The Neural Correlates of Consciousness and Attention: Two Sister Processes of the Brain

Genetic variability of FOXP2 and its targets CNTNAP2 and PRNP in frontotemporal dementia: A pilot study in a southern Italian population

The Forkhead box P2 (FOXP2) is an evolutionary conserved transcription factor involved in the maintenance of neuronal networks, implicated in language disorders. Some evidence suggests a possible link between FOXP2 genetic variability and frontotemporal dementia (FTD) pathology and related endophenotypes. To shed light on this issue, we analysed the association between single-nucleotide polymorphisms (SNPs) in FOXP2 and FTD in 113 patients and 223 healthy controls. In addition, we investigated SNPs in two putative targets of FOXP2, CNTNAP2, Contactin-associated protein-like 2 and PRNP, prion protein genes. Overall, 27 SNPs were selected by a tagging approach. FOXP2-rs17213159-C/T resulted associated with disease risk (OR = 2.16, P = 0.0004), as well as with age at onset and severity of dementia. Other FOXP2 markers were associated with semantic and phonological fluency scores, cognitive levels (MMSE) and neuropsychological tests. Associations with language, cognitive and brain atrophy measures were found with CNTNAP2 and PRNP genetic variability. Overall, although preliminary, results here presented suggest an influence of regulatory pathways centred on FOXP2 as a molecular background of FTD affecting neurological function of multiple brain areas.

The Role of Momentary Dissociation in the Sensory Cortex: A Neurophysiological Review and its Implications for Maladaptive Daydreaming

Daydreaming, a form of spontaneous and self-generated mental process, may lead to the disintegration of attention from the immediate external environment. In extreme cases, patients may develop maladaptive daydreaming comorbid with dissociation. The examination of dissociative alterations frequently occurs within the framework of complex cognitive processes. While dissociation may be a neurological and psychological dysfunction of integration, transient dissociative occurrences, i.e., momentary dissociation may signify a dynamic interplay between attentional division and orientation within the sensory cortex. Furthermore, previous studies have recorded the interactivity of attention by stimuli onset with P3 event-related potentials and the active suppression of distractor positivity. In this context, during auditory and visual mismatch negativity, the sensory cortex may interact with attentional orientation. Additionally, distractor positivity during task-relevant stimuli may play a crucial role in predicting momentary dissociation since sensory cortices share cerebral correlates with attentional fluctuations during mental imagery. Thus, this theoretical review investigated the cerebral activities associated with attentional orientation and may be extended to mindfulness. By integrating these findings, we aim to provide a comprehensive understanding of dissociative states which may lead to a resolution for dissociative psychopathology.

Task-based EEG and fMRI paradigms in a multimodal clinical diagnostic framework for disorders of consciousness

Disorders of consciousness (DoC) are generally diagnosed by clinical assessment, which is a predominantly motor-driven process and accounts for up to 40 % of non-communication being misdiagnosed as unresponsive wakefulness syndrome (UWS) (previously known as prolonged/persistent vegetative state). Given the consequences of misdiagnosis, a more reliable and objective multimodal protocol to diagnosing DoC is needed, but has not been produced due to concerns regarding their interpretation and reliability. Of the techniques commonly used to detect consciousness in DoC, task-based paradigms (active paradigms) produce the most unequivocal result when findings are positive. It is well-established that command following (CF) reliably reflects preserved consciousness. Task-based electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) can detect motor-independent CF and reveal preserved covert consciousness in up to 14 % of UWS patients. Accordingly, to improve the diagnostic accuracy of DoC, we propose a practical multimodal clinical decision framework centered on task-based EEG and fMRI, and complemented by measures like transcranial magnetic stimulation (TMS-EEG).

Approaching the nature of consciousness through a phenomenal analysis of early vision. What is the explanandum?

Loorits (2014) identifies the solution to the hard problem of consciousness in the possibility of fully analyzing seemingly non-structural aspects of consciousness in structural terms. However, research on consciousness conducted in recent decades has failed to bridge the explanatory gap between the brain and conscious mind. One reason why the explanatory gap cannot be filled, and consequently the problem remains hard, is that experience and neural structure are too different or "distant" to be directly compatible. Conversely, structural aspects of consciousness can be found in phenomenal experience. One possible alternative, therefore, is to seek the structure of seemingly non-structural aspects of consciousness not in the neural substrate, but within consciousness itself, through a phenomenal analysis of the qualitative aspects of experience, starting from its simplest forms. An essential premise is to reformulate the explanandum of consciousness, which is usually attributed to qualia and what it is like to be in a certain state. However, these properties do not allow us to identify the fundamental aspects of phenomenal experience. Sensations such as the redness of red or the painfulness of pain are inseparable from the context of the experience to which they belong, making qualia appear as phenomenal artifacts. Furthermore, the simplest qualitative aspects can be found in early vision. They are involved in perceptual organization and necessarily have relational significance. The unitary set of qualities found in early vision-such as those related to being an object, background or detail-constitutes the explanandum of the simplest forms of consciousness and seems to imply a justifying structure. Although early vision is characterized by interdependent qualitative components that form a unitary whole, we cannot find in it the structure of seemingly non-structural aspects of consciousness. Phenomenal appearance alone does not seem sufficient to identify a unitary structure of consciousness. However, the closeness of these characteristics to a unitary structure prompts us to delve into less explored territory, using the components of experience also as possible explanans.

