Stimulating Self-Regulation: A Review of Non-invasive Brain Stimulation Studies of Goal-Directed Behavior

A conceptual framework for a neurophysiological basis of art therapy for PTSD

Post-traumatic stress disorder (PTSD) is a heterogeneous condition that affects many civilians and military service members. Lack of engagement, high dropout rate, and variable response to psychotherapy necessitates more compelling and accessible treatment options that are based on sound neuroscientific evidence-informed decision-making. Art therapy incorporates elements proven to be effective in psychotherapy, such as exposure, making it a potentially valuable treatment option. This conceptual paper aims to inform the neurophysiological rationale for the use of art therapy as a therapeutic approach for individuals with PTSD. A narrative synthesis was conducted using literature review of empirical research on the neurophysiological effects of art therapy, with supporting literature on neuroaesthetics and psychotherapies to identify art therapy factors most pertinent for PTSD. Findings were synthesized through a proposed framework based on the triple network model considering the network-based dysfunctions due to PTSD. Art therapy's active components, such as concretization and metaphor, active art engagement, emotion processing and regulation, perspective taking and reframing, and therapeutic alliance, may improve symptoms of PTSD and prompt adaptive brain functioning. Given the scarcity of rigorous studies on art therapy's effectiveness and mechanisms of alleviating PTSD symptoms, the suggested framework offers a neurophysiological rationale and a future research agenda to investigate the impact of art therapy as a therapeutic approach for individuals with PTSD.

The Effect of Induced Regulatory Focus on Frontal Cortical Activity

The motivation-direction model has served as the primary framework for understanding frontal cortical activity. However, research on the link between approach/avoidance motivation and left/right frontal cortical activity has produced inconsistent findings. Recent studies suggest that regulatory systems may offer a more accurate explanation than the motivational direction model. Despite being regulatory systems, the relationship between regulatory focus and frontal cortical activity has received limited attention. Only one experimental study has explored this connection through correlational analysis, yet it lacks causal evidence. The present study aimed to address this gap by manipulating regulatory focus and measuring frontal cortical activity in 36 college students. Our results revealed that induced promotion focus led to increased left frontal cortical activity, whereas induced prevention focus led to increased right frontal cortical activity. These findings enhance our physiological understanding of regulatory focus and offer a deeper explanation of how regulatory focus influences alterations in psychology and behavior.

Self-Reported Mood and Lifestyle-Related Physical Activity of Young Adults With Major Depressive Disorder

We investigated whether mood and lifestyle-related indicators of physical health are differentially expressed according to self-reported levels of depressive symptoms among young adults with a current episode of major depression. In a cross-sectional study, we recruited 94 young adults (females = 67, 71.3%; males = 27, 28.7%; aged 18-35 years) with a current episode of major depression. We assessed their mood with the Profile of Mood States (POMS), and Beck Anxiety Inventory-(BAI), sleep with the Pittsburgh Sleep Quality Index (PSQI), physical activity with the Simple Physical Activity Questionnaire (SIMPAQ), and their cardiorespiratory fitness. Participants' depression levels were classified as follows using established cut-points: (a) Mild Depressive Symptoms (MIDS, BDI-II 14-19 points, n = 17), (b) Moderate Depressive Symptoms (MODS, BDI-II 20-28 points, n = 37) or (c) Severe Depressive Symptoms (SEDS, BDI-II 29-63 points, n = 40). As expected, we found that young adults with SEDS, when compared to those with MODS and MIDS, showed higher depressive mood on the POMS, and they exhibited greater anxiety symptoms, lower reported 'vigor' on physical activity measures, worse sleep quality as expressed by their global score sleep; daytime dysfunction; and sleep disturbance, and they showed lower cardiorespiratory fitness. Those with moderate depressive symptoms only differed from those with mild symptoms with respect to hostility, fatigue and mood disturbance. Although there was a gradient whereby worse mental and physical health indicators were more closely related to the SEDS depression categorization, while healthier indicators were associated with the MIDS category, some parameters were not different between the MDD severity groups, particularly when comparing MIDS and MODS. Clinicians treating patients with MDD should consider these factors when designing lifestyle-based interventions.

The scalp prefrontal-limbic functional connectivity moderates stress-related rumination effects on stress recovery

BACKGROUND

Mood disorders are often associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction, and rumination has been implicated in delayed cortisol recovery. However, research findings on the impact of rumination on cortisol recovery have been inconsistent. The moderating effects of scalp prefrontal-limbic connections on the relationship between rumination and cortisol recovery may explain these discrepancies.

METHOD

Acute stress was induced by a 5-min simulated job interview. Salivary samples and affective ratings were collected at seven pre-determined time points. After the simulated job interview, 35 healthy adult participants were randomly assigned to either the rumination condition (n = 17) or the distraction condition (n = 18).

