Domain-General and Domain-Specific Patterns of Activity Supporting Metacognition in Human Prefrontal Cortex

Direct stimulation of anterior insula and ventromedial prefrontal cortex disrupts economic choices

Neural activity within the ventromedial prefrontal cortex (vmPFC) and anterior insula (aIns) is often associated with economic choices and confidence. However, it remains unclear whether these brain regions are causally related to these processes. To address this issue, we leveraged intracranial electrical stimulation (iES) data obtained from patients with epilepsy performing an economic choice task. Our results reveal opposite effects of stimulation on decision-making depending on its location along a dorso-ventral axis within each region. Specifically, stimulation of the ventral subregion within aIns reduces risk-taking by increasing participants' sensitivity to potential losses, whereas stimulation of the dorsal subregion of aIns and the ventral portion of the vmPFC increases risk-taking by reducing participants' sensitivity to losses. Moreover, stimulation of the aIns consistently decreases participants' confidence, regardless of its location within the aIns. These findings suggest the existence of functionally dissociated neural subregions and circuits causally involved in accepting or avoiding challenges.

Metacognition as a window into subjective affective experience

When patients seek professional help for mental disorders, they often do so because of troubling subjective affective experiences. While these subjective states are at the center of the patient's symptomatology, scientific tools for studying them and their cognitive antecedents are limited. Here, we explore the use of concepts and analytic tools from the science of consciousness, a field of research that has faced similar challenges in having to develop robust empirical methods for addressing a phenomenon that has been considered difficult to pin down experimentally. One important strand is the operationalization of some relevant processes in terms of metacognition and confidence ratings, which can be rigorously studied in both humans and animals. By assessing subjective experience with similar approaches, we hope to develop new scientific approaches for studying affective processes and promoting psychological resilience in the face of debilitating emotional experiences.

Neural mechanisms underpinning metacognitive shifts driven by non-informative predictions

Humans constantly make predictions and such predictions allow us to prepare for future events. Yet, such benefits may come with drawbacks as premature predictions may potentially bias subsequent judgments. Here we examined how prediction influences our perceptual decisions and subsequent confidence judgments, on scenarios where the predictions were arbitrary and independent of the identity of the upcoming stimuli. We defined them as invalid and non-informative predictions. Behavioral results showed that, such non-informative predictions biased perceptual decisions in favor of the predicted choice, and such prediction-induced perceptual bias further increased the metacognitive efficiency. The functional MRI results showed that activities in the medial prefrontal cortex (mPFC) and subgenual anterior cingulate cortex (sgACC) encoded the response consistency between predictions and perceptual decisions. Activity in mPFC predicted the strength of this congruency bias across individuals. Moreover, the parametric encoding of confidence in putamen was modulated by prediction-choice consistency, such that activity in putamen was negatively correlated with confidence rating after inconsistent responses. These findings suggest that predictions, while made arbitrarily, orchestrate the neural representations of choice and confidence judgment.

Neural correlates of metacognition impairment in opioid addiction

BACKGROUND

Individuals with substance use disorder show impaired self-awareness of ongoing behavior. This deficit suggests problems with metacognition, operationalized in the cognitive neuroscience literature as the ability to monitor and evaluate the success of one's own cognition and behavior. However, the neural mechanisms of metacognition have not been characterized in a drug-addicted population.

METHODS

Community samples of participants with opioid use disorder (OUD) (N=27) and healthy controls (N=29) performed a previously-validated fMRI metacognition task (perceptual decision-making task along with confidence ratings of performance). Measures of recent drug use and addiction severity were also acquired.

RESULTS

Individuals with OUD had lower metacognitive sensitivity than controls (i.e., disconnection between task performance and task-related confidence). Trial-by-trial analyses showed that this overall group difference was driven by (suboptimally) low confidence in OUD during correct trials. In fMRI analyses, the task engaged an expected network of brain regions (e.g., rostrolateral prefrontal cortex and dorsal anterior cingulate/supplementary motor area, both previously linked to metacognition); group differences emerged in a large ventral anterior cluster that included the medial and lateral orbitofrontal cortex and striatum (higher activation in OUD). Trial-by-trial fMRI analyses showed group differences in rostrolateral prefrontal cortex activation, which further correlated with metacognitive behavior across all participants. Exploratory analyses suggested that the behavioral and neural group differences were exacerbated by recent illicit opioid use and unexplained by general cognition.

CONCLUSIONS

With confirmation and extension of these findings, metacognition and its associated neural circuits could become new, promising therapeutic targets in addiction.

Pharmacological Elevation of Catecholamine Levels Improves Perceptual Decisions, But Not Metacognitive Insight

Perceptual decisions are often accompanied by a feeling of decision confidence. Where the parietal cortex is known for its crucial role in shaping such perceptual decisions, metacognitive evaluations are thought to additionally rely on the (pre)frontal cortex. Because of this supposed neural differentiation between these processes, perceptual and metacognitive decisions may be divergently affected by changes in internal (e.g., attention, arousal) and external (e.g., task and environmental demands) factors. Although intriguing, causal evidence for this hypothesis remains scarce. Here, we investigated the causal effect of two neuromodulatory systems on behavioral and neural measures of perceptual and metacognitive decision-making. Specifically, we pharmacologically elevated levels of catecholamines (with atomoxetine) and acetylcholine (with donepezil) in healthy adult human participants performing a visual discrimination task in which we gauged decision confidence, while electroencephalography was measured. Where cholinergic effects were not robust, catecholaminergic enhancement improved perceptual sensitivity, while at the same time leaving metacognitive sensitivity unaffected. Neurally, catecholaminergic elevation did not affect sensory representations of task-relevant visual stimuli but instead enhanced well-known decision signals measured over the centroparietal cortex, reflecting the accumulation of sensory evidence over time. Crucially, catecholaminergic enhancement concurrently impoverished neural markers measured over the frontal cortex linked to the formation of metacognitive evaluations. Enhanced catecholaminergic neuromodulation thus improves perceptual but not metacognitive decision-making.

Behavioral and neural measures of confidence using a novel auditory pitch identification task

Observers can discriminate between correct versus incorrect perceptual decisions with feelings of confidence. The centro-parietal positivity build-up rate (CPP slope) has been suggested as a likely neural signature of accumulated evidence, which may guide both perceptual performance and confidence. However, CPP slope also covaries with reaction time, which also covaries with confidence in previous studies, and performance and confidence typically covary; thus, CPP slope may index signatures of perceptual performance rather than confidence per se. Moreover, perceptual metacognition-including neural correlates-has largely been studied in vision, with few exceptions. Thus, we lack understanding of domain-general neural signatures of perceptual metacognition outside vision. Here we designed a novel auditory pitch identification task and collected behavior with simultaneous 32-channel EEG in healthy adults. Participants saw two tone labels which varied in tonal distance on each trial (e.g., C vs D, C vs F), then heard a single auditory tone; they identified which label was correct and rated confidence. We found that pitch identification confidence varied with tonal distance, but performance, metacognitive sensitivity (trial-by-trial covariation of confidence with accuracy), and reaction time did not. Interestingly, however, while CPP slope covaried with performance and reaction time, it did not significantly covary with confidence. We interpret these results to mean that CPP slope is likely a signature of first-order perceptual processing and not confidence-specific signals or computations in auditory tasks. Our novel pitch identification task offers a valuable method to examine the neural correlates of auditory and domain-general perceptual confidence.