EEG Microstate Dynamics Associated with Dream-Like Experiences During the Transition to Sleep

Consciousness always requires some representational content; that is, one can only be conscious about something. However, the presence of conscious experience (awareness) alone does not determine whether its content is in line with the external and physical world. Dreams, apart from certain forms of hallucinations, typically consist of non-veridical percepts, which are not recognized as false, but rather considered real. This type of experiences have been described as a state of dissociation between phenomenal and reflective awareness. Interestingly, during the transition to sleep, reflective awareness seems to break down before phenomenal awareness as conscious experience does not immediately fade with reduced wakefulness but is rather characterized by the occurrence of uncontrolled thinking and perceptual images, together with a reduced ability to recognize the internal origin of the experience. Relative deactivation of the frontoparietal and preserved activity in parieto-occipital networks has been suggested to account for dream-like experiences during the transition to sleep. We tested this hypothesis by investigating subjective reports of conscious experience and large-scale brain networks using EEG microstates in 45 healthy young subjects during the transition to sleep. We observed an inverse relationship between cognitive effects and physiological activation; dream-like experiences were associated with an increased presence of a microstate with sources in the superior and middle frontal gyrus and precuneus. Additionally, the presence of a microstate associated with higher-order visual areas was decreased. The observed inverse relationship might therefore indicate a disengagement of cognitive control systems that is mediated by specific, inhibitory EEG microstates.

Short-Term Effect of Auditory Stimulation on Neural Activities: A Scoping Review of Longitudinal Electroencephalography and Magnetoencephalography Studies

Explored through EEG/MEG, auditory stimuli function as a suitable research probe to reveal various neural activities, including event-related potentials, brain oscillations and functional connectivity. Accumulating evidence in this field stems from studies investigating neuroplasticity induced by long-term auditory training, specifically cross-sectional studies comparing musicians and non-musicians as well as longitudinal studies with musicians. In contrast, studies that address the neural effects of short-term interventions whose duration lasts from minutes to hours are only beginning to be featured. Over the past decade, an increasing body of evidence has shown that short-term auditory interventions evoke rapid changes in neural activities, and oscillatory fluctuations can be observed even in the prestimulus period. In this scoping review, we divided the extracted neurophysiological studies into three groups to discuss neural activities with short-term auditory interventions: the pre-stimulus period, during stimulation, and a comparison of before and after stimulation. We show that oscillatory activities vary depending on the context of the stimuli and are greatly affected by the interplay of bottom-up and top-down modulational mechanisms, including attention. We conclude that the observed rapid changes in neural activitiesin the auditory cortex and the higher-order cognitive part of the brain are causally attributed to short-term auditory interventions.

The exclusionary approach to consciousness

The standard approach in the field of consciousness research involves identifying the neural correlates of consciousness (NCCs) by comparing neural activity between conscious and unconscious trials. However, this method has been met with criticism due to the lack of consensus on how to operationalize and measure consciousness. In this paper, I propose an alternative approach: the exclusionary approach. Rather than utilizing near-threshold conditions to contrast conscious and unconscious trials, this approach leverages the widely accepted notion that subjective reports are reliable under normal conditions. I propose that this can be done by assessing whether consciousness remains stable across trials while manipulating other factors such as reports, tasks, stimulation, or attention. We can use the resulting contrast to exclude certain kinds of neural activity as candidate NCCs. This method produces results that are less contentious, allowing for the establishment of hard criteria for theories of consciousness. Additionally, this approach does not require the development of new research paradigms, but can incorporate existing studies, particularly those aimed at identifying confounding factors in the standard approach. It is important to note, however, that the proposed exclusionary approach does not negate the value of the identification approach. Rather, they should be considered as complementary methods.

The claustrum and consciousness: An update

The seminal paper of Crick and Koch (2005) proposed that the claustrum, an enigmatic and thin grey matter structure that lies beside the insular cortex, may be involved in the processing of consciousness. As a result, this otherwise obscure structure has received ever-increasing interest in the search for neural correlates of consciousness. Here we review theories of consciousness and discuss the possible relationship between the claustrum and consciousness. We review relevant experimental evidence collected since the Crick and Koch (2005) paper and consider whether these findings support or contradict their hypothesis. We also explore how future experimental work can be designed to clarify how consciousness emerges from neural activity and to understand the role of the claustrum in consciousness.