RESULTS

Inducing stress and rumination led to increased cortisol levels, negative mood, and state rumination. Compared with the distraction group, the rumination group displayed delayed cortisol recovery and decreased scalp prefrontal-limbic connectivities, that is, left ventrolateral prefrontal cortex (LVLPFC) and left temporal area (LTMP) [ps < .05], and right dorsolateral prefrontal cortex (RDLPFC) and anterior cingulate cortex (ACC) [ps < .05]. The relationship between rumination and cortisol recovery was moderated by connectivities between the left dorsolateral prefrontal cortex (LDLPFC) and LTMP, RDLPFC and LTMP, LDLPFC and ACC, and RDLPFC and ACC [B = -0.98 to -0.35, SE = 0.15-0.34, ps < .05]. Higher rumination combined with reduced scalp prefrontal-limbic connectivities to predict delayed cortisol recovery.

CONCLUSION

The current findings suggest that scalp prefrontal-limbic connectivity is a neural underpinning related to emotion regulation for the effects of state rumination on stress recovery. These findings also provide a potential target for non-invasive intervention in HPA axis dysregulation.

Too Tired to Think: Within and Between-Person Relations Among Impulsive Traits, Sleep Duration, and Mental Health Outcomes

Heavier drinking and depression are common mental health concerns in the USA, yet few studies have sought to understand transdiagnostic risk factors for both. Two health-focused risk factors are impulsive personality traits and sleep duration, but research typically separates the two, precluding additive and interactive relations. The current study sought to test a theoretical model where risk conferred from impulsive traits is heightened when individuals have reduced sleep. Public-access data from the National Longitudinal Study on Adolescent to Adult Health (Add Health) were used to test study hypotheses. Participants reported on impulsive traits (i.e., lack of premeditation, sensation seeking), sleep duration, depression, and drinking across three waves spanning adolescence, emerging adulthood, and adulthood. Multilevel models distinguished risk processes at the between- vs. within-person level. At the between-person level, sensation seeking predicted drinking whereas premeditation predicted depression. Additionally, within-person deviations in both traits were associated with drinking, whereas within-person deviations in premeditation were associated with depression. Sleep duration was protective against outcomes at both levels. However, main effects were qualified by interactions at both levels, such that having below average sleep duration heightened the effects of premeditation at the between-person level, whereas within-person decreases in sleep heightened the effects of sensation seeking at the within-person level. Findings support a theoretical model where poor sleep exacerbates risk conferred from impulsive traits. Risk conferred from impulsive traits diverged based upon level of analysis, suggesting that global and just-in-time interventions may benefit from targeting specific impulsive traits as well as sleep.

Anodal cerebellar t-DCS impacts skill learning and transfer on a robotic surgery training task

The cerebellum has demonstrated a critical role during adaptation in motor learning. However, the extent to which it can contribute to the skill acquisition of complex real-world tasks remains unclear. One particularly challenging application in terms of motor activities is robotic surgery, which requires surgeons to complete complex multidimensional visuomotor tasks through a remotely operated robot. Given the need for high skill proficiency and the lack of haptic feedback, there is a pressing need for understanding and improving skill development. We investigated the effect of cerebellar transcranial direct current stimulation applied during the execution of a robotic surgery training task. Study participants received either real or sham stimulation while performing a needle driving task in a virtual (simulated) and a real-world (actual surgical robot) setting. We found that cerebellar stimulation significantly improved performance compared to sham stimulation at fast (more demanding) execution speeds in both virtual and real-world training settings. Furthermore, participants that received cerebellar stimulation more effectively transferred the skills they acquired during virtual training to the real world. Our findings underline the potential of non-invasive brain stimulation to enhance skill learning and transfer in real-world relevant tasks and, more broadly, its potential for improving complex motor learning.

The neurophysiological Behavioral Perspective Model of consumer choice and its contribution to the intentional behaviorist research programme

Cognitive explanations raise epistemological problems not faced by accounts confined to observable variables. Many explanatory components of cognitive models are unobservable: beliefs, attitudes, and intentions, for instance, must be made empirically available to the researcher in the form of measures of observable behavior from which the latent variables are inferred. The explanatory variables are abstract and theoretical and rely, if they are to enter investigations and explanations, on reasoned agreement on how they can be captured by proxy variables derived from what people say and how they behave. Psychometrics must be founded upon a firm, intersubjective agreement among researchers and users of research on the relationship of behavioral measures to the intentional constructs to which they point and the latent variables they seek to operationalize. Only if these considerations are adequately addressed can we arrive at consistent interpretations of the data. This problem provides the substance of the intentional behaviorist research programme which seeks to provide a rationale for the cognitive explanation. Within this programme, two versions of the Behavioral Perspective Model (BPM), an extensional portrayal of socioeconomic behavior and a corresponding intentional approach, address the task of identifying where intentional explanation becomes necessary and the form it should take. This study explores a third version, based on neurophysiological substrates of consumer choice as a contributor to this task. The nature of "value" is closely related to the rationale for a neurophysiological model of consumer choice. The variables involved are operationally specified and measured with high intersubjective agreement. The intentional model (BPM-I), depicting consumer action in terms of mental processes such as perception, deliberation, and choice, extends the purview of the BPM to new situations and areas of explanation.