Intention offloading: Domain-general versus task-specific confidence signals

Intention offloading refers to the use of external reminders to help remember delayed intentions (e.g., setting an alert to help you remember when you need to take your medication). Research has found that metacognitive processes influence offloading such that individual differences in confidence predict individual differences in offloading regardless of objective cognitive ability. The current study investigated the cross-domain organization of this relationship. Participants performed two perceptual discrimination tasks where objective accuracy was equalized using a staircase procedure. In a memory task, two measures of intention offloading were collected, (1) the overall likelihood of setting reminders, and (2) the bias in reminder-setting compared to the optimal strategy. It was found that perceptual confidence was associated with the first measure but not the second. It is shown that this is because individual differences in perceptual confidence capture meaningful differences in objective ability despite the staircase procedure. These findings indicate that intention offloading is influenced by both domain-general and task-specific metacognitive signals. They also show that even when task performance is equalized via staircasing, individual differences in confidence cannot be considered a pure measure of metacognitive bias.

Elucidating the underlying components of metacognitive systematic bias in the human dorsolateral prefrontal cortex and inferior parietal cortex

Metacognitive systematic bias impairs human learning efficiency, which is characterized by the inconsistency between predicted and actual memory performance. However, the underlying mechanism of metacognitive systematic bias remains unclear in existing studies. In this study, we utilized judgments of learning task in human participants to compare the neural mechanism difference in metacognitive systematic bias. Participants encoded words in fMRI sessions that would be tested later. Immediately after encoding each item, participants predicted how likely they would remember it. Multivariate analyses on fMRI data demonstrated that working memory and uncertainty decisions are represented in patterns of neural activity in metacognitive systematic bias. The available information participants used led to overestimated bias and underestimated bias. Effective connectivity analyses further indicate that information about the metacognitive systematic bias is represented in the dorsolateral prefrontal cortex and inferior parietal cortex. Different neural patterns were found underlying overestimated bias and underestimated bias. Specifically, connectivity regions with the dorsolateral prefrontal cortex, anterior cingulate cortex, and supramarginal gyrus form overestimated bias, while less regional connectivity forms underestimated bias. These findings provide a mechanistic account for the construction of metacognitive systematic bias.

Distinct genetic and environmental origins of hierarchical cognitive abilities in adult humans

Human cognitive abilities ranging from basic perceptions to complex social behaviors exhibit substantial variation in individual differences. These cognitive functions can be categorized into a two-order hierarchy based on the levels of cognitive processes. Second-order cognition including metacognition and mentalizing monitors and regulates first-order cognitive processes. These two-order hierarchical cognitive functions exhibit distinct abilities. However, it remains unclear whether individual differences in these cognitive abilities have distinct origins. We employ the classical twin paradigm to compare the genetic and environmental contributions to the two-order cognitive abilities in the same tasks from the same population. The results reveal that individual differences in first-order cognitive abilities were primarily influenced by genetic factors. Conversely, the second-order cognitive abilities have a stronger influence from shared environmental factors. These findings suggest that the abilities of metacognition and mentalizing in adults are profoundly shaped by their environmental experiences and less determined by their biological nature.

The cognitive reality monitoring network and theories of consciousness

Theories of consciousness abound. However, it is difficult to arbitrate reliably among competing theories because they target different levels of neural and cognitive processing or anatomical loci, and only some were developed with computational models in mind. In particular, theories of consciousness need to fully address the three levels of understanding of the brain proposed by David Marr: computational theory, algorithms and hardware. Most major theories refer to only one or two levels, often indirectly. The cognitive reality monitoring network (CRMN) model is derived from computational theories of mixture-of-experts architecture, hierarchical reinforcement learning and generative/inference computing modules, addressing all three levels of understanding. A central feature of the CRMN is the mapping of a gating network onto the prefrontal cortex, making it a prime coding circuit involved in monitoring the accuracy of one's mental states and distinguishing them from external reality. Because the CRMN builds on the hierarchical and layer structure of the cerebral cortex, it may connect research and findings across species, further enabling concrete computational models of consciousness with new, explicitly testable hypotheses. In sum, we discuss how the CRMN model can help further our understanding of the nature and function of consciousness.

Relation of life sciences students' metacognitive monitoring to neural activity during biology error detection

Metacognitive calibration-the capacity to accurately self-assess one's performance-forms the basis for error detection and self-monitoring and is a potential catalyst for conceptual change. Limited brain imaging research on authentic learning tasks implicates the lateral prefrontal and anterior cingulate brain regions in expert scientific reasoning. This study aimed to determine how variation in undergraduate life sciences students' metacognitive calibration relates to their brain activity when evaluating the accuracy of biological models. Fifty undergraduate students enrolled in an introductory life sciences course completed a biology model error detection task during fMRI. Students with higher metacognitive calibration recruited lateral prefrontal regions linked in prior research to expert STEM reasoning to a greater extent than those with lower metacognitive calibration. Findings suggest that metacognition relates to important individual differences in undergraduate students' use of neural resources during an authentic educational task and underscore the importance of fostering metacognitive calibration in the classroom.

Overlapping yet dissociable contributions of superiority illusion features to Ponzo illusion strength and metacognitive performance

Humans are typically inept at evaluating their abilities and predispositions. People dismiss such a lack of metacognitive insight into their capacities while even enhancing (albeit illusorily) self-evaluation such that they should have more desirable traits than an average peer. This superiority illusion helps maintain a healthy mental state. However, the scope and range of its influence on broader human behavior, especially perceptual tasks, remain elusive. As belief shapes the way people perceive and recognize, the illusory self-superiority belief potentially regulates our perceptual and metacognitive performance. In this study, we used hierarchical Bayesian estimation and machine learning of signal detection theoretic measures to understand how the superiority illusion influences visual perception and metacognition for the Ponzo illusion. Our results demonstrated that the superiority illusion correlated with the Ponzo illusion magnitude and metacognitive performance. Next, we combined principal component analysis and cross-validated regularized regression (relaxed elastic net) to identify which superiority components contributed to the correlations. We revealed that the "extraversion" superiority dimension tapped into the Ponzo illusion magnitude and metacognitive ability. In contrast, the "honesty-humility" and "neuroticism" dimensions only predicted Ponzo illusion magnitude and metacognitive ability, respectively. These results suggest common and distinct influences of superiority features on perceptual sensitivity and metacognition. Our findings contribute to the accumulating body of evidence indicating that the leverage of superiority illusion is far-reaching, even to visual perception.

