Controlling your impulses: electrical stimulation of the human supplementary motor complex prevents impulsive errors

Aberrant glutamatergic systems underlying impulsive behaviors: Insights from clinical and preclinical research

Impulsivity is a broad construct that often refers to one of several distinct behaviors and can be measured with self-report questionnaires and behavioral paradigms. Several psychiatric conditions are characterized by one or more forms of impulsive behavior, most notably the impulsive/hyperactive subtype of attention-deficit/hyperactivity disorder (ADHD), mood disorders, and substance use disorders. Monoaminergic neurotransmitters are known to mediate impulsive behaviors and are implicated in various psychiatric conditions. However, growing evidence suggests that glutamate, the major excitatory neurotransmitter of the mammalian brain, regulates important functions that become dysregulated in conditions like ADHD. The purpose of the current review is to discuss clinical and preclinical evidence linking glutamate to separate aspects of impulsivity, specifically motor impulsivity, impulsive choice, and affective impulsivity. Hyperactive glutamatergic activity in the corticostriatal and the cerebro-cerebellar pathways are major determinants of motor impulsivity. Conversely, hypoactive glutamatergic activity in frontal cortical areas and hippocampus and hyperactive glutamatergic activity in anterior cingulate cortex and nucleus accumbens mediate impulsive choice. Affective impulsivity is controlled by similar glutamatergic dysfunction observed for motor impulsivity, except a hyperactive limbic system is also involved. Loss of glutamate homeostasis in prefrontal and nucleus accumbens may contribute to motor impulsivity/affective impulsivity and impulsive choice, respectively. These results are important as they can lead to novel treatments for those with a condition characterized by increased impulsivity that are resistant to conventional treatments.

Decisional components of motor responses are not related to online response control: Evidence from lexical decision and speed-accuracy tradeoff manipulations

Evidence suggests that decision processes can propagate to motor-response execution. However, the functional characterization of motor decisional components is not yet fully understood. By combining a classic lexical decision experiment with manipulations of speed-accuracy tradeoff (SAT), the present experiment assessed the hypothesis that decisional effects on chronometric measures of motor-response execution are related to online response control. The electromyographic (EMG) signal associated with manual button-press responses was used to dissociate the premotor component (from stimulus onset until the onset of the EMG activity) from the motor component (from EMG onset until the button-press), thus enabling the assessment of decision-related effects in terms of motor-response duration within single-trial reaction times. Other than replicating all the previously reported SAT effects, the experiment revealed hindered control processes when the instructions emphasized speed over accuracy, as indicated by measures of response control such as partial errors, fast errors, and correction likelihood. Nonetheless, the lexicality effect on motor responses, consisting of slower motor times for pseudowords compared to words, was impervious to any SAT modulation. The results suggest that SAT-induced variations in decision and response control policies may not be the prominent determinant of decision-related effects on motor times, highlighting the multiple "cognitive" components that affect peripheral response execution.

Distinct brain dynamics and networks for processing short and long auditory time intervals

Psychophysical studies suggest that time intervals above and below 1.2 s are processed differently in the human brain. However, the neural underpinnings of this dissociation remain unclear. Here, we investigate whether distinct or common brain networks and dynamics support the passive perception of short (below 1.2 s) and long (above 1.2 s) empty time intervals. Twenty participants underwent an EEG recording during an auditory oddball paradigm with .8- and 1.6-s standard time intervals and deviant intervals either shorter (early) or longer (delayed) than the standard interval. We computed the auditory ERPs for each condition at the sensor and source levels. We then performed whole brain cluster-based permutation statistics for the CNV, N1 and P2, components, testing deviants against standards. A CNV was found only for above 1.2 s intervals (delayed deviants), with generators in temporo-parietal, SMA, and motor regions. Deviance detection of above 1.2 s intervals occurred during the N1 period over fronto-central sensors for delayed deviants only, with generators in parietal and motor regions. Deviance detection of below 1.2 s intervals occurred during the P2 period over fronto-central sensors for delayed deviants only, with generators in primary auditory cortex, SMA, IFG, cingulate and parietal cortex. We then identified deviance related changes in directed connectivity using bivariate Granger causality to highlight the networks dynamics associated with interval processing above and below 1.2. These results suggest that distinct brain dynamics and networks support the perception of time intervals above and below 1.2 s.

Offline 20 Hz transcranial alternating current stimulation over the right inferior frontal gyrus increases theta activity during a motor response inhibition task

OBJECTIVES

Previous studies have shown that the right inferior frontal gyrus (rIFG) and the pre-supplementary motor area (preSMA) play an important role in motor inhibitory control. The aim of the study was to use theta frequency transcranial alternating current stimulation (tACS) to modulate brain activity in the rIFG and preSMA and to test the effects of stimulation using a motor response inhibition task.