Changes in synaptic markers after administration of ketamine or psychedelics: a systematic scoping review

Background

Ketamine and psychedelics have abuse liability. They can also induce "transformative experiences" where individuals experience enhanced states of awareness. This enhanced awareness can lead to changes in preexisting behavioral patterns which could be beneficial in the treatment of substance use disorders (SUDs). Preclinical and clinical studies suggest that ketamine and psychedelics may alter markers associated with synaptic density, and that these changes may underlie effects such as sensitization, conditioned place preference, drug self-administration, and verbal memory performance. In this scoping review, we examined studies that measured synaptic markers in animals and humans after exposure to ketamine and/or psychedelics.

Methods

A systematic search was conducted following PRISMA guidelines, through PubMed, EBSCO, Scopus, and Web of Science, based on a published protocol (Open Science Framework, DOI: 10.17605/OSF.IO/43FQ9). Both in vivo and in vitro studies were included. Studies on the following synaptic markers were included: dendritic structural changes, PSD-95, synapsin-1, synaptophysin-1, synaptotagmin-1, and SV2A.

Results

Eighty-four studies were included in the final analyses. Seventy-one studies examined synaptic markers following ketamine treatment, nine examined psychedelics, and four examined both. Psychedelics included psilocybin/psilocin, lysergic acid diethylamide, N,N-dimethyltryptamine, 2,5-dimethoxy-4-iodoamphetamine, and ibogaine/noribogaine. Mixed findings regarding synaptic changes in the hippocampus and prefrontal cortex (PFC) have been reported when ketamine was administered in a single dose under basal conditions. Similar mixed findings were seen under basal conditions in studies that used repeated administration of ketamine. However, studies that examined animals during stressful conditions found that a single dose of ketamine counteracted stress-related reductions in synaptic markers in the hippocampus and PFC. Repeated administration of ketamine also counteracted stress effects in the hippocampus. Psychedelics generally increased synaptic markers, but results were more consistently positive for certain agents.

Conclusion

Ketamine and psychedelics can increase synaptic markers under certain conditions. Heterogeneous findings may relate to methodological differences, agents administered (or different formulations of the same agent), sex, and type of markers. Future studies could address seemingly mixed results by using meta-analytical approaches or study designs that more fully consider individual differences.

Modulated effectiveness of rehabilitation motivation by reward strategies combined with tDCS in stroke: study protocol for a randomized controlled trial

Background

Stroke survivors often exhibit low motivation for rehabilitation, hindering their ability to effectively complete rehabilitation training task effectively and participate in daily activities actively. Reward strategies have been identified as an effective method for boosting rehabilitation motivation, but their long-term efficacy remains uncertain. Transcranial direct current stimulation (tDCS) has been recognized as a technique that facilitates plastic changes and functional reorganization of cortical areas. Particularly, tDCS can improve the functional connectivity between brain regions associated with goal-directed behavior when applied to the left dorsolateral prefrontal cortex (dlPFC). Combing reward strategies with tDCS (RStDCS) has been shown to motivate healthy individuals to exert more effort in task performance. However, research exploring the combined and sustained effects of these strategies on rehabilitation motivation in stroke survivors is lacking.

Methods and design

Eighty-seven stroke survivors with low motivation and upper extremity dysfunction will be randomized to receive either conventional treatment, RS treatment, or RStDCS treatment. The RStDCS group will receive reward strategies combined with anodal tDCS stimulation of the left dlPFC. The RS group will receive reward strategies combined with sham stimulation. The conventional group will receive conventional treatment combined with sham stimulation. tDCS stimulation is performed over 3 weeks of hospitalization, 20 min/time, five times a week. Reward strategies refers to personalized active exercise programs for patients during hospitalization and at home. Patients can voluntarily choose tasks for active exercise and self-report to the therapist so as to punch a card for points and exchange gifts. The conventional group will receive home rehabilitation instructions prior to discharge. Rehabilitation motivation, measured using RMS. RMS, FMA, FIM, and ICF activity and social engagement scale will be compared at baseline, 3 weeks, 6 weeks, and 3 months post-enrollment to evaluate patients' multifaceted health condition based on the ICF framework.