How do humans give confidence? A comprehensive comparison of process models of perceptual metacognition

Humans have the metacognitive ability to assess the accuracy of their decisions via confidence judgments. Several computational models of confidence have been developed but not enough has been done to compare these models, making it difficult to adjudicate between them. Here, we compare 14 popular models of confidence that make various assumptions, such as confidence being derived from postdecisional evidence, from positive (decision-congruent) evidence, from posterior probability computations, or from a separate decision-making system for metacognitive judgments. We fit all models to three large experiments in which subjects completed a basic perceptual task with confidence ratings. In Experiments 1 and 2, the best-fitting model was the lognormal meta noise (LogN) model, which postulates that confidence is selectively corrupted by signal-dependent noise. However, in Experiment 3, the positive evidence (PE) model provided the best fits. We evaluated a new model combining the two consistently best-performing models-LogN and the weighted evidence and visibility (WEV). The resulting model, which we call logWEV, outperformed its individual counterparts and the PE model across all data sets, offering a better, more generalizable explanation for these data. Parameter and model recovery analyses showed mostly good recoverability but with important exceptions carrying implications for our ability to discriminate between models. Finally, we evaluated each model's ability to explain different patterns in the data, which led to additional insight into their performances. These results comprehensively characterize the relative adequacy of current confidence models to fit data from basic perceptual tasks and highlight the most plausible mechanisms underlying confidence generation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Metric error monitoring as a component of metacognitive processing

Metacognitive processing constitutes one of the contemporary target domains in consciousness research. Error monitoring (the ability to correctly report one's own errors without feedback) is considered one of the functional outcomes of metacognitive processing. Error monitoring is traditionally investigated as part of categorical decisions where choice accuracy is a binary construct (choice is either correct or incorrect). However, recent studies revealed that this ability is characterized by metric features (i.e., direction and magnitude) in temporal, spatial, and numerical domains. Here, we discuss methodological approaches to investigating metric error monitoring in both humans and non-human animals and review their findings. The potential neural substrates of metric error monitoring measures are also discussed. This new scope of metacognitive processing can help improve our current understanding of conscious processing from a new perspective. Thus, by summarizing and discussing the perspectives, findings, and common applications in the metric error monitoring literature, this paper aims to provide a guideline for future research.

Embodied metacognition as strengthened functional connection between neural correlates of metacognition and dance in dancers: exploring creativity implications

Introduction

Dance education fosters embodied metacognition, enhancing student's creativity. This study examines the crucial role of functional connectivity (FC) between the neural correlates of metacognition (NCM) and dance (NCD) as the neurological foundation for dancers' embodied metacognition. The investigation also explores whether these consolidated FCs inform the general creativity in dancers.

Methods

The research involved 29 dancers and 28 non-dancer controls. The study examined resting-state connections of the NCM through seed-based FC analysis. Correlation analyses were employed to investigate the connections between the targeted NCM-NCD FCs, initiated from the a priori NCM seed, and general creativity.

Results

Dancers demonstrated heightened FC between NCM and NCD compared to non-dancer controls. The targeted regions included the putamen, globus pallidus, posterior cerebellum, and anterior insula of NCD. The dancers exhibited higher originality scores. In dancers, the enhanced FC showed a negative correlation with originality and a positive correlation with flexibility. Conversely, the controls exhibited no significant correlations.

Discussion

Extended dance training enhances the NCM-NCD connection signifying embodied metacognition. This interconnectedness may serve as the neural predisposition for fostering general creativity performance in dancers. Dancers with heightened levels of originality could leverage the relatively weaker NCM-NCD FCs to facilitate better integration and coordination of creative cognitive processes. Our findings suggest that the consolidated functional connections as sculpted by domain-specific training may inform general creativity.

The future of metacognition research: Balancing construct breadth with measurement rigor

Foundational work in the psychology of metacognition identified a distinction between metacognitive knowledge (stable beliefs about one's capacities) and metacognitive experiences (local evaluations of performance). More recently, the field has focused on developing tasks and metrics that seek to identify metacognitive capacities from momentary estimates of confidence in performance, and providing precise computational accounts of metacognitive failure. However, this notable progress in formalising models of metacognitive judgments may come at a cost of ignoring broader elements of the psychology of metacognition - such as how stable meta-knowledge is formed, how social cognition and metacognition interact, and how we evaluate affective states that do not have an obvious ground truth. We propose that construct breadth in metacognition research can be restored while maintaining rigour in measurement, and highlight promising avenues for expanding the scope of metacognition research. Such a research programme is well placed to recapture qualitative features of metacognitive knowledge and experience while maintaining the psychophysical rigor that characterises modern research on confidence and performance monitoring.

A confidence framing effect: Flexible use of evidence in metacognitive monitoring

Human behavior is flexibly regulated by specific goals of cognitive tasks. One notable example is goal-directed modulation of metacognitive behavior, where logically equivalent decision-making problems can yield different patterns of introspective confidence depending on the frame in which they are presented. While this observation highlights the important heuristic nature of metacognitive monitoring, computational mechanisms underlying this phenomenon remain elusive. We confirmed the confidence framing effect in two-alternative dot-number discrimination and in previously published preference-choice data, demonstrating distinctive confidence patterns between "choose more" or "choose less" frames. Formal model comparisons revealed a simple confidence heuristic behind this phenomenon, which assigns greater weight to chosen than unchosen stimulus evidence. This computation appears to be based on internal evidence constituted under specific task demands rather than physical stimulus intensity itself, a view justified in terms of ecological rationality. These results shed light on the adaptive nature of human decision-making and metacognitive monitoring.

Neural correlates of impaired cognitive processes underlying self-unawareness in Alzheimer's disease

Self-unawareness concerning current symptoms remains a clinical challenge in Alzheimer's disease. Reduced self-awareness likely depends on complex biopsychosocial mechanisms that comprise multiple cognitive processes, regulated by personal goals and values. We specifically reviewed the cognitive processes impaired in unaware participants with AD by emphasizing the related impaired brain activity observed during task-based fMRI. Unawareness can be explained by a failure in functioning of or in connection between brain regions that intervene in access, retrieval and updating of (present or extended) self-information (posterior midline, medial temporal, inferior parietal cortices), or in its monitoring, evaluation, or control (medial and lateral prefrontal cortices). Although one must be cautious when relating function to brain regions, impaired processes were tentatively related to the Cognitive Awareness Model. Although brain function depends on neural networks, impaired brain activity during cognitive processes was discussed according to previous studies reporting correlations between brain regions and scores of anosognosia. The review provides a framework to help clinicians considering processes that can explain unawareness in dementia. In patients at early stages of AD, different levels of awareness of cognitive or social clinical changes might be described as impairment in the interaction between specific cognitive processes and contents.