METHODS

In four sessions, 20 healthy participants received tACS at 6 Hz over preSMA or rIFG, or 20 Hz over rIFG (to test frequency specificity), or sham stimulation before task processing. After each type of stimulation, the participants performed the Go/NoGo task with simultaneous electroencephalogram (EEG) recording.

RESULTS

By stimulating rIFG and preSMA with 6 Hz tACS, we were not able to modulate either behavioral performance nor the EEG correlate. Interestingly, 20 Hz tACS over the rIFG significantly increased theta activity, however without behavioral effects. This increased theta activity did not coincide with the stimulation area and was localized in the fronto-central and centro-parietal areas.

CONCLUSIONS

The inclusion of a control frequency is crucial to test for frequency specificity. Our findings are in accordance with previous studies showing that after effects of tACS are not restricted to the stimulation frequency but can also occur in other frequency bands.

Developmental changes in impulse control: Trial-by-trial EMG dissociates the evolution of impulse strength from its subsequent suppression

Goal-oriented behavior can be disrupted by irrelevant information that automatically activates incorrect responses. While behavioral errors reveal response capture in such situations, they are only the tip of the iceberg. Additional subliminal activations of the incorrect responses (partial errors) can be revealed on correctly responded trials thanks to electromyography (EMG). In the current study, for the first time, EMG recorded in children was combined with distributional analyses. This allowed to investigate the properties of incorrect response activations and to highlight developmental changes in impulse control. A sample of 114 children aged 6-14 years was studied. Children performed a Simon task in which the irrelevant stimulus-position automatically activates a response that might be compatible or incompatible with the correct one. On incompatible trials, the automatic response activation must be overcome by controlled response selection. As previously observed in adults, our approach revealed the presence of an automatic EMG activation of the incorrect response elicited by the irrelevant stimulus dimension. Further, it revealed another independent source at the origin of incorrect response activations: the tendency to guess for response alternation. Both sources increased the frequency of early incorrect EMG activations, indicating impulsive responding. In addition, the influence of both sources decreased with increasing age. Thus, development is marked by improved ability to manage distractibility on the one hand and decreased tendency to rely on a guessing strategy on the other.

Feasibility and acceptability of transcranial stimulation in obsessive-compulsive symptoms (FEATSOCS): study protocol for a randomised controlled trial of transcranial direct current stimulation (tDCS) in obsessive-compulsive disorder (OCD)

BACKGROUND

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder which often proves refractory to current treatment approaches. Transcranial direct current stimulation (tDCS), a noninvasive form of neurostimulation, with potential for development as a self-administered intervention, has shown potential as a safe and efficacious treatment for OCD in a small number of trials. The two most promising stimulation sites are located above the orbitofrontal cortex (OFC) and the supplementary motor area (SMA).

METHODS

The aim of this feasibility study is to inform the development of a definitive trial, focussing on the acceptability, safety of the intervention, feasibility of recruitment, adherence and tolerability to tDCS and study assessments and the size of the treatment effect. To this end, we will deliver a double-blind, sham-controlled, crossover randomised multicentre study in 25 adults with OCD. Each participant will receive three courses of tDCS (SMA, OFC and sham), randomly allocated and given in counterbalanced order. Each course comprises four 20-min stimulations, delivered over two consecutive days, separated by at least 4 weeks' washout period. We will collect information about recruitment, study conduct and tDCS delivery. Blinded raters will assess clinical outcomes before, during and up to 4 weeks after stimulation using validated scales. We will include relevant objective neurocognitive tasks, testing cognitive flexibility, motor disinhibition, cooperation and habit learning.

DISCUSSION

We will analyse the magnitude of the effect of the interventions on OCD symptoms alongside the standard deviation of the outcome measure, to estimate effect size and determine the optimal stimulation target. We will also measure the duration of the effect of stimulation, to provide information on spacing treatments efficiently. We will evaluate the usefulness and limitations of specific neurocognitive tests to determine a definitive test battery. Additionally, qualitative data will be collected from participants to better understand their experience of taking part in a tDCS intervention, as well as the impact on their overall quality of life. These clinical outcomes will enable the project team to further refine the methodology to ensure optimal efficiency in terms of both delivering and assessing the treatment in a full-scale trial.

TRIAL REGISTRATION

ISRCTN17937049 . (date applied 08/07/2019). Recruitment (ongoing) began 23rd July 2019 and is anticipated to complete 30th April 2021.