Fronto-parietal networks shape human conscious report through attention gain and reorienting

How do attention and consciousness interact in the human brain? Rival theories of consciousness disagree on the role of fronto-parietal attentional networks in conscious perception. We recorded neural activity from 727 intracerebral contacts in 13 epileptic patients, while they detected near-threshold targets preceded by attentional cues. Clustering revealed three neural patterns: first, attention-enhanced conscious report accompanied sustained right-hemisphere fronto-temporal activity in networks connected by the superior longitudinal fasciculus (SLF) II-III, and late accumulation of activity (>300 ms post-target) in bilateral dorso-prefrontal and right-hemisphere orbitofrontal cortex (SLF I-III). Second, attentional reorienting affected conscious report through early, sustained activity in a right-hemisphere network (SLF III). Third, conscious report accompanied left-hemisphere dorsolateral-prefrontal activity. Task modeling with recurrent neural networks revealed multiple clusters matching the identified brain clusters, elucidating the causal relationship between clusters in conscious perception of near-threshold targets. Thus, distinct, hemisphere-asymmetric fronto-parietal networks support attentional gain and reorienting in shaping human conscious experience.

Memory Deficits in Parkinson's Disease Are Associated with Impaired Attentional Filtering and Memory Consolidation Processes

The present study examined mechanisms underlying memory deficits in Parkinson's disease (PD) and their associations with brain structural metrics. Nineteen PD patients and twenty-two matched controls underwent two memory experiments. In Experiment 1 (delayed memory task), subjects were asked to remember an array of colored rectangles with varying memory set sizes (Low-Load (2 items), Low-Load (relevant 2 items) with Distractor (irrelevant 3 items), and High-Load (5 items)). After a 7 s delay period, they reported whether the orientation of any relevant figures had changed (test period). In Experiment 2 (working memory task), memory arrays were presented in varying set sizes (2 to 6 items) without distractors, followed by a 2 s delay period and a subsequent test period. Brain MRI data were acquired to assess structural differences (volumes and cortical thickness) in areas related to attention, working memory storage capacity, and episodic memory. Multivariate analyses of covariance revealed that, compared with controls, PD patients had lower memory capacity scores in all memory load conditions for Experiment 1 (p < 0.021), whereas there were no group differences in any memory load conditions for Experiment 2 (p > 0.06). In addition, PD patients had lower cortical thickness in the left superior temporal gyrus (p = 0.02), a region related to the ventral attentional system. Moreover, regression analyses revealed that lower cortical thickness values in the left superior temporal gyrus significantly predicted lower memory scores of Low-Load and Low-Load with Distractor conditions in Experiment 1 (p < 0.044) and lower scores of memory load conditions of 4 and 5 items in Experiment 2 (p < 0.012). These findings suggest that memory deficits in PD may partly be due to impaired attentional filtering and memory consolidation processes that may be related to superior temporal neurodegeneration. Future studies are warranted to confirm the current findings to guide the development of effective treatments for memory deficits in PD.

Revealing robust neural correlates of conscious and unconscious visual processing: activation likelihood estimation meta-analyses

Our ability to consciously perceive information from the visual scene relies on a myriad of intrinsic neural mechanisms. Functional neuroimaging studies have sought to identify the neural correlates of conscious visual processing and to further dissociate from those pertaining to preconscious and unconscious visual processing. However, delineating what core brain regions are involved in eliciting a conscious percept remains a challenge, particularly regarding the role of prefrontal-parietal regions. We performed a systematic search of the literature that yielded a total of 54 functional neuroimaging studies. We conducted two quantitative meta-analyses using activation likelihood estimation to identify reliable patterns of activation engaged by i. conscious (n = 45 studies, comprising 704 participants) and ii. unconscious (n = 16 studies, comprising 262 participants) visual processing during various task performances. Results of the meta-analysis specific to conscious percepts quantitatively revealed reliable activations across a constellation of regions comprising the bilateral inferior frontal junction, intraparietal sulcus, dorsal anterior cingulate, angular gyrus, temporo-occipital cortex and anterior insula. Neurosynth reverse inference revealed conscious visual processing to be intertwined with cognitive terms related to attention, cognitive control and working memory. Results of the meta-analysis on unconscious percepts revealed consistent activations in the lateral occipital complex, intraparietal sulcus and precuneus. These findings highlight the notion that conscious visual processing readily engages higher-level regions including the inferior frontal junction and unconscious processing reliably recruits posterior regions, mainly the lateral occipital complex.

