence) for 10 min. Our results demonstrate that happy music increased alerting attention, particularly when relevant and irrelevant information conflicted within a trial. Contrary to what was predicted, sad music modulated executive control performance. Overall, our findings indicate that music written in the major mode with a fast tempo (happy) and minor mode with a slow tempo (sad) modulate different aspects of attention in the short-term.

Negative Impacts of Sleep-Wake Rhythm Disturbances on Attention in Young Adults

Sleep-wake rhythm disturbances have a negative impact on attention. However, how it affects attention and whether the restoration of regular rhythms can restore attention are unclear. This study aims to explore the effects of sleep-wake rhythm disturbances on three subfunctions of attention (alertness, orientation, and executive control) and the restoration of regular rhythms on these functions. Twenty-one participants in the experimental group (who experienced sleep-wake rhythm disturbances for at least one month; aged 18-26) were required to sleep regularly following a sleep schedule, whereas 20 participants in the control group (who maintained regular sleep for at least three months; aged 19-22) received no manipulation of their sleep. All participants were assessed using the attention network test three times in six days. All of them wore spectrum activity monitors and kept sleep diaries every day. The results showed that the effects of alertness and executive control in the experimental group were significantly lower than those in the control group. After five days of regular sleep, the difference in the alertness effect between the two groups significantly decreased. These results suggested that under natural conditions, sleep-wake rhythm disturbances could negatively influence alertness and executive control, and a short period of restoring a regular rhythm has a recovery effect on alertness.

Attention neuroenhancement through tDCS or neurofeedback: a randomized, single-blind, controlled trial

Neurofeedback and transcranial Direct Current Stimulation (tDCS) are promising techniques for neuroenhancement of attentional performance. As far as we know no study compared both techniques on attentional performance in healthy participants. We compared tDCS and neurofeedback in a randomized, single-blind, controlled experiment assessing both behavioral (accuracy and time reaction) and electrophysiological (N1, P1, and P3 components) data of participants responding to the Attention Network Task (ANT). Eighty volunteers volunteered for this study. We adopted standard protocols for both techniques, i.e., a Sensorimotor Rhythm (SMR) protocol for neurofeedback and the right DLPFC anodal stimulation for tDCS, applied over nine sessions (two weeks). We did not find significant differences between treatment groups on ANT, neither at the behavioral nor at the electrophysiological levels. However, we found that participants from both neuromodulation groups, irrespective of if active or sham, reported attentional improvements in response to the treatment on a subjective scale. Our study adds another null result to the neuromodulation literature, showing that neurofeedback and tDCS effects are more complex than previously suggested and associated with placebo effect. More studies in neuroenhancement literature are necessary to fully comprehend neuromodulation mechanisms.

Standing and Walking Attention Visual Field (SWAVF) task: A new method to assess visuospatial attention during walking

Visuospatial attention during walking has been associated with pedestrian safety and fall risks. However, visuospatial attention measures during walking remained under-explored. Current studies introduced a newly-developed Standing and Walking Visual Attention Field (SWAVF) task to assess visuospatial attention during walking and examined its reliability, validity, and stability. Thirty young adults completed a traditional computerized Attention Visual Field (AVF) task while sitting, and the SWAVF task under walking and standing settings. Nine participants also performed the SWAVF task under additional distraction conditions. Results showed good split-half reliability during standing (r = 0.70) and walking (r = 0.69), moderate concurrent validity with the sitting AVF task (r = 0.42), moderate convergent validity between the standing and walking settings (r = 0.69), good construct validity, and moderate rank-order stability (r = 0.53). Overall, the SWAVF task showed good psychometric properties. Potential applications to the evaluation of prosthetic and other exoskeleton devices, smart glasses, and ground-level traffic lights or signs were discussed.

Effects of transcranial direct current stimulation on visuospatial attention in air traffic controllers

Visuospatial attention is a cognitive skill essential to the performance of air traffic control activities. We evaluated the effect of an anodic session of transcranial low-intensity direct current stimulation (tDCS) right parietal associated with cognitive training of visuospatial attention of 21 air traffic controllers. Within-subject designs were used, with all volunteers undergoing two tDCS sessions; an experimental (2 mA anodic) and control (sham) performed concomitantly with the cognitive training (2-Back). Visuospatial performance was measured using the Attention Network Test for Interactions and Vigilance pre- and post-intervention. The results indicate that after an active parietal tDCS session, the ATCOs showed faster responses, but not more accurate, for visuospatial attention in its aspects of orientation and reorientation. This result was significant when comparing baseline and post-tests in the active tDCS group. Comparing the post-tests between the tDCS active and sham groups, it is possible to infer a trend of improvement in the results based on faster and more accurate responses, which suggests a possible refinement of the ATCO's attentional orientation. However, this population may eventually have reached a plateau in the performance of this skill. From the analysis of the results we arrive at the following hypotheses: (I) the increase in cortical excitability mediated by anodic tDCS frequently recorded may not be accompanied by improvements in behavioural measures; (II) the interaction between anodic tDCS with another event of increased excitability-execution of a cognitive task, may have hindered the occurrence of neuroplasticity; (III) the air traffic control activity may be associated with a high level of attention, which may have contributed to a ceiling effect for the development of this skill; (IV) online assessments may be more relevant to identify acute effects; (V) repeated sessions may be more efficient to find cumulative effects; (VI) the analysis of interactions between attentional networks can contribute to the study of visuospatial attention; (VII) tDCS protocols aimed at ATCO need to consider the specifics of this audience, such as circadian rhythm and sleep and fatigue conditions.

