On the (un)reliability of common behavioral and electrophysiological measures from the stop signal task: Measures of inhibition lack stability over time

Response inhibition, the intentional stopping of planned or initiated actions, is often considered a key facet of control, impulsivity, and self-regulation. The stop signal task is argued to be the purest inhibition task we have, and it is thus central to much work investigating the role of inhibition in areas like development and psychopathology. Most of this work quantifies stopping behavior by calculating the stop signal reaction time as a measure of individual stopping latency. Individual difference studies aiming to investigate why and how stopping latencies differ between people often do this under the assumption that the stop signal reaction time indexes a stable, dispositional trait. However, empirical support for this assumption is lacking, as common measures of inhibition and control tend to show low test-retest reliability and thus appear unstable over time. The reasons for this could be methodological, where low stability is driven by measurement noise, or substantive, where low stability is driven by a larger influence of state-like and situational factors. To investigate this, we characterized the split-half and test-retest reliability of a range of common behavioral and electrophysiological measures derived from the stop signal task. Across three independent studies, different measurement modalities, and a systematic review of the literature, we found a pattern of low temporal stability for inhibition measures and higher stability for measures of manifest behavior and non-inhibitory processing. This pattern could not be explained by measurement noise and low internal consistency. Consequently, response inhibition appears to have mostly state-like and situational determinants, and there is little support for the validity of conceptualizing common inhibition measures as reflecting stable traits.

Corticospinal excitability reductions during action preparation and action stopping in humans: Different sides of the same inhibitory coin?

Motor functions and cognitive processes are closely associated with each other. In humans, this linkage is reflected in motor system state changes both when an action must be prepared and stopped. Single-pulse transcranial magnetic stimulation showed that both action preparation and action stopping are accompanied by a reduction of corticospinal excitability, referred to as preparatory and response inhibition, respectively. While previous efforts have been made to describe both phenomena extensively, an updated and comprehensive comparison of the two phenomena is lacking. To ameliorate such deficit, this review focuses on the role and interpretation of single-coil (single-pulse and paired-pulse) and dual-coil TMS outcome measures during action preparation and action stopping in humans. To that effect, it aims to identify commonalities and differences, detailing how TMS-based outcome measures are affected by states, traits, and psychopathologies in both processes. Eventually, findings will be compared, and open questions will be addressed to aid future research.

Relationship between transcranial magnetic stimulation markers of motor control and clinical recovery in obsessive compulsive disorder/Gilles de la Tourette syndrome: a proof of concept case study

Background

Obsessive compulsive disorder (OCD) and Gilles de la Tourette syndrome (GTS) are neurodevelopmental disorders characterized by difficulties in controlling intrusive thoughts (obsessions) and undesired actions (tics), respectively. Both conditions have been associated with abnormal inhibition but a tangible deficit of inhibitory control abilities is controversial in GTS.

Methods

Here, we examined a 25 years-old male patient with severe OCD symptoms and a mild form of GTS, where impairments in motor control were central. Transcranial magnetic stimulation (TMS) was applied over the primary motor cortex (M1) to elicit motor-evoked potentials (MEPs) during four experimental sessions, allowing us to assess the excitability of motor intracortical circuitry at rest as well as the degree of MEP suppression during action preparation, a phenomenon thought to regulate movement initiation.

Results

When tested for the first time, the patient presented a decent level of MEP suppression during action preparation, but he exhibited a lack of intracortical inhibition at rest, as evidenced by reduced short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI). Interestingly, the patient's symptomatology drastically improved over the course of the sessions (reduced obsessions and tics), coinciding with feedback given on his good motor control abilities. These changes were reflected in the TMS measurements, with a significant strengthening of intracortical inhibition (SICI and LICI more pronounced than previously) and a more selective tuning of MEPs during action preparation; MEPs became even more suppressed, or selectively facilitated depending on the behavioral condition in which they we probed.

Conclusion

This study highlights the importance of better understanding motor inhibitory mechanisms in neurodevelopmental disorders and suggests a biofeedback approach as a potential novel treatment.

The effect of staircase stopping accuracy and testing environment on stop-signal reaction time

The stop-signal task is widely used in experimental psychology and cognitive neuroscience research, as well as neuropsychological and clinical practice for assessing response inhibition. The task requires participants to make speeded responses on a majority of trials, but to inhibit responses when a stop signal appears after the imperative cue. The stop-signal delay after the onset of the imperative cue determines how difficult it is to cancel an initiated action. The delay is typically staircased to maintain a 50% stopping accuracy for an estimation of stopping speed to be calculated. However, the validity of this estimation is compromised when participants engage in strategic slowing, motivated by a desire to avoid stopping failures. We hypothesized that maintaining stopping accuracy at 66.67% reduces this bias, and that slowing may also be impacted by the level of experimenter supervision. We found that compared with 50%, using a 66.67% stopping accuracy staircase produced slower stop-signal reaction time estimations (≈7 ms), but resulted in fewer strategic slowing exclusions. Additionally, both staircase procedures had similar within-experiment test-retest reliability. We also found that while individual and group testing in a laboratory setting produced similar estimations of stopping speed, participants tested online produced slower estimates. Our findings indicate that maintaining stopping accuracy at 66.67% is a reliable method for estimating stopping speed and can have benefits over the standard 50% staircase procedure. Further, our results show that care should be taken when comparing between experiments using different staircases or conducted in different testing environments.

