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Lasaponara S, Scozia G, Lozito S, Pinto M, Conversi D, Costanzi M, Vriens T, Silvetti M, Doricchi F. Temperament and probabilistic predictive coding in visual-spatial attention. Cortex 2024; 171:60-74. [PMID: 37979232 DOI: 10.1016/j.cortex.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/21/2023] [Accepted: 10/16/2023] [Indexed: 11/20/2023]
Abstract
Cholinergic (Ach), Noradrenergic (NE), and Dopaminergic (DA) pathways play an important role in the regulation of spatial attention. The same neurotransmitters are also responsible for inter-individual differences in temperamental traits. Here we explored whether biologically defined temperamental traits determine differences in the ability to orient spatial attention as a function of the probabilistic association between cues and targets. To this aim, we administered the Structure of Temperament Questionnaire (STQ-77) to a sample of 151 participants who also performed a Posner task with central endogenous predictive (80 % valid/20 % invalid) or non-predictive cues (50 % valid/50 % invalid). We found that only participants with high scores in Plasticity and Intellectual Endurance showed a selective abatement of attentional costs with non-predictive cues. In addition, stepwise regression showed that costs in the non-predictive condition were negatively predicted by scores in Plasticity and positively predicted by scores in Probabilistic Thinking. These results show that stable temperamental characteristics play an important role in defining the inter-individual differences in attentional behaviour, especially in the presence of different probabilistic organisations of the sensory environment. These findings emphasize the importance of considering temperamental and personality traits in social and professional environments where the ability to control one's attention is a crucial functional skill.
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Affiliation(s)
- Stefano Lasaponara
- Department of Psychology, "Sapienza" University of Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy.
| | - Gabriele Scozia
- Department of Psychology, "Sapienza" University of Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy; PhD Programme in Behavioural Neuroscience, "Sapienza" University of Rome, Italy
| | - Silvana Lozito
- Department of Psychology, "Sapienza" University of Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy; PhD Programme in Behavioural Neuroscience, "Sapienza" University of Rome, Italy
| | - Mario Pinto
- Department of Psychology, "Sapienza" University of Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
| | - David Conversi
- Department of Psychology, "Sapienza" University of Rome, Italy
| | - Marco Costanzi
- Department of Human Science, LUMSA University, Rome, Italy
| | - Tim Vriens
- Computational and Translational Neuroscience Laboratory (CTNLab), Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - Massimo Silvetti
- Computational and Translational Neuroscience Laboratory (CTNLab), Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - Fabrizio Doricchi
- Department of Psychology, "Sapienza" University of Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy.
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Alnawmasi MM, Khuu SK. Deficits in the pupillary response associated with abnormal visuospatial attention allocation in mild traumatic brain injury. J Clin Exp Neuropsychol 2023; 45:855-873. [PMID: 38368620 DOI: 10.1080/13803395.2024.2314727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 11/25/2023] [Indexed: 02/20/2024]
Abstract
INTRODUCTION The ability to allocate visual attention is known to be impaired in patients with mild traumatic brain injury (mTBI). In the present study, we investigated a possible neural correlate of this cognitive deficit by examining the pupil response of patients with mTBI whilst performing a modified Posner visual search task. METHOD Two experiments were conducted in which the target location was either not cued (Experiment 1) or cued (Experiment 2). Additionally, in Experiment 2, the type of cue (endogenous vs exogenous cue) and cue validity were treated as independent variables. In both experiments, search efficiency was varied by changing shape similarity between target and distractor patterns. The reaction time required to judge whether the target was present or absent and pupil dilation metrics, particularly the pupil dilation latency (PDL) and amplitude (PDA), were measured. Thirteen patients with chronic mTBI and 21 age-, sex-, and IQ -matched controls participated in the study. RESULTS In Experiment 1, patients with mTBI displayed a similar PDA for both efficient and inefficient search conditions, while control participants had a significantly larger PDA in inefficient search conditions compared to efficient search conditions. As cognitive load is positively correlated with PDA, our findings suggest that mTBI patients were unable to apply more mental effort whilst performing visual search, particularly if the task is difficult when visual search is inefficient. In Experiment 2, when the target location was cued, patients with mTBI displayed no significant pupil dilation response to the target regardless of the efficiency of the search, nor whether the cue was valid or invalid. These results contrasted with control participants, who were additionally sensitive to the validity of the cue in which PDA was smaller for cue-valid conditions than invalid conditions, particularly for efficient search conditions. CONCLUSION Pupillometry provided further evidence of attention allocation deficits following mTBI.
