Interactive effects of music and prefrontal cortex stimulation in modulating response inhibition

Visual art- and music-based interventions as adjuvants in the treatment of eating disorders: a systematic review and a theoretical model

AIM

To assess the effect of visual art- and music-based interventions in the treatment of eating disorders.

METHODS

This study was registered in PROSPERO (CRD42020161503). Six databases (CINAHL, EMBASE, Lilacs, PsycINFO, PubMed and The Cochrane Library) were consulted. The searches were performed on 19 June 2019, and updated on 18 March 2022. No restriction on language, date, or publication status was applied. Methodological quality was assessed using Joanna Briggs Institute's instruments. All steps were performed by two independent reviewers and a third participated in the event of disagreement.

RESULTS

Eight studies were included. Few statistically significant results were found. Overall, both interventions might help to reduce negative emotional states.

CONCLUSION

Visual art- and music-based interventions present limited and inconclusive scientific evidence in patients with eating disorders and therefore their effectiveness is currently unknown. A theoretical model is proposed to guide future research. Further studies are needed to clarify their clinical relevance.

Combining HD-tDCS with music stimulation for patients with prolonged disorders of consciousness: Study protocol for an RCT trial

BACKGROUND

Patients with prolonged disorders of consciousness (pDOC) pose significant challenges to healthcare workers due to their severe motor impairments and limited interaction with the environment. Non-invasive brain stimulation such as high-definition transcranial direct current stimulation (HD-tDCS) and music stimulation show promise in awakening this population.

OBJECTIVE

In this study, we present a protocol aiming at investigating the efficacy of combined HD-tDCS and music stimulation in awakening patients with pDOC through a single-blind, randomized controlled trial.

METHODS

Ninety patients with pDOC will be randomly divided into three groups: active HD-tDCS with music stimulation, active HD-tDCS, and sham HD-tDCS. All participants will receive 20 treatment sessions over a period of 10 days and the Coma Recovery Scale-Revised, Glasgow Outcome Scale and electroencephalogram will be used as assessment measures to evaluate their level of consciousness throughout the study. Adverse events and complications will be recorded during treatment. Within-group pre-post comparisons and between-group efficacy comparisons will be conducted to identify the most effective intervention approach. Statistical analysis will be performed using SPSS software with a significance level set at P < 0.05.

CONCLUSION

The pursuit of awakening therapy for patients with pDOC remains a clinical research challenge. This study protocol is designed with the aim of introducing an innovative non-pharmacological approach which combined HD-tDCS and music stimulation to facilitate the reinstatement of consciousness in patients with pDOC.

Frontal two-electrode transcranial direct current stimulation protocols may not affect performance on a combined flanker Go/No-Go task

Transcranial direct current stimulation (tDCS) has been tested to modulate cognitive control or response inhibition using various electrode montages. However, electrode montages and current polarities have not been systematically compared when examining tDCS effects on cognitive control and response inhibition. In this randomized, sham-controlled study, 38 healthy volunteers were randomly grouped into receiving one session of sham, anodal, and cathodal each in an electrode montage that targeted either the dorsolateral prefrontal cortex (DLPFC) or the fronto-medial (FM) region. Participants performed a combined flanker Go/No-Go task during stimulation. No effect of tDCS was found in the DLPFC and FM groups neither using anodal nor cathodal stimulation. No major adverse effects of tDCS were identified using either montage or stimulation type and the two groups did not differ in terms of the reported sensations. The present study suggests that single-session tDCS delivered in two two-electrode montages might not affect cognitive control or response inhibition, despite using widely popular stimulation parameters. This is in line with the heterogeneous findings in the field and calls for further systematic research to exclude less reliable methods from those with more pronounced effects, identify the determinants of responsiveness, and develop optimal ways to utilize this technique.

Dynamic modulation of inhibition ability following repeated exposures to morphine in macaque monkey

BACKGROUND

Deficits in cognitive control, particularly inhibition ability, play crucial roles in susceptibility, progress, and relapse to opioid addiction. However, it is unclear when and how such deficits develop and interact with repeated exposures to prescribed opioids.

AIM

Using macaque monkey (Macaca mulatta), as an animal model with high translational merits in cognitive neuroscience, we tried to delineate alterations of inhibition ability in the course of repeated exposures to morphine.

METHODS

Monkeys were trained to perform stop-signal task and then we closely monitored their inhibition ability before exposure, after initial exposure, and following repeated exposures to morphine when they experienced abstinent periods. We also assessed morphine-induced conditioned place preference (CPP) in these monkeys to monitor the long-lasting effects of morphine on other behaviors.