Metacognition and Confidence: A Review and Synthesis

Determining the psychological, computational, and neural bases of confidence and uncertainty holds promise for understanding foundational aspects of human metacognition. While a neuroscience of confidence has focused on the mechanisms underpinning subpersonal phenomena such as representations of uncertainty in the visual or motor system, metacognition research has been concerned with personal-level beliefs and knowledge about self-performance. I provide a road map for bridging this divide by focusing on a particular class of confidence computation: propositional confidence in one's own (hypothetical) decisions or actions. Propositional confidence is informed by the observer's models of the world and their cognitive system, which may be more or less accurate-thus explaining why metacognitive judgments are inferential and sometimes diverge from task performance. Disparate findings on the neural basis of uncertainty and performance monitoring are integrated into a common framework, and a new understanding of the locus of action of metacognitive interventions is developed.

Unskilled, underperforming, or unaware? Testing three accounts of individual differences in metacognitive monitoring

Many studies show that competence (e.g., skill, expertise, natural ability) influences individuals' capabilities of monitoring their item-level performance. However, debate persists about how best to explain these individual differences in metacognition. The competence-based account ascribes differences in monitoring to individuals' objective ability level, arguing that the same skills necessary to perform a task are required to effectively monitor performance. The performance-based account attributes differences in monitoring to changes in overall task performance - no individual differences in competence required. Finally, the metacognitive awareness account proposes that alignment between an individuals' self-assessed and objective ability leads to differences in monitoring. In this study, 603 participants completed a self-assessment of face recognition ability, a lineup identification task, and an objective assessment of face recognition ability. We manipulated the number of encoding repetitions and delay between encoding and test to produce varying levels of task performance across objective face recognition ability. Following each lineup decision, participants provided both a numeric confidence rating and a written expression of verbal confidence. We transformed verbal confidence into a quantitative value using machine learning techniques. When matched on overall identification accuracy, objectively stronger face recognizers used numeric and verbal confidence that a) better discriminates between correct and filler lineup identifications than weaker recognizers, and b) shows better calibration to accuracy. Participants with greater self-assessed ability used higher levels of confidence, irrespective of trial accuracy. These results support the competence-based account.

Boundary updating as a source of history effect on decision uncertainty

When sorting a sequence of stimuli into binary classes, current choices are often negatively correlated with recent stimulus history. This phenomenon-dubbed the repulsive bias-can be explained by boundary updating, a process of shifting the class boundary to previous stimuli. This explanation implies that recent stimulus history can also influence "decision uncertainty," the probability of making incorrect decisions, because it depends on the location of the boundary. However, there have been no previous efforts to elucidate the impact of previous stimulus history on decision uncertainty. Here, from the boundary-updating process that accounts for the repulsive bias, we derived a prediction that decision uncertainty increases as current choices become more congruent with previous stimuli. We confirmed this prediction in behavioral, physiological, and neural correlates of decision uncertainty. Our work demonstrates that boundary updating offers a principled account of how previous stimulus history concurrently relates to choice bias and decision uncertainty.

Common computations for metacognition and meta-metacognition

Recent evidence shows that people have the meta-metacognitive ability to evaluate their metacognitive judgments of confidence. However, it is unclear whether meta-metacognitive judgments are made by a different system and rely on a separate set of computations compared to metacognitive judgments. To address this question, we asked participants (N = 36) to perform a perceptual decision-making task and provide (i) an object-level, Type-1 response about the identity of the stimulus; (ii) a metacognitive, Type-2 response (low/high) regarding their confidence in their Type-1 decision; and (iii) a meta-metacognitive, Type-3 response (low/high) regarding the quality of their Type-2 rating. We found strong evidence for the existence of Type-3, meta-metacognitive ability. In a separate condition, participants performed an identical task with only a Type-1 response followed by a Type-2 response given on a 4-point scale. We found that the two conditions produced equivalent results such that the combination of binary Type-2 and binary Type-3 responses acts similar to a 4-point Type-2 response. Critically, while Type-2 evaluations were subject to metacognitive noise, Type-3 judgments were made at no additional cost. These results suggest that it is unlikely that there is a distinction between Type-2 and Type-3 systems (metacognition and meta-metacognition) in perceptual decision-making and, instead, a single system can be flexibly adapted to produce both Type-2 and Type-3 evaluations recursively.

The timing of confidence computations in human prefrontal cortex

Knowing when confidence computations take place is critical for building a mechanistic understanding of the neural and computational bases of metacognition. Yet, even though a substantial amount of research has focused on revealing the neural correlates and computations underlying human confidence judgments, very little is known about the timing of confidence computations. To understand when confidence is computed, we delivered single pulses of transcranial magnetic stimulation (TMS) at different times after stimulus presentation while subjects judged the orientation of a briefly presented visual stimulus and provided a confidence rating. TMS was delivered to either the right dorsolateral prefrontal cortex (DLPFC) in the experimental group or to vertex in the control group. We found that TMS to right DLPFC, but not to vertex, led to increased confidence in the absence of changes to accuracy or metacognitive efficiency. Critically, equivalent levels of confidence increase occurred for TMS delivered between 200 and 500 msec after stimulus presentation. These results suggest that confidence computations occur during a broad window that begins before the perceptual decision has been fully made and thus provide important constraints for theories of confidence generation.

Neural and computational underpinnings of biased confidence in human reinforcement learning

While navigating a fundamentally uncertain world, humans and animals constantly evaluate the probability of their decisions, actions or statements being correct. When explicitly elicited, these confidence estimates typically correlates positively with neural activity in a ventromedial-prefrontal (VMPFC) network and negatively in a dorsolateral and dorsomedial prefrontal network. Here, combining fMRI with a reinforcement-learning paradigm, we leverage the fact that humans are more confident in their choices when seeking gains than avoiding losses to reveal a functional dissociation: whereas the dorsal prefrontal network correlates negatively with a condition-specific confidence signal, the VMPFC network positively encodes task-wide confidence signal incorporating the valence-induced bias. Challenging dominant neuro-computational models, we found that decision-related VMPFC activity better correlates with confidence than with option-values inferred from reinforcement-learning models. Altogether, these results identify the VMPFC as a key node in the neuro-computational architecture that builds global feeling-of-confidence signals from latent decision variables and contextual biases during reinforcement-learning.

