Vigilance Decrement and Enhancement Techniques: A Review

The effect of interstimulus interval on sustained attention

The ability of nervous systems to filter out irrelevant and repetitive stimuli may prevent animals from becoming 'saturated' with excess information. However, animals must be particular about which stimuli to attend to and which to ignore, as mistakes may be costly. Using a comparative approach, we explored the effect of interstimulus interval (ISI) between repeated presentations of visual stimuli presented on a screen to test the decrease in responses (response decrement) of both Trite planiceps jumping spiders and untrained Columba livia pigeons, animals with comparable visual ability despite having structurally different visual systems and brain size. We used ISIs of 2.5 s, 5 s, 10 s, predicting that decreases in ISI would lead to progressively less responses to the stimuli. Following from previous work on T. planiceps, we also manipulated pigeon hunger level, finding that hungry birds were initially more responsive than sated pigeons, but the rate of decrease in responses to the stimulus did not differ between the two groups. While a clear response decrement was seen in both species across all conditions, shorter ISIs resulted in more dramatic response decrements, aligning with previous work and with the resource depletion theory posited in the human-based literature.

Audiovisual messages may improve the processing of traffic information and driver attention during partially automated driving: An EEG study

Partially autonomous vehicles can help minimize human errors. However, being free from some driving subtasks can result in a low vigilance state, which can affect the driver's attention towards the road. The present study first tested whether drivers of partially autonomous vehicles would benefit from the addition of auditory versions of the messages presented in variable message signs (VMS), particularly, when they find themselves in a monotonous driving situation. A second aim was to test whether the addition of auditory messages would also produce an indirect effect on the driver's vigilance, improving performance on other driving subtasks not related to the message processing. Forty-three volunteers participated in a driving simulator study. They completed two tasks: (a) a VMS task, where they had to regain manual control of the car if the VMS message was critical, and (b) a car-following task, where they had to pay attention to the preceding car to respond to occasional brake events. Behavioral and EEG data were registered. Overall, results indicated that the addition of audio messages helped drivers process VMS information more effectively and maintain a higher level of vigilance throughout the driving time. These findings would provide useful information for the development of partially automated vehicles, as their design must guarantee that the driver remains attentive enough to assume control when necessary.

Can transcutaneous auricular vagus nerve stimulation mitigate vigilance loss? Examining the effects of stimulation at individualized versus constant current intensity

According to the arousal model of vigilance, the locus coeruleus-norepinephrine (LC-NE) system modulates sustained attention over long periods by regulating physiological arousal. Recent research has proposed that transcutaneous auricular vagus nerve stimulation (taVNS) modulates indirect physiological markers of LC-NE activity, although its effects on vigilance have not yet been examined. Aiming to develop a safe and noninvasive procedure to prevent vigilance failures in prolonged tasks, the present study examined whether taVNS can mitigate vigilance loss while modulating indirect markers of LC-NE activity. Following a preregistered protocol (https://osf.io/tu2xy/), 50 participants completed three repeated sessions in a randomized order, in which either active taVNS at individualized intensity set by participant, active taVNS set at 0.5 mA for all participants, or sham taVNS, was delivered while performing an attentional and vigilance task (i.e., ANTI-Vea). Changes in salivary alpha-amylase and cortisol concentrations were measured as markers of LC-NE activity. Self-reports of feelings associated with stimulation and guessing rate of active/sham conditions supported the efficacy of the single-blind procedure. Contrary to our predictions, the observed vigilance decrement was not modulated by active taVNS. Pairwise comparisons showed a mitigation by active taVNS on cortisol reduction across time. Interestingly, Spearman's correlational analyses showed some interindividual effects of taVNS on indirect markers of LC-NE, evidenced by positive associations between changes in salivary alpha-amylase and cortisol in active but not sham taVNS. We highlight the relevance of replicating and extending the present outcomes, investigating further parameters of stimulation and its effects on other indirect markers of LC-NE activity.

Cognitive subtypes in youth at clinical high risk for psychosis

Introduction

Schizophrenia is a mental health condition that severely impacts well-being. Cognitive impairment is among its core features, often presenting well before the onset of overt psychosis, underscoring a critical need to study it in the psychosis proneness (clinical high risk; CHR) stage, to maximize the benefits of interventions and to improve clinical outcomes. However, given the heterogeneity of cognitive impairment in this population, a one-size-fits-all approach to therapeutic interventions would likely be insufficient. Thus, identifying cognitive subtypes in this population is crucial for tailored and successful therapeutic interventions. Here we identify, validate, and characterize cognitive subtypes in large CHR samples and delineate their baseline and longitudinal cognitive and functional trajectories.

Methods

Using machine learning, we performed cluster analysis on cognitive measures in a large sample of CHR youth (n = 764), and demographically comparable controls (HC; n = 280) from the North American Prodrome Longitudinal Study (NAPLS) 2, and independently validated our findings with an equally large sample (NAPLS 3; n = 628 CHR, 84 HC). By utilizing several statistical approaches, we compared the clusters on cognition and functioning at baseline, and over 24 months of followup. We further delineate the conversion status within those clusters.