RESULTS

Compared to the baseline level, monkeys' inhibition ability was significantly enhanced after initial exposure to morphine (early phase); however, it became significantly attenuated after repeated exposures (late phase). These alterations occurred while monkeys consistently expressed the morphine-induced CPP over the course of morphine exposure.

CONCLUSIONS

Our findings indicate that repeated and scheduled exposures to morphine, which is akin to its clinical and recreational use, lead to dynamic alterations in primates' cognitive control depending on the extent of exposure. Enhancement of inhibition after limited exposure might provide opportunities to intervene and prevent the progress and culmination of opioid addiction, which is characterized by disinhibited drug-seeking and consumption.

Dissociable effects of music and white noise on conflict-induced behavioral adjustments

Auditory stimuli, encompassing a continually expanding collection of musical genres and sonic hues, present a safe and easily administrable therapeutic option for alleviating cognitive deficits associated with neuropsychological disorders, but their effects on executive control are yet to be completely understood. To better understand how the processing of certain acoustic properties can influence conflict processing, we had a large of cohort of undergraduate students complete the Stroop colour and word test in three different background conditions: classical music, white noise, and silence. Because of pandemic guidelines and the necessity to run the experiment remotely, participants also completed the Wisconsin card sorting test (WCST), so that the reliability and consistency of acquired data could be assessed. We found that white noise, but not classical music increased the response time difference between congruent (low conflict) and incongruent (high conflict) trials (conflict cost), hence impairing performance. Results from the WCST indicated that home-based data collection was reliable, replicating a performance bias reported in our previous laboratory-based experiments. Both the auditory stimuli were played at a similar intensity, thus their dissociable effects may have resulted from differing emotional responses within participants, where white noise, but not music elicited a negative response. Integrated with previous literature, our findings indicate that outside of changes in tempo and valence, classical music does not affect cognitive functions associated with conflict processing, whilst white noise impairs these functions in a manner similar to other stressors, and hence requires further research before its implementation into neuropsychiatric care.

Transcranial Direct Current Stimulation Combined With Listening to Preferred Music Alters Cortical Speech Processing in Older Adults

Emerging evidence suggests transcranial direct current stimulation (tDCS) can improve cognitive performance in older adults. Similarly, music listening may improve arousal and stimulate subsequent performance on memory-related tasks. We examined the synergistic effects of tDCS paired with music listening on auditory neurobehavioral measures to investigate causal evidence of short-term plasticity in speech processing among older adults. In a randomized sham-controlled crossover study, we measured how combined anodal tDCS over dorsolateral prefrontal cortex (DLPFC) paired with listening to autobiographically salient music alters neural speech processing in older adults compared to either music listening (sham stimulation) or tDCS alone. EEG assays included both frequency-following responses (FFRs) and auditory event-related potentials (ERPs) to trace neuromodulation-related changes at brainstem and cortical levels. Relative to music without tDCS (sham), we found tDCS alone (without music) modulates the early cortical neural encoding of speech in the time frame of ∼100-150 ms. Whereas tDCS by itself appeared to largely produce suppressive effects (i.e., reducing ERP amplitude), concurrent music with tDCS restored responses to those of the music+sham levels. However, the interpretation of this effect is somewhat ambiguous as this neural modulation could be attributable to a true effect of tDCS or presence/absence music. Still, the combined benefit of tDCS+music (above tDCS alone) was correlated with listeners' education level suggesting the benefit of neurostimulation paired with music might depend on listener demographics. tDCS changes in speech-FFRs were not observed with DLPFC stimulation. Improvements in working memory pre to post session were also associated with better speech-in-noise listening skills. Our findings provide new causal evidence that combined tDCS+music relative to tDCS-alone (i) modulates the early (100-150 ms) cortical encoding of speech and (ii) improves working memory, a cognitive skill which may indirectly bolster noise-degraded speech perception in older listeners.