Using serial dependence to predict confidence across observers and cognitive domains

Our perceptual system appears hardwired to exploit regularities of input features across space and time in seemingly stable environments. This can lead to serial dependence effects whereby recent perceptual representations bias current perception. Serial dependence has also been demonstrated for more abstract representations, such as perceptual confidence. Here, we ask whether temporal patterns in the generation of confidence judgments across trials generalize across observers and different cognitive domains. Data from the Confidence Database across perceptual, memory, and cognitive paradigms was reanalyzed. Machine learning classifiers were used to predict the confidence on the current trial based on the history of confidence judgments on the previous trials. Cross-observer and cross-domain decoding results showed that a model trained to predict confidence in the perceptual domain generalized across observers to predict confidence across the different cognitive domains. The recent history of confidence was the most critical factor. The history of accuracy or Type 1 reaction time alone, or in combination with confidence, did not improve the prediction of the current confidence. We also observed that confidence predictions generalized across correct and incorrect trials, indicating that serial dependence effects in confidence generation are uncoupled to metacognition (i.e., how we evaluate the precision of our own behavior). We discuss the ramifications of these findings for the ongoing debate on domain-generality versus domain-specificity of metacognition.

Modality independent or modality specific? Common computations underlie confidence judgements in visual and auditory decisions

The mechanisms that enable humans to evaluate their confidence across a range of different decisions remain poorly understood. To bridge this gap in understanding, we used computational modelling to investigate the processes that underlie confidence judgements for perceptual decisions and the extent to which these computations are the same in the visual and auditory modalities. Participants completed two versions of a categorisation task with visual or auditory stimuli and made confidence judgements about their category decisions. In each modality, we varied both evidence strength, (i.e., the strength of the evidence for a particular category) and sensory uncertainty (i.e., the intensity of the sensory signal). We evaluated several classes of computational models which formalise the mapping of evidence strength and sensory uncertainty to confidence in different ways: 1) unscaled evidence strength models, 2) scaled evidence strength models, and 3) Bayesian models. Our model comparison results showed that across tasks and modalities, participants take evidence strength and sensory uncertainty into account in a way that is consistent with the scaled evidence strength class. Notably, the Bayesian class provided a relatively poor account of the data across modalities, particularly in the more complex categorisation task. Our findings suggest that a common process is used for evaluating confidence in perceptual decisions across domains, but that the parameter settings governing the process are tuned differently in each modality. Overall, our results highlight the impact of sensory uncertainty on confidence and the unity of metacognitive processing across sensory modalities.

The conscious processing of emotion in depression disorder: a meta-analysis of neuroimaging studies

Background

Depression is generally accompanied by a disturbed conscious processing of emotion, which manifests as a negative bias to facial/voice emotion information and a decreased accuracy in emotion recognition tasks. Several studies have proved that abnormal brain activation was responsible for the deficit function of conscious emotion recognition in depression. However, the altered brain activation related to the conscious processing of emotion in depression was incongruent among studies. Therefore, we conducted an activation likelihood estimation (ALE) analysis to better understand the underlying neurophysiological mechanism of conscious processing of emotion in depression.

Method

Electronic databases were searched using the search terms "depression," "emotion recognition," and "neuroimaging" from inceptions to April 10th, 2023. We retrieved trials which explored the neuro-responses of depressive patients to explicit emotion recognition tasks. Two investigators independently performed literature selection, data extraction, and risk of bias assessment. The spatial consistency of brain activation in conscious facial expressions recognition was calculated using ALE. The robustness of the results was examined by Jackknife sensitivity analysis.

Results

We retrieved 11,365 articles in total, 28 of which were included. In the overall analysis, we found increased activity in the middle temporal gyrus, superior temporal gyrus, parahippocampal gyrus, and cuneus, and decreased activity in the superior temporal gyrus, inferior parietal lobule, insula, and superior frontal gyrus. In response to positive stimuli, depressive patients showed hyperactivity in the medial frontal gyrus, middle temporal gyrus, and insula (uncorrected p < 0.001). When receiving negative stimuli, a higher activation was found in the precentral gyrus, middle frontal gyrus, precuneus, and superior temporal gyrus (uncorrected p < 0.001).

Conclusion

Among depressive patients, a broad spectrum of brain areas was involved in a deficit of conscious emotion processing. The activation of brain regions was different in response to positive or negative stimuli. Due to potential clinical heterogeneity, the findings should be treated with caution.

Systematic review registration

https://inplasy.com/inplasy-2022-11-0057/, identifier: 2022110057.

Late ERP correlates of confidence for auditory categorization of complex sounds

Recent research suggests that confidence judgments relate to the quality of early sensory representations and later modality independent processing stages. It is not known whether the nature of this finding might vary based on task and/or stimulus characteristics (e.g., detection vs. categorization). The present study investigated the neural correlates of confidence using electroencephalography (EEG) in an auditory categorization task. This allowed us to examine whether the early event-related potentials (ERPs) related to confidence in detection also apply to a more complex auditory task. Participants listened to frequency-modulated (FM) tonal stimuli going up or down in pitch. The rate of FM tones ranged from slow to fast, making the stimuli harder or easier to categorize. Tone-locked late posterior positivity (LPP) but not N1 or P2 amplitudes were larger for (correct-only) trials rated with high than low confidence. These results replicated for trials presenting stimuli at individually identified threshold levels (rate of change producing ∼71.7% correct performance). This finding suggests that, in this task, neural correlates of confidence do not vary based on difficulty level. We suggest that the LPP is a task general indication of the confidence for an upcoming judgment in a variety of paradigms.

Age-related decreases in global metacognition are independent of local metacognition and task performance

Metacognition refers to a capacity to reflect on and control other cognitive processes, commonly quantified as the extent to which confidence tracks objective performance. There is conflicting evidence about how "local" metacognition (monitoring of individual judgments) and "global" metacognition (estimates of self-performance) change across the lifespan. Additionally, the degree to which metacognition generalises across cognitive domains may itself change with age due to increased experience with one's own abilities. Using a gamified suite of performance-controlled memory and visual perception tasks, we measured local and global metacognition in an age-stratified sample of 304 healthy volunteers (18-83 years; N = 50 in each of 6 age groups). We calculated both local and global metrics of metacognition and quantified how and whether domain-generality changes with age. First-order task performance was stable across the age range. People's global self-performance estimates and local metacognitive bias decreased with age, indicating overall lower confidence in performance. In contrast, local metacognitive efficiency was spared in older age and remained correlated across the two cognitive domains. A stability of local metacognition indicates distinct mechanisms contributing to local and global metacognition. Our study reveals how local and global metacognition change across the lifespan and provide a benchmark against which disease-related changes in metacognition can be compared.

Cross-modal metacognition: Visual and tactile confidence share a common scale

Humans can judge the quality of their perceptual decisions-an ability known as perceptual confidence. Previous work suggested that confidence can be evaluated on an abstract scale that can be sensory modality-independent or even domain-general. However, evidence is still scarce on whether confidence judgments can be directly made across visual and tactile decisions. Here, we investigated in a sample of 56 adults whether visual and tactile confidence share a common scale by measuring visual contrast and vibrotactile discrimination thresholds in a confidence-forced choice paradigm. Confidence judgments were made about the correctness of the perceptual decision between two trials involving either the same or different modalities. To estimate confidence efficiency, we compared discrimination thresholds obtained from all trials to those from trials judged to be relatively more confident. We found evidence for metaperception because higher confidence was associated with better perceptual performance in both modalities. Importantly, participants were able to judge their confidence across modalities without any costs in metaperceptual sensitivity and only minor changes in response times compared to unimodal confidence judgments. In addition, we were able to predict cross-modal confidence well from unimodal judgments. In conclusion, our findings show that perceptual confidence is computed on an abstract scale and that it can assess the quality of our decisions across sensory modalities.