Results

Two main cognitive clusters were identified, "impaired" and "intact" across all cognitive domains in CHR compared to HC. Baseline differences between the cognitively intact cluster and HC were found in the verbal abilities and attention and working memory domains. Longitudinally, those in the cognitively impaired cluster group demonstrated an overall floor effect and did not deteriorate further over time. However, a "catch up" trajectory was observed in the attention and working memory domain. This group had higher instances of conversion overall, with these converters having significantly more non-affective psychotic disorder diagnosis versus bipolar disorder, than those with intact cognition. In the cognitively intact group, we observed differences in trajectory based on conversion status, where those who start with intact cognition and later convert demonstrate a sharp decline in attention and functioning. Functioning was significantly better in the cognitively intact than in the impaired group at baseline. Most of the cognitive trajectories demonstrate a positive relationship with functional ones.

Conclusion

Our findings provide evidence for intact and impaired cognitive subtypes in youth at CHR, independent of conversion status. They further indicate that attention and working memory are important to distinguish between the CHR with intact cognition and controls. The cognitively intact CHR group becomes less attentive after conversion, while the cognitively impaired one demonstrates a catch up trajectory on both attention and working memory. Overall, early evaluation, covering several cognitive domains, is crucial for identifying trajectories of improvement and deterioration for the purpose of tailoring intervention for improving outcomes in individuals at CHR for psychosis.

Determining the efficacy of visual inspections at detecting non-biosecurity-compliant goods

Examination of imported commodities by trained inspectors searching for pest organisms is a common practice that phytosanitary regulatory agencies use to mitigate biosecurity risks along trade pathways. To investigate the effects of target size and color on the efficacy of these visual assessments, we affixed square decals to polystyrene models of mandarins. Sample units of 100 model fruit containing up to 10 marked models were examined by inspectors. Six sizes in six shades of brown were tested across two prevalence levels. The experiment consisted of five inspection rounds where 11 inspectors examined 77 sample units within an allocated time. The probability that decals were detected increased with mark size and color contrast. Smaller, low-contrast marks were mainly missed. The prevalence rate did not affect the detectability. Through the experiment, the false-positive rate dropped from 6% to 3%, whereas false-negative rates were constant throughout. Large, dark targets were readily found with a mean recall of >90%, whereas small, pale marks had a mean recall of 9%. Increased experience made inspectors more competent at recognizing decals, reducing the false positive rate. However, constant false-negative rates indicate that experience did not prevent inspectors from overlooking targets they could not perceive.

Touch Helps Hearing: Evidence From Continuous Audio-Tactile Stimulation

OBJECTIVES

Identifying target sounds in challenging environments is crucial for daily experiences. It is important to note that it can be enhanced by nonauditory stimuli, for example, through lip-reading in an ongoing conversation. However, how tactile stimuli affect auditory processing is still relatively unclear. Recent studies have shown that brief tactile stimuli can reliably facilitate auditory perception, while studies using longer-lasting audio-tactile stimulation yielded conflicting results. This study aimed to investigate the impact of ongoing pulsating tactile stimulation on basic auditory processing.

DESIGN

In experiment 1, the electroencephalogram (EEG) was recorded while 24 participants performed a loudness-discrimination task on a 4-Hz modulated tone-in-noise and received either in-phase, anti-phase, or no 4-Hz electrotactile stimulation above the median nerve. In experiment 2, another 24 participants were presented with the same tactile stimulation as before, but performed a tone-in-noise detection task while their selective auditory attention was manipulated.

RESULTS

We found that in-phase tactile stimulation enhanced EEG responses to the tone, whereas anti-phase tactile stimulation suppressed these responses. No corresponding tactile effects on loudness-discrimination performance were observed in experiment 1. Using a yes/no paradigm in experiment 2, we found that in-phase tactile stimulation, but not anti-phase tactile stimulation, improved detection thresholds. Selective attention also improved thresholds but did not modulate the observed benefit from in-phase tactile stimulation.

CONCLUSIONS

Our study highlights that ongoing in-phase tactile input can enhance basic auditory processing as reflected in scalp EEG and detection thresholds. This might have implications for the development of hearing enhancement technologies and interventions.

The human-factors' challenges of (tele)drivers of Autonomous Vehicles

Autonomous capabilities, including Autonomous Vehicle (AV) technology, aim to reduce human effort, extend capabilities, and enhance safety. While AVs offer societal benefits, human intervention remains necessary, especially in complex situations. As communication technology advances, human intervention is possible from remote sites. In such remote locations, highly skilled tele-drivers (TEDs) are ready to face situations too complicated for the AV. However, current work still needs a comprehensive mapping of the challenges that TEDs would face. Some of these challenges are shared with IVDs but may have stronger or weaker effects on the remote driver's ability to maintain safety. Other challenges, such as limited situational awareness of the road scene, the indirect experience of vehicle motion, and communication latency, are unique to TEDs. We assess the challenges, comparing their impact on TEDs versus IVDs, and explore technological countermeasures aimed at mitigating specific challenges encountered by TEDs. Lastly, we identified knowledge gaps and areas lacking understanding in the literature, highlighting avenues for future research and practical implications for practitioners.

The Effect of Brainwave Synchronization Using Binaural Beats on Improving Working Memory and Reducing the Severity of Symptoms in Women With Obsessive-compulsive Disorder

Introduction

Binaural beats are one of the new methods of brainwave synchronization. However, there is little knowledge about its clinical applications. The positive effect of this method on executive functions, such as attention and working memory, in the γ band has been mainly confirmed in healthy individuals. Still, its effectiveness on disorders such as obsessive-compulsive disorder (OCD), with a prominent cognitive profile, has not been established. Therefore, the present study was conducted to examine the effect of binaural beats on working memory and the severity of OCD symptoms in the γ band in the affected women.