Dimension of visual information interacts with working memory in monkeys and humans

Humans demonstrate behavioural advantages (biases) towards particular dimensions (colour or shape of visual objects), but such biases are significantly altered in neuropsychological disorders. Recent studies have shown that lesions in the prefrontal cortex do not abolish dimensional biases, and therefore suggest that such biases might not depend on top-down prefrontal-mediated attention and instead emerge as bottom-up processing advantages. We hypothesised that if dimensional biases merely emerge from an enhancement of object features, the presence of visual objects would be necessary for the manifestation of dimensional biases. In a specifically-designed working memory task, in which macaque monkeys and humans performed matching based on the object memory rather than the actual object, we found significant dimensional biases in both species, which appeared as a shorter response time and higher accuracy in the preferred dimension (colour and shape dimension in humans and monkeys, respectively). Moreover, the mnemonic demands of the task influenced the magnitude of dimensional bias. Our findings in two primate species indicate that the dichotomy of top-down and bottom-up processing does not fully explain the emergence of dimensional biases. Instead, dimensional biases may emerge when processed information regarding visual object features interact with mnemonic and executive functions to guide goal-directed behaviour.

Does maternal inhibitory control mediate effects of a parenting intervention on maternal sensitive discipline? Evidence from a randomized-controlled trial

The quality of parenting greatly impacts child development, highlighting the importance of support programs that effectively improve parenting. Studies on successful intervention programs define their efficacy by gains in parenting and/or child development. However, much remains unknown about the internal processes that explain how parenting interventions bring about their effects. The aims of the current randomized‐controlled study were to test whether the Video‐feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP‐SD) improved maternal inhibitory control (1) and whether inhibitory control mediated any effects of VIPP‐SD on maternal sensitive discipline (2). In total, 66 mothers of whom a random 33% received the VIPP‐SD and the others a “dummy” intervention participated in pre‐ and post‐intervention assessments. Sensitive discipline was observed during a semi‐structured limit‐setting situation and inhibitory control was measured using a stop‐signal task. Contrary to expectations, inhibitory control improved over time in the control group and sensitive discipline did not show the expected increase in the intervention group. Results did not support mediation. We suggest that the intervention may have induced cognitive restructuring of parenting schemas, delaying improvements in post‐intervention inhibitory control and sensitive discipline. Factors that may be involved in parents’ susceptibility to interventions require attention in future work.

Do you listen to music while studying? A portrait of how people use music to optimize their cognitive performance

The effect of background music (BGM) on cognitive task performance is a popular topic. However, the evidence is not converging: experimental studies show mixed results depending on the task, the type of music used and individual characteristics. Here, we explored how people use BGM while optimally performing various cognitive tasks in everyday life, such as reading, writing, memorizing, and critical thinking. Specifically, the frequency of BGM usage, preferred music types, beliefs about the scientific evidence on BGM, and individual characteristics, such as age, extraversion and musical background were investigated. Although the results confirmed highly diverse strategies among individuals regarding when, how often, why and what type of BGM is used, we found several general tendencies: people tend to use less BGM when engaged in more difficult tasks, they become less critical about the type of BGM when engaged in easier tasks, and there is a negative correlation between the frequency of BGM and age, indicating that younger generations tend to use more BGM than older adults. The current and previous evidence are discussed in light of existing theories. Altogether, this study identifies essential variables to consider in future research and further forwards a theory-driven perspective in the field.

Musical components important for the Mozart K448 effect in epilepsy

There is growing evidence for the efficacy of music, specifically Mozart’s Sonata for Two Pianos in D Major (K448), at reducing ictal and interictal epileptiform activity. Nonetheless, little is known about the mechanism underlying this beneficial “Mozart K448 effect” for persons with epilepsy. Here, we measured the influence that K448 had on intracranial interictal epileptiform discharges (IEDs) in sixteen subjects undergoing intracranial monitoring for refractory focal epilepsy. We found reduced IEDs during the original version of K448 after at least 30-s of exposure. Nonsignificant IED rate reductions were witnessed in all brain regions apart from the bilateral frontal cortices, where we observed increased frontal theta power during transitions from prolonged musical segments. All other presented musical stimuli were associated with nonsignificant IED alterations. These results suggest that the “Mozart K448 effect” is dependent on the duration of exposure and may preferentially modulate activity in frontal emotional networks, providing insight into the mechanism underlying this response. Our findings encourage the continued evaluation of Mozart’s K448 as a noninvasive, non-pharmacological intervention for refractory epilepsy.

