Different patterns of cerebral activation in genuine and malingered cognitive effort during performance on the Word Memory Test

What Deception Tasks Used in the Lab Really Do: Systematic Review and Meta-analysis of Ecological Validity of fMRI Deception Tasks

Interpretation of the neural findings of deception without considering the ecological validity of the experimental tasks could lead to biased conclusions. In this study we classified the experimental tasks according to their inclusion of three essential components required for ecological validity: intention to lie, social interaction and motivation. First, we carried out a systematic review to categorize fMRI deception tasks and to weigh the degree of ecological validity of each one. Second, we performed a meta-analysis to identify if each type of task involves a different neural substrate and to distinguish the neurocognitive contribution of each component of ecological validity essential to deception. We detected six categories of deception tasks. Intention to lie was the component least frequently included, followed by social interaction. Monetary reward was the most frequent motivator. The results of the meta-analysis, including 59 contrasts, revealed that intention to lie is associated with activation in the left lateral occipital cortex (superior division) whereas the left angular gyrus and right inferior frontal gyrus (IFG) are engaged during lying under instructions. Additionally, the right IFG appears to participate in the social aspect of lying including simulated and real interactions. We found no effect of monetary reward in our analysis. Finally, tasks with high ecological validity recruited fewer brain areas (right insular cortex and bilateral anterior cingulate cortex (ACC)) compared to less ecological tasks, perhaps because they are more natural and realistic, and engage a wide network of brain mechanisms, as opposed to specific tasks that demand more centralized processes.

Dump the "dimorphism": Comprehensive synthesis of human brain studies reveals few male-female differences beyond size

With the explosion of neuroimaging, differences between male and female brains have been exhaustively analyzed. Here we synthesize three decades of human MRI and postmortem data, emphasizing meta-analyses and other large studies, which collectively reveal few reliable sex/gender differences and a history of unreplicated claims. Males' brains are larger than females' from birth, stabilizing around 11 % in adults. This size difference accounts for other reproducible findings: higher white/gray matter ratio, intra- versus interhemispheric connectivity, and regional cortical and subcortical volumes in males. But when structural and lateralization differences are present independent of size, sex/gender explains only about 1% of total variance. Connectome differences and multivariate sex/gender prediction are largely based on brain size, and perform poorly across diverse populations. Task-based fMRI has especially failed to find reproducible activation differences between men and women in verbal, spatial or emotion processing due to high rates of false discovery. Overall, male/female brain differences appear trivial and population-specific. The human brain is not "sexually dimorphic."

White Matter Associations With Performance Validity Testing in Veterans With Mild Traumatic Brain Injury: The Utility of Biomarkers in Complicated Assessment

OBJECTIVE

Failure on performance validity tests (PVTs) is common in Veterans with histories of mild traumatic brain injury (mTBI), leading to questionable validity of clinical presentations.

PARTICIPANTS

Using diffusion tensor imaging, we investigated white matter (WM) integrity and cognition in 79 Veterans with history of mTBI who passed PVTs (n = 43; traumatic brain injury [TBI]-passed), history of mTBI who failed at least 1 PVT (n = 13; TBI-failed), and military controls (n = 23; MCs) with no history of TBI.

RESULTS

The TBI-failed group demonstrated significantly lower cognitive scores relative to MCs and the TBI-passed group; however, no such differences were observed between MCs and the TBI-passed group. On a global measure of WM integrity (ie, WM burden), the TBI-failed group showed more overall WM abnormalities than the other groups. However, no differences were observed between the MCs and TBI-passed group on WM burden. Interestingly, regional WM analyses revealed abnormalities in the anterior internal capsule and cingulum of both TBI subgroups relative to MCs. Moreover, compared with the TBI-passed group, the TBI-failed group demonstrated significantly decreased WM integrity in the corpus callosum.

CONCLUSIONS

Findings revealed that, within our sample, WM abnormalities are evident in those who fail PVTs. This study adds to the burgeoning PVT literature by suggesting that poor PVT performance does not negate the possibility of underlying WM abnormalities in military personnel with history of mTBI.