Methods

Twenty-nine OCD women aged 25-40 years referring to psychological clinics in Tehran City, Iran, were selected by convenience sampling. After completing the symptom checklist 90 (SCL90) and the Yale-Brown severity scale (SS), the participants were given the Wechsler memory scale (WMS) digit repetition subtests. Then, they were randomly assigned to the experimental (n=15) and control (n=14) groups. The audio file of the binaural beats in the γ band was provided to the experimental group. The participants in the control group listened to the normal (no-wave) audio file. Both groups listened to the audio files for two weeks, three times a week, for 30 minutes each time. The Yale-Brown SS and digit repetition in post-test and one-month follow-up periods were obtained from both groups.

Results

According to the results, the severity of OCD symptoms was significantly reduced in the post-test and follow-up stages by the γ binaural beats (P<0.05). Also, the working memory function was improved, although it was not statistically significant (P>0.05).

Conclusion

The results of this study show that binaural beats can be used as a complementary treatment to reduce the severity of OCD symptoms. Also, it seems that the patients' working memory is strengthened with this method.

Modulating Driver Alertness via Ambient Olfactory Stimulation: A Wearable Electroencephalography Study

Poor alertness levels and related changes in cognitive efficiency are common when performing monotonous tasks such as extended driving. Recent studies have investigated driver alertness decrement and possible strategies for modulating alertness with the goal of improving reaction times to safety critical events. However, most studies rely on subjective measures in assessing alertness changes, while the use of olfactory stimuli, which are known to be strong modulators of cognitive states, has not been commensurately explored in driving alertness settings. To address this gap, in the present study we investigated the effectiveness of olfactory stimuli in modulating the alertness state of drivers and explored the utility of electroencephalography (EEG) in developing objective brain-based tools for assessing the resulting changes in cortical activity. Olfactory stimulation induced a significant differential effect on braking reaction time. The corresponding effect to the cortical activity was characterized using EEG-derived metrics and the devised machine learning framework yielded a high discriminating accuracy (92.1%). Furthermore, neural activity in the alpha frequency band was found to be significantly associated with the observed drivers' behavioral changes. Overall, our results demonstrate the potential of olfactory stimuli to modulate the alertness state and the efficiency of EEG in objectively assessing the resulting cognitive changes.

Remote neurocognitive interventions for attention-deficit/hyperactivity disorder - Opportunities and challenges

Improving neurocognitive functions through remote interventions has been a promising approach to developing new treatments for attention-deficit/hyperactivity disorder (AD/HD). Remote neurocognitive interventions may address the shortcomings of the current prevailing pharmacological therapies for AD/HD, e.g., side effects and access barriers. Here we review the current options for remote neurocognitive interventions to reduce AD/HD symptoms, including cognitive training, EEG neurofeedback training, transcranial electrical stimulation, and external cranial nerve stimulation. We begin with an overview of the neurocognitive deficits in AD/HD to identify the targets for developing interventions. The role of neuroplasticity in each intervention is then highlighted due to its essential role in facilitating neuropsychological adaptations. Following this, each intervention type is discussed in terms of the critical details of the intervention protocols, the role of neuroplasticity, and the available evidence. Finally, we offer suggestions for future directions in terms of optimizing the existing intervention protocols and developing novel protocols.

Attempting to counteract vigilance decrement in older adults with brain stimulation

Introduction

Against the background of demographic change and the need for enhancement techniques for an aging society, we set out to repeat a study that utilized 40-Hz transcranial alternating current stimulation (tACS) to counteract the slowdown of reaction times in a vigilance experiment but with participants aged 65 years and older. On an oscillatory level, vigilance decrement is linked to rising occipital alpha power, which has been shown to be downregulated using gamma-tACS.

Method

We applied tACS on the visual cortex and compared reaction times, error rates, and alpha power of a group stimulated with 40 Hz to a sham and a 5-Hz-stimulated control group. All groups executed two 30-min-long blocks of a visual task and were stimulated according to group in the second block. We hypothesized that the expected increase in reaction times and alpha power would be reduced in the 40-Hz group compared to the control groups in the second block (INTERVENTION).

Results

Statistical analysis with linear mixed models showed that reaction times increased significantly over time in the first block (BASELINE) with approximately 3 ms/min for the SHAM and 2 ms/min for the 5-Hz and 40-Hz groups, with no difference between the groups. The increase was less pronounced in the INTERVENTION block (1 ms/min for SHAM and 5-Hz groups, 3 ms/min for the 40-Hz group). Differences among groups in the INTERVENTION block were not significant if the 5-Hz or the 40-Hz group was used as the base group for the linear mixed model. Statistical analysis with a generalized linear mixed model showed that alpha power was significantly higher after the experiment (1.37 μV2) compared to before (1 μV2). No influence of stimulation (40 Hz, 5 Hz, or sham) could be detected.

Discussion

Although the literature has shown that tACS offers potential for older adults, our results indicate that findings from general studies cannot simply be transferred to an old-aged group. We suggest adjusting stimulation parameters to the neurophysiological features expected in this group. Next to heterogeneity and cognitive fitness, the influence of motivation and medication should be considered.

