Food-related exploration across the menstrual cycle

When deciding what to eat we constantly weigh different aspects of the options at hand and make trade-offs between exploiting opportunities with a known outcome (e.g., eating your usual meal) and exploring novel opportunities with a potentially better outcome (e.g., trying a new dish). Environmental factors, such as scarcity, have previously been shown to tip the balance towards either exploration or exploitation. Studies in animals have further linked female steroid hormones (including estradiol and progesterone) to exploratory behavior. Previous work in humans has suggested that food preferences and food intake also change over the menstrual cycle. However, it remains unknown whether exploratory behavior in food choices also changes across the menstrual phases in humans. In a rating phase, 112 adult women (age range 18-45 years) on or off hormonal birth control rated 40 food items on desirability. In the choice phase, participants made binary choices between food items. On some trials, a surprise box replaced one of the two food options, allowing us to examine exploratory choices. Women off hormonal birth control reported their average cycle length and time since the first day of their last menstruation. Analysis of the percentage surprise choices across the menstrual cycle indicated a small, but significant effect, with exploratory choice behavior tending to increase around the middle of/later during the cycle. This provides preliminary novel evidence that hormonal fluctuations are associated with food-related exploratory choice behavior. Importantly, these effects were observed beyond effects of other food-related factors. Future studies should investigate the nature of these effects using more direct hormonal measures.

Don't be late! Postponing cognitive decline and preventing early unemployment in people with multiple sclerosis: a study protocol

BACKGROUND

Up to 65% of people with multiple sclerosis (PwMS) develop cognitive deficits, which hampers their ability to work, participating in day-to-day life and ultimately reducing quality of life (QoL). Early cognitive symptoms are often less tangible to PwMS and their direct environment and are noticed only when symptoms and work functioning problems become more advanced, i.e., when (brain) damage is already advanced. Treatment of symptoms at a late stage can lead to cognitive impairment and unemployment, highlighting the need for preventative interventions in PwMS.

AIMS

This study aims to evaluate the (cost-) effectiveness of two innovative preventative interventions, aimed at postponing cognitive decline and work functioning problems, compared to enhanced usual care in improving health-related QoL (HRQoL).

METHODS

Randomised controlled trial including 270 PwMS with mild cognitive impairment, who have paid employment ≥ 12 h per week and are able to participate in physical exercise (Expanded Disability Status Scale < 6.0). Participants are randomised across three study arms: 1) 'strengthening the brain' - a lifestyle intervention combining personal fitness, mental coaching, dietary advice, and cognitive training; 2) 'strengthening the mind' - a work-focused intervention combining the capability approach and the participatory approach in one-on-one coaching by trained work coaches who have MS themselves; 3) Control group-receiving general information about cognitive impairment in MS and receiving care as usual. Intervention duration is four months, with short-term and long-term follow-up measurements at 10 and 16 months, respectively. The primary outcome measure of the Don't be late! intervention study will be HRQoL as measured with the 36-item Short Form. Secondary outcomes include cognition, work related outcomes, physical functioning, structural and functional brain changes, psychological functioning, and societal costs. Semi-structured interviews and focus groups with stakeholders will be organised to qualitatively reflect on the process and outcome of the interventions.

DISCUSSION

This study seeks to prevent (further) cognitive decline and job loss due to MS by introducing tailor-made interventions at an early stage of cognitive symptoms, thereby maintaining or improving HRQoL. Qualitative analyses will be performed to allow successful implementation into clinical practice.

TRIAL REGISTRATION

Retrospectively registered at ClinicalTrials.gov with reference number NCT06068582 on 10 October 2023.

Don't be late! Timely identification of cognitive impairment in people with multiple sclerosis: a study protocol

BACKGROUND

Cognitive impairment occurs in up to 65% of people with multiple sclerosis (PwMS), negatively affecting daily functioning and health-related quality of life. In general, neuropsychological testing is not part of standard MS-care due to insufficient time and trained personnel. Consequently, a baseline assessment of cognitive functioning is often lacking, hampering early identification of cognitive decline and change within a person over time. To assess cognitive functioning in PwMS in a time-efficient manner, a BICAMS-based self-explanatory digital screening tool called the Multiple Screener©, has recently been developed. The aim of the current study is to validate the Multiple Screener© in a representative sample of PwMS in the Netherlands. Additionally, we aim to investigate how cognitive functioning is related to psychological factors, and both work and societal participation.