From the origins to the stream of consciousness and its neural correlates

There are now dozens of very different theories of consciousness, each somehow contributing to our understanding of its nature. The science of consciousness needs therefore not new theories but a general framework integrating insights from those, yet not making it a still-born "Frankenstein" theory. First, the framework must operate explicitly on the stream of consciousness, not on its static description. Second, this dynamical account must also be put on the evolutionary timeline to explain the origins of consciousness. The Cognitive Evolution Theory (CET), outlined here, proposes such a framework. This starts with the assumption that brains have primarily evolved as volitional subsystems of organisms, inherited from primitive (fast and random) reflexes of simplest neural networks, only then resembling error-minimizing prediction machines. CET adopts the tools of critical dynamics to account for metastability, scale-free avalanches, and self-organization which are all intrinsic to brain dynamics. This formalizes the stream of consciousness as a discrete (transitive, irreflexive) chain of momentary states derived from critical brain dynamics at points of phase transitions and mapped then onto a state space as neural correlates of a particular conscious state. The continuous/discrete dichotomy appears naturally between the brain dynamics at the causal level and conscious states at the phenomenal level, each volitionally triggered from arousal centers of the brainstem and cognitively modulated by thalamocortical systems. Their objective observables can be entropy-based complexity measures, reflecting the transient level or quantity of consciousness at that moment.

Awareness and consciousness in humans and animals – neural and behavioral correlates in an evolutionary perspective

Awareness or consciousness in the context of stimulus perception can directly be assessed in well controlled test situations with humans via the persons’ reports about their subjective experiences with the stimuli. Since we have no direct access to subjective experiences in animals, their possible awareness or consciousness in stimulus perception tasks has often been inferred from behavior and cognitive abilities previously observed in aware and conscious humans. Here, we analyze published human data primarily on event-related potentials and brain-wave generation during perception and responding to sensory stimuli and extract neural markers (mainly latencies of evoked-potential peaks and of gamma-wave occurrence) indicating that a person became aware or conscious of the perceived stimulus. These neural correlates of consciousness were then applied to sets of corresponding data from various animals including several species of mammals, and one species each of birds, fish, cephalopods, and insects. We found that the neural markers from studies in humans could also successfully be applied to the mammal and bird data suggesting that species in these animal groups can become subjectively aware of and conscious about perceived stimuli. Fish, cephalopod and insect data remained inconclusive. In an evolutionary perspective we have to consider that both awareness of and consciousness about perceived stimuli appear as evolved, attention-dependent options added to the ongoing neural activities of stimulus processing and action generation. Since gamma-wave generation for functional coupling of brain areas in aware/conscious states is energetically highly cost-intensive, it remains to be shown which animal species under which conditions of lifestyle and ecological niche may achieve significant advantages in reproductive fitness by drawing upon these options. Hence, we started our discussion about awareness and consciousness in animals with the question in how far these expressions of brain activity are necessary attributes for perceiving stimuli and responding in an adaptive way.

Psychoneuroimmunology of Meditation

Background:

Meditation is a conscious mental discipline, that has been implicated in the relaxation response. The mechanism behind such a relaxing effect is psychoneuroimmunology (PNI), based on the interaction between mind, physical health, and self-healing; that conceptualizes that stress and an individual’s emotional state led to predisposition to diseases. Research to date suggests that meditation may play an active role in remodeling the imbalance between mind and body by modulating the psychoneuroimmunological effects of stress. However, to date, the multi-dimensional psychoneuroimmune aspects of meditation together have not been completely explicated. An evidence-based mechanism has been framed for the first time in India to explain the psychoneuroimmunology of regular and long-term meditation practice.

Summary:

Present evidence-based mechanism confirms prefrontal cortex (PFC) acts as a ‘Functional Connectome’ where psycho-neuro-immune aspects of meditation function simultaneously to exert positive benefits in the regulation of cognitive and emotional behavior. Also, this mechanism will help us to understand how human augmentation with lifestyle modification fosters brain plasticity to overcome various neuropsychiatric illnesses.

Key Message:

Meditation is a scientific tool against neuro-psychiatric illnesses.

Art and Perception: Using Empirical Aesthetics in Research on Consciousness

Understanding consciousness is a major frontier in the natural sciences. However, given the nuanced and ambiguous sets of conditions regarding how and when consciousness appears to manifest, it is also one of the most elusive topics for investigation. In this context, we argue that research in empirical aesthetics—specifically on the experience of art—holds strong potential for this research area. We suggest that empirical aesthetics of art provides a more exhaustive description of conscious perception than standard laboratory studies or investigations of the less artificial, more ecological perceptual conditions that dominate this research, leading to novel and better suited designs for natural science research on consciousness. Specifically, we discuss whether empirical aesthetics of art could be used for a more adequate picture of an observer’s attributions in the context of conscious perception. We point out that attributions in the course of conscious perception to (distal) objects versus to media (proximal objects) as origins of the contents of consciousness are typically swift and automatic. However, unconventional or novel object-media relations used in art can bring these attributions to the foreground of the observer’s conscious reflection. This is the reason that art may be ideally suited to study human attributions in conscious perception compared to protocols dedicated only to the most common and conventional perceptual abilities observed under standard laboratory or “natural”/ecological conditions alone. We also conclude that art provides an enormous stock of such unconventional and novel object-media relations, allowing more systematic falsification of tentative conclusions about conscious perception versus research protocols covering more conventional (ecological) perception only. We end with an outline of how this research could be carried out in general.