The ANTI-Vea-UGR Platform: A Free Online Resource to Measure Attentional Networks (Alertness, Orienting, and Executive Control) Functioning and Executive/Arousal Vigilance

The Attentional Networks Test for Interactions and Vigilance-executive and arousal components (ANTI-Vea) is a computerized task of 32 min duration in the standard format. The task simultaneously assesses the main effects and interactions of the three attentional networks (i.e., phasic alertness, orienting, and executive control) and two dissociated components of vigilance with reasonable reliability (executive and arousal vigilance). We present this free and publicly accessible resource (ANTI-Vea-UGR; https://anti-vea.ugr.es/) developed to easily run, collect, and analyze data with the ANTI-Vea (or its subtasks measuring some attentional and/or vigilance components embedded in the ANTI-Vea). Available in six different languages, the platform allows for the adaptation of stimulus timing and procedure to facilitate data collection from different populations (e.g., clinical patients, children). Collected data can be freely downloaded and easily analyzed with the provided scripts and tools, including a Shiny app. We discuss previous evidence supporting that attention and vigilance components can be assessed in typical lab conditions as well as online and outside the laboratory. We hope this tutorial will help researchers interested in measuring attention and vigilance with a tool useful to collect data from large sample sizes and easy to use in applied contexts.

Multimodal assessment of adult attention-deficit hyperactivity disorder: A controlled virtual seminar room study

In the assessment of adult attention-deficit hyperactivity disorder (ADHD) symptoms, the diagnostic value of neuropsychological testing is limited. Partly, this is due to the rather low ecological validity of traditional neuropsychological tests, which usually present abstract stimuli on a computer screen. A potential remedy for this shortcoming might be the use of virtual reality (VR), which enables a more realistic and complex, yet still standardized test environment. The present study investigates a new VR-based multimodal assessment tool for adult ADHD, the virtual seminar room (VSR). Twenty-five unmedicated ADHD patients, 25 medicated ADHD patients, and 25 healthy controls underwent a virtual continuous performance task (CPT) in the VSR with concurrent visual, auditive, and audiovisual distractions. Simultaneously, head movements (actigraphy), gaze behaviour (eye tracking), subjective experience, electroencephalography (EEG), and functional near-infrared spectroscopy (fNIRS) were recorded. Significant differences between unmedicated patients with ADHD and healthy controls were found in CPT performance, head actigraphy, distractor gaze behaviour, and subjective experience. Moreover, CPT performance parameters demonstrated potential utility for assessing medication effects within the ADHD population. No group differences were found in the Theta-Beta-Ratio (EEG) or dorsolateral-prefrontal oxy-haemoglobin (fNIRS). Overall, the results are very promising regarding the potential of the VSR as an assessment tool for adult ADHD. In particular, the combined assessment of CPT, actigraphy, and eye tracking parameters appears to be a valid approach to more accurately capture the heterogeneous symptom presentation of the disorder.

Mental Stress Detection and Mitigation using Machine Learning and Binaural Beat Stimulation

Stress is an inevitable problem experienced by people worldwide. Continuous exposure to stress can greatly impact mental activity as well as physical health thereby leading to several diseases. In this study, we investigate the effectiveness of audio binaural beat stimulation (BBs) in mitigating mental stress. We developed an experimental protocol to induce four mental states: rest, control, stress, and stress mitigation. The stress was induced by utilizing Stroop Color Word Test (SCWT) with time constraints and mitigated, by listening to 16 Hz of BBs. The four mental states were assessed using behavioral responses (accuracy of target detection), a perceived stress state questionnaire (PSS-10), and electroencephalography (EEG). The mean spectral power of four frequency bands was estimated using Power Spectral Density (PSD), and five different machine learning classifiers were used to classify the four mental states. Our results show that SCWT reduced the detection accuracy by 59.58% while listening to 16-Hz BBs significantly increased the accuracy of detection by 27.08%, (p = .00392). Furthermore, the support vector machine (SVM) significantly outperformed other classifiers achieving the highest accuracy of 82.5 ± 2.0 % using the beta band information. Similarly, the PSD topographical maps showed different patterns between the four mental states, where the temporal region's PSD was mostly affected by stress. Nevertheless, under mitigation, there was a noticeable restoration in the temporal activity. Overall, our results demonstrate that BBs at 16 Hz can be used to mitigate stress levels.

Applicability of the Sustained Attention to Response Task (SART) in hypersomnolence: Experience and results from a tertiary referral center

OBJECTIVE/BACKGROUND

Evaluation of hypersomnolence disorders ideally includes an assessment of vigilance using the short Sustained Attention to Response Task (SART). We evaluated whether this task can differentiate between hypersomnolence disorders, whether it correlates with subjective and objective sleepiness, whether it is affected by the time of day, and symptoms of anxiety and depression.

PATIENTS/METHODS

We analyzed diagnostic data of 306 individuals with hypersomnolence complaints diagnosed with narcolepsy type 1 (n=100), narcolepsy type 2 (n=20), idiopathic hypersomnia (n=49), obstructive sleep apnea (n=27) and other causes or without explanatory diagnosis (n=110). We included the Multiple Sleep Latency Test (MSLT), polysomnography, Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale and SART, which were administered five times during the day (outcomes: reaction time, total, commission and omission errors).