Re-evaluating frontopolar and temporoparietal contributions to detection and discrimination confidence

Previously, we identified a subset of regions where the relation between decision confidence and univariate functional magnetic resonance imaging (fMRI) activity was quadratic, with stronger activation for both high and low compared with intermediate levels of confidence. We further showed that, in a subset of these regions, this quadratic modulation appeared only for confidence in detection decisions about the presence or absence of a stimulus, and not for confidence in discrimination decisions about stimulus identity (Mazor et al. 2021). Here, in a pre-registered follow-up experiment, we sought to replicate our original findings and identify the origins of putative detection-specific confidence signals by introducing a novel asymmetric-discrimination condition. The new condition required discriminating two alternatives but was engineered such that the distribution of perceptual evidence was asymmetric, just as in yes/no detection. We successfully replicated the quadratic modulation of subjective confidence in prefrontal, parietal and temporal cortices. However, in contrast with our original report, this quadratic effect was similar in detection and discrimination responses, but stronger in the novel asymmetric-discrimination condition. We interpret our findings as weighing against the detection-specificity of confidence signatures and speculate about possible alternative origins of a quadratic modulation of decision confidence.

The timing of confidence computations in human prefrontal cortex

Knowing when confidence computations take place is critical for building mechanistic understanding of the neural and computational bases of metacognition. Yet, even though substantial amount of research has focused on revealing the neural correlates and computations underlying human confidence judgments, very little is known about the timing of confidence computations. Subjects judged the orientation of a briefly presented visual stimulus and provided a confidence rating regarding the accuracy of their decision. We delivered single pulses of transcranial magnetic stimulation (TMS) at different times after stimulus presentation. TMS was delivered to either dorsolateral prefrontal cortex (DLPFC) in the experimental group or to vertex in the control group. We found that TMS to DLPFC, but not to vertex, led to increased confidence in the absence of changes to accuracy or metacognitive ability. Critically, equivalent levels of confidence increase occurred for TMS delivered between 200 and 500 ms after stimulus presentation. These results suggest that confidence computations occur during a broad window that begins before the perceptual decision has been fully made and thus provide important constraints for theories of confidence generation.

Is visual metacognition associated with autistic traits? A regression analysis shows no link between visual metacognition and Autism-Spectrum Quotient scores

Metacognition -the human ability to recognize correct decisions- is a key cognitive process linked to learning and development. Several recent studies investigated the relationship between metacognition and autism. However, the evidence is still inconsistent. While some studies reported autistic people having lower levels of metacognitive sensitivity, others did not. Leveraging the fact that autistic traits are present in the general population, our study investigated the relationship between visual metacognition and autistic traits in a sample of 360 neurotypical participants. We measured metacognition as the correspondence between confidence and accuracy in a visual two alternative forced choice task. Autistic-traits were assessed through the Autism-spectrum Quotient (AQ) score. A regression analysis revealed no statistically significant association between autistic traits and metacognition or confidence. Furthermore, we found no link between AQ sub-scales and metacognition. We do not find support for the hypothesis that autistic traits are associated with metacognition in the general population.

Confidence in consciousness research

To study (un)conscious perception and test hypotheses about consciousness, researchers need procedures for determining whether subjects consciously perceive stimuli or not. This article is an introduction to a family of procedures called "confidence-based procedures," which consist in interpreting metacognitive indicators as indicators of consciousness. I assess the validity and accuracy of these procedures, and answer a series of common objections to their use in consciousness research. I conclude that confidence-based procedures are valid for assessing consciousness, and, in most cases, accurate enough for our practical and scientific purposes. This article is categorized under: Psychology > Perception and Psychophysics Philosophy > Consciousness.

Continuous Theta Burst Stimulation to the left anterior medial prefrontal cortex influences metacognitive efficiency

The contribution of the prefrontal areas to visual awareness is critical for the Global Neuronal Workspace Theory and higher-order theories of consciousness. The goal of the present study was to test the potential engagement of the anterior medial prefrontal cortex (aMPFC) in visual awareness judgements. We aimed to temporarily influence the neuronal dynamics of the left aMPFC via neuroplasticity-like mechanisms. We used different Theta Burst Stimulation (TBS) protocols in combination with a visual identification task and visual awareness ratings. Either continuous TBS (cTBS), intermittent TBS (iTBS), or sham TBS was applied prior to the experimental paradigm in a within-participant design. Compared with sham TBS, we observed an increase in participants' ability to judge their perception adequately (metacognitive efficiency) following cTBS but not iTBS. The effect was accompanied by lower visual awareness ratings in incorrect responses. No significant differences in the identification task performance were observed. We interpret these results as evidence of the involvement of PFC in the brain network that underlies metacognition. Further, we discuss whether the results of TMS studies on perceptual metacognition can be taken as evidence for PFC involvement in awareness itself.

Imagining the future self through thought experiments

The ability of the mind to conceptualize what is not present is essential. It allows us to reason counterfactually about what might have happened had events unfolded differently or had another course of action been taken. It allows us to think about what might happen - to perform 'Gedankenexperimente' (thought experiments) - before we act. However, the cognitive and neural mechanisms mediating this ability are poorly understood. We suggest that the frontopolar cortex (FPC) keeps track of and evaluates alternative choices (what we might have done), whereas the anterior lateral prefrontal cortex (alPFC) compares simulations of possible future scenarios (what we might do) and evaluates their reward values. Together, these brain regions support the construction of suppositional scenarios.

A shared brain system forming confidence judgment across cognitive domains

Confidence is typically defined as a subjective judgment about whether a decision is right. Decisions are based on sources of information that come from various cognitive domains and are processed in different brain systems. An unsettled question is whether the brain computes confidence in a similar manner whatever the domain or in a manner that would be idiosyncratic to each domain. To address this issue, human participants performed two tasks probing confidence in decisions made about the same material (history and geography statements), but based on different cognitive processes: semantic memory for deciding whether the statement was true or false, and duration perception for deciding whether the statement display was long or short. At the behavioral level, we found that the same factors (difficulty, accuracy, response time, and confidence in the preceding decision) predicted confidence judgments in both tasks. At the neural level, we observed using functional magnetic resonance imaging that confidence judgments in both tasks were associated to activity in the same brain regions: positively in the ventromedial prefrontal cortex and negatively in a prefronto-parietal network. Together, these findings suggest the existence of a shared brain system that generates confidence judgments in a similar manner across cognitive domains.