Evidences of emerging pain consciousness during prenatal development: a narrative review

BACKGROUND

The study of consciousness has always been considered a challenge for neonatologists, even more when considering the uterine period. Our review aimed to individuate at what gestational age the fetus, which later became a premature infant, can feel the perception of external stimuli. Therefore, the aim of our review was to study the onset of consciousness during the fetal life.

MATERIALS AND METHODS

A literature search was performed in Medline-PubMed database. We included all papers found with the following MeSH words: "consciousness or cognition or awareness or comprehension or cognitive or consciousness of pain" in combination with "embryo or fetus or fetal life or newborn." Studies were selected if titles and/or abstracts suggested an association between formation of consciousness (the basics of neurodevelopment) and preterm infant or fetus. Titles and abstracts were first screened by three independent reviewers according to Cochrane Collaboration's recommendations.

RESULTS

From the literature review, we found only 8 papers describing the onset of consciousness in the transition period from fetus to premature newborn. Therefore, according to these papers, we temporally analyzed the formation of the thalamocortical connections that are the basis of consciousness.

CONCLUSIONS

We can conclude that from a neuroanatomical point of view, it is rather unlikely that the infant can be seen as a conscious human before 24 weeks of gestational age, thus before all the thalamocortical connections are established. Further literature data have to confirm this hypothesis.

Consumer Consciousness in Multisensory Extended Reality

The reality-virtuality continuum encompasses a multitude of objects, events and environments ranging from real-world multisensory inputs to interactive multisensory virtual simulators, in which sensory integration can involve very different combinations of both physical and digital inputs. These different ways of stimulating the senses can affect the consumer's consciousness, potentially altering their judgements and behaviours. In this perspective paper, we explore how technologies such as Augmented Reality (AR) and Virtual Reality (VR) can, by generating and modifying the human sensorium, act on consumer consciousness. We discuss the potential impact of this altered consciousness for consumer behaviour while, at the same time, considering how it may pave the way for further research.

Reduced Precision Underwrites Ego Dissolution and Therapeutic Outcomes Under Psychedelics

Evidence suggests classic psychedelics reduce the precision of belief updating and enable access to a range of alternate hypotheses that underwrite how we make sense of the world. This process, in the higher cortices, has been postulated to explain the therapeutic efficacy of psychedelics for the treatment of internalizing disorders. We argue reduced precision also underpins change to consciousness, known as “ego dissolution,” and that alterations to consciousness and attention under psychedelics have a common mechanism of reduced precision of Bayesian belief updating. Evidence, connecting the role of serotonergic receptors to large-scale connectivity changes in the cortex, suggests the precision of Bayesian belief updating may be a mechanism to modify and investigate consciousness and attention.

A survey of brain network analysis by electroencephalographic signals

Brain network analysis is one efficient tool in exploring human brain diseases and can differentiate the alterations from comparative networks. The alterations account for time, mental states, tasks, individuals, and so forth. Furthermore, the changes determine the segregation and integration of functional networks that lead to network reorganization (or reconfiguration) to extend the neuroplasticity of the brain. Exploring related brain networks should be of interest that may provide roadmaps for brain research and clinical diagnosis. Recent electroencephalogram (EEG) studies have revealed the secrets of the brain networks and diseases (or disorders) within and between subjects and have provided instructive and promising suggestions and methods. This review summarized the corresponding algorithms that had been used to construct functional or effective networks on the scalp and cerebral cortex. We reviewed EEG network analysis that unveils more cognitive functions and neural disorders of the human and then explored the relationship between brain science and artificial intelligence which may fuel each other to accelerate their advances, and also discussed some innovations and future challenges in the end.

Consciousness Beyond Neural Fields: Expanding the Possibilities of What Has Not Yet Happened

In the field theories in physics, any particular region of the presumed space-time continuum and all interactions between elementary objects therein can be objectively measured and/or accounted for mathematically. Since this does not apply to any of the field theories, or any other neural theory, of consciousness, their explanatory power is limited. As discussed in detail herein, the matter is complicated further by the facts than any scientifically operational definition of consciousness is inevitably partial, and that the phenomenon has no spatial dimensionality. Under the light of insights from research on meditation and expanded consciousness, chronic pain syndrome, healthy aging, and eudaimonic well-being, we may conceive consciousness as a source of potential energy that has no clearly defined spatial dimensionality, but can produce significant changes in others and in the world, observable in terms of changes in time. It is argued that consciousness may have evolved to enable the human species to generate such changes in order to cope with unprecedented and/or unpredictable adversity. Such coping could, ultimately, include the conscious planning of our own extinction when survival on the planet is no longer an acceptable option.