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Affiliation(s)
- Mohammed M Alnawmasi
- Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Sieu K Khuu
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
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Antono JE, Vakhrushev R, Pooresmaeili A. Value-driven modulation of visual perception by visual and auditory reward cues: The role of performance-contingent delivery of reward. Front Hum Neurosci 2022; 16:1062168. [PMID: 36618995 PMCID: PMC9816136 DOI: 10.3389/fnhum.2022.1062168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Perception is modulated by reward value, an effect elicited not only by stimuli that are predictive of performance-contingent delivery of reward (PC) but also by stimuli that were previously rewarded (PR). PC and PR cues may engage different mechanisms relying on goal-driven versus stimulus-driven prioritization of high value stimuli, respectively. However, these two modes of reward modulation have not been systematically compared against each other. This study employed a behavioral paradigm where participants' visual orientation discrimination was tested in the presence of task-irrelevant visual or auditory reward cues. In the first phase (PC), correct performance led to a high or low monetary reward dependent on the identity of visual or auditory cues. In the subsequent phase (PR), visual or auditory cues were not followed by reward delivery anymore. We hypothesized that PC cues have a stronger modulatory effect on visual discrimination and pupil responses compared to PR cues. We found an overall larger task-evoked pupil dilation in PC compared to PR phase. Whereas PC and PR cues both increased the accuracy of visual discrimination, value-driven acceleration of reaction times (RTs) and pupillary responses only occurred for PC cues. The modulation of pupil size by high reward PC cues was strongly correlated with the modulation of a combined measure of speed and accuracy. These results indicate that although value-driven modulation of perception can occur even when reward delivery is halted, stronger goal-driven control elicited by PC reward cues additionally results in a more efficient balance between accuracy and speed of perceptual choices.
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Affiliation(s)
- Jessica Emily Antono
- Perception and Cognition Lab, European Neuroscience Institute Göttingen–A Joint Initiative of the University Medical Center Göttingen and the Max-Planck-Society, Göttingen, Germany
| | | | - Arezoo Pooresmaeili
- Perception and Cognition Lab, European Neuroscience Institute Göttingen–A Joint Initiative of the University Medical Center Göttingen and the Max-Planck-Society, Göttingen, Germany
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Steinhauer SR, Bradley MM, Siegle GJ, Roecklein KA, Dix A. Publication guidelines and recommendations for pupillary measurement in psychophysiological studies. Psychophysiology 2022; 59:e14035. [PMID: 35318693 PMCID: PMC9272460 DOI: 10.1111/psyp.14035] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/11/2022] [Indexed: 11/27/2022]
Abstract
A variety of psychological and physical phenomena elicit variations in the diameter of pupil of the eye. Changes in pupil size are mediated by the relative activation of the sphincter pupillae muscle (decrease pupil diameter) and the dilator pupillae muscle (increase pupil diameter), innervated by the parasympathetic and sympathetic branches, respectively, of the autonomic nervous system. The current guidelines are intended to inform and guide psychophysiological research involving pupil measurement by (1) summarizing important aspects concerning the physiology of the pupil, (2) providing methodological and data-analytic guidelines and recommendations, and (3) briefly reviewing psychological phenomena that modulate pupillary reactivity. Because of the increased ease and tractability of pupil measurement, the goal of these guidelines is to promote accurate recording, analysis, and reporting of pupillary data in psychophysiological research.