A vigilance decrement comes along with an executive control decrement: Testing the resource-control theory

A decrease in vigilance over time is often observed when performing prolonged tasks, a phenomenon known as “vigilance decrement.” The present study aimed at testing some of the critical predictions of the resource-control theory about the vigilance decrement. Specifically, the theory predicts that the vigilance decrement is mainly due to a drop in executive control, which fails to keep attentional resources on the external task, thus devoting a larger number of resources to mind-wandering across time-on-task. Datasets gathered from a large sample size (N = 617) who completed the Attentional Networks Test for Interactions and Vigilance—executive and arousal components in Luna, Roca, Martín-Arévalo, and Lupiáñez (2021b, Behavior Research Methods, 53[3], 1124–1147) were reanalyzed to test whether executive control decreases across time in a vigilance task and whether the vigilance decrement comes along with the decrement in executive control. Vigilance was examined as two dissociated components: executive vigilance, as the ability to detect infrequent critical signals, and arousal vigilance, as the maintenance of a fast reaction to stimuli. The executive control decrement was evidenced by a linear increase in the interference effect for mean reaction time, errors, and the inverse efficiency score. Critically, interindividual differences showed that the decrease in the executive—but not in the arousal—component of vigilance was modulated by the change in executive control across time-on-task, thus supporting the predictions of the resource-control theory. Nevertheless, given the small effect sizes observed in our large sample size, the present outcomes suggest further consideration of the role of executive control in resource-control theory.

Attention and executive control in varsity athletes engaging in strategic and static sports

Examining non-sport-related cognitive tasks of attention and executive control in skilled athletes may provide insight into the acquisition of highly specific skills developed in experts as well as help identify successful performance in sport. Through a cross-sectional design, this study examined performance on aspects of attention and executive control among varsity athletes playing soccer (strategic sport) or track & field (static sport) using a computerized test of attention and executive control. Ninety-seven university athletes participating in soccer (n = 50) or track and field (n = 47) were included in the study. Domains of attention and executive control were examined using the Attention Network Test-Interactions (ANT-I). Mean reaction time (RT) and intra-individual variability (IIV) were compared between groups as measures of performance speed and performance stability respectively. Soccer players demonstrated overall faster RTs (p = 0.0499; ηp2 = .04) and higher response accuracy (p = .021, d = .48) on the ANT-I compared to track and field athletes. Faster RTs were observed for soccer players when presented with an alerting tone (p = .029, d = .45), valid orienting cue (p = .019, d = .49) and incongruent flanker (p = .031, d = .45). No significant group differences were observed in IIV (p = .083, d = .36). Athletes engaging in strategic sports (i.e., soccer) demonstrated faster performance under test conditions that required higher vigilance and conflict resolution. These findings suggest that engagement in strategic sports is associated with enhanced performance on non-sport-related cognitive tasks of attention and executive control.

Phasic Alertness is Unaffected by the Attentional Set for Orienting

Warning stimuli preceding target stimuli for behaviour improve behavioural performance, which is referred to as phasic alerting. Similar benefits occur due to preceding orienting cues that draw spatial attention to the targets. It has long been assumed that alerting and orienting effects arise from separate attention systems, but recent views call this into question. As it stands, it remains unclear if the two systems are interdependent, or if they function independently. Here, we investigated whether the current attentional set for orienting modulates the effectiveness of alerting. In three experiments, participants classified visual stimuli in a speeded fashion. These target stimuli were preceded by orienting cues that could predict the target’s location, by alerting cues that were neutral regarding the target’s location, or by no cues. Alerting cues and orienting cues consisted of the same visual stimuli, linking alerting cues with the attentional set for orienting. The attentional set for orienting was manipulated in blocks, in which orienting cues were either informative or uninformative about the target’s location. Results showed that while alerting generally enhanced performance, alerting was unaffected by the informativeness of the orienting cues. These findings show that alerting does not depend on the attentional set that controls orienting based on the informational value of orienting cues. As such, the findings provide a simple dissociation of mechanisms underlying phasic alertness and spatial attentional orienting.