Discussion

This study integrates knowledge from social cognitive science, economic behavioral science, and other relevant fields. We utilize straightforward and feasible reward strategies, combined with neuromodulation technology, to jointly improve patients' rehabilitation motivation. Behavioral observations and various assessment tools will be used to monitor patients' rehabilitation motivation and multifaceted health condition according to the ICF framework. The aim is to provide a preliminary exploration path for professionals to develop comprehensive strategies for improving patient rehabilitation motivation and facilitating a complete "hospital-home-society" rehabilitation process.

Clinical trial registration

https://www.chictr.org.cn/showproj.aspx?proj=182589, ChiCTR2300069068.

Fifty Years Integrating Neurobiology and Psychology to Study Attention

At the time of the start of Biological Psychology cognitive studies had developed approaches to measuring cognitive processes. However, linking these to the underlying biology in the typical human brain had hardly begun. A critical step came in 1988 when methods for imaging the human brain in cognitive tasks began. By 1990 it was possible to describe three brain networks that carried out the hypothesized cognitive functions outlined 20 years before. Their development was traced in infancy, first using age-appropriate tasks and later through resting state imaging. Imaging was applied to both voluntary and involuntary cued shifts of visual orienting in humans and primates, and a summary was presented in 2002. By 2008 these new imaging findings were used to test hypotheses about the genes involved in each network. Recently, studies of mice using optogenetics to control populations of neurons have brought us closer to a synthesis of how attention and memory networks operate together in human learning. Perhaps the coming years will bring us to an integrated theory of aspects of attention using data from all the levels that can illuminate these issues, thus fulfilling a key goal of the Journal.

The role of socio-cultural background and child age for parental regulation strategies and children's self-regulation: A comparison between Germany, Chile, and El Salvador

This study compared parental regulation strategies and children's self-regulation in three different countries (Germany, Chile, El Salvador). N = 300 primary caregivers of 1- to 3-year-olds filled out a parental questionnaire (IMpulse-MAnagement in the caregiver-child dyad, IMMA; Pauen et al., 2019) assessing (a) socio-demographic variables, (b) parental ideas and goals regarding children's self-regulation skills, (c) children's self-regulation strategies in dealing with internal challenges or demands, and (d) caregiver's regulation strategies. Age-group comparisons revealed that (1) children increased compliance and verbal negotiation with their caregivers as they grow older, and (2) parents adapted their regulation strategies to the age of the child. Country-group comparisons further indicated substantial similarities and differences between countries with respect to (3) how parents expected children to deal with requests and prohibitions, as well as with their own needs, feelings, and impulses, (4) how children responded to goal-frustration and parental demands, and (5) which regulatory strategies parents used to support their offspring. These exploratory findings are discussed in the light of current models on cultural learning, parent-child interactions, and child self-regulation development.

Social avoidance behavior modulates motivational responses to social reward-threat conflict signals: A preliminary fMRI study

Social avoidance behavior (SAB) produces impairment in multiple domains and contributes to the development and maintenance of several psychiatric disorders. Social behaviors such as SAB are influenced by approach-avoidance (AA) motivational responses to affective facial expressions. Notably, affective facial expressions communicate varying degrees of social reward signals (happiness), social threat signals (anger), or social reward-threat conflict signals (co-occurring happiness and anger). SAB is associated with dysregulated modulation of automatic approach-avoidance (AA) motivational responses exclusively to social reward-threat conflict signals. However, no neuroimaging research has characterized SAB-related modulation of automatic and subjective AA motivational responses to social reward-threat conflict signals. We recruited 30 adults reporting clinical, moderate, or minimal SAB based on questionnaire cutoff scores. SAB groups were matched on age range and gender. During fMRI scanning, participants completed implicit and subjective approach-avoidance tasks (AATs), which involved more incidental or more explicit evaluation of facial expressions that parametrically varied in social reward signals (e.g., 50%_Happy), social threat signals (e.g., 50%_Angry), or social reward-threat conflict signals (e.g., 50%_Happy + 50%_Angry). In the implicit AAT, SAB was associated with slower automatic avoidance actions and weaker amygdala-pgACC connectivity exclusively as a function of social reward-threat conflict signals. In the subjective AAT, SAB was associated with smaller increases in approach ratings, smaller decreases in avoidance ratings, and weaker dlPFC-pgACC connectivity exclusively in response to social reward-threat conflict signals. Thus, SAB is associated with dysregulated modulation of automatic and subjective AA motivational sensitivity to social reward-threat conflict signals, which may be facilitated by overlapping neural systems.