Is cortical inhibition in primary motor cortex related to executive control?

Recent research using paired-pulse transcranial magnetic stimulation (TMS) has shown that the speed with which people can stop an action is linked to GABAergic inhibitory activity in the motor system. Specifically, a significant proportion of the variance in stop signal reaction time (SSRT; a widely used measure of inhibitory control) is accounted for by short-interval cortical inhibition (SICI). It is still unclear whether this relationship reflects a broader link between GABAergic processes and executive functions, or a specific link between GABAergic processes and motor stopping ability. The current study sought to replicate the correlation between SSRT and SICI while investigating whether this association generalises to other measures of inhibitory control and working memory, and to long-interval cortical inhibition (LICI). Participants completed a battery of inhibition (Stop-Signal, Stroop, Flanker) and working memory (n-back, Digit Span, and Operation Span) tasks. We replicated the correlation between SICI and SSRT but found no other correlations between behavioural measures of executive control and the two cortical measures of inhibition. These findings indicate that the relationship between SSRT and SICI is specific to a particular property of response inhibition and likely reflects the function of local inhibitory networks mediated by GABA_A.

Exploring stop signal reaction time over two sessions of the anticipatory response inhibition task

Various behavioural tasks measure response inhibition encompassing the ability to cancel unwanted actions, evaluated via stop signal reaction time (SSRT). It is unclear whether SSRT is an unchangeable inherent measure of inhibitory network integrity or whether it can improve with repetition. The current study explored if and how SSRT changed over two sessions for the Anticipatory Response Inhibition Task (ARIT), and how this compared with the Stop Signal Task (SST). Forty-four participants repeated the ARIT and SST over two sessions. SSRT and its constituent measures (Go trial reaction time, stop signal delay) were calculated. SSRT reflecting non-selective response inhibition was consistent between sessions in the ARIT and SST (both p > 0.293). Reaction time and stop signal delay also remained stable across sessions in the ARIT (all p > 0.063), whereas in the SST, reaction time (p = 0.013) and stop signal delay (p = 0.009) increased. SSRT reflecting behaviourally selective stopping on the ARIT improved (p < 0.001) over two sessions, which was underpinned by changes to reaction time (p < 0.001) and stop signal delay (p < 0.001). Overall, the maximal efficiency of non-selective inhibition remained stable across two sessions in the ARIT. Results of the SST confirmed that non-selective inhibition can, however, be affected by more than inhibitory network integrity. Behaviourally selective stopping on the ARIT changed across sessions, suggesting the sequential neural process captured by the SSRT occurred more quickly in session two. These findings have implications for future studies that necessitate behavioural measures over multiple sessions.

Motor Imagery Combined With Physical Training Improves Response Inhibition in the Stop Signal Task

Background

Motor imagery training has a similar effect to that of physical training on motor performance. The objective of this study was to investigate the short-term effectiveness of motor imagery training on response inhibition using the stop signal task (SST).

Methods

Participants were divided into a physical training group (PT, n = 17), a motor imagery training group (MIT, n = 17), and a motor imagery combined with physical training group (MIPT, n = 17). All participants performed 10 SST training sessions over 5 days. Both stop signal reaction time (SSRT) and non-signal reaction time (NSRT) were measured before and after SST training.

Results

There were significant interaction (time × group) and time effects, although the group effect was not statistically significant. Bonferroni post hoc analysis showed that MIPT group revealed a significantly greater change in SSRT than PT and MIT groups, while there was no significant difference between PT and MIT groups. SSRT significantly decreased after training in all groups. In NSRT, there was a significant effect of time, but there was no significant interaction effect (time × group) or group effect.

Conclusion

Response inhibition could be enhanced via training, and it was most effective when motor imagery and physical training were combined. We demonstrate that motor imagery training significantly improves response inhibition and should be accompanied by physical training when performing SST.

Strengthening the GABAergic system through neurofeedback training suppresses implicit motor learning

Gamma-aminobutyric acid (GABA) activity within the primary motor cortex (M1) is essential for motor learning in cortical plasticity, and a recent study has suggested that real-time neurofeedback training (NFT) can self-regulate GABA activity. Therefore, this study aimed to investigate the effect of GABA activity strengthening via NFT on subsequent motor learning. Thirty-six healthy participants were randomly assigned to either an NFT group or control group, which received sham feedback. GABA activity was assessed for short intracortical inhibition (SICI) within the right M1 using paired-pulse transcranial magnetic stimulation. During the NFT intervention period, the participants tried to modulate the size of a circle, which was altered according to the degree of SICI in the NFT group. However, the size was altered independently of the degree of SICI in the control group. We measured the reaction time before, after (online learning), and 24 h after (offline learning) the finger-tapping task. Results showed the strengthening of GABA activity induced by the NFT intervention, and the suppression of the online but not the offline learning. These findings suggest that prior GABA activity modulation may affect online motor learning.