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Affiliation(s)
- Stuart R. Steinhauer
- Veterans Affairs Pittsburgh Healthcare System, VISN 4 MIRECC, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Greg J. Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Annika Dix
- Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
- Centre for Tactile Internet with Human-in-the-Loop (CeTI), Technische Universität Dresden, Dresden, Germany
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Walz JA, Mani R, Alnawmasi MM, Khuu SK. Visuospatial Attention Allocation as an Indicator of Cognitive Deficit in Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Front Hum Neurosci 2021; 15:675376. [PMID: 34354575 PMCID: PMC8329082 DOI: 10.3389/fnhum.2021.675376] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/23/2021] [Indexed: 01/02/2023] Open
Abstract
Traumatic Brain Injury (TBI) is defined by changes in brain function resulting from external forces acting on the brain and is typically characterized by a host of physiological and functional changes such as cognitive deficits including attention problems. In the present study, we focused on the effect of TBI on the ability to allocate attention in vision (i.e., the use of endogenous and exogenous visual cues) by systematically reviewing previous literature on the topic. We conducted quantitative synthesis of 16 selected studies of visual attention following TBI, calculating 80 effect size estimates. The combined effect size was large (g = 0.79, p < 0.0001) with medium heterogeneity (I2 = 68.39%). Subgroup analyses revealed an increase in deficit with moderate-to-severe and severe TBI as compared to mild TBI [F(2, 76) = 24.14, p < 0.0001]. Task type was another key source of variability and subgroup analyses indicated that higher order attention processes were severely affected by TBI [F(2, 77) = 5.66, p = 0.0051). Meta-regression analyses revealed significant improvement in visual attention deficit with time [p(mild) = 0.031, p(moderate-to-severe) = 0.002, p(severe) < 0.0001]. Taken together, these results demonstrate that visual attention is affected by TBI and that regular assessment of visual attention, using a systematic attention allocation task, may provide a useful clinical measure of cognitive impairment and change after TBI.
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Affiliation(s)
- Jacinta A Walz
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
| | - Revathy Mani
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
| | - Mohammed M Alnawmasi
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
| | - Sieu K Khuu
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
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Pupil dilation during orienting of attention and conscious detection of visual targets in patients with left spatial neglect. Cortex 2020; 134:265-277. [PMID: 33310541 DOI: 10.1016/j.cortex.2020.10.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 08/27/2020] [Accepted: 10/25/2020] [Indexed: 12/18/2022]
Abstract
Right Brain-Damaged patients (RBD) with left spatial neglect (N+), are characterised by deficits in orienting and re-orienting attention to stimuli in the contralesional left side of space. In a recent ERPs study with visual stimuli (Lasaponara et al., 2018) we have pointed out that the pathological attentional bias of N+ is matched with exaggerated novelty reaction and contextual updating of targets in the right ipsilesional space and reduced novelty reaction and contextual updating of targets in the left contralesional space. To characterise further the attentional performance of N+, here we measured Pupil Dilation (PDil), which is a reliable marker of noradrenergic-locus coeruleus activity and response to unexpected events/rewards. Compared to Neutral and Valid targets, N+ patients displayed a pathological reduction of PDil in response to infrequent Invalid targets in the left side of space, while in Healthy Controls (HC) and RBD without neglect (N-) the same targets enhanced PDil with respect to Neutral and frequent Valid targets. Invalid targets in the right side of space enhanced PDil in all experimental groups. Interestingly, both N- and N+ showed a consistent number of target omissions both in the left and right side of space. With respect to seen targets, N- showed reduced PDil in response to unseen targets both in the left and right side of space. In contrast, N+ had reduced PDil in response to unseen targets in the left side of space though not in the right side, where seen and unseen targets evoked comparable levels of PDil. These results disclose, for the first time, the PDil correlates of spatial attention in left spatial neglect and suggest that the pathological attentional bias suffered by N+ might enhance the autonomic responses reflected in PDil to unseen ipsilesional stimuli. This enhancement can contribute to biasing contextual updating and predictive coding of stimuli in the ipsilesional space, thus worsening the pathological attentional bias of N+.