RESULTS

The SART outcomes did not differ between groups when adjusted for relevant covariates. Higher ESS scores were associated with longer reaction times and more commission errors (p<.01). The main outcome, total errors, did not differ between times of the day. Reaction times and omission errors were impacted (p<.05).

CONCLUSIONS

The SART quantifies disturbed vigilance, an important dimension of disorders of hypersomnolence. Results do not suggest that depressive symptoms influence SART outcomes. A practice session is advised. Testing time should be taken into account when interpreting results. We conclude that the SART does not differentiate between central disorders of hypersomnolence. It may be a helpful addition to the standard diagnostic workup and monitoring of these disorders.

A review of cyber vigilance tasks for network defense

The capacity to sustain attention to virtual threat landscapes has led cyber security to emerge as a new and novel domain for vigilance research. However, unlike classic domains, such as driving and air traffic control and baggage security, very few vigilance tasks exist for the cyber security domain. Four essential challenges that must be overcome in the development of a modern, validated cyber vigilance task are extracted from this review of existent platforms that can be found in the literature. Firstly, it can be difficult for researchers to access confidential cyber security systems and personnel. Secondly, network defense is vastly more complex and difficult to emulate than classic vigilance domains such as driving. Thirdly, there exists no single, common software console in cyber security that a cyber vigilance task could be based on. Finally, the rapid pace of technological evolution in network defense correspondingly means that cyber vigilance tasks can become obsolete just as quickly. Understanding these challenges is imperative in advancing human factors research in cyber security.

CCS categories

Human-centered computing~Human computer interaction (HCI)~HCI design and evaluation methods.

Assessment of Vigilance Level during Work: Fitting a Hidden Markov Model to Heart Rate Variability

This study aimed to enhance the real-time performance and accuracy of vigilance assessment by developing a hidden Markov model (HMM). Electrocardiogram (ECG) signals were collected and processed to remove noise and baseline drift. A group of 20 volunteers participated in the study. Their heart rate variability (HRV) was measured to train parameters of the modified hidden Markov model for a vigilance assessment. The data were collected to train the model using the Baum-Welch algorithm and to obtain the state transition probability matrix A^ and the observation probability matrix B^. Finally, the data of three volunteers with different transition patterns of mental state were selected randomly and the Viterbi algorithm was used to find the optimal state, which was compared with the actual state. The constructed vigilance assessment model had a high accuracy rate, and the accuracy rate of data prediction for these three volunteers exceeded 80%. Our approach can be used in wearable products to improve their vigilance level assessment functionality or in other fields that have key positions with high concentration requirements and monotonous repetitive work.

Impaired disengagement from worry: Dissociating the impacts of valence and internally-directed attention

Worry is a repetitive, negative thought process that is widely experienced as difficult to control. Despite the adverse effects of uncontrollable worry on academic and other role functioning, the mechanisms by which worry becomes uncontrollable remain poorly understood. Previous experimental work has historically emphasized valence (negative versus positive or neutral). However, contemporary cognitive neuroscience also distinguishes between internally-directed attention (e.g., to thoughts) and externally-directed attention (e.g., to perceptual stimuli). To date, no studies have experimentally examined potential dissociable contributions of valence versus attentional direction to impaired disengagement from worry. In a 2 (negative or neutral valence) x 2 (internal or external attention) between-subjects, experimental and prospective design (https://osf.io/vdyfn/), participants (N = 200) completed alternating blocks of a randomly-assigned attention manipulation and validated sustained attention task. Participants also rated trait worry and distress during the experimental session (T1) and a naturalistic stressor (the week before finals; T2). There was a main effect, such that internally-directed attention impaired sustained attention (increased commission errors). Worry (internal x negative) also impaired sustained attention (faster and less accurate responding) in planned group contrasts. Trait worry did not moderate these effects. Sustained attention at T1 did not predict distress or worry during the T2 stressor. These findings augment the literature on the attentional consequences of worry and replicate and extend previous findings of altered speed-accuracy tradeoffs following experimentally-induced worry. We also find evidence for impaired disengagement from internally-directed (versus externally-directed) attention, which may help to explain impaired disengagement from related forms of perseverative thought (e.g., rumination).

The mitigation of the executive vigilance decrement via HD-tDCS over the right posterior parietal cortex and its association with neural oscillations

Vigilance-maintaining a prolonged state of preparation to detect and respond to specific yet unpredictable environmental changes-usually decreases across prolonged tasks, causing potentially severe real-life consequences, which could be mitigated through transcranial direct current stimulation (tDCS). The present study aimed at replicating previous mitigatory effects observed with anodal high-definition tDCS (HD-tDCS) over the right posterior parietal cortex (rPPC) while extending the analyses on electrophysiological measures associated with vigilance. In sum, 60 participants completed the ANTI-Vea task while receiving anodal (1.5 mA, n = 30) or sham (0 mA, n = 30) HD-tDCS over the rPPC for ~ 28 min. EEG recordings were completed before and after stimulation. Anodal HD-tDCS specifically mitigated executive vigilance (EV) and reduced the alpha power increment across time-on-task while increasing the gamma power increment. To further account for the observed behavioral and physiological outcomes, a new index of Alphaparietal/Gammafrontal is proposed. Interestingly, the increment of this Alphaparietal/Gammafrontal Index with time-on-task is associated with a steeper EV decrement in the sham group, which was mitigated by anodal HD-tDCS. We highlight the relevance of replicating mitigatory effects of tDCS and the need to integrate conventional and novel physiological measures to account for how anodal HD-tDCS can be used to modulate cognitive performance.