Neural correlates of malingering in mild traumatic brain injury: A positron emission tomography study

The detection of malingering in cognitive performance is a challenge in clinical and legal environments. Neuroimaging may provide an objective method to determine the source of failure on tests of symptom validity. Participants comprised 45 combat veterans, 31 with mild traumatic brain injury (mTBI), not seeking medical or legal compensation, who completed the Tombaugh Test of Memory Malingering (TOMM) and a positron emission tomography (PET) scan. Based on TOMM performance (i.e., less than 45 of 50 total correct, suggesting suboptimal effort or malingering), subjects were separated into poor TOMM score (PT; n=10) and good TOMM score (GT; n=35) groups. Voxel-based multiple regression analysis with Group (GT/PT) predicting uptake of fluorodeoxyglucose revealed decreased brain metabolism in the ventromedial prefrontal cortex of poor performers. The current findings may suggest that poor TOMM performance in those with combat trauma and mTBI may be related to ventromedial prefrontal cortical dysfunction. These findings have important implications for the disentanglement of feigned versus actual memory impairment, where the latter may be secondary to neural mechanisms not consistent with forgetting or deception.

Bridging the gap between neurocognitive processing theory and performance validity assessment among the cognitively impaired: a review and methodological approach

Bigler (2012) and Larrabee (2012) recently addressed the state of the science surrounding performance validity tests (PVTs) in a dialogue highlighting evidence for the valid and increased use of PVTs, but also for unresolved problems. Specifically, Bigler criticized the lack of guidance from neurocognitive processing theory in the PVT literature. For example, individual PVTs have applied the simultaneous forced-choice methodology using a variety of test characteristics (e.g., word vs. picture stimuli) with known neurocognitive processing implications (e.g., the "picture superiority effect"). However, the influence of such variations on classification accuracy has been inadequately evaluated, particularly among cognitively impaired individuals. The current review places the PVT literature in the context of neurocognitive processing theory, and identifies potential methodological factors to account for the significant variability we identified in classification accuracy across current PVTs. We subsequently evaluated the utility of a well-known cognitive manipulation to provide a Clinical Analogue Methodology (CAM), that is, to alter the PVT performance of healthy individuals to be similar to that of a cognitively impaired group. Initial support was found, suggesting the CAM may be useful alongside other approaches (analogue malingering methodology) for the systematic evaluation of PVTs, particularly the influence of specific neurocognitive processing components on performance.

Effort, symptom validity testing, performance validity testing and traumatic brain injury

BACKGROUND

To understand the neurocognitive effects of brain injury, valid neuropsychological test findings are paramount.

REVIEW

This review examines the research on what has been referred to a symptom validity testing (SVT). Above a designated cut-score signifies a 'passing' SVT performance which is likely the best indicator of valid neuropsychological test findings. Likewise, substantially below cut-point performance that nears chance or is at chance signifies invalid test performance. Significantly below chance is the sine qua non neuropsychological indicator for malingering. However, the interpretative problems with SVT performance below the cut-point yet far above chance are substantial, as pointed out in this review. This intermediate, border-zone performance on SVT measures is where substantial interpretative challenges exist. Case studies are used to highlight the many areas where additional research is needed. Historical perspectives are reviewed along with the neurobiology of effort. Reasons why performance validity testing (PVT) may be better than the SVT term are reviewed.

CONCLUSIONS

Advances in neuroimaging techniques may be key in better understanding the meaning of border zone SVT failure. The review demonstrates the problems with rigidity in interpretation with established cut-scores. A better understanding of how certain types of neurological, neuropsychiatric and/or even test conditions may affect SVT performance is needed.

Symptom validity testing, effort, and neuropsychological assessment

Symptom validity testing (SVT) has become a major theme of contemporary neuropsychological research. However, many issues about the meaning and interpretation of SVT findings will require the best in research design and methods to more precisely characterize what SVT tasks measure and how SVT test findings are to be used in neuropsychological assessment. Major clinical and research issues are overviewed including the use of the “effort” term to connote validity of SVT performance, the use of cut-scores, the absence of lesion-localization studies in SVT research, neuropsychiatric status and SVT performance and the rigor of SVT research designs. Case studies that demonstrate critical issues involving SVT interpretation are presented.