Investigating the sex-dependent effects of prefrontal cortex stimulation on response execution and inhibition

Context-dependent execution or inhibition of a response is an important aspect of executive control, which is impaired in neuropsychological and addiction disorders. Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) has been considered a remedial approach to address deficits in response control; however, considerable variability has been observed in tDCS effects. These variabilities might be related to contextual differences such as background visual-auditory stimuli or subjects' sex. In this study, we examined the interaction of two contextual factors, participants' sex and background acoustic stimuli, in modulating the effects of tDCS on response inhibition and execution. In a sham-controlled and cross-over (repeated-measure) design, 73 participants (37 females) performed a Stop-Signal Task in different background acoustic conditions before and after tDCS (anodal or sham) was applied over the DLPFC. Participants had to execute a speeded response in Go trials but inhibit their response in Stop trials. Participants' sex was fully counterbalanced across all experimental conditions (acoustic and tDCS). We found significant practice-related learning that appeared as changes in indices of response inhibition (stop-signal reaction time and percentage of successful inhibition) and action execution (response time and percentage correct). The tDCS and acoustic stimuli interactively influenced practice-related changes in response inhibition and these effects were uniformly seen in both males and females. However, the effects of tDCS on response execution (percentage of correct responses) were sex-dependent in that practice-related changes diminished in females but heightened in males. Our findings indicate that participants' sex influenced the effects of tDCS on the execution, but not inhibition, of responses.

Effects of single-session transcranial direct current stimulation on reactive response inhibition

Transcranial direct current stimulation (tDCS) is widely used to explore the role of various cortical regions for reactive response inhibition. In recent years, tDCS studies reported polarity-, time- and stimulation-site dependent effects on response inhibition. Given the large parameter space in which study designs, tDCS procedures and task procedures can differ, it is crucial to systematically explore the existing tDCS literature to increase the current understanding of potential modulatory effects and limitations of different approaches. We performed a systematic review on the modulatory effects of tDCS on response inhibition as measured by the Stop-Signal Task. The final dataset shows a large variation in methodology and heterogeneous effects of tDCS on performance. The most consistent result across studies is a performance enhancement due to anodal tDCS over the right prefrontal cortex. Partially sub-optimal choices in study design, methodology and lacking consistency in reporting procedures may impede valid conclusions and obscured the effects of tDCS on response inhibition in some previous studies. Finally, we outline future directions and areas to improve research.

Effects of transcranial direct current stimulation combined with listening to preferred music on memory in older adults

Listening to autobiographically-salient music (i.e., music evoking personal memories from the past), and transcranial direct current stimulation (tDCS) have each been suggested to temporarily improve older adults' subsequent performance on memory tasks. Limited research has investigated the effects of combining both tDCS and music listening together on cognition. The present study examined whether anodal tDCS stimulation over the left dorsolateral prefrontal cortex (2 mA, 20 min) with concurrent listening to autobiographically-salient music amplified subsequent changes in working memory and recognition memory in older adults than either tDCS or music listening alone. In a randomized sham-controlled crossover study, 14 healthy older adults (64-81 years) participated in three neurostimulation conditions: tDCS with music listening (tDCS + Music), tDCS in silence (tDCS-only), or sham-tDCS with music listening (Sham + Music), each separated by at least a week. Working memory was assessed pre- and post-stimulation using a digit span task, and recognition memory was assessed post-stimulation using an auditory word recognition task (WRT) during which electroencephalography (EEG) was recorded. Performance on the backwards digit span showed improvement in tDCS + Music, but not in tDCS-only or Sham + Music conditions. Although no differences in behavioural performance were observed in the auditory WRT, changes in neural correlates underlying recognition memory were observed following tDCS + Music compared to Sham + Music. Findings suggest listening to autobiographically-salient music may amplify the effects of tDCS for working memory, and highlight the potential utility of neurostimulation combined with personalized music to improve cognitive performance in the aging population.

The effects of emotional stimuli and oxytocin on inhibition ability and response execution in macaque monkeys

Social and emotional content of environmental stimuli influence executive control of behavior. There has been a great variability in the behavioral effects of emotional stimuli in humans. These variabilities might arise from other contextual factors, such as specific task demands or natural hormones, which potentially interact with emotional stimuli in modulating executive functions. This study aimed at examining the effects of social-emotional visual stimuli and a natural hormone (oxytocin) on inhibition ability and response execution of macaque monkeys. In a crossover design, monkeys received inhaled oxytocin or its vehicle before performing a stop-signal task in which they must respond rapidly to a visual go-cue in Go trials but inhibit the initiated response following the onset of a stop-cue in Stop trials. The social-emotional content (negative, positive or neutral) of the go-cue was changed trial-by-trial. We found that monkeys' inhibition ability was significantly influenced by the social-emotional content of stimuli and appeared as an enhanced inhibition ability when monkeys were exposed to negative stimuli. However, response execution was not influenced by the emotional content of stimuli in the current or preceding trials. The same dose of oxytocin, which modulated working memory in monkeys, had no significant effect on the inhibition ability, but significantly decreased monkeys' response time regardless of the stimulus valence. Our findings indicate that emotional stimuli, valence dependently, influence monkeys' inhibition ability but not their response execution and suggest that oxytocin might attenuate reorientation of cognitive resources to the task irrelevant emotional information.