The effects of acute stress on attentional networks and working memory in females

Neurobiological models indicate that acute stress facilitates bottom-up stimulus processing while impairing top-down executive control. To test this hypothesis, the present study investigated the effects of acute stress on behavioural and electrophysiological measures of human attentional networks, and behavioural measures of working memory. Forty-five female participants (M_age = 22.1, SD = 2.4) performed the Attention Network Test (ANT) and the n-back task before and after the Maastricht Acute Stress Test (MAST; n = 23) or a non-stressful MAST-placebo (n = 22). Subjective distress ratings and salivary cortisol concentrations revealed a successful stress induction. Increased salivary cortisol at baseline was associated with slower reaction times across both tasks, suggesting a general detrimental effect of cortisol on cognitive functioning. Despite these findings, however, the hypothesised effects of the acute stress manipulation were not found for either task. Supplementary analyses indicated that these results were unrelated to the magnitude or duration of the stress response. Our results therefore suggest the standard version of the ANT may be insensitive to the effects of acute stress, and that higher cognitive loads may be necessary to observe stress effects on the n-back task.

Cognitive performance in idiopathic intracranial hypertension and relevance of intracranial pressure

Cognitive impairments have been reported in idiopathic intracranial hypertension; however, evidence supporting these deficits is scarce and contributing factors have not been defined. Using a case-control prospective study, we identified multiple domains of deficiency in a cohort of 66 female adult idiopathic intracranial hypertension patients. We identified significantly impaired attention networks (executive function) and sustained attention compared to a body mass index and age matched control group of 25 healthy female participants. We aimed to investigate how cognitive function changed over time and demonstrated that deficits were not permanent. Participants exhibited improvement in several domains including executive function, sustained attention and verbal short-term memory over 12-month follow-up. Improved cognition over time was associated with reduction in intracranial pressure but not body weight. We then evaluated cognition before and after a lumbar puncture with acute reduction in intracranial pressure and noted significant improvement in sustained attention to response task performance. The impact of comorbidities (headache, depression, adiposity and obstructive sleep apnoea) was also explored. We observed that body mass index and the obesity associated cytokine interleukin-6 (serum and cerebrospinal fluid) were not associated with cognitive performance. Headache severity during cognitive testing, co-morbid depression and markers of obstructive sleep apnoea were adversely associated with cognitive performance. Dysregulation of the cortisol generating enzyme 11β hydroxysteroid dehydrogenase type 1 has been observed in idiopathic intracranial hypertension. Elevated cortisol has been associated with impaired cognition. Here, we utilized liquid chromatography-tandem mass spectrometry for multi-steroid profiling in serum and cerebrospinal fluid in idiopathic intracranial hypertension patients. We noted that reduction in the serum cortisol:cortisone ratio in those undergoing bariatric surgery at 12 months was associated with improving verbal working memory. The clinical relevance of cognitive deficits was noted in their significant association with impaired reliability to perform visual field tests, the cornerstone of monitoring vision in idiopathic intracranial hypertension. Our findings propose that cognitive impairment should be accepted as a clinical manifestation of idiopathic intracranial hypertension and impairs the ability to perform visual field testing reliably. Importantly, cognitive deficits can improve over time and with reduction of intracranial pressure. Treating comorbid depression, obstructive sleep apnoea and headache could improve cognitive performance in idiopathic intracranial hypertension.

Comparing saccadic and manual responses in the attention network test

Attention is proposed to be a system of multiple functional networks, including alertness, orienting and executive control. A popular experimental paradigm for testing these networks and their interactions within a single design is the Attentional Networks Test (ANT) (Fan et al., 2002). The role of the oculomotor system in these various networks, however, has not been tested despite the strong link between attention and eye movements. We modified the executive control component of the manual response ANT version (ANTm) that allows testing the networks' involvement with oculomotor responses. Specifically, we used a central target to signal pro or anti-saccades that allows us to match the saccadic response compatibility of the original ANTm. We conducted three experiments to compare interactions of the networks between the traditional ANTm that used a flanker task response, our new ANTs with saccadic responses signalled with a fixation arrow, and a manual response version with the response arrow at fixation (ANTf). Results for all three experiments showed typical main effects of all three attention networks, but we observed differences in their interactions. The ANTm showed only an interaction of alerting enhancing the orienting; ANTs showed a congruency by orienting interaction with the orienting effect only observed for pro-saccades. The ANTf showed both alerting by orienting, and orienting by congruency. Although the saccadic response did differ from the original ANTm, key differences were also highlighted by the switch from peripheral to central target. Overall the proposed ANTf is a valid tool to test main effects of attentional networks. Further investigation of interaction differences between manual and oculomotor systems is required.