Inhibitory control training and transcranial direct current stimulation of the pre-supplementary motor area: behavioral gains and transfer effects

Inhibitory control is a critical part of executive function and an important cognitive process in daily life. It is currently unclear how to optimally improve inhibitory control ability through behavior training and other interventions. Here, we explored the factors that influence inhibition control training in two experiments, focusing on the gains and transfer effects of training. Experiments 1 and 2 investigated the effects of anodal transcranial direct current stimulation (tDCS) over the pre-supplementary motor area and an increase in training duration on the training effect for inhibitory control, respectively, as well as the transfer effects when participants completed the Stroop and directed forgetting tasks. The results showed a stable training effect in relation to inhibitory control and a transfer effect for the Stroop task. Anodal tDCS in the pre-supplementary motor area could effectively improve inhibitory control ability, but not further enhance the training effect for inhibitory control. Moreover, increasing the training duration did not enhance the training effect for inhibitory control. The addition of tDCS and the extension of training duration failed to enhance the training effect, indicating that there may be a limitation of improvement in inhibitory control. The findings provide evidence regarding the further intervention effects of behavioral training and tDCS.

The Pause-then-Cancel model of human action-stopping: Theoretical considerations and empirical evidence

The ability to stop already-initiated actions is a key cognitive control ability. Recent work on human action-stopping has been dominated by two controversial debates. First, the contributions (and neural signatures) of attentional orienting and motor inhibition after stop-signals are near-impossible to disentangle. Second, the timing of purportedly inhibitory (neuro)physiological activity after stop-signals has called into question which neural signatures reflect processes that actually contribute to action-stopping. Here, we propose that a two-stage model of action-stopping - proposed by Schmidt and Berke (2017) based on subcortical rodent recordings - may resolve these controversies. Translating this model to humans, we first argue that attentional orienting and motor inhibition are inseparable because orienting to salient events like stop-signals automatically invokes broad motor inhibition, reflecting a fast-acting, ubiquitous Pause process. We then argue that inhibitory signatures after stop-signals differ in latency because they map onto two sequential stages: the salience-related Pause and a slower, stop-specific Cancel process. We formulate the model, discuss recent supporting evidence in humans, and interpret existing data within its context.

Cortical silent period reflects individual differences in action stopping performance

Inhibitory control is the ability to suppress inappropriate movements and unwanted actions, allowing to regulate impulses and responses. This ability can be measured via the Stop Signal Task, which provides a temporal index of response inhibition, namely the stop signal reaction time (SSRT). At the neural level, Transcranial Magnetic Stimulation (TMS) allows to investigate motor inhibition within the primary motor cortex (M1), such as the cortical silent period (CSP) which is an index of GABAB-mediated intracortical inhibition within M1. Although there is strong evidence that intracortical inhibition varies during action stopping, it is still not clear whether differences in the neurophysiological markers of intracortical inhibition contribute to behavioral differences in actual inhibitory capacities. Hence, here we explored the relationship between intracortical inhibition within M1 and behavioral response inhibition. GABABergic-mediated inhibition in M1 was determined by the duration of CSP, while behavioral inhibition was assessed by the SSRT. We found a significant positive correlation between CSP's duration and SSRT, namely that individuals with greater levels of GABABergic-mediated inhibition seem to perform overall worse in inhibiting behavioral responses. These results support the assumption that individual differences in intracortical inhibition are mirrored by individual differences in action stopping abilities.

Short intracortical facilitation associates with motor-inhibitory control

The ability of motor-inhibitory control is important in daily life. Inhibitory control deficits are commonly observed in psychiatric conditions with enhanced impulsivity. The physiological mechanisms underlying the inhibitory control deficits are not well elucidated. We systematically investigated the relationship between resting-state intracortical inhibition or facilitation and inhibitory control (indicated by stop signal reaction time, SSRT) to determine whether reduced intracortical inhibition or increased intracortical facilitation was related to the poorer inhibitory control. Thirty-three healthy subjects (age: 21.46 ± 1.40 years) participated in this study. We used paired-pulse transcranial magnetic stimulation to induce short intracortical inhibition, intracortical facilitation, long intracortical inhibition, and short intracortical facilitation at rest. SSRT was derived from stop signal task. We performed all measurements in two repeat sessions conducted two weeks apart. A negative correlation between short intracortical inhibition and SSRT was only observed in session 1; however, the correlation did not persist after controlling for short intracortical facilitation. Positive correlation between short intracortical facilitation and SSRT was observed in both sessions, indicating that individuals with greater resting-state short intracortical facilitation tend to have less efficient stopping performance. Our results help explain the inconsistency with respect to the relationship between short intracortical inhibition and SSRT in the existing literature. Short intracortical facilitation may be used as a potential physiological biomarker for motor-inhibitory control, which may have clinical implications for disorders associated with inhibitory control deficits.