On Perception and Consciousness in HPPD: A Systematic Review

Hallucinogen-persisting perception disorder (HPPD) features as a diagnostic category in the DSM-5, ICD-11, and other major classifications, but our knowledge of the phenomenology of the perceptual symptoms involved and the changes in consciousness during the characteristic “flashbacks” is limited. We systematically evaluated original case reports and case series on HPPD to define its phenomenology, associated (psycho)pathology, and course. Our search of PubMed and Embase yielded 66 relevant publications that described 97 people who, together, experienced 64 unique symptoms of HPPD. Of these, 76% concerned symptoms characteristic of Alice in Wonderland syndrome, over 50% non-visual symptoms, and 38% perceptual symptoms not clearly linked to prior intoxication states. This is in contrast with the DSM-5 diagnostic criteria for HPPD. Even though less than half of the patients showed a protracted disease course of over a year, a third achieved remission. However, in patients with co-occurring depression (with or without anxiety) HPPD symptoms persisted longer and treatment outcomes were more often negative. Thus, unlike the acute stages of psychedelic drug intoxication, which may be accompanied by altered states of consciousness, HPPD is rather characterized by changes in the content of consciousness and an attentional shift from exogenous to endogenous phenomena. Since HPPD is a more encompassing nosological entity than suggested in the DSM-5, we recommend expanding its diagnostic criteria. In addition, we make recommendations for clinical practice and future research.

An action-observation/motor-imagery based approach to differentiate disorders of consciousness: what is beneath the tip of the iceberg?

BACKGROUND

The evaluation of motor imagery in persons with prolonged Disorders of Consciousness (pDOC) is a practical approach to differentiate between patients with Minimally Conscious State (MCS) and Unresponsive Wakefulness Syndrome (UWS) and to identify residual awareness even in individuals with UWS. Investigating the influence of motor observation on motor imagery could be helpful in this regard.

OBJECTIVE

In order to corroborate the clinical diagnosis and identify misdiagnosed individuals, we used EEG recordings, to assess the influence of the low-level perceptual and motoric mechanisms on motor observation on motor imagery, taking into account the role of the high-level cognitive mechanisms in patients with pDOC.

METHODS

We assessed the influence of motor observation of walking in first-person or third-person view (by a video provision) on motor imagery of walking in the first-person view on the visual N190 (expression of motor observation processing), the readiness potential (RP) (expressing motor preparation), and the P3 component (high-level cognitive processes) in a sample of 10 persons with MCS, 10 with UWS, and 10 healthy controls (CG). Specifically, the video showed a first-view or third-view walk down the street while the participants were asked to imagine a first-view walking down the street.

RESULTS

CG showed greater N190 response (low-level sensorimotor processing) in the non-matching than in the matching condition. Conversely, the P3 and RP responses (high-level sensorimotor processing) were greater in the matching than in the non-matching condition. Remarkably, 6 out of 10 patients with MCS showed the preservation of both high- and low-level sensorimotor processing. One UWS patient showed responses similar to those six patients, suggesting a preservation of cognitively-mediated sensorimotor processing despite a detrimental motor preparation process. The remaining patients with MCS did not show diversified EEG responses, suggesting limited cognitive functioning.

CONCLUSIONS

Our study suggests that identifying the low-level visual and high-level motor preparation processes in response to a simple influence of motor observation of motor imagery tasks potentially supports the clinical differential diagnosis of with MCS and UWS. This might help identify UWS patients which were misdiagnosed and who deserve more sophisticated diagnoses.

Brain-Adjusted Relational Leadership: A Social-Constructed Consciousness Approach to Leader-Follower Interaction

Relationship-based approaches to leadership represent one of the fastest-growing leadership fields and help us to understand better organizational leadership. Relation-based approaches emphasize the relationship and interaction between the leader and the follower. The emphasis is placed on the way that they interact and influence each other at attaining mutual goals. It is known that leaders are linked to followers and vice versa in a sense of responding to other's needs toward the achievement of mutual goals. Leaders and followers are an essential part of this social process implying that they are losing their traditional identity rooted in the formal organizational structure (manager-subordinate) and become inseparable actors of a co-constructing process of leadership. What is less known though is the way that leadership actors are linked to each other and in particular how they try to understand how to do that in the workplace. What is even less understood is the importance and role of consciousness in this relationship. Especially since consciousness appears to be both a fundamental and a very elusive element in human relations. Therefore, this paper conceptually explores the concept of consciousness within the context of the social brain theory to argue that leadership actors need to rethink their approach to individuality and focus on mutually dependent relations with each other. This paper contributes to the field of Neuro-management by introducing the concept of Homo Relationalis. In this respect, we suggest that leadership is not just a socially constructed element but also a social brain constructed phenomenon that requires an understanding of the human brain as a social organ. We further recommend a new approach of applying cognitive style analysis to capture the duality of leader/follower in the same person, following the self-illusion theory. Finally, we conclude that we need to further emphasize a social brain-adjusted relational leadership approach and we introduce two new cognitive styles that can help capture the essence of it.