Validation of the attention-related driving errors scale in novice adolescent drivers

INTRODUCTION

Motor vehicle collisions (MVCs) are a leading cause of death among adolescents. Identifying factors that contribute to adolescent MVCs is a pressing public health need. Exogenous (cell phones, passengers, music) and endogenous (stress, worry, mind-wandering) forms of driver inattention account for approximately 78% of all MVCs in the United States. Though both exogenous and endogenous distraction contribute to crash risk, prior work investigating adolescent crash risk has largely focused on exogenous distractors. The Attention-Related Driving Errors Scale (ARDES) is a promising measure assessing individual differences in endogenous driver inattention that has been validated in adult drivers. Its validation in an adolescent sample may prove useful in tailoring future interventions to decrease MVC risk in young drivers.

METHODS

This study sought to validate the ARDES in novice adolescent drivers by investigating its underlying factor structure and its relations with self-reported measures of daily inattention, performance-based attention assessments, and a self-report measure of driving behavior.

RESULTS

Replicating earlier work in adults, results suggested ARDES items can be classified according to their operational level of the driving. The ARDES had good internal reliability and construct validity, suggesting it is a valid self-report measure of the propensity for adolescents' attentional errors while driving.

DISCUSSION

The ARDES provides a useful tool for researchers to identify adolescents at greater risk of attentional errors while driving. Future research should use the ARDES to better understand the role of driver inattention in adolescent crash risk.

Effects of testosterone administration on fMRI responses to executive function, aggressive behavior, and emotion processing tasks during severe exercise- and diet-induced energy deficit

BACKGROUND

Clinical administration of testosterone is widely used due to a variety of claimed physical and cognitive benefits. Testosterone administration is associated with enhanced brain and cognitive function, as well as mood, in energy-balanced males, although such relationships are controversial. However, the effects of testosterone administration on the brains of energy-deficient males, whose testosterone concentrations are likely to be well below normal, have not been investigated.

METHODS

This study collected functional magnetic resonance imaging (fMRI) data from 50 non-obese young men before (PRE) and shortly after (POST) 28 days of severe exercise-and-diet-induced energy deficit during which testosterone (200 mg testosterone enanthate per week in sesame oil, TEST) or placebo (sesame seed oil only, PLA) were administered. Scans were also collected after a post-energy-deficit weight regain period (REC). Participants completed five fMRI tasks that assessed aspects of: 1) executive function (Attention Network Task or ANT; Multi-Source Interference Task or MSIT; AXE Continuous Processing Task or AXCPT); 2) aggressive behavior (Provoked Aggression Task or AGG); and 3) latent emotion processing (Emotional Face Processing or EMO).

RESULTS

Changes over time in task-related fMRI activation in a priori defined task-critical brain regions during performance of 2 out of 5 tasks were significantly different between TEST and PLA, with TEST showing greater levels of activation during ANT in the right anterior cingulate gyrus at POST and during MSIT in several brain regions at REC. Changes over time in objective task performance were not statistically significant; testosterone-treated volunteers had greater self-reported anger during AGG at POST.

CONCLUSIONS

Testosterone administration can alter some aspects of brain function during severe energy deficit and increase levels of anger.

Age-Related Changes in Hemispherical Specialization for Attentional Networks

Many cognitive functions face a decline in the healthy elderly. Within the cognitive domains, both attentional processes and executive functions are impaired with aging. Attention includes three attentional networks, i.e., alerting, orienting, and executive control, showing a hemispheric lateralized pattern in adults. This lateralized pattern could play a role in modulating the efficiency of attentional networks. For these reasons, it could be relevant to analyze the age-related change of the hemispheric specialization of attentional networks. This study aims to clarify this aspect with a lateralized version of the Attentional Network Test for Interaction (ANTI)-Fruit. One hundred seventy-one participants took part in this study. They were divided in three age groups: youth (N = 57; range: 20-30); adults (N = 57; range 31-64), and elderly/older people (N = 57; range: 65-87). The results confirmed the previous outcomes on the efficiency and interactions among attentional networks. Moreover, an age-related generalized slowness was evidenced. These findings also support the hypothesis of a hemispheric asymmetry reduction in elderly/older adults.

Auditory spatial attention gradients and cognitive control as a function of vigilance

Selection and effort are central to attention, yet it is unclear whether they draw on a common pool of cognitive resources, and if so, whether there are differences for early versus later stages of cognitive processing. This study assessed effort by quantifying the vigilance decrement, and spatial processing at early and later stages as a function of time-on-task. Participants performed an auditory spatial attention task, with occasional "catch" trials requiring no response. Psychophysiological measures included bilateral cerebral blood flow (transcranial Doppler), pupil dilation, and blink rate. The shape of attention gradients using reaction time indexed early processing, and did not significantly vary over time. Later stimulus-response conflict was comparable over time, except for a reduction to left hemispace stimuli. Target and catch trial accuracy decreased with time, with a more abrupt decrease for catch versus target trials. Diffusion decision modeling found progressive decreases in information accumulation rate and non-decision time, and the adoption of more liberal response criteria. Cerebral blood flow increased from baseline and then decreased over time, particularly in the left hemisphere. Blink rate steadily increased over time, while pupil dilation increased only at the beginning and then returned towards baseline. The findings suggest dissociations between resources for selectivity and effort. Measures of high subjective effort and temporal declines in catch trial accuracy and cerebral blood flow velocity suggest a standard vigilance decrement was evident in parallel with preserved selection. Different attentional systems and classes of computations that may account for dissociations between selectivity versus effort are discussed.