Metacognitive sensitivity and symptoms of mental disorder: A systematic review and meta-analysis

Introduction

Metacognition is a term used to refer to cognition about cognitive processes. In this systematic review and meta-analysis, we reviewed studies that investigated the relationship between experimentally measured objective metacognitive sensitivity and diverse symptoms of mental disorder. In these studies, metacognitive sensitivity is operationalized as the correspondence between the accuracy of task performance and reported confidence therein.

Methods

A literature search was conducted across four databases and studies were selected for review based on predefined eligibility criteria. Twenty studies were included in the review and separate meta-analyses were conducted for psychotic and non-psychotic categories of psychiatric symptoms.

Results

A significant reduction (medium effect size) in metacognitive sensitivity was found in individuals with psychosis-related symptoms of mental disorder compared to healthy control groups, but no significant difference was found for individuals with non-psychotic symptoms. It should be noted though, that fewer studies were available for the latter group. Sub-group analysis found no evidence that the effect of metacognitive impairment depended on whether perceptual or non-perceptual experimental tasks were employed.

Discussion

These findings are discussed in relation to other conceptualizations of metacognition and the role reduced metacognitive sensitivity may play in forms of mental disorder.

Value certainty and choice confidence are multidimensional constructs that guide decision-making

The degree of certainty that decision-makers have about their evaluations of available choice alternatives and their confidence about selecting the subjectively best alternative are important factors that affect current and future value-based choices. Assessments of the alternatives in a given choice set are rarely unidimensional; their values are usually derived from a combination of multiple distinct attributes. For example, the taste, texture, quantity, and nutritional content of a snack food may all be considered when determining whether to consume it. We examined how certainty about the levels of individual attributes of an option relates to certainty about the overall value of that option as a whole and/or to confidence in having chosen the subjectively best available option. We found that certainty and confidence are derived from unequally weighted combinations of attribute certainties rather than simple, equal combinations of all sources of uncertainty. Attributes that matter more in determining choice outcomes also are weighted more in metacognitive evaluations of certainty or confidence. Moreover, we found that the process of deciding between two alternatives leads to refinements in both attribute estimations and the degree of certainty in those estimates. Attributes that are more important in determining choice outcomes are refined more during the decision process in terms of both estimates and certainty. Although certainty and confidence are typically treated as unidimensional, our results indicate that they, like value estimates, are subjective, multidimensional constructs.

Neurophysiological and emotional influences on team communication and metacognitive cyber situational awareness during a cyber engineering exercise

Background: Cyber operations unfold at superhuman speeds where cyber defense decisions are based on human-to-human communication aiming to achieve a shared cyber situational awareness. The recently proposed Orient, Locate, Bridge (OLB) model suggests a three-phase metacognitive approach for successful communication of cyber situational awareness for good cyber defense decision-making. Successful OLB execution implies applying cognitive control to coordinate self-referential and externally directed cognitive processes. In the brain, this is dependent on the frontoparietal control network and its connectivity to the default mode network. Emotional reactions may increase default mode network activity and reduce attention allocation to analytical processes resulting in sub-optimal decision-making. Vagal tone is an indicator of activity in the dorsolateral prefrontal node of the frontoparietal control network and is associated with functional connectivity between the frontoparietal control network and the default mode network. Aim: The aim of the present study was to assess whether indicators of neural activity relevant to the processes outlined by the OLB model were related to outcomes hypothesized by the model. Methods: Cyber cadets (N = 36) enrolled in a 3-day cyber engineering exercise organized by the Norwegian Defense Cyber Academy participated in the study. Differences in prospective metacognitive judgments of cyber situational awareness, communication demands, and mood were compared between cyber cadets with high and low vagal tone. Vagal tone was measured at rest prior to the exercise. Affective states, communication demands, cyber situational awareness, and metacognitive accuracy were measured on each day of the exercise. Results: We found that cyber cadets with higher vagal tone had better metacognitive judgments of cyber situational awareness, imposed fewer communication demands on their teams, and had more neutral moods compared to cyber cadets with lower vagal tone. Conclusion: These findings provide neuroergonomic support for the OLB model and suggest that it may be useful in education and training. Future studies should assess the effect of OLB-ing as an intervention on communication and performance.

The effect of mindfulness and metacognition on anxiety symptoms: a case-control study

Background

Anxiety disorders (ADs) are associated with numerous psychiatric disorders; despite the efforts in psychotherapy models targeting their etiology, novel treatment strategies are still developing. We aimed to assess whether mindfulness and metacognition differ between patients with ADs and healthy controls (HCs) and whether the symptom severity of ADs is related to mindfulness and metacognition among patients. Two-hundred participants were enrolled in this study. Structured clinical interview, sociodemographic form, Five Facet Mindfulness Questionnaire-Short Form, Metacognition Questionnaire-30, and Hamilton Anxiety Rating Scale were administered. Multivariate analysis of covariance was conducted to compare the groups in terms of mindfulness and metacognition. Correlation and multiple linear regression analyses were performed to measure the association between the variables.

Results

The main finding indicates that positive beliefs about worry are associated with reduced symptom severity of ADs. Furthermore, HCs have more positive beliefs about worry and nonjudging of inner experience compared to patients with ADs, who utilize negative beliefs about uncontrollability and danger and need to control thoughts to a greater extent.

Conclusions

This study demonstrates that dysfunctional metacognitive beliefs may influence the anxiety severity of adult patients. We suggest that focusing on reducing maladaptive metacognitions may be supportive of AD improvement.

Metacognitive Domains Are Not Aligned along a Dimension of Internal-External Information Source

It is still debated whether metacognition, or the ability to monitor our own mental states, relies on processes that are “domain-general” (a single set of processes can account for the monitoring of any mental process) or “domain-specific” (metacognition is accomplished by a collection of multiple monitoring modules, one for each cognitive domain). It has been speculated that two broad categories of metacognitive processes may exist: those that monitor primarily externally generated versus those that monitor primarily internally generated information. To test this proposed division, we measured metacognitive performance (using m-ratio, a signal detection theoretical measure) in four tasks that could be ranked along an internal-external axis of the source of information, namely memory, motor, visuomotor, and visual tasks. We found correlations between m-ratios in visuomotor and motor tasks, but no correlations between m-ratios in visual and visuomotor tasks, or between motor and memory tasks. While we found no correlation in metacognitive ability between visual and memory tasks, and a positive correlation between visuomotor and motor tasks, we found no evidence for a correlation between motor and memory tasks. This pattern of correlations does not support the grouping of domains based on whether the source of information is primarily internal or external. We suggest that other groupings could be more reflective of the nature of metacognition and discuss the need to consider other non-domain task-features when using correlations as a way to test the underlying shared processes between domains.

Are involuntary autobiographical memory and déjà vu natural products of memory retrieval?