A pilot randomized clinical trial of tDCS for increasing exercise engagement in individuals with elevated depressive symptoms: Rationale, design, and baseline characteristics

Regular exercise protects against overweight/obesity as well as numerous chronic diseases. Yet, less than half of Americans exercise sufficiently. Elevated levels of depressive symptoms have been identified as an important correlate of physical inactivity as well as poor adherence to exercise programs. Individuals with depression are less sensitive to rewards and demonstrate an attentional bias toward negative stimuli. These, and other features of depression, may place them at increased risk for effectively managing the affective experience of exercise. Lower baseline levels of activation of the left (vs right) frontal cortex, an area implicated in affect regulation, have also been found in depression, potentially pointing to this region as a potential target for intervening on affect regulation during exercise. Transcranial direct current stimulation (tDCS) has shown promise in impacting a variety of cognitive and affective processes in a large number of individuals, including people with depression. Some findings have suggested that tDCS targeting the left dorsolateral prefrontal cortex (DLPFC), specifically, may improve emotion regulation. Transcranial direct current stimulation could theoretically be a novel and potentially promising approach to improving the affective experience of exercise, thereby increasing exercise adherence among individuals with depressive symptoms. Here we present the rationale, design, and baseline characteristics of a pilot randomized controlled trial of tDCS versus sham delivered 3x/week for 8 weeks in the context of supervised aerobic exercise (AE) program among 51 low-active individuals with elevated depressive symptoms (86.3% female; mean age = 49.5). Follow-up assessments were conducted at end of treatment, and three and six months after enrollment to examine changes in levels of objectively-measured moderate-to-vigorous physical activity (MVPA). If effective, this approach could have high public health impact on preventing obesity and chronic diseases among these at-risk individuals.

Association of Transcranial Direct Current Stimulation and Neurofeedback With Declarative Memory and Cerebral Arterial Flow in University Students: Protocol for a Double-blind Randomized Controlled Study

BACKGROUND

The performance of a task depends on ongoing brain activity, which can be influenced by attention, excitement, or motivation. Scientific studies have confirmed that mindfulness leads to better performance, health, and well-being. However, these cognitive efficiency modulating factors are nonspecific, can be difficult to control, and are not suitable to specifically facilitate neural processing.

OBJECTIVE

The aim of this study is to evaluate the effects of transcranial direct current stimulation associated with neurofeedback on declarative memory and cerebral blood flow in university students.

METHODS

In this study, we will use transcranial direct current stimulation, a low-cost physical resource that is easy to apply, has few adverse effects, and is associated with a neurofeedback resource. This, in turn, has been shown to be a training program capable of improving working memory function.

RESULTS

Participants will be recruited between July 2022 and December 2022. This study is expected to conclude in July 2023.

CONCLUSIONS

This study will provide preliminary results on the benefits of using the direct current neurostimulation and neurofeedback tools on the participants being analyzed.

TRIAL REGISTRATION

Brazilian Clinical Trials Registry RBR-7zs8b5; https://ensaiosclinicos.gov.br/rg/RBR-7zs8b5.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/36294.

Application of EMGB to Study Impacts of Public Green Space on Active Transport Behavior: Evidence from South Korea

Public green spaces (e.g., parks, green trails, greenways) and motivations to engage in active transport are essential for encouraging walking and cycling. However, how these key factors influence walker and cyclist behavior is potentially being increasingly influenced by the use of smart apps, as they become more ubiquitous in everyday practices. To fill this research gap, this work creates and tests a theoretically integrated study framework grounded in an extended model of goal-directed behavior, including public green space and motivation with perceived usefulness of smart apps. In order to accomplish the purpose of this study, we conducted an online survey of Korean walkers (n = 325) and cyclists (n = 326) between 10 and 25 July 2021 and applied partial least squares, structural equation, and multi-group analysis to validate the research model. Results revealed that active transport users' awareness of public green space positively influences attitude toward (γ = 0.163), as well as behavioral intention of (γ = 0.159), walking and cycling. Additionally, motivation (extrinsic and intrinsic) greatly influences attitude (γ = 0.539) and behavioral intention (γ = 0.535). Subjective norms (γ = 0.137) and positive (γ = 0.466) and negative anticipated emotions (γ = 0.225) have a significant impact on the desire that leads to behavioral intention. High and low perceived smart app usefulness also significantly moderates between public green space and attitude (t-value = 25.705), public green space and behavioral intention (t-value = 25.726), motivation and attitude (t-value = -25.561), and motivation and behavioral intention (t-value = -15.812). Consequently, the findings are useful to academics and practitioners by providing new knowledge and insights.