The neuroelectrophysiological and behavioral effects of transcranial direct current stimulation on executive vigilance under a continuous monotonous condition

A prolonged period of vigilance task will lead to vigilance decrement and a drop in cognitive efficiency. Although transcranial direct current stimulation (tDCS) can be used to improve cognitive performance following vigilance decrement, the findings in this area of study are inconsistent. This study aims to identify the neuroelectrophysiological and behavioral effects of tDCS over the left dorsolateral prefrontal cortex (DLPFC) on executive vigilance under a continuous monotonous condition. We recruited 29 participants who randomly received 30 min active or sham tDCS before the vigilance task (anode electrode at the left DLPFC, cathode electrode at the right supraorbital area). Participants completed four sessions of vigilance task and five sessions of self-report sleepiness, Oddball task, and Go/Nogo task, for a total of about 5 h. EEG was acquired in real-time throughout the experiment. Repeated measures of ANOVA were utilized to analyze the evolution of each metric with task-on-time. The results demonstrated that subjective arousal state, vigilance performance, event-related potentials (ERPs), and EEG power were significantly affected by time on task. Brain stimulation did not significantly affect the evolution of subjective and objective executive vigilance performance, but significantly modulated spontaneous activity in the alpha and beta bands across the entire brain. The continuous enhancement of the prefrontal cortex increased P2 amplitude for the Oddball task, which was associated with the enhancement of the early stage of information processing. P3 amplitude had a temporary enhancement effect, which significantly decreased following a cognitive fatigue. tDCS had a continuous enhancement effect on N2 amplitude for the Go/Nogo task, which was associated with the enhanced inhibition of distracting stimuli. Together, the current data suggest that anodal tDCS over left DLPFC possibly enhances the early stage of relevant information processing and the inhibitory control of distracting stimuli during a continuous and monotonous vigilance task.

Listening to 15 Hz Binaural Beats Enhances the Connectivity of Functional Brain Networks in the Mental Fatigue State—An EEG Study

Introduction: It is clear that mental fatigue can have many negative impacts on individuals, such as impairing cognitive function or affecting performance. The aim of this study was to investigate the role of sound interventions in combating mental fatigue. Method: The subjects were assessed on various scales, a psychomotor vigilance task (PVT) task, and a 3 min resting-state electroencephalogram (EEG), followed by a 20 min mental fatigue–inducing task (Time Load Dual Back, TloadDback), during which subjects in different condition groups listened to either 15 Hz binaural beats, 40 Hz binaural beats, relaxing music, or a 240 Hz pure tone. After the mental fatigue–inducing task, subjects were again assessed on various scales, a PVT task, and a 3 min resting-state EEG. Results: After the fatigue-inducing task, there was no significant difference between the four groups on the scales or the PVT task performance. In TloadDback, the accuracy rate of the 40 Hz binaural beats group and the relaxing music group decreased in the middle stage of the task, while the 15 Hz binaural beats group and the 240 Hz pure tone group remained unchanged in all stages of the task. The EEG results showed that after fatigue inducement, the average path length of the 15 Hz binaural beats group decreased, and local efficiency showed an increasing tendency, indicating enhanced brain network connectivity. Meanwhile, the 240 Hz pure tone group showed enhanced functional connectivity, suggesting a state of mental fatigue in the group. Conclusions: The results of this study show that listening to 15 Hz binaural beats is a proven intervention for mental fatigue that can contribute to maintaining working memory function, enhancing brain topological structure, and alleviating the decline in brain function that occurs in a mentally fatigued state. As such, these results are of great scientific and practical value.

The Effect of Non-immersive Virtual Reality Exergames Versus Band Stretching on Cardiovascular and Cerebral Hemodynamic Response: A Functional Near-Infrared Spectroscopy Study

Background

Exercise is one of the effective ways to improve cognition. Different forms of exercises, such as aerobic exercise, resistance exercise, and coordination exercise, have different effects on the improvement of cognitive impairment. In recent years, exergames based on Non-Immersive Virtual Reality (NIVR-Exergames) have been widely used in entertainment and have gradually been applied to clinical rehabilitation. However, the mechanism of NIVR-Exergames on improving motor cognition has not been clarified. Therefore, the aim of this study is to find whether NIVR-Exergames result in a better neural response mechanism to improve the area of the cerebral cortex related to motor cognition under functional near-infrared spectroscopy (fNIRS) dynamic monitoring in comparison with resistance exercise (resistance band stretching).

Methods

A cross-over study design was adopted in this study, and 15 healthy young subjects (18–24 years old) were randomly divided into group A (n = 8) and group B (n = 7) according to a computerized digital table method. Task 1 was an NIVR-Exergame task, and Task 2 was resistance band stretching. Group A first performed Task 1, rested for 30 min (i.e., a washout period), and then performed Task 2. Group B had the reverse order. The fNIRS test was synchronized in real time during exercise tasks, and heart rate measurements, blood pressure measurements, and 2-back task synchronization fNIRS tests were performed at baseline, Post-task 1, and Post-task 2. The primary outcomes were beta values from the general linear model (GLM) in different regions of interest (ROIs), and the secondary outcomes were heart rate, blood pressure, reaction time of 2-back, and accuracy rate of 2-back.