Short-term research projects in cognitive neuroscience for undergraduate students: a contingency plan to maintain quality teaching during COVID-19 pandemic

The Corona Virus Disease 19 (COVID-19) pandemic has imposed serious restrictions for academic institutions to maintain their research and teaching practical subjects. Universities have implemented adaptive measures to maintain educational activities and achieve the learning objectives for undergraduate and postgraduate students by shifting to online teaching and learning. Although such approaches have enabled delivering the theoretical content of courses during the pandemic, universities have faced serious difficulties in running practicals with actual research experiments and teaching hand-on skills because such activities potentially override the required safety guidelines. Here, we report an adaptive measure, implemented at Monash University, to run home-based studies in cognitive neuroscience and achieve learning objectives, which are normally delivered in face-to-face practicals. We introduce two specifically designed short-term research projects and describe how different aspects of these projects, such as tutorials, experiments, and assessments, were modified to meet the required social distancing. The results of cognitive tests were closely comparable between the laboratory-based and home-based experiments indicating that students followed the guidelines and the required procedures for a reliable data collection. Our assessments of students' performance and feedback indicate that the majority of our educational goals were achieved, while all safety guidelines and distancing requirements were also met.

The Role of Primate Prefrontal Cortex in Bias and Shift Between Visual Dimensions

Imaging and neural activity recording studies have shown activation in the primate prefrontal cortex when shifting attention between visual dimensions is necessary to achieve goals. A fundamental unanswered question is whether representations of these dimensions emerge from top-down attentional processes mediated by prefrontal regions or from bottom-up processes within visual cortical regions. We hypothesized a causative link between prefrontal cortical regions and dimension-based behavior. In large cohorts of humans and macaque monkeys, performing the same attention shifting task, we found that both species successfully shifted between visual dimensions, but both species also showed a significant behavioral advantage/bias to a particular dimension; however, these biases were in opposite directions in humans (bias to color) versus monkeys (bias to shape). Monkeys' bias remained after selective bilateral lesions within the anterior cingulate cortex (ACC), frontopolar cortex, dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC), or superior, lateral prefrontal cortex. However, lesions within certain regions (ACC, DLPFC, or OFC) impaired monkeys' ability to shift between these dimensions. We conclude that goal-directed processing of a particular dimension for the executive control of behavior depends on the integrity of prefrontal cortex; however, representation of competing dimensions and bias toward them does not depend on top-down prefrontal-mediated processes.

Color-hierarchies in executive control of monkeys' behavior

Processing advantages for particular colors (color-hierarchies) influence emotional regulation and cognitive functions in humans and manifest as an advantage of the red color, compared with the green color, in triggering response inhibition but not in response execution. It remains unknown how such color-hierarchies emerge in human cognition and whether they are the unique properties of human brain with advanced trichromatic vision. Dominant models propose that color-hierarchies are formed as experience-dependent learning that associates various colors with different human-made conventions and concepts (e.g., traffic lights). We hypothesized that if color-hierarchies modulate cognitive functions in trichromatic nonhuman primates, it would indicate a preserved neurobiological basis for such color-hierarchies. We trained six macaque monkeys to perform cognitive tasks that required behavioral control based on colored cues. Color-hierarchies significantly influenced monkeys' behavior and appeared as an advantage of the red color, compared to the green, in triggering response inhibition but not response execution. For all monkeys, the order of color-hierarchies, in response inhibition and also execution, was similar to that in humans. In addition, the cognitive effects of color-hierarchies were not limited to the trial in which the colored cues were encountered but also persisted in the following trials in which there was no colored cue on the visual scene. These findings suggest that color-hierarchies are not resulting from association of colors with human-made conventions and that simple processing advantage in retina or early visual pathways does not explain the cognitive effects of color-hierarchies. The discovery of color-hierarchies in cognitive repertoire of monkeys indicates that although the evolution of humans and monkeys diverged in about 25 million years ago, the color-hierarchies are evolutionary preserved, with the same order, in trichromatic primates and exert overarching effects on the executive control of behavior.