Efficacy and tolerability of Brain Stimulation interventions in Borderline Personality Disorder: state of the art and future perspectives - A systematic review

Treating Borderline Personality Disorder (BPD) is a major challenge for psychiatrists. As Brain Stimulation represents an alternative approach to treat psychiatric disorders, our systematic review is the first to focus on both invasive and Non-Invasive Brain Stimulation (NIBS) interventions in people living with BPD, examining clinical effects over core features and comorbid conditions. Following PRISMA guidelines, out of 422 original records, 24 papers were included regarding Deep Brain Stimulation (n = 1), Electroconvulsive therapy (n = 5), Transcranial Magnetic Stimulation (n = 13) and transcranial Direct Current Stimulation (n = 5). According to impulsivity and emotional dysregulated domain improvements, NIBS in BPD appears to restore frontolimbic network deficiencies. NIBS seems also to modulate depressive features. Safety and tolerability profiles for each technique are discussed. Despite encouraging results, definitive recommendations on Brain Stimulation in BPD are mitigated by protocols heterogeneity, lack of randomized controlled trials and poor quality of included studies, including high risk of methodological biases. To serve as guide for future systematic investigations, protocols optimization proposals are provided, focusing on alternative stimulation sites and suggesting a NIBS symptom-based approach.

Frontal Asymmetry as a Neural Correlate of Motivational Conflict

Motivational systems of approach, avoidance, and inhibition are fundamental to human behavior. While past research has linked approach motivation with greater relative left frontal asymmetry, many attempts to link avoidance motivation with greater relative right frontal asymmetry have been mixed. These mixed effects could be due to coactivation of the avoidance and behavioral inhibition system (BIS). Much recent evidence indicates that the behavioral inhibition system may be associated with greater relative right frontal activation. The current review examines evidence linking traits associated with the behavioral inhibition system with resting right frontal asymmetry. Other research links individual differences associated with the behavioral inhibition system with state changes in relative right frontal asymmetry. Moreover, activation of the behavioral inhibition system, but not activation of withdrawal motivation, increases greater relative right frontal asymmetry. Together, this work highlights the role of relative frontal asymmetry as a neural correlate in motivational conflict and helps to disentangle behavioral inhibition from avoidance motivation.

Leveraging Factors of Self-Efficacy and Motivation to Optimize Stroke Recovery

The International Classification of Functioning, Disability and Health framework recognizes that an individual's functioning post-stroke reflects an interaction between their health condition and contextual factors encompassing personal and environmental factors. Personal factors significantly impact rehabilitation outcomes as they determine how an individual evaluates their situation and copes with their condition in daily life. A key personal factor is self-efficacy-an individual's belief in their capacity to achieve certain outcomes. Self-efficacy influences an individual's motivational state to execute behaviors necessary for achieving desired rehabilitation outcomes. Stroke rehabilitation practice and research now acknowledge self-efficacy and motivation as critical elements in post-stroke recovery, and increasing evidence highlights their contributions to motor (re)learning. Given the informative value of neuroimaging-based biomarkers in stroke, elucidating the neurological underpinnings of self-efficacy and motivation may optimize post-stroke recovery. In this review, we examine the role of self-efficacy and motivation in stroke rehabilitation and recovery, identify potential neural substrates underlying these factors from current neuroimaging literature, and discuss how leveraging these factors and their associated neural substrates has the potential to advance the field of stroke rehabilitation.

The influence of perceived stress and self-control on efficacy of repeated transcranial direct current stimulation in non-treatment-seeking smokers

INTRODUCTION

Transcranial direct current stimulation (tDCS) has recently been raising interest in its therapeutic impact on tobacco use disorder. This study investigates the effects of repeated frontal tDCS (anode: F3, cathode: F4) on cigarette consumption, craving and executive functions.

MATERIAL AND METHODS

In a randomized sham-controlled trial, 24 individuals received active (2.0 mA) and 20 individuals received sham stimulation (0.3 mA) for 20 min on five consecutive days. The participants indicated their tobacco cravings, answered questionnaires and completed neuropsychological tasks at various time points throughout the study. Carbon monoxide (CO) levels and the daily numbers of consumed cigarettes were recorded.

RESULTS

Both intervention groups experienced a significant decrease in the daily number of smoked cigarettes, CO levels, and craving after the stimulation, however, there were no improvements in executive functions. These results did not differ significantly between both intervention groups. Additionally, in the active group, a higher level of perceived stress and a lower level of self-control were linked to a lower cigarette consumption, respectively a higher reduction of the level of CO.

CONCLUSION

This study does not support the hypotheses that tDCS reduces cigarette consumption, attenuates substance craving, or improves executive functions beyond the placebo effect. Our subgroup analysis suggests that high levels of perceived stress and low self-control may be predictors for a successful reduction in cigarette consumption. Furthermore, the placebo effect might be rather high for light smokers, whereas heavy smokers seem to benefit more from the specific effects of tDCS.

CLINICAL TRIAL REGISTRATION NUMBER

NCT03691805.