The Relationship Between Facial Expression and Cognitive Function in Patients With Depression

Objective: Considerable evidence has shown that facial expression recognition ability and cognitive function are impaired in patients with depression. We aimed to investigate the relationship between facial expression recognition and cognitive function in patients with depression.

Methods: A total of 51 participants (i.e., 31 patients with depression and 20 healthy control subjects) underwent facial expression recognition tests, measuring anger, fear, disgust, sadness, happiness, and surprise. The Chinese version of the MATRICS Consensus Cognitive Battery (MCCB), which assesses seven cognitive domains, was used.

Results: When compared with a control group, there were differences in the recognition of the expressions of sadness (p = 0.036), happiness (p = 0.041), and disgust (p = 0.030) in a depression group. In terms of cognitive function, the scores of patients with depression in the Trail Making Test (TMT; p < 0.001), symbol coding (p < 0.001), spatial span (p < 0.001), mazes (p = 0.007), the Brief Visuospatial Memory Test (BVMT; p = 0.001), category fluency (p = 0.029), and continuous performance test (p = 0.001) were lower than those of the control group, and the difference was statistically significant. The accuracy of sadness and disgust expression recognition in patients with depression was significantly positively correlated with cognitive function scores. The deficits in sadness expression recognition were significantly correlated with the TMT (p = 0.001, r = 0.561), symbol coding (p = 0.001, r = 0.596), maze (p = 0.015, r = 0.439), and the BVMT (p = 0.044, r = 0.370). The deficits in disgust expression recognition were significantly correlated with impairments in the TMT (p = 0.005, r = 0.501) and symbol coding (p = 0.001, r = 0.560).

Conclusion: Since cognitive function is impaired in patients with depression, the ability to recognize negative facial expressions declines, which is mainly reflected in processing speed, reasoning, problem-solving, and memory.

Increased peripheral inflammation in schizophrenia is associated with worse cognitive performance and related cortical thickness reductions

While the biological substrates of brain and behavioural changes in persons with schizophrenia remain unclear, increasing evidence implicates that inflammation is involved. In schizophrenia, including first-episode psychosis and anti-psychotic naïve patients, there are numerous reports of increased peripheral inflammation, cognitive deficits and neuropathologies such as cortical thinning. Research defining the relationship between inflammation and schizophrenia symptomatology and neuropathology is needed. Therefore, we analysed the level of C-reactive protein (CRP), a peripheral inflammation marker, and its relationship with cognitive functioning in a cohort of 644 controls and 499 schizophrenia patients. In a subset of individuals who underwent MRI scanning (99 controls and 194 schizophrenia cases), we tested if serum CRP was associated with cortical thickness. CRP was significantly increased in schizophrenia patients compared to controls, co-varying for age, sex, overweight/obesity and diabetes (p < 0.006E-10). In schizophrenia, increased CRP was mildly associated with worse performance in attention, controlling for age, sex and education (R =- 0.15, p = 0.001). Further, increased CRP was associated with reduced cortical thickness in three regions related to attention: the caudal middle frontal, the pars opercularis and the posterior cingulate cortices, which remained significant after controlling for multiple comparisons (all p < 0.05). Together, these findings indicate that increased peripheral inflammation is associated with deficits in cognitive function and brain structure in schizophrenia, especially reduced attention and reduced cortical thickness in associated brain regions. Using CRP as a biomarker of peripheral inflammation in persons with schizophrenia may help to identify vulnerable patients and those that may benefit from adjunctive anti-inflammatory treatments.

Growing evidence for separate neural mechanisms for attention and consciousness

Our conscious experience of the world seems to go in lockstep with our attentional focus: We tend to see, hear, taste, and feel what we attend to, and vice versa. This tight coupling between attention and consciousness has given rise to the idea that these two phenomena are indivisible. In the late 1950s, the honoree of this special issue, Charles Eriksen, was among a small group of early pioneers that sought to investigate whether a transient increase in overall level of attention (alertness) in response to a noxious stimulus can be decoupled from conscious perception using experimental techniques. Recent years saw a similar debate regarding whether attention and consciousness are two dissociable processes. Initial evidence that attention and consciousness are two separate processes primarily rested on behavioral data. However, the past couple of years witnessed an explosion of studies aimed at testing this conjecture using neuroscientific techniques. Here we provide an overview of these and related empirical studies on the distinction between the neuronal correlates of attention and consciousness, and detail how advancements in theory and technology can bring about a more detailed understanding of the two. We argue that the most promising approach will combine ever-evolving neurophysiological and interventionist tools with quantitative, empirically testable theories of consciousness that are grounded in a mathematically formalized understanding of phenomenology.