The sooner the better: clinical and neural correlates of impulsive choice in Tourette disorder

Reward sensitivity has been suggested as one of the central pathophysiological mechanisms in Tourette disorder. However, the subjective valuation of a reward by introduction of delay has received little attention in Tourette disorder, even though it has been suggested as a trans-diagnostic feature of numerous neuropsychiatric disorders. We aimed to assess delay discounting in Tourette disorder and to identify its brain functional correlates. We evaluated delayed discounting and its brain functional correlates in a large group of 54 Tourette disorder patients and 31 healthy controls using a data-driven approach. We identified a subgroup of 29 patients with steeper reward discounting, characterised by a higher burden of impulse-control disorders and a higher level of general impulsivity compared to patients with normal behavioural performance or to controls. Reward discounting was underpinned by resting-state activity of a network comprising the orbito-frontal, cingulate, pre-supplementary motor area, temporal and insular cortices, as well as ventral striatum and hippocampus. Within this network, (i) lower connectivity of pre-supplementary motor area with ventral striatum predicted a higher impulsivity and a steeper reward discounting and (ii) a greater connectivity of pre-supplementary motor area with anterior insular cortex predicted steeper reward discounting and more severe tics. Overall, our results highlight the heterogeneity of the delayed reward processing in Tourette disorder, with steeper reward discounting being a marker of burden in impulsivity and impulse control disorders, and the pre-supplementary motor area being a hub region for the delay discounting, impulsivity and tic severity.

An Electromyographic Analysis of the Effects of Cognitive Fatigue on Online and Anticipatory Action Control

Cognitive fatigue is a problem for the safety of critical systems (e.g., aircraft) as it can lead to accidents, especially during unexpected events. In order to determine the extent to which it disrupts adaptive capabilities, we evaluated its effect on online and anticipatory control. Despite numerous studies conducted to determine its effects, the exact mechanism(s) affected by fatigue remains to be clarified. In this study, we used distribution and electromyographic analysis to assess whether cognitive fatigue increases the capture of the incorrect automatic response or if it impairs its suppression (online control), and whether the conflict adaptation effect is reduced (anticipatory control). To this end, we evaluated the evolution of the performance over time during the Simon task, a classic conflict task that elicits incorrect automatic responses. To accentuate the presence of fatigue during the Simon task, two groups previously performed a dual-task with two different cognitive load levels to create two different levels of fatigue. The results revealed that time on task impaired online control by disrupting the capacity to suppress the incorrect response but leaving unaffected the expression of the automatic response. Furthermore, participants emphasized speed rather than accuracy with time on task, with in addition more fast guesses, suggesting that they opted for a less effortful response strategy. As the implementation of the suppression mechanism requires cognitive effort, the conjunction of these results suggests that the deficits observed may be due to disengagement of effort over time rather than reflecting an incapacity to make an effort.

Inferring Causality from Noninvasive Brain Stimulation in Cognitive Neuroscience

Noninvasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation or transcranial direct and alternating current stimulation, are advocated as measures to enable causal inference in cognitive neuroscience experiments. Transcending the limitations of purely correlative neuroimaging measures and experimental sensory stimulation, they allow to experimentally manipulate brain activity and study its consequences for perception, cognition, and eventually, behavior. Although this is true in principle, particular caution is advised when interpreting brain stimulation experiments in a causal manner. Research hypotheses are often oversimplified, disregarding the underlying (implicitly assumed) complex chain of causation, namely, that the stimulation technique has to generate an electric field in the brain tissue, which then evokes or modulates neuronal activity both locally in the target region and in connected remote sites of the network, which in consequence affects the cognitive function of interest and eventually results in a change of the behavioral measure. Importantly, every link in this causal chain of effects can be confounded by several factors that have to be experimentally eliminated or controlled to attribute the observed results to their assumed cause. This is complicated by the fact that many of the mediating and confounding variables are not directly observable and dose-response relationships are often nonlinear. We will walk the reader through the chain of causation for a generic cognitive neuroscience NIBS study, discuss possible confounds, and advise appropriate control conditions. If crucial assumptions are explicitly tested (where possible) and confounds are experimentally well controlled, NIBS can indeed reveal cause-effect relationships in cognitive neuroscience studies.

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.