Explaining the high working memory capacity of gifted children: Contributions of processing skills and executive control

Intellectually gifted children tend to demonstrate especially high working memory capacity, an ability that holds a critical role in intellectual functioning. What could explain the differences in working memory performance between intellectually gifted and nongifted children? We investigated this issue by measuring working memory capacity with complex spans in a sample of 55 gifted and 55 nongifted children. Based on prior studies, we expected the higher working memory capacity of intellectually gifted children to be driven by more effective executive control, as measured using the Attention Network Test. The findings confirmed that intellectually gifted children had higher working memory capacity than typical children, as well as more effective executive attention. Surprisingly, however, working memory differences between groups were not mediated by differences in executive attention. Instead, it appears that gifted children resolve problems faster in the processing phase of the working memory task, which leaves them more time to refresh to-be-remembered items. This faster problem solving speed mediated their advantage in working memory capacity. Importantly, this effect was specific to speed on complex problems: low-level processing speed, as measured with the Attention Network Test, did not contribute to the higher working memory capacity of gifted children.

A randomized experimental analysis of the attention training technique: Effects on worry and relevant processes in individuals with probable generalized anxiety disorder

CONTEXT

The Attention Training Technique (ATT, Wells, 1990) is an intervention guiding individuals to focus, shift, and divide their attention in response to sounds presented in an audiorecording. The ATT has long been recommended for generalized anxiety disorder (GAD); however, there is insufficient research on its effects on excessive worry and related processes.

OBJECTIVES

This experiment examined whether the ATT is more efficacious than a control intervention at reducing worry and modifying worry-related processes (e.g., attention control, negative metacognitive beliefs, attention bias, mindfulness).

PARTICIPANTS

78 adults with probable GAD.

DESIGN

Participants completed measures of worry and worry-related processes at the lab. They then monitored worry and attention daily for a week. Following this baseline, participants recompleted the lab measures and were randomly assigned to ATT or control. Participants listened to their assigned recording once/day for a week while again monitoring worry and attention daily. Participants then recompleted the lab measures.

RESULTS

The ATT did not perform better than the control condition on any measure. A variety of improvements were seen over the intervention period in both conditions.

CONCLUSIONS

ATT may not have meaningful effects on excessive worry and worry-related processes. Explanations for null findings are offered. CLINICALTRIALS.

GOV REGISTRATION

NCT03216382.

On the origins and evolution of the Attention Network Tests

Attention is a pivotal cognitive function and efforts to understand its properties and operations are fundamental. Building upon the best known taxonomy of attention put forward by Posner and colleagues, the Attention Network Test (ANT) was designed to efficiently provide scores that reflect the efficacy of alerting, orienting and executive control. The ANT has not only been very widely adopted by scholars around the world, it has inspired a wide range of variants, the ANTs, - each with its own purpose. This review will describe the origin of the ANT in the taxonomic contributions of Posner and the evolution of the ANTs with some discussion of the nature and rationale for each major variant described here. We briefly allude to minor modifications of the ANT and present some suggestions related to data reporting and data analysis. We end with some projections about the future use of the original ANT and its notable variants.

The role of transcranial magnetic stimulation in understanding attention-related networks in single subjects

Attention is a cognitive mechanism that has been studied through several methodological viewpoints, including animal models, MRI in stroke patients, and fMRI in healthy subjects. Activation-based fMRI research has also pointed to specific networks that activate during attention tasks. Most recently, network neuroscience has been used to study the functional connectivity of large-scale networks for attention to reveal how strongly correlated networks are to each other when engaged in specific behaviors. While neuroimaging has revealed important information about the neural correlates of attention, it is crucial to better understand how these processes are organized and executed in the brain in single subjects to guide theories and treatments for attention. Noninvasive brain stimulation is an effective tool to causally manipulate neural activity to detect the causal roles of circuits in behavior. We describe how combining transcranial magnetic stimulation (TMS) with modern precision network analysis in single-subject neuroimaging could test the roles of regions, circuits, and networks in regulating attention as a pathway to improve treatment effect magnitudes and specificity.

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Though studied for over 100 years, the brain basis of attention is still queried.

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Complexity in frameworks for attention makes brain mapping difficult.

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Relevant brain networks vary significantly across subjects, challenging progress.

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Single-subject neuroimaging with TMS can improve our understanding of attention.