Results

The activation differences of Task 1 and Task 2 in the right premotor cortex (PMC) (P = 0.025) and the left PMC (P = 0.011) were statistically significant. There were statistically significant differences in the activation of the right supplementary motor area (SMA) (P = 0.007), left dorsolateral prefrontal cortex (DLPFC) (P = 0.031), left and right PMC (P = 0.005; P = 0.002) between baseline and Post-task 1. The differences in systolic pressure (SBP) between the two groups at three time points among women were statistically significant (P1 = 0.009, P2 < 0.001, P3 = 0.044).

Conclusion

In this study, we found that NIVR-Exergames combined with motor and challenging cognitive tasks can promote the activation of SMA, PMC and DLPFC in healthy young people compared with resistance exercise alone, providing compelling preliminary evidence of the power for the rehabilitation of motor and cognitive function in patients with central nervous system diseases.

Stress management using fNIRS and binaural beats stimulation

In this study, we investigate the effectiveness of binaural beats stimulation (BBs) in enhancing cognitive vigilance and mitigating mental stress level at the workplace. We developed an experimental protocol under four cognitive conditions: high vigilance (HV), vigilance enhancement (VE), mental stress (MS) and stress mitigation (SM). The VE and SM conditions were achieved by listening to 16 Hz of BBs. We assessed the four cognitive conditions using salivary alpha-amylase, behavioral responses, and Functional Near-Infrared Spectroscopy (fNIRS). We quantified the vigilance and stress levels using the reaction time (RT) to stimuli, accuracy of detection, and the functional connectivity metrics of the fNIRS estimated by Phase Locking Values (PLV). We propose using the orthogonal minimum spanning tree (OMST) to determine the true connectivity network patterns of the PLV. Our results show that listening to 16-Hz BBs has significantly reduced the level of alpha amylase by 44%, reduced the RT to stimuli by 20% and increased the accuracy of target detection by 25%, (p < 0.001). The analysis of the connectivity network across the four different cognitive conditions revealed several statistically significant trends. Specifically, a significant increase in connectivity between the right and left dorsolateral prefrontal cortex (DLPFC) areas and left orbitofrontal cortex was found during the vigilance enhancement condition compared to the high vigilance. Likewise, similar patterns were found between the right and left DLPFC, orbitofrontal cortex, right ventrolateral prefrontal cortex (VLPFC) and right frontopolar PFC (prefrontal cortex) area during stress mitigation compared to mental stress. Furthermore, the connectivity network under stress condition alone showed significant connectivity increase between the VLPFC and DLPFC compared to other areas. The laterality index demonstrated left frontal laterality under high vigilance and VE conditions, and right DLPFC and left frontopolar PFC while under mental stress. Overall, our results showed that BBs can be used for vigilance enhancement and stress mitigation.

Improved Cognitive Vigilance Assessment after Artifact Reduction with Wavelet Independent Component Analysis

Vigilance level assessment is of prime importance to avoid life-threatening human error. Critical working environments such as air traffic control, driving, or military surveillance require the operator to be alert the whole time. The electroencephalogram (EEG) is a very common modality that can be used in assessing vigilance. Unfortunately, EEG signals are prone to artifacts due to eye movement, muscle contraction, and electrical noise. Mitigating these artifacts is important for an accurate vigilance level assessment. Independent Component Analysis (ICA) is an effective method and has been extensively used in the suppression of EEG artifacts. However, in vigilance assessment applications, it was found to suffer from leakage of the cerebral activity into artifacts. In this work, we show that the wavelet ICA (wICA) method provides an alternative for artifact reduction, leading to improved vigilance level assessment results. We conducted an experiment in nine human subjects to induce two vigilance states, alert and vigilance decrement, while performing a Stroop Color-Word Test for approximately 45 min. We then compared the performance of the ICA and wICA preprocessing methods using five classifiers. Our classification results showed that in terms of features extraction, the wICA method outperformed the existing ICA method. In the delta, theta, and alpha bands, we obtained a mean classification accuracy of 84.66% using the ICA method, whereas the mean accuracy using the wICA methodwas 96.9%. However, no significant improvement was observed in the beta band. In addition, we compared the topographical map to show the changes in power spectral density across the brain regions for the two vigilance states. The proposed method showed that the frontal and central regions were most sensitive to vigilance decrement. However, in this application, the proposed wICA shows a marginal improvement compared to the Fast-ICA.

The Infraslow Frequency Oscillatory Transcranial Direct Current Stimulation Over the Left Dorsolateral Prefrontal Cortex Enhances Sustained Attention

Background

The vigilance fluctuation and decrement of sustained attention have large detrimental consequences to most tasks in daily life, especially among the elderly. Non-invasive brain stimulations (e.g., transcranial direct current stimulation, tDCS) have been widely applied to improve sustained attention, however, with mixed results.

Objective

An infraslow frequency oscillatory tDCS approach was designed to improve sustained attention.

Methods

The infraslow frequency oscillatory tDCS (O-tDCS) over the left dorsolateral prefrontal cortex at 0.05 Hz was designed and compared with conventional tDCS (C-tDCS) to test whether this new protocol improves sustained attention more effectively. The sustained attention was evaluated by reaction time and accuracy.