Mechanisms of Impulsive Responding to Temporally Predictable Events as Revealed by Electromyography

Temporal predictability optimises behaviour when a simple response is required, as demonstrated by faster reaction times (RTs) and higher accuracy. However, its beneficial effects come at a cost under situations of response conflict. Here, we investigated the motor underpinnings of behaviour to temporally predictable events in the Simon conflict task. We compared motor responses to lateralised targets whose position conflicted (incompatible condition) or not (compatible condition) with the hand of response. Importantly, electromyographic (EMG) recordings allowed us to study "partial errors", defined as subthreshold muscle activity in the incorrect response agonist preceding a correct response. Advanced distributional analyses coupled with EMG data revealed that temporal predictability induced impulsive premature responding, as indexed by increased likelihood of fast incorrect EMG activations (both partial errors and errors) to incompatible targets. In parallel, responding to temporally predictable targets speeded the latency of partial errors, further indicating that temporal predictability increased the tendency to act prematurely. There was, however, no effect of temporal predictability on subsequent suppression of partial errors. Our results provide direct evidence that temporal predictability acts by increasing the urge to initiate a fast, yet potentially erroneous, response. This mechanism parsimoniously explains both beneficial effects of temporal predictability when no conflict in the environment is present, as well as its costs when more complex motor behaviour is required.

Static magnetic field stimulation of the supplementary motor area modulates resting-state activity and motor behavior

Focal application of a strong static magnetic field over the human scalp induces measurable local changes in brain function. Whether it also induces distant effects across the brain and how these local and distant effects collectively affect motor behavior remains unclear. Here we applied transcranial static magnetic field stimulation (tSMS) over the supplementary motor area (SMA) in healthy subjects. At a behavioral level, tSMS increased the time to initiate movement while decreasing errors in choice reaction-time tasks. At a functional level, tSMS increased SMA resting-state fMRI activity and bilateral functional connectivity between the SMA and both the paracentral lobule and the lateral frontotemporal cortex, including the inferior frontal gyrus. These results suggest that tSMS over the SMA can induce behavioral aftereffects associated with modulation of both local and distant functionally-connected cortical circuits involved in the control of speed-accuracy tradeoffs, thus offering a promising protocol for cognitive and clinical research.

Reduced premovement positivity during the stimulus-response interval precedes errors: Using single-trial and regression ERPs to understand performance deficits in ADHD

Brain mechanisms linked to incorrect response selections made under time pressure during cognitive task performance are poorly understood, particularly in adolescents with attention-deficit hyperactivity disorder (ADHD). Using subject-specific multimodal imaging (electroencephalogram, magnetic resonance imaging, behavior) during flanker task performance by a sample of 94 human adolescents (mean age = 15.5 years, 50% female) with varying degrees of ADHD symptomatology, we examined the degree to which amplitude features of source-resolved event-related potentials (ERPs) from brain-independent component processes within a critical (but often ignored) period in the action selection process, the stimulus-response interval, were associated with motor response errors (across trials) and error rates (across individuals). Response errors were typically preceded by two smaller peaks in both trial-level and trial-averaged ERP projections from posterior medial frontal cortex (pMFC): a frontocentral P3 peaking about 390 ms after stimulus onset, and a premovement positivity (PMP) peaking about 110 ms before the motor response. Separating overlapping stimulus-locked and response-locked ERP contributions using a "regression ERP" approach showed that trial errors and participant error rates were primarily associated with smaller PMP, and not with frontocentral P3. Moreover, smaller PMP mediated the association between larger numbers of errors and ADHD symptoms, suggesting the possible value of using PMP as an intervention target to remediate performance deficits in ADHD.

Do sensorimotor perturbations to standing balance elicit an error-related negativity?

Detecting and correcting errors is essential to successful action. Studies on response monitoring have examined scalp ERPs following the commission of motor slips in speeded-response tasks, focusing on a frontocentral negativity (i.e., error-related negativity or ERN). Sensorimotor neurophysiologists investigating cortical monitoring of reactive balance recovery behavior observe a strikingly similar pattern of scalp ERPs following externally imposed postural errors, including a brief frontocentral negativity that has been referred to as the balance N1. We integrate and review relevant literature from these discrepant fields to suggest shared underlying mechanisms and potential benefits of collaboration across fields. Unlike the cognitive tasks leveraged to study the ERN, balance perturbations afford precise experimental control of postural errors to elicit balance N1s that are an order of magnitude larger than the ERN and drive robust and well-characterized adaptation of behavior within an experimental session. Many factors that modulate the ERN, including motivation, perceived consequences, perceptual salience, expectation, development, and aging, are likewise known to modulate the balance N1. We propose that the ERN and balance N1 reflect common neural activity for detecting errors. Collaboration across fields could help clarify the functional significance of the ERN and poorly understood interactions between motor and cognitive impairments.