Involuntary autobiographical memories (IAMs) and déjà vu are phenomena that occur spontaneously in daily life. IAMs are recollections of the personal past, whereas déjà vu is defined as an experience in which the person feels familiarity at the same time as knowing that the familiarity is false. We present and discuss the idea that both IAMs and déjà vu can be explained as natural phenomena resulting from memory processing and, importantly, are both based on the same memory retrieval processes. Briefly, we hypothesise that both can be described as "involuntary" or spontaneous cognitions, where IAMs deliver content and déjà vu delivers only the feeling of retrieval. We map out the similarities and differences between the two, making a theoretical and neuroscientific account for their integration into models of memory retrieval and how the autobiographical memory literature can explain these quirks of daily life and unusual but meaningful phenomena. We explain the emergence of the déjà vu phenomenon by relating it to well-known mechanisms of autobiographical memory retrieval, concluding that IAMs and déjà vu lie on a continuum.

Metacognition and the effect of incentive motivation in two compulsive disorders: Gambling disorder and obsessive-compulsive disorder

AIMS

Compulsivity is a common phenotype among psychiatric disorders, such as obsessive-compulsive disorder (OCD) and gambling disorder (GD). Deficiencies in metacognition, such as the inability to estimate one's performance via confidence judgments could contribute to pathological decision-making. Earlier research has shown that patients with OCD exhibit underconfidence, while patients with GD exhibit overconfidence. Moreover, it is known that motivational states (e.g. monetary incentives) influence metacognition, with gain (respectively loss) prospects increasing (respectively decreasing) confidence. Here, we reasoned that OCD and GD symptoms might correspond to an exacerbation of this interaction between metacognition and motivation.

METHODS

We hypothesized GD's overconfidence to be exaggerated during gain prospects, while OCD's underconfidence to be worsened in loss context, which we expected to see represented in ventromedial prefrontal cortex (VMPFC) blood-oxygen-level-dependent activity. We tested those hypotheses in a task-based functional magnetic resonance imaging (fMRI) design (27 patients with GD, 28 patients with OCD, 55 controls). The trial is registered in the Dutch Trial Register (NL6171).

RESULTS

We showed increased confidence for patients with GD versus patients with OCD, which could partly be explained by sex and IQ. Although our primary analyses did not support the hypothesized interaction between incentives and groups, exploratory analyses did show increased confidence in patients with GD specifically in gain context. fMRI analyses confirmed a central role for VMPFC in the processing of confidence and incentives, but no differences between the groups.

CONCLUSION

Patients with OCD and those with GD reside at opposite ends of the confidence spectrum, while no interaction with incentives was found, nor group differences in neuronal processing of confidence.

Psychiatrically relevant signatures of domain-general decision-making and metacognition in the general population

Human behaviours are guided by how confident we feel in our abilities. When confidence does not reflect objective performance, this can impact critical adaptive functions and impair life quality. Distorted decision-making and confidence have been associated with mental health problems. Here, utilising advances in computational and transdiagnostic psychiatry, we sought to map relationships between psychopathology and both decision-making and confidence in the general population across two online studies (N's = 344 and 473, respectively). The results revealed dissociable decision-making and confidence signatures related to distinct symptom dimensions. A dimension characterised by compulsivity and intrusive thoughts was found to be associated with reduced objective accuracy but, paradoxically, increased absolute confidence, whereas a dimension characterized by anxiety and depression was associated with systematically low confidence in the absence of impairments in objective accuracy. These relationships replicated across both studies and distinct cognitive domains (perception and general knowledge), suggesting that they are reliable and domain general. Additionally, whereas Big-5 personality traits also predicted objective task performance, only symptom dimensions related to subjective confidence. Domain-general signatures of decision-making and metacognition characterise distinct psychological dispositions and psychopathology in the general population and implicate confidence as a central component of mental health.

Time-sensitive prefrontal involvement in associating confidence with task performance illustrates metacognitive introspection in monkeys

Metacognition refers to the ability to be aware of one's own cognition. Ample evidence indicates that metacognition in the human primate is highly dissociable from cognition, specialized across domains, and subserved by distinct neural substrates. However, these aspects remain relatively understudied in macaque monkeys. In the present study, we investigated the functionality of macaque metacognition by combining a confidence proxy, hierarchical Bayesian meta-d' computational modelling, and a single-pulse transcranial magnetic stimulation technique. We found that Brodmann area 46d (BA46d) played a critical role in supporting metacognition independent of task performance; we also found that the critical role of this region in meta-calculation was time-sensitive. Additionally, we report that macaque metacognition is highly domain-specific with respect to memory and perception decisions. These findings carry implications for our understanding of metacognitive introspection within the primate lineage.

Modulation of Brain Activity and Functional Connectivity by Acupuncture Combined With Donepezil on Mild-to-Moderate Alzheimer's Disease: A Neuroimaging Pilot Study

Background

Functional brain imaging changes have been proven as potential pathophysiological targets in early-stage AD. Current longitudinal neuroimaging studies of AD treated by acupuncture, which is one of the growingly acknowledged non-pharmacological interventions, have neither adopted comprehensive acupuncture protocols, nor explored the changes after a complete treatment duration. Thus, the mechanisms of acupuncture effects remain not fully investigated.

Objective

This study aimed to investigate the changes in spontaneous brain activity and functional connectivity and provide evidence for central mechanism of a 12-week acupuncture program on mild-to-moderate AD.

Methods

A total of forty-four patients with mild-to-moderate AD and twenty-two age- and education-level-matched healthy subjects were enrolled in this study. The forty-four patients with AD received a 12-week intervention of either acupuncture combined with Donepezil (the treatment group) or Donepezil alone (the control group). The two groups received two functional magnetic resonance imaging (fMRI) scans before and after treatment. The healthy subject group underwent no intervention, and only one fMRI scan was performed after enrollment. The fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) were applied to analyze the imaging data. The correlations between the imaging indicators and the changed score of Alzheimer's Disease Assessment Scale-Cognitive Section (ADAS-cog) were also explored.

Results

After the 12-week intervention, compared to those in the control group, patients with AD in the treatment group scored significantly lower on ADAS-cog value. Moreover, compared to healthy subjects, the areas where the fALFF value decreased in patients with AD were mainly located in the right inferior temporal gyrus, middle/inferior frontal gyrus, middle occipital gyrus, left precuneus, and bilateral superior temporal gyrus. Compared with the control group, the right precuneus demonstrated the greatest changed value of fALFF after the intervention in the treatment group. The difference in ADAS-cog after interventions was positively correlated with the difference in fALFF value in the left temporal lobe. Right precuneus-based FC analysis showed that the altered FC by the treatment group compared to the control group was mainly located in the bilateral middle temporal gyrus.

Conclusion

The study revealed the key role of precuneus in the effect of the combination of acupuncture and Donepezil on mild-to-moderate AD for cognitive function, as well as its connection with middle temporal gyrus, which provided a potential treating target for AD.

Trial Registration Number:

NCT03810794 (http://www.clinicaltrials.gov).