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Spatial uncertainty improves the distribution of visual attention and the availability of sensory information for conscious report. Exp Brain Res 2020; 238:2031-2040. [DOI: 10.1007/s00221-020-05862-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 06/26/2020] [Indexed: 11/26/2022]
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Doricchi F, Pellegrino M, Marson F, Pinto M, Caratelli L, Cestari V, Rossi-Arnaud C, Lasaponara S. Deconstructing Reorienting of Attention: Cue Predictiveness Modulates the Inhibition of the No-target Side and the Hemispheric Distribution of the P1 Response to Invalid Targets. J Cogn Neurosci 2020; 32:1046-1060. [DOI: 10.1162/jocn_a_01534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Orienting of attention produces a “sensory gain” in the processing of visual targets at attended locations and an increase in the amplitude of target-related P1 and N1 ERPs. P1 marks gain reduction at unattended locations; N1 marks gain enhancement at attended ones. Lateral targets that are preceded by valid cues also evoke a larger P1 over the hemisphere contralateral to the no-target side, which reflects inhibition of this side of space [Slagter, H. A., Prinssen, S., Reteig, L. C., & Mazaheri, A. Facilitation and inhibition in attention: Functional dissociation of pre-stimulus alpha activity, P1, and N1 components. Neuroimage, 125, 25–35, 2016]. To clarify the relationships among cue predictiveness, sensory gain, and the inhibitory P1 response, we compared cue- and target-related ERPs among valid, neutral, and invalid trials with predictive (80% valid/20% invalid) or nonpredictive (50% valid/50% invalid) directional cues. Preparatory facilitation over the visual cortex contralateral to the cued side of space (lateral directing attention positivity component) was reduced during nonpredictive cueing. With predictive cues, the target-related inhibitory P1 was larger over the hemisphere contralateral to the no-target side not only in response to valid but also in response to neutral and invalid targets: This result highlights a default inhibitory hemispheric asymmetry that is independent from cued orienting of attention. With nonpredictive cues, valid targets reduced the amplitude of the inhibitory P1 over the hemisphere contralateral to the no-target side whereas invalid targets enhanced the amplitude of the same inhibitory component. Enhanced inhibition was matched with speeded reorienting to invalid targets and drop in attentional costs. These findings show that reorienting of attention is modulated by the combination of cue-related facilitatory and target-related inhibitory activity.
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Affiliation(s)
- Fabrizio Doricchi
- Università degli Studi di Roma “La Sapienza”
- Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Michele Pellegrino
- Università degli Studi di Roma “La Sapienza”
- Fondazione Santa Lucia IRCCS, Rome, Italy
| | | | - Mario Pinto
- Università degli Studi di Roma “La Sapienza”
- Fondazione Santa Lucia IRCCS, Rome, Italy
| | | | | | | | - Stefano Lasaponara
- Fondazione Santa Lucia IRCCS, Rome, Italy
- Libera Università Maria Santissima Assunta, Rome, Italy
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Pietrock C, Ebrahimi C, Katthagen TM, Koch SP, Heinz A, Rothkirch M, Schlagenhauf F. Pupil dilation as an implicit measure of appetitive Pavlovian learning. Psychophysiology 2019; 56:e13463. [PMID: 31424104 DOI: 10.1111/psyp.13463] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 12/27/2022]
Abstract
Appetitive Pavlovian conditioning is a learning mechanism of fundamental biological and pathophysiological significance. Nonetheless, its exploration in humans remains sparse, which is partly attributed to the lack of an established psychophysiological parameter that aptly represents conditioned responding. This study evaluated pupil diameter and other ocular response measures (gaze dwelling time, blink duration and count) as indices of conditioning. Additionally, a learning model was used to infer participants' learning progress on the basis of their pupil dilation. Twenty-nine healthy volunteers completed an appetitive differential delay conditioning paradigm with a primary reward, while the ocular response measures along with other psychophysiological (heart rate, electrodermal activity, postauricular and eyeblink reflex) and behavioral (ratings, contingency awareness) parameters were obtained to examine the relation among different measures. A significantly stronger increase in pupil diameter, longer gaze duration and shorter eyeblink duration was observed in response to the reward-predicting cue compared to the control cue. The Pearce-Hall attention model best predicted the trial-by-trial pupil diameter. This conditioned response was corroborated by a pronounced heart rate deceleration to the reward-predicting cue, while no conditioning effect was observed in the electrodermal activity or startle responses. There was no discernible correlation between the psychophysiological response measures. These results highlight the potential value of ocular response measures as sensitive indices for representing appetitive conditioning.