Short-Term Impact of tDCS Over the Right Inferior Frontal Cortex on Impulsive Responses in a Go/No-go Task

Inhibitory control, a process deeply studied in laboratory settings, refers to the ability to inhibit an action once it has been initiated. A common way to process data in such tasks is to take the mean response time (RT) and error rate per participant. However, such an analysis ignores the strong dependency between spontaneous RT variations and error rate. Conditional accuracy function (CAF) is of particular interest, as by plotting the probability of a response to be correct as a function of its latency, it provides a means for studying the strength of impulsive responses associated with a higher frequency of fast response errors. This procedure was applied to a recent set of data in which the right inferior frontal gyrus (rIFG) was modulated using transcranial direct current stimulation (tDCS). Healthy participants (n = 40) were presented with a "Go/No-go" task (click on letter M, not on letter W, session 1). Then, one subgroup (n = 20) was randomly assigned to one 20-minutes neuromodulation session with tDCS (anodal electrode, rIFG; cathodal electrode, neck); and the other group (n = 20) to a condition with sham (placebo) tDCS. All participants were finally confronted to the same "Go/No-go" task (session 2). The rate of commission errors (click on W) and speed of response to Go trials were similar between sessions 1 and 2 in both neuromodulation groups. However, CAF showed that active tDCS over rIFG leads to a reduction of the drop in accuracy for fast responses (suggesting less impulsivity and greater inhibitory efficiency), this effect being only visible for the first experimental block following tDCS stimulation. Overall, the present data indicate that boosting the rIFG may be useful to enhance inhibitory skills, but that CAF could be of the greatest relevance to monitor the temporal dynamics of the neuromodulation effect.

Crossover design in transcranial direct current stimulation studies on motor learning: potential pitfalls and difficulties in interpretation of findings

Crossover designs are used by a high proportion of studies investigating the effects of transcranial direct current stimulation (tDCS) on motor learning. These designs necessitate attention to aspects of data collection and analysis to take account of design-related confounds including order, carryover, and period effects. In this systematic review, we appraised the method sections of crossover-designed tDCS studies of motor learning and discussed the strategies adopted to address these factors. A systematic search of 10 databases was performed and 19 research papers, including 21 experimental studies, were identified. Potential risks of bias were addressed in all of the studies, however, not in a rigorous and structured manner. In the data collection phase, unclear methods of randomization, various lengths of washout period, and inconsistency in the counteracting period effect can be observed. In the analytical procedures, the stratification by sequence group was often ignored, and data were treated as if it belongs to a simple repeated-measures design. An inappropriate use of crossover design can seriously affect the findings and therefore the conclusions drawn from tDCS studies on motor learning. The results indicate a pressing need for the development of detailed guidelines for this type of studies to benefit from the advantages of a crossover design.

Visuomotor Correlates of Conflict Expectation in the Context of Motor Decisions

Many behaviors require choosing between conflicting options competing against each other in visuomotor areas. Such choices can benefit from top-down control processes engaging frontal areas in advance of conflict when it is anticipated. Yet, very little is known about how this proactive control system shapes the visuomotor competition. Here, we used electroencephalography in human subjects (male and female) to identify the visual and motor correlates of conflict expectation in a version of the Eriksen Flanker task that required left or right responses according to the direction of a central target arrow surrounded by congruent or incongruent (conflicting) flankers. Visual conflict was either highly expected (it occurred in 80% of trials; mostly incongruent blocks) or very unlikely (20% of trials; mostly congruent blocks). We evaluated selective attention in the visual cortex by recording target- and flanker-related steady-state visual-evoked potentials (SSVEPs) and probed action selection by measuring response-locked potentials (RLPs) in the motor cortex. Conflict expectation enhanced accuracy in incongruent trials, but this improvement occurred at the cost of speed in congruent trials. Intriguingly, this behavioral adjustment occurred while visuomotor activity was less finely tuned: target-related SSVEPs were smaller while flanker-related SSVEPs were higher in mostly incongruent blocks than in mostly congruent blocks, and incongruent trials were associated with larger RLPs in the ipsilateral (nonselected) motor cortex. Hence, our data suggest that conflict expectation recruits control processes that augment the tolerance for inappropriate visuomotor activations (rather than processes that downregulate their amplitude), allowing for overflow activity to occur without having it turn into the selection of an incorrect response.SIGNIFICANCE STATEMENT Motor choices made in front of discordant visual information are more accurate when conflict can be anticipated, probably due to the engagement of top-down control from frontal areas. How this control system modulates activity within visual and motor areas is unknown. Here, we show that, when control processes are recruited in anticipation of conflict, as evidenced by higher midfrontal theta activity, visuomotor activity is less finely tuned: visual processing of the goal-relevant location was reduced and the motor cortex displayed more inappropriate activations, compared with when conflict was unlikely. We argue that conflict expectation is associated with an expansion of the distance-to-selection threshold, improving accuracy while the need for online control of visuomotor activity is reduced.