Microstructural white matter connectivity underlying the attentional networks system

Nowadays, there is considerable controversy regarding the structural connectivity underlying the attentional networks system (i.e., alerting and vigilance, orienting, and executive control). The present study aimed at further examining and dissociating the white matter connectivity underlying attentional and vigilance functioning by overcoming some critical limitations in previous research. To this end, we performed virtual in vivo dissections of attention-related white matter tracts from thirty healthy adults. Participants completed two sessions of the Attentional Networks Test for Interactions and Vigilance, a suitable task to assess simultaneously phasic alertness, orienting, executive control, and the executive component of vigilance (i.e., the ability to detect infrequent critical signals). Whereas we found a consistent correlation between phasic alertness and both the right dorsolateral prefrontal caudate tract and the splenium of the corpus callosum, evidence obtained for white matter connectivity underlying orienting, executive control, and executive vigilance, was either weak at the best, inconsistent, or null. White matter connectivity seemed to support nevertheless the most reliable performance: overall reaction time for attentional functioning was significantly associated with the left cingulate fasciculus and overall reaction time for executive vigilance was significantly linked to the bilateral superior longitudinal fasciculus I. The present outcomes provide interesting, consistent, and reliable evidence concerning the structural connectivity underlying the alerting network. We still consider that further evidence is necessary to better understand the controversial relationship between attentional/vigilance processes and microstructural white matter connectivity though.

Changes in attentional processing following neurofeedback in patients with persistent post-concussive symptoms: a pilot study

OBJECTIVE

Persistent post-concussive symptoms (PPCS) often include attention deficits, particularly orienting and executive attention. Research in other clinical populations has demonstrated that neurofeedback therapy (NFT) is effective at improving orienting and executive attention, although its effects on attentional networks in patients with PPCS are unknown.

METHOD

In this single-group pilot study, we examined attention-related event-related potentials (ERPs) - N1 and P3 - and cognitive outcomes following Live Z-score training (LZT), a variant of NFT.

RESULTS

No changes in early selective attention, as indexed by N1 amplitude, were observed; however, P3 amplitude, which indexes neural resource allocation, increased following LZT and returned to baseline by 3 months. Cognitive performance improved following treatment, which was sustained at 3 months. The magnitude of change in P3 and ANT performance did not differ between orienting or executive attention, suggesting LZT improved general attentional processing efficiency.

CONCLUSION

Our results suggest that LZT may positively affect attention globally, but does not target specific attention networks. These pilot data warrant the initiation of a clinical trial evaluating the effectiveness of LZT for treating attention deficits in patients with PPCS.

Brief Report: A Gaming Approach to the Assessment of Attention Networks in Autism Spectrum Disorder and Typical Development

Attentional impairments are among the earliest identifiable features of autism spectrum disorders (ASDs). Three attention networks have been extensively studied using the attention network test (ANT), but this long and repetitive task may pose challenges for individuals with ASDs. The AttentionTrip was developed as a more engaging measure of attention network efficiency. In 20 adults with ASDs and 20 typically developing controls, both tasks produced typical network scores (all p < .003, all Cohen's d > 0.78). Reaction time was less variable in the AttentionTrip than the ANT, possibly reflecting improved task engagement. Although the AttentionTrip elicited more consistent responses throughout an experimental session, anomalously low split-half reliability for its executive control network suggests that some changes may be needed.

Measuring attention and vigilance in the laboratory vs. online: The split-half reliability of the ANTI-Vea

Over the past few years, there has been growing interest in using online methods for collecting data from large samples. However, only a few studies have administered online behavioral tasks to assess attention outside the lab. In the present study, we assessed the classic attentional functions and two vigilance components using two versions of the Attentional Networks Test for Interactions and Vigilance-executive and arousal vigilance components (ANTI-Vea): (1) a standard version, performed under typical experimental conditions (n = 314), and (2) an online version, completed outside the lab (n = 303). Both versions were equally effective in assessing (1) the main effects and interactions of phasic alertness, orienting, and executive control, and (2) the executive (i.e., a decline in the ability to detect infrequent critical signals) and the arousal (i.e., a progressive slowness and variability in responses to stimuli from the environment) vigilance decrement across time on task. Responses were generally slower in the online than in the standard version. Importantly, the split-half reliability observed for both tasks was (1) higher for executive control (~.67) than for phasic alertness and orienting (< .40), as observed in previous versions of the task, and (2) between .71 and .99 for the executive and arousal vigilance measures. We expect the present study will be of interest to researchers aiming to assess attentional functions with a valid and reliable method that, importantly, is publicly available on an open website ( https://www.ugr.es/~neurocog/ANTI/ ) and is easy to use in applied contexts.