Please, don't do it! Fifteen years of progress of non-invasive brain stimulation in action inhibition

The ability to inhibit prepotent responses is critical for survival. Action inhibition can be investigated using a stop-signal task (SST), designed to provide a reliable measure of the time taken by the brain to suppress motor responses. Here we review the major research advances using the combination of this paradigm with the use of non-invasive brain stimulation techniques in the last fifteen years. We highlight new methodological approaches to understanding and exploiting several processes underlying action control, which is critically impaired in several psychiatric disorders. In this review we present and discuss existing literature demonstrating i) the importance of the use of non-invasive brain stimulation in studying human action inhibition, unveiling the neural network involved ii) the critical role of prefrontal areas, including the pre-supplementary motor area (pre-SMA) and the inferior frontal gyrus (IFG), in inhibitory control iii) the neural and behavioral evidence of proactive and reactive action inhibition. As the main result of this review, the specific literature demonstrated the crucial role of pre-SMA and IFG as evidenced from the field of noninvasive brain stimulation studies. Finally, we discuss the critical questions that remain unanswered about how such non-invasive brain stimulation protocols can be translated to therapeutic treatments.

Can transcranial direct current stimulation (tDCS) improve impulsivity in healthy and psychiatric adult populations? A systematic review

Impulsivity is a multidimensional phenomenon that remains hard to define. It compounds the core pathological construct of many neuropsychiatric illnesses, and despite its close relation to suicide risk, it currently has no specific treatment. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique whose application results in cognitive function improvement, both in healthy and psychiatric populations. Following PRISMA recommendations, a systematic review of the literature concerning tDCS's effects on impulsive behaviour was performed using the PubMed database. The research was based on the combination of the keyword 'tDCS' with 'impulsivity', 'response inhibition', 'risk-taking', 'planning', 'delay discounting' or 'craving'. The initial search yielded 309 articles, 92 of which were included. Seventy-four papers demonstrated improvement in task performance related to impulsivity in both healthy and clinical adult populations. However, results were often inconsistent. The conditions associated with improvement, such as tDCS parameters and other aspects that may influence tDCS's outcomes, are discussed. The overall effects of tDCS on impulsivity are promising. Yet further research is required to develop a more comprehensive understanding of impulsivity, allowing for a more accurate assessment of its behavioural outcomes as well as a definition of tDCS therapeutic protocols for impulsive disorders.

Negative Emotional Stimuli Enhance Conflict Resolution Without Altering Arousal

In our daily life, we frequently need to make decisions between competing behavioral options while we are exposed to various contextual factors containing emotional/social information. We examined how changes in emotional/arousal state influence resolving conflict between behavioral rules. Visual stimuli with emotional content (positive, negative and neutral) and music (High/Low tempo), which could potentially alter emotional/arousal states, were included in the task context while participants performed the Wisconsin Card Sorting Test (WCST). The WCST requires the application of abstract matching rules, to resolve conflict between competing behavioral options. We found that conflict influenced both accuracy and response time (RT) in implementing rules. Measuring event-related autonomic responses indicated that these behavioral effects were accompanied by concomitant alterations in arousal levels. Performance in the WCST was modulated by the emotional content of visual stimuli and appeared as a faster response and higher accuracy when trials commenced with negative emotional stimuli. These effects were dependent on the level of conflict but were not accompanied by changes in arousal levels. Here, we report that visual stimuli with emotional content influence conflict processing without trial-by-trial changes in arousal level. Our findings indicate intricate interactions between emotional context and various aspects of executive control such as conflict resolution and suggest that these interactions are not necessarily mediated through alterations in arousal level.

Musical Attention Control Training for Psychotic Psychiatric Patients: An Experimental Pilot Study in a Forensic Psychiatric Hospital

Poor attention skills constitute a major problem for psychiatric patients with psychotic symptoms, and increase their chances of treatment drop-out. This study investigated possible benefits of musical attention control training (MACT). To examine the effect of MACT on attention skills of psychiatric patients with psychotic features a randomized controlled trial (RCT) was conducted in a forensic psychiatric clinic. Participants (N = 35, age M = 34.7, 69% male) were pair matched (on age, gender, and educational level), and randomly assigned to an experimental and control group. The experimental group received a 30-min MACT training once a week over 6 weeks' time, whereas the controls received treatment as usual without attention training. Single blind pre- and post-neuropsychological assessments were performed to measure different attention levels. The experimental MACT group outperformed the control group in selective, sustained and alternating attention. In addition, overall attendance of MACT participants was high (87.1%). This result suggests that in this experimental pilot study MACT was effective for attention skills of psychiatric patients with psychotic features. To obtain larger intervention effects additional research is necessary, with a larger sample and a more specific MACT intervention.