No Evidence That Frontal Eye Field tDCS Affects Latency or Accuracy of Prosaccades

Transcranial direct current stimulation (tDCS) may be used to directly affect neural activity from outside of the skull. However, its exact physiological mechanisms remain elusive, particularly when applied to new brain areas. The frontal eye field (FEF) has rarely been targeted with tDCS, even though it plays a crucial role in control of overt and covert spatial attention. Here, we investigate whether tDCS over the FEF can affect the latency and accuracy of saccadic eye movements. Twenty-six participants performed a prosaccade task in which they made eye movements to a sudden-onset eccentric visual target (lateral saccades). After each lateral saccade, they made an eye movement back to the center (center saccades). The task was administered before, during, and after anodal or cathodal tDCS over the FEF, in a randomized, double-blind, within-subject design. One previous study (Kanai et al., 2012) found that anodal tDCS over the FEF decreased the latency of saccades contralateral to the stimulated hemisphere. We did not find the same effect: neither anodal nor cathodal tDCS influenced the latency of lateral saccades. tDCS also did not affect accuracy of lateral saccades (saccade endpoint deviation and saccade endpoint variability). For center saccades, we found some differences between the anodal and cathodal sessions, but these were not consistent across analyses (latency, endpoint variability), or were already present before tDCS onset (endpoint deviation). We tried to improve on the design of Kanai et al. (2012) in several ways, including the tDCS duration and electrode montage, which could explain the discrepant results. Our findings add to a growing number of null results, which have sparked concerns that tDCS outcomes are highly variable. Future studies should aim to establish the boundary conditions for FEF-tDCS to be effective, in addition to increasing sample size and adding additional controls such as a sham condition. At present, we conclude that it is unclear whether eye movements or other aspects of spatial attention can be affected through tDCS of the frontal eye fields.

Conflict processing in kindergarten children: New evidence from distribution analyses reveals the dynamics of incorrect response activation and suppression

The development of cognitive control is known to follow a long and protracted development. However, whether the interference effect in conflict tasks in children would entail the same core processes as in adults, namely an automatic activation of incorrect response and its subsequent suppression, remains an open question. We applied distributional analyses to reaction times and accuracy of 5- and 6-year-old children performing three conflict tasks (flanker, Simon, and Stroop) in a within-participants design. This revealed both strong commonalities and differences between children and adults. As in adults, fast responses were more error prone than slow ones on incompatible trials, indicating a fast "automatic" activation of the incorrect response. In addition, the strength of this activation differed across tasks, following a pattern similar to that of adults. Moreover, modeling the data with a drift diffusion model adapted for conflict tasks allowed one to better assess the origin of the typical slowing down observed in children. Besides showing that advanced distribution analyses can be successfully applied to children, the current results support the notion that interference effects in 5- and 6-year-olds are driven by mechanisms very similar to the ones at play in adults but with different time courses.

The Role of Transcranial Direct Current Stimulation (tDCS) in Tourette Syndrome: A Review and Preliminary Findings

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that is being investigated for a variety of neurological and psychiatric conditions. Preliminary evidence suggests that tDCS may be useful in the treatment of Tourette Syndrome (TS). This paper reviews the literature on the use of tDCS in commonly occurring comorbid conditions that are relevant to its proposed use in TS. We describe the protocol for a double-blind, crossover, sham-controlled trial of tDCS (Trial ID: ACTRN12615000592549, registered at www.anzctr.org.au) investigating the efficacy, feasibility, safety, and tolerability of tDCS in patients with TS aged 12 years and over. The intervention consists of cathodal tDCS positioned over the Supplementary Motor Area. Patients receive either sham tDCS for three weeks followed by six weeks of active tDCS (1.4 mA, 18 sessions over six weeks), or six weeks of active sessions followed by three weeks of sham sessions, with follow-up at three and six months. Pilot findings from two patients are presented. There was a reduction in the frequency and intensity of patients’ tics and premonitory urges, as well as evidence of improvements in inhibitory function, over the course of treatment. Larger scale studies are indicated to ascertain the maintenance of symptom improvement over time, as well as the long-term consequences of the repetitions of sessions.