Neural Evidence of Mirror Self-Recognition in the Secondary Somatosensory Cortex of Macaque: Observations from a Single-Cell Recording Experiment and Implications for Consciousness

Despite mirror self-recognition being regarded as a classical indication of self-awareness, little is known about its neural underpinnings. An increasing body of evidence pointing to a role of multimodal somatosensory neurons in self-recognition guided our investigation toward the secondary somatosensory cortex (SII), as we observed single-neuron activity from a macaque monkey sitting in front of a mirror. The monkey was previously habituated to the mirror, successfully acquiring the ability of mirror self-recognition. While the monkey underwent visual and somatosensory stimulation, multimodal visual and somatosensory activity was detected in the SII, with neurons found to respond to stimuli seen through the mirror. Responses were also modulated by self-related or non-self-related stimuli. These observations corroborate that vision is an important aspect of SII activity, with electrophysiological evidence of mirror self-recognition at the neuronal level, even when such an ability is not innate. We also show that the SII may be involved in distinguishing self and non-self. Together, these results point to the involvement of the SII in the establishment of bodily self-consciousness.

Channels to consciousness: a possible role of gap junctions in consciousness

The neurophysiological basis of consciousness is still unknown and one of the most challenging questions in the field of neuroscience and related disciplines. We propose that consciousness is characterized by the maintenance of mental representations of internal and external stimuli for the execution of cognitive operations. Consciousness cannot exist without working memory, and it is likely that consciousness and working memory share the same neural substrates. Here, we present a novel psychological and neurophysiological framework that explains the role of consciousness for cognition, adaptive behavior, and everyday life. A hypothetical architecture of consciousness is presented that is organized as a system of operation and storage units named platforms that are controlled by a consciousness center (central executive/online platform). Platforms maintain mental representations or contents, are entrusted with different executive functions, and operate at different levels of consciousness. The model includes conscious-mode central executive/online and mental time travel platforms and semiconscious steady-state and preconscious standby platforms. Mental representations or contents are represented by neural circuits and their support cells (astrocytes, oligodendrocytes, etc.) and become conscious when neural circuits reverberate, that is, fire sequentially and continuously with relative synchronicity. Reverberatory activity in neural circuits may be initiated and maintained by pacemaker cells/neural circuit pulsars, enhanced electronic coupling via gap junctions, and unapposed hemichannel opening. The central executive/online platform controls which mental representations or contents should become conscious by recruiting pacemaker cells/neural network pulsars, the opening of hemichannels, and promoting enhanced neural circuit coupling via gap junctions.

Neural signs and mechanisms of consciousness: Is there a potential convergence of theories of consciousness in sight?

Various theories for the neural basis of consciousness have been proposed, suggesting a diversity of neural signs and mechanisms. We ask to what extent this diversity is real, or whether many theories share the same basic ideas with a potential for convergence towards a more unified theory of the neural basis of consciousness. For that purpose, we review and compare the various neural signs, measures, and mechanisms proposed in the different theories. We demonstrate that different theories focus on neural signs and measures of distinct aspects of neural activity including stimulus-related, prestimulus, and resting state activity as well as on distinct features of consciousness. Therefore, the various mechanisms proposed in the different theories may, in part, complement each other. Together, we provide insight into the shared basis and convergences (and, in part, discrepancies) of the different theories of consciousness. We conclude that the different theories concern distinct aspects of both neural activity and consciousness which, as we suppose, may be integrated and nested within the brain's overall temporo-spatial dynamics.

Neural mechanism of attention control in long-term preksha meditation

Meditation is a complex mental process-practiced widely for stress management and promotion of health- exerts beneficial effects on physical and mental health, and cognitive performance. However, until now, few theoretical neural mechanisms of meditation had been proposed, still not completely elucidated. We have previously evaluated the brain activity during Preksha meditation using an innovative 18FDG-PET methodological approach. Based on our previous study observations, we proposed here the neurophysiological framework of long-term and regular practice of preksha meditation. This mechanism will provide the scientific evidence to understand the attention control mechanisms resulting from the advanced state of preksha meditation. This might have multiple clinical applications as well as effective in a healthy population for attention-related tasks. Also, it is expected that the present neural model will provide a scientific platform for future clinical studies of meditation.

Neurophysiological correlates of emotional face perception consciousness

Aim of the present study was to investigate the neurophysiologic correlates of the conscious and not conscious perception of faces (presented for 14, 40, 80 ms) with happy and sad emotional valence. Electroencephalographic data of 22 participants during a report-based visual task were recorded. Both happy and sad faces presented for 14 ms showed a longer N170 latency compared to the faces presented for 40 and 80 ms. A shorter latency of early components (before N170) was found in the right hemisphere and a longer latency in the left one in response to the happy faces presented for 14 ms compared to those presented for longer times. The faces presented for 14 ms, declared as consciously perceived, evoked a higher brain response compared to those declared as not perceived. Parietal and cingulate brain areas showed a lower intensity of the brain response to the consciously perceived faces in the early components. Happy faces showed a greater brain response when consciously detected, while the sad faces induced a greater brain response when not consciously detected. The findings suggest that the N170 may be the epiphenomenon of an earlier consciously detection. Moreover, these preliminary results seem to support a main role of parietal and cingulate brain areas into not conscious perception.