Deliberate Soccer Practice Modulates Attentional Functioning in Children

The main purpose of this study was to explore the association between the regular practice of open-skill sports (i.e., soccer) and executive control, along with other attentional functions (i.e., alerting and orienting) during preadolescence. The study was conducted on 131 participants (70 non-athletes and 61 soccer players). To measure cognitive performance, participants performed the Attentional Network Test—Interactions (ANT-I) task. Compared to non-athletes, soccer players showed overall faster responses and better executive control (e.g., reduced interference from distractors). Overall, our results provide new empirical evidence supporting the positive association between regular sports practice and cognitive performance, and more specifically executive functions. However, is important to note that the relationship between regular sport practice and cognition is complex and multifactorial. Our findings can be partly explained by the “cardiovascular fitness hypothesis” and the “cognitive component skills approach,” suggesting that an externally paced sport environment with high physical fitness and perceptual–cognitive demands may be an appropriate setting to optimize the development of cognitive functioning during early adolescence.

The Attention Network Test Database: ADHD and Cross-Cultural Applications

Attention is a central component of cognitive and behavioral processes and plays a key role in basic and higher-level functioning. Posner's model of attention describes three components or networks of attention: the alerting, which involves high intensity states of arousal; the orienting, which involves the selective direction of attention; and the executive control, which involves cognitive functions such as conflict resolution and working memory. The Attention Network Test (ANT) is a computerized testing measure that was developed to measure these three networks of attention. This project describes the ANT, its widely used variants, and the recently developed ANT Database, a repository of data extracted from all studies that have used the ANT as of 2019. To illustrate the potential uses of the database, two meta-analyses conducted using the ANT Database are described. One explores task performance in children with and without attention deficit/hyperactivity disorder (ADHD). The other one explores regional differences between studies conducted in China, Europe, and the United States. We are currently in the process of integrating the database into a publicly available web interface. When that work is complete, researchers, clinicians, and the general public will be able to use the database to explore topics of interest related to attention.

Age-related changes in the functional integrity of the phasic alerting system: a pupillometric investigation

Enhanced processing following a warning cue is thought to be mediated by a phasic alerting response involving the locus coeruleus-noradrenergic (LC-NA) system. We examined the effect of aging on phasic alerting using pupil dilation as a marker of LC-NA activity in conjunction with a novel assessment of task-evoked pupil dilation. While both young and older adults displayed behavioral and pupillary alerting effects, reflected in decreased RT and increased pupillary response under high (tone) versus low (no tone) alerting conditions, older adults displayed a weaker pupillary response that benefited more from the alerting tone. The strong association between dilation and speed displayed by older adults in both alerting conditions was reduced in young adults in the high alerting condition, suggesting that in young (but not older) adults the tone conferred relatively little behavioral benefit beyond that provided by the alerting effect elicited by the target. These findings suggest a functioning but deficient LC-NA alerting system in older adults, and help reconcile previous results concerning the effects of aging on phasic alerting.

Caffeine intake modulates the functioning of the attentional networks depending on consumption habits and acute exercise demands

Consume of stimulants (as caffeine) is very usual in different contexts where the performers have to take quick and accurate decisions during physical effort. Decision-making processes are mediated by the attentional networks. An experiment was carried out to examine the effect of caffeine intake on attention (alerting, orienting, and executive control) as a function of consumption habit under two physical exertion conditions (rest vs. aerobic exercise). Two groups of participants with different caffeine consumption profiles (moderate consumers vs. low consumers) performed the Attention Network Test-Interactions under four different conditions regarding activity (rest vs. exercise) and intake (caffeine vs. placebo). Results showed that whereas exercise led to faster reaction times (RT) in all cases, caffeine intake accelerated RT but only at rest and in moderate caffeine consumers. More importantly, caffeine intake reduced the alertness effect in moderate consumers only at the rest condition. No interactions between Intake and Activity were observed in the other attentional networks, with exercise reducing orienting independently of caffeine intake, which suggests that physical exercise and caffeine are different modulators of attention but can interact. Caffeine intake had differential effects on reaction speed at rest and during physical exercise depending on the individual consumption habit. On the basis of these finding it seems that mainly alertness is modulated differently by internal and external "arousing" conditions.

Ten years younger: Practice of chronic aerobic exercise improves attention and spatial memory functions in ageing

Aerobic exercise is associated with changes in brain morphology and improvement of cognitive functions. Physical activity may be especially important after age 60 when cognitive decline is more pronounced. In this paper, the effect of chronic practice of aerobic sports was studied in old adults by assessing their executive and mnesic functions, supported by frontal and temporal brain structures. Two groups were formed according to their age (60-69 and 70-79 years-old) including sportsmen (n = 23) and sedentary men (n = 24). Spatial memory and efficiency of attentional networks were measured, as well as general intelligence. Results showed that sportsmen outperformed sedentary participants in many of the tests employed. Thus their alerting, orienting and executive networks worked more effectively in the ANT-I task for executive functions, and they were more accurate in the spatial memory task, displaying a better spatial orientation. Scores in other neuropsychological tasks followed the same tendency. These data support the protective effect of aerobic exercise on cognitive functions.