Symptom-specific amygdala hyperactivity modulates motor control network in conversion disorder

Initial historical accounts as well as recent data suggest that emotion processing is dysfunctional in conversion disorder patients and that this alteration may be the pathomechanistic neurocognitive basis for symptoms in conversion disorder. However, to date evidence of direct interaction of altered negative emotion processing with motor control networks in conversion disorder is still lacking. To specifically study the neural correlates of emotion processing interacting with motor networks we used a task combining emotional and sensorimotor stimuli both separately as well as simultaneously during functional magnetic resonance imaging in a well characterized group of 13 conversion disorder patients with functional hemiparesis and 19 demographically matched healthy controls. We performed voxelwise statistical parametrical mapping for a priori regions of interest within emotion processing and motor control networks. Psychophysiological interaction (PPI) was used to test altered functional connectivity of emotion and motor control networks. Only during simultaneous emotional stimulation and passive movement of the affected hand patients displayed left amygdala hyperactivity. PPI revealed increased functional connectivity in patients between the left amygdala and the (pre-)supplemental motor area and the subthalamic nucleus, key regions within the motor control network. These findings suggest a novel mechanistic direct link between dysregulated emotion processing and motor control circuitry in conversion disorder.

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We studied emotion processing effects on motor networks in conversion disorder (CD).

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Simultaneous motor and emotional stimulation resulted in enhanced amygdala activation.

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Left amygdala showed increased functional connectivity with an inhibitory motor loop.

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This suggests a direct link of impaired emotion processing and motor networks in CD.

Impulsive oculomotor action selection in Parkinson's disease

The effects of Parkinson's disease (PD) on the dynamics of impulsive action selection and suppression have recently been studied using distributional analyses, but with mixed results, especially for selection. Furthermore, some authors have suggested that impulsivity, regarded as a personality trait, shares common features with behavioral tasks' measures. The current study was designed to clarify the impact of PD on impulsive action selection and suppression, and investigate the link between cognitive action control and self-reported impulsivity. We administered an oculomotor version of the Simon task to 32 patients with PD and 32 matched healthy controls (HC), and conducted distributional analyses in accordance with the activation-suppression model. Patients and HC also filled out the Barratt Impulsiveness Scale (BIS) questionnaire. Results showed that patients with PD were faster overall and exhibited a greater congruence effect than HC. They also displayed enhanced impulsive action selection. By contrast, the suppression of impulsive responses was similar across both groups. Furthermore, patients had higher impulsivity scores, which were correlated with higher impulsive action selection and higher suppression. Our study yielded two interesting findings. First, PD resulted in a higher number of fast errors. The activation-suppression model suggests that patients with PD are more susceptible to the impulsive action selection induced by the irrelevant stimulus dimension. Second, impulsive action selection and suppression were both associated with trait impulsivity, as measured by the BIS, indicating that these two aspects of impulsivity share common features.

Enhanced Impulsive Action Selection in Middle-Aged Adults-Insights From an Oculomotor Simon Task

Several studies have investigated the age-related impact in cognitive action control. However, to our knowledge, none of the studies have focused on the effect of moderate age on the strength of automatic activation according to the activation-suppression model. We therefore investigated the effect of moderate age on cognitive action control using an oculomotor version of the Simon task and distributional analyses. A group of middle-aged (n = 39; 57 ± 9 years) healthy adults were compared to a group of young healthy participants (n = 43; 24 ± 3 years). We first analyzed the overall impact of age on the congruence effect and then used conditional accuracy functions (CAFs) and delta plots to assess the strength of automatic activation and selective inhibition, respectively. Compared to young participants, middle-aged participants showed a greater congruence effect as well as higher rates of fast errors in conflict situations indicating an enhanced impulsive action selection. Furthermore, the overall downward slope of the congruence effect’s evolution was significantly steeper in older participants and the last slope tended to be significantly steeper. This may indicate that the middle-aged participants exerted a stronger selective inhibition. Our results suggest that middle-aged adults are more prone to impulsive action selection than young adults. Recent theories postulate that older adults might implement compensatory mechanisms to supply cognitive difficulties. This is in line with our results suggesting a potential greater selective inhibition. Overall, this study proposes that moderate aging impacts both processes of impulsive response selection and suppression underlying cognitive action control.