Results

Compared with the C-tDCS and sham, the O-tDCS significantly enhanced sustained attention by increasing response accuracy, reducing response time, and its variability. These effects were predicted by the evoked oscillation of response time at the stimulation frequency.

Conclusion

Similar to previous studies, the modulation effect of C-tDCS on sustained attention is weak and unstable. In contrast, the O-tDCS effectively and systematically enhances sustained attention by optimizing vigilance fluctuation. The modulation effect of O-tDCS is probably driven by neural oscillations at the infraslow frequency range.

Asymmetry of Regional Phase Synchrony Cortical Networks Under Cognitive Alertness and Vigilance Decrement States

This study investigates intra-regional connectivity and regional hemispheric asymmetry under two vigilance states: alertness and vigilance decrement. The vigilance states were induced on nine healthy subjects while performing 30 min in-congruent Stroop color-word task (I-SCWT). We measured brain activity using Electroencephalography (EEG) signals with 64-channels. We quantified the regional network connectivity using the phase-locking value (PLV) with graph theory analysis (GTA) and Support Vector Machines (SVM). Results showed that the vigilance decrement state was associated with impaired information processing within the frontal and central regions in delta and theta frequency bands. Meanwhile, the hemispheric asymmetry results showed that the laterality shifted to the right-temporal in delta, right-central, parietal, and left frontal in theta, right-frontal and left-central, temporal and parietal in alpha, and right-parietal and left temporal in beta frequency bands. These findings represent the first demonstration of intra-regional connectivity and hemispheric asymmetry changes as a function of cognitive vigilance states. The overall results showed that vigilance decrement is region and frequency band-specific. Our SVM model achieved the highest classification accuracy of 99.73% in differentiating between the two vigilance states based on the frontal and central connectivity networks measures.

The medical pause: Importance, processes and training

Research has shown that taking 'timeouts' in medical practice improves performance and patient safety. However, the benefits of taking timeouts, or pausing, are not sufficiently acknowledged in workplaces and training programmes. To promote this acknowledgement, we suggest a systematic conceptualisation of the medical pause, focusing on its importance, processes and implementation in training programmes. By employing insights from educational and cognitive psychology, we first identified pausing as an important skill to interrupt negative momentum and bolster learning. Subsequently, we categorised constituent cognitive processes for pausing skills into two phases: the decision-making phase (determining when and how to take pauses) and the executive phase (applying relaxation or reflection during pauses). We present a model that describes how relaxation and reflection during pauses can optimise cognitive load in performance. Several strategies to implement pause training in medical curricula are proposed: intertwining pause training with training of primary skills, providing second-order scaffolding through shared control and employing auxiliary tools such as computer-based simulations with a pause function.

Neurophysiological Vigilance Characterisation and Assessment: Laboratory and Realistic Validations Involving Professional Air Traffic Controllers

Vigilance degradation usually causes significant performance decrement. It is also considered the major factor causing the out-of-the-loop phenomenon (OOTL) occurrence. OOTL is strongly related to a high level of automation in operative contexts such as the Air Traffic Management (ATM), and it could lead to a negative impact on the Air Traffic Controllers’ (ATCOs) engagement. As a consequence, being able to monitor the ATCOs’ vigilance would be very important to prevent risky situations. In this context, the present study aimed to characterise and assess the vigilance level by using electroencephalographic (EEG) measures. The first study, involving 13 participants in laboratory settings allowed to find out the neurophysiological features mostly related to vigilance decrements. Those results were also confirmed under realistic ATM settings recruiting 10 professional ATCOs. The results demonstrated that (i) there was a significant performance decrement related to vigilance reduction; (ii) there were no substantial differences between the identified neurophysiological features in controlled and ecological settings, and the EEG-channel configuration defined in laboratory was able to discriminate and classify vigilance changes in ATCOs’ vigilance with high accuracy (up to 84%); (iii) the derived two EEG-channel configuration was able to assess vigilance variations reporting only slight accuracy reduction.

Brain Connectivity Analysis Under Semantic Vigilance and Enhanced Mental States

In this paper, we present a method to quantify the coupling between brain regions under vigilance and enhanced mental states by utilizing partial directed coherence (PDC) and graph theory analysis (GTA). The vigilance state is induced using a modified version of stroop color-word task (SCWT) while the enhancement state is based on audio stimulation with a pure tone of 250 Hz. The audio stimulation was presented to the right and left ears simultaneously for one-hour while participants perform the SCWT. The quantification of mental states was performed by means of statistical analysis of indexes based on GTA, behavioral responses of time-on-task (TOT), and Brunel Mood Scale (BRMUS). The results show that PDC is very sensitive to vigilance decrement and shows that the brain connectivity network is significantly reduced with increasing TOT, p < 0.05. Meanwhile, during the enhanced state, the connectivity network maintains high connectivity as time passes and shows significant improvements compared to vigilance state. The audio stimulation enhances the connectivity network over the frontal and parietal regions and the right hemisphere. The increase in the connectivity network correlates with individual differences in the magnitude of the vigilance enhancement assessed by response time to stimuli. Our results provide evidence for enhancement of cognitive processing efficiency with audio stimulation. The BRMUS was used to evaluate the emotional states of vigilance task before and after using the audio stimulation. BRMUS factors, such as fatigue, depression, and anger, significantly decrease in the enhancement group compared to vigilance group. On the other hand, happy and calmness factors increased with audio stimulation, p < 0.05.