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Affiliation(s)
- Charlotte Pietrock
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia Ebrahimi
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Teresa M Katthagen
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Stefan P Koch
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Cluster of Excellence NeuroCure, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Bernstein Center for Computational Neuroscience Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marcus Rothkirch
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Florian Schlagenhauf
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Bernstein Center for Computational Neuroscience Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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Ceravolo MG, Cerroni R, Farina V, Fattobene L, Leonelli L, Mercuri NB, Raggetti G. Attention Allocation to Financial Information: The Role of Color and Impulsivity Personality Trait. Front Neurosci 2019; 13:818. [PMID: 31447637 PMCID: PMC6691097 DOI: 10.3389/fnins.2019.00818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 07/22/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In order to raise the level of investor's protection, the European Commission has recently introduced the key investor information document (KIID), a standard, plainly worded, and consumer-friendly document which should provide individuals with essential information for their investment decisions. KIID layout has been delineated relying on results from focus groups, surveys and telephone interviews, ignoring the reliable, and unbiased insights offered by neuroscientific approaches. AIM The current study aims to elucidate the patterns of eye movements in the early phases of information acquisition during the reading of financial disclosure documents, disentangling the independent role of color and impulsivity at modulating attention distribution toward the different sources of financial information. MATERIALS AND METHODS Oculomotor behavior was monitored in eighty-one healthy adults through the eye tracking technology (SMI REDn Scientific 60 Hz). An ecological protocol exploiting KIIDs was developed to control for several individual variables, through delivering standard visual stimuli based on official financial documents. Participants performed a passive exploration task (with the only specific instruction of visually exploring the document), followed by an active task where they were asked to rate the financial attractiveness of the products, as low, medium or high. The Barratt impulsiveness scale (BIS-11) was administered to each participant, to score such personality trait. RESULTS Attention distribution over the different information sources, included in the KIIDs, has been quantified and found to be independently modulated by both color and impulsivity, with a greater role of the former over the latter. The addition of either red or blue information to some KIID's sections increases attention allocation toward the whole document, compared to the usual black and white version. BIS-11 total scores were inversely related to the first and average fixation duration in the neutral, though not in the colored condition. DISCUSSION Bottom-up, stimulus-related mechanisms of attention allocation influence information acquisition during the reading of financial prospectuses to the point that the increased attention induced by color compensates for individual impulsivity. Such evidence should be considered by regulators when devising the disclosure documents in order to increase investors' protection.
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Affiliation(s)
- Maria G. Ceravolo
- Department of Experimental and Clinical Medicine, School of Medicine, Marche Polytechnic University, Ancona, Italy
- Neuroeconomics Laboratory, Centre for Health Care Management, School of Medicine, Marche Polytechnic University, Ancona, Italy
| | - Rocco Cerroni
- Neurological Unit, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Vincenzo Farina
- Department of Management and Law, School of Economics, University of Rome “Tor Vergata”, Rome, Italy
| | - Lucrezia Fattobene
- Department of Experimental and Clinical Medicine, School of Medicine, Marche Polytechnic University, Ancona, Italy
| | - Lucia Leonelli
- Department of Management and Law, School of Economics, University of Rome “Tor Vergata”, Rome, Italy
| | - Nicola B. Mercuri
- Neurological Unit, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
- IRCCS Santa Lucia Foundation, European Centre for Brain Research, Rome, Italy
| | - GianMario Raggetti
- Neuroeconomics Laboratory, Centre for Health Care Management, School of Medicine, Marche Polytechnic University, Ancona, Italy
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