Transcranial Direct Current Stimulation in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder (ADHD): A Pilot Study

Studies investigating the possible benefits of transcranial direct current stimulation on left dorsolateral prefrontal cortex in children and adolescents with attention-deficit hyperactivity disorder (ADHD) have not been performed. This study assesses the effect of transcranial direct current stimulation in children and adolescents with ADHD on neuropsychological tests of visual attention, visual and verbal working memory, and inhibitory control. An auto-matched clinical trial was performed involving transcranial direct current stimulation in children and adolescents with ADHD, using SNAP-IV and subtests Vocabulary and Cubes of the Wechsler Intelligence Scale for Children III (WISC-III). Subjects were assessed before and after transcranial direct current stimulation sessions with the Digit Span subtest of the WISC-III, inhibitory control subtest of the NEPSY-II, Corsi cubes, and the Visual Attention Test (TAVIS-3). There were 9 individuals with ADHD according to Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria. There was statistically significant difference in some aspects of TAVIS-3 tests and the inhibitory control subtest of NEPSY-II. Transcranial direct current stimulation can be related to a more efficient processing speed, improved detection of stimuli, and improved ability to switch between an ongoing activity and a new one.

Transcranial Direct Current Stimulation Does Not Influence the Speed-Accuracy Tradeoff in Perceptual Decision-making: Evidence from Three Independent Studies

In perceptual decision-making tasks, people balance the speed and accuracy with which they make their decisions by modulating a response threshold. Neuroimaging studies suggest that this speed-accuracy tradeoff is implemented in a corticobasal ganglia network that includes an important contribution from the pre-SMA. To test this hypothesis, we used anodal transcranial direct current stimulation (tDCS) to modulate neural activity in pre-SMA while participants performed a simple perceptual decision-making task. Participants viewed a pattern of moving dots and judged the direction of the global motion. In separate trials, they were cued to either respond quickly or accurately. We used the diffusion decision model to estimate the response threshold parameter, comparing conditions in which participants received sham or anodal tDCS. In three independent experiments, we failed to observe an influence of tDCS on the response threshold. Additional, exploratory analyses showed no influence of tDCS on the duration of nondecision processes or on the efficiency of information processing. Taken together, these findings provide a cautionary note, either concerning the causal role of pre-SMA in decision-making or on the utility of tDCS for modifying response caution in decision-making tasks.

The Role of the Frontal and Parietal Cortex in Proactive and Reactive Inhibitory Control: A Transcranial Direct Current Stimulation Study

Mounting evidence suggests that response inhibition involves both proactive and reactive inhibitory control, yet its underlying neural mechanisms remain elusive. In particular, the roles of the right inferior frontal gyrus (IFG) and inferior parietal lobe (IPL) in proactive and reactive inhibitory control are still under debate. This study aimed at examining the causal role of the right IFG and IPL in proactive and reactive inhibitory control, using transcranial direct current stimulation (tDCS) and the stop signal task. Twenty-two participants completed three sessions of the stop signal task, under anodal tDCS in the right IFG, the right IPL, or the primary visual cortex (VC; 1.5 mA for 15 min), respectively. The VC stimulation served as the active control condition. The tDCS effect for each condition was calculated as the difference between pre- and post-tDCS performance. Proactive control was indexed by the RT increase for go trials (or preparatory cost), and reactive control by the stop signal RT. Compared to the VC stimulation, anodal stimulation of the right IFG, but not that of the IPL, facilitated both proactive and reactive control. However, the facilitation of reactive control was not mediated by the facilitation of proactive control. Furthermore, tDCS did not affect the intraindividual variability in go RT. These results suggest a causal role of the right IFG, but not the right IPL, in both reactive and proactive inhibitory control.

Deciphering interference control in adults with ADHD by using distribution analyses and electromyographic activity

A deficit in "interference control" is commonly found in adults with Attention Deficit Hyperactivity Disorder (ADHD). This has mainly been interpreted as difficulties in inhibiting inappropriate responses. However, interference control involves processes other than simply the ability to inhibit. Consequently, we used sophisticated analysis to decipher the additional processes of interference control in these patients. We compared interference control between 16 adults with ADHD and 15 control adults performing a Simon task. In most studies, performance is generally reported in terms of mean error rates and reaction times (RTs). However, here we used distribution analyses of behavioral data, complemented by analyses of electromyographic (EMG) activity. This allowed us to better quantify the control of interference, specifically the part that remains hidden when pure correct trials are not distinguished from partial errors. Partial errors correspond to sub-threshold EMG bursts induced by incorrect responses that immediately precede a correct response. Moreover, besides "online" control, we also investigated cognitive control effects manifesting across consecutive trials. The main findings were that adults with ADHD were slower and showed a larger interference effect in comparison to controls. However, the data revealed that the larger interference effect was due neither to higher impulse expression, nor to a deficit in inhibition but that these patients presented a larger interference effect than the controls after congruent trials. We propose and discuss the hypothesis that the interference control deficit found in adults with ADHD is secondary to impairments in sustained attention.