Cortical gyrification in children with attention deficit-hyperactivity disorder and prenatal alcohol exposure

BACKGROUND

An improved understanding of the neurodevelopmental differences between attention deficit hyperactivity disorder with and without prenatal alcohol exposure (ADHD + PAE and ADHD-PAE, respectively) is needed. Herein, we evaluated gyrification (cortical folding) in children with ADHD + PAE compared to that in children with familial ADHD-PAE and typically developing (TD) children.

METHODS

ADHD + PAE (n = 37), ADHD-PAE (n = 25), and TD children (n = 27), aged 8-13 years, were compared on facial morphological, neurobehavioral, and neuroimaging assessments. Local gyrification index (LGI) maps were compared between groups using general linear modelling. Relationships between LGI and clincobehavioral parameters in children with ADHD ± PAE were evaluated using multivariate partial least squares.

RESULTS

ADHD + PAE and ADHD-PAE groups showed significantly lower LGI (relative to TD) in numerous regions, overlapping in medial prefrontal, parietal, and temporo-occipital cortices (p < 0.001). However, LGI in left mid-dorsolateral prefrontal cortex was uniquely lower in the ADHD + PAE group (p < 0.001). Partial least squares analysis identified one significant latent variable (accounting for 59.3 % of the crossblock correlation, p < 0.001), reflecting a significant relationship between a profile of lower LGI in prefrontal (including left mid-dorsolateral), insular, cingulate, temporal, and parietal cortices and a clinicobehavioral profile of PAE, including a flat philtrum and upper vermillion border, lower IQ, poorer behavioral regulation scores, and greater hyperactivity/impulsivity.

CONCLUSIONS

Children with ADHD + PAE uniquely demonstrate lower mid-dorsolateral LGI, with widespread lower LGI related to more severe facial dysmorphia and neurobehavioral impairments. These findings add insight into the brain bases of PAE symptoms, potentially informing more targeted ADHD treatments based on an objective differential diagnosis of ADHD + PAE vs. ADHD-PAE.

Neural activity during cognitive reappraisal in chronic low back pain: a preliminary study

OBJECTIVES

Chronic pain patients often report higher levels of negative emotions, suggesting reduced ability to regulate emotions effectively, however, little is known of the underlying neural cognitive mechanisms. Therefore, the aim of this study was to explore brain activity and connectivity during cognitive reappraisal in chronic low back pain (CLBP).

METHODS

This study recruited 24 female participants; 12 with CLBP and 12 healthy controls. Participants completed an emotion regulation task that involved cognitive reappraisal of negative images during functional magnetic resonance imaging. The negative affect following each image and perceived success of the task were reported. Region of interest and seed-to-voxel analyses were conducted using key regions involved in cognitive reappraisal (i.e., amygdalae and dorsomedial prefrontal cortex) as seed regions.

RESULTS

During the task, there were no group differences in the behavioural measures and blood oxygen level-dependent (BOLD) brain activation in the seed regions. Functional connectivity analysis showed reduced coupling between the amygdalae and dorsolateral prefrontal cortex, orbitofrontal cortex and inferior parietal cortex in the CLBP group compared to controls. Connectivity between the amygdala and inferior parietal cortex positively correlated with the percent of reduced negative affect during reappraisal in the CLBP group.

CONCLUSIONS

These preliminary findings demonstrate that individuals with CLBP exhibit similar emotion regulation abilities to healthy controls at the behavioural and BOLD level. However, altered functional connectivity observed in the CLBP group may reduce effective cognitive reappraisal. These results provide evidence for the potential clinical impact of network changes in CLBP.

Frontal Asymmetry in an approach-avoidance conflict paradigm

The frontal cortex appears to be asymmetrically related to approach motivation, avoidance motivation, and motivational conflict. Much past work has investigated approach and avoidance motivation, but little work has investigated frontal asymmetry in the face of motivational conflict in part because of the inherent conflict between avoidance motivation and motivational conflict. The current study sought to disentangle the existing confound between avoidance motivation and motivational conflict. In the study, participants selected the likelihood of viewing negative (vs. positive) images for zero reward points (avoidance only condition), or negative (vs. positive) images for the chance to win reward points (approach-avoidance conflict conditions). Participants exhibited greater relative right frontal asymmetry while making percent likelihood selections in the approach-avoidance conflict conditions relative to the avoidance only conditions. Additionally, participants exhibited greater relative right frontal asymmetry while viewing disgust images during trials with the greatest approach-avoidance conflict relative to trials with the lowest approach-avoidance conflict. Together, these results suggest that motivational conflict, and not avoidance motivation, is associated with greater relative right frontal activity.