Temperamental factors in remitted depression: The role of effortful control and attentional mechanisms

BACKGROUND

Temperamental effortful control and attentional networks are increasingly viewed as important underlying processes in depression and anxiety. However, it is still unknown whether these factors facilitate depressive and anxiety symptoms in the general population and, more specifically, in remitted depressed individuals.

METHODS

We investigated to what extent effortful control and attentional networks (i.e., Attention Network Task) explain concurrent depressive and anxious symptoms in healthy individuals (n = 270) and remitted depressed individuals (n = 90). Both samples were highly representative of the US population.

RESULTS

Increased effortful control predicted a substantial decrease in symptoms of both depression and anxiety in the whole sample, whereas decreased efficiency of executive attention predicted a modest increase in depressive symptoms. Remitted depressed individuals did not show less effortful control nor less efficient attentional networks than healthy individuals. Moreover, clinical status did not moderate the relationship between temperamental factors and either depressive or anxiety symptoms.

LIMITATIONS

Limitations include the cross-sectional nature of the study.

CONCLUSIONS

Our study shows that temperamental effortful control represents an important transdiagnostic process for depressive and anxiety symptoms in adults.

Decreased functional connectivity and structural deficit in alertness network with right-sided temporal lobe epilepsy

Patients with temporal lobe epilepsy (TLE) often suffer from alertness alterations. However, specific regions connected with alertness remain controversial, and whether these regions have structural impairment is also elusive. This study aimed to investigate the characteristics and neural mechanisms underlying the functions and structures of alertness network in patients with right-sided temporal lobe epilepsy (rTLE) by performing the attentional network test (ANT), resting-state functional magnetic resonance imaging (R-SfMRI), and diffusion tensor imaging (DTI).A total of 47 patients with rTLE and 34 healthy controls underwent ANT, R-SfMRI, and DTI scan. The seed-based functional connectivity (FC) method and deterministic tractography were used to analyze the data.Patients with rTLE had longer reaction times in the no-cue and double-cue conditions. However, no differences were noted in the alertness effect between the 2 groups. The patient group had lower FC compared with the control group in the right inferior parietal lobe (IPL), amygdala, and insula. Structural deficits were found in the right parahippocampal gyrus, superior temporal pole, insula, and amygdala in the patient group compared with the control group. Also significantly negative correlations were observed between abnormal fractional anisotropy (between the right insula and the superior temporal pole) and illness duration in the patients with rTLE.The findings of this study suggested abnormal intrinsic and phasic alertness, decreased FC, and structural deficits within the alerting network in the rTLE. This study provided new insights into the mechanisms of alertness alterations in rTLE.

Attention networks in adolescent anorexia nervosa

Anorexia nervosa (AN) usually develops during adolescence when considerable structural and functional brain changes are taking place. Neurocognitive inefficiencies have been consistently found in adults with enduring AN and were suggested to play a role in maintaining the disorder. However, such findings are inconsistent in children and adolescents with AN. The current study conducted a comprehensive assessment of attention networks in adolescents with AN who were not severely underweight during the study using an approach that permits disentangling independent components of attention. Twenty partially weight-restored adolescents with AN (AN-WR) and 24 healthy adolescents performed the Attention Network Test which assesses the efficiency of three main attention networks-executive control, orienting, and alerting. The results revealed abnormal function in the executive control network among adolescents with AN-WR. Specifically, adolescents with AN-WR demonstrated superior ability to suppress attention to task-irrelevant information while focusing on a central task. Moreover, the alerting network modulated this ability. No difference was found between the groups in the speed of orienting attention, but reorienting attention to a target resulted in higher error rates in the AN-WR group. The findings suggest that adolescents with AN have attentional abnormalities that cannot be explained by a state of starvation. These attentional dysregulations may underlie clinical phenotypes of the disorder such as increased attention of details.

Deficit of supramodal executive control of attention in schizophrenia

Although a deficit in executive control of attention is one of the hallmarks in schizophrenia that has significant impact on everyday functioning due to its relationship with thought processing, whether this deficit occurs across modalities, i.e., is supramodal, remains unclear. To investigate the supramodal mechanism in SZ, we examined cross-modal correlations between visual and auditory executive control of attention in a group of patients with schizophrenia (SZ, n = 55) compared to neurotypical controls (NC, n = 55). While the executive control effects were significantly correlated between the two modalities in the NC group, these effects were not correlated in the SZ group, with a significant group difference in the correlation. Further, the inconsistency and magnitude of the cross-modal executive control effects were significantly larger in the SZ group compared to the NC group. Together, these results suggest that there is a disruption of a common supramodal executive control mechanism in patients with schizophrenia, which may be related to the thought processing disorder characterizing the disorder.