Rhythmic air-puff into nasal cavity modulates activity across multiple brain areas: A non-invasive brain stimulation method to reduce ventilator-induced memory impairment

Mechanical ventilation (MV) can result in long-term brain impairments that are resistant to treatment. The mechanisms underlying MV-induced brain function impairment remain unclear. Since nasal airflow modulates brain activity, here we evaluated whether reinstating airflow during MV could influence the memory performance of rats after recovery. Rats were allocated into two study groups: one group received rhythmic air-puff into the nasal cavity during MV and a control group that underwent ventilation without air-puff. During MV, air-puffs induced time-locked event potentials in OB, mPFC and vHPC and significantly increased the oscillatory activity at the air-puff frequency. Furthermore, in mPFC and vHPC, (but not in OB), delta and theta oscillations were more prominent during air-puff application. After recovery, working memory performance was significantly higher in the air-puff group compared to control. Our study thus suggests a promising non-invasive brain stimulation approach to alleviate the neurological complications of prolonged mechanical ventilation.

Interactions between decision-making and emotion in behavioral-variant frontotemporal dementia and Alzheimer's disease

Negative and positive emotions are known to shape decision-making toward more or less impulsive responses, respectively. Decision-making and emotion processing are underpinned by shared brain regions including the ventromedial prefrontal cortex (vmPFC) and the amygdala. How these processes interact at the behavioral and brain levels is still unclear. We used a lesion model to address this question. Study participants included individuals diagnosed with behavioral-variant frontotemporal dementia (bvFTD, n = 18), who typically present deficits in decision-making/emotion processing and atrophy of the vmPFC, individuals with Alzheimer’s disease (AD, n = 12) who present with atrophy in limbic structures and age-matched healthy controls (CTRL, n = 15). Prior to each choice on the delay discounting task participants were cued with a positive, negative or neutral picture and asked to vividly imagine witnessing the event. As hypothesized, our findings showed that bvFTD patients were more impulsive than AD patients and CTRL and did not show any emotion-related modulation of delay discounting rate. In contrast, AD patients showed increased impulsivity when primed by negative emotion. This increased impulsivity was associated with reduced integrity of bilateral amygdala in AD but not in bvFTD. Altogether, our results indicate that decision-making and emotion interact at the level of the amygdala supporting findings from animal studies.

Frontal asymmetry: A novel biomarker for physical activity and sedentary behavior

Past research has demonstrated that regular physical activity provides a myriad of physical, mental, and emotional benefits. The decision of whether to partake in physical activity (PA) or remain sedentary appears to be partially influenced by motivational and emotional systems. Research suggests left frontal alpha asymmetry is a neural marker of approach motivation. However, studies have not explored whether habitual levels of PA and sedentary behavior relate to this neurophysiological signal. Across two studies, individuals completed measures of habitual PA and sedentary behavior using the International Physical Activity Questionnaire-Short Form. Then, resting electroencephalography activity was recorded. Results of Study 1 (N = 32, 72% women) indicated that more time spent sitting on both weekdays and weekend days were associated with less left frontal asymmetry (r = -.45, p = .027, and r = -.55, p = .005, respectively). Study 2 recruited a larger sample (N = 96, 31% women) and investigated moderators. Greater levels of moderate (r = .27) and total (r = .29) PA were associated with greater left frontal asymmetry (ps < .05), and the relationship between sedentary behavior and less left frontal asymmetry was moderated by sex (weekday: β = .62, p = .011; weekend day: β = .41, p = .034). Our results suggest that left frontal asymmetry may be a novel neurophysiological marker for PA and sedentary behavior.

Transcranial direct current stimulation (tDCS) over vmPFC modulates interactions between reward and emotion in delay discounting

Delay discounting requires computing trade-offs between immediate-small rewards and later-larger rewards. Negative and positive emotions shift decisions towards more or less impulsive responses, respectively. Models have conceptualized this trade-off by describing an interplay between “emotional” and “rational” processes, with the former involved during immediate choices and relying on the ventromedial prefrontal cortex (vmPFC), and the latter involved in long-term choices and relying on the dorsolateral prefrontal cortex (dlPFC). Whether stimulation of the vmPFC modulates emotion-induced delay discounting remains unclear. We applied tDCS over the vmPFC in 20 healthy individuals during a delay discounting task following an emotional (positive, negative) or neutral induction. Our results showed that cathodal tDCS increased impulsivity after positive emotions in high impulsivity trials. For low impulsivity trials, anodal tDCS decreased impulsivity following neutral induction compared with emotional induction. Our findings demonstrate that the vmPFC integrates reward and emotion most prominently in situations of increased impulsivity, whereas when higher cognitive control is required the vmPFC appears to be less engaged, possibly due to recruitment of the dlPFC. Understanding how stimulation and emotion influence decision-making at the behavioural and neural levels holds promise to develop interventions to reduce impulsivity.