METHODS

In this cross-sectional multicentre study, 750 PwMS (aged 18-67 years) are included. To obtain a representative sample, PwMS are recruited via 12 hospitals across the Netherlands. They undergo assessment with the Minimal Assessment of Cognitive Functioning in MS (MACFIMS; reference-standard) and the Multiple Screener©. Sensitivity, specificity, and predictive values for identifying (mild) cognitive impairment are determined in a subset of 300 participants. In a second step, the identified cut-off values are tested in an independent subset of at least 150 PwMS. Moreover, test-retest reliability for the Multiple Screener© is determined in 30 PwMS. Information on psychological and work-related factors is assessed with questionnaires.

DISCUSSION

Validating the Multiple Screener© in PwMS and investigating cognition and its determinants will further facilitate early identification and adequate monitoring of cognitive decline in PwMS.

Developmental and age differences in visuomotor adaptation across the lifespan

In the present cross-sectional study, we examined age and sex differences in sensorimotor adaptation. We tested 253 individuals at a local science museum (NEMO Science Museum, Amsterdam). Participants spanned a wide age range (8-70 years old; 54% male), allowing us to examine effects of both development and healthy aging within a single study. Participants performed a visuomotor adaptation task in which they had to adapt manual joystick movements to rotated visual feedback. We assessed the rate of adaptation following the introduction of the visual perturbation (both for early and later stages of adaptation), and the rate of de-adaptation following its removal. Results showed reliable adaptation patterns which did not differ by sex. We observed a quadratic relationship between age and both early adaptation and de-adaptation rates, with younger and older adults exhibiting the fasted adaptation rates. Our findings suggest that both younger and older age are associated with poorer strategic, cognitive processes involved in adaptation. We propose that developmental and age differences in cognitive functions and brain properties may underlie these effects on sensorimotor functioning.

Trait Anxiety as a Risk Factor for Impulse Control Disorders in de novo Parkinson's Disease

BACKGROUND

In addition to the well-known motor symptoms, patients with Parkinson's disease (PD) also frequently experience disabling non-motor symptoms including impulse control disorders (ICDs). ICDs are characterized by a loss of voluntary control over impulses, drives, or temptations regarding excessive hedonic behavior.

OBJECTIVE

The present study examined whether depression and anxiety in de novo PD patients predict the prospective development of ICDs.

METHODS

We selected 330 de novo PD patients from the Parkinson's Progression Markers Initiative database who were free of ICDs at the start of the study. ICD presence at baseline and follow-up assessments was evaluated via the shortened version of the Questionnaire for Impulsive-Compulsive Disorders (QUIP-S). Baseline depression and anxiety were measured via the Geriatric Depression Scale (GDS-15) and State-Trait-Anxiety Inventory (STAI-Y), respectively.

RESULTS

A total of 149 participants (45.2%) developed an ICD at follow-up and average time of ICD onset was 35 months after baseline. Results of a Cox regression analysis showed that STAI-Y scores but not GDS-15 scores significantly predicted ICD presence. Specifically, scores reflecting higher trait anxiety were associated with an increased risk of developing an ICD. This effect was not confounded by age, gender or UPDRS motor score. We also replicated the well-established result that dopamine agonist use is predictive of ICDs.

CONCLUSION

Our findings indicate that higher anxiety levels in de novo PD patients represent a risk factor for ICD development during the course of the disorder. This highlights the need for early and routine based anxiety screening in these patients.

The subjective evaluation of task switch cues is related to voluntary task switching

Task switching refers to the effortful mental process of shifting attention between different tasks. While it is well-established that task switching usually comes with an objective performance cost, recent studies have shown that people also subjectively evaluate task switching as negative. An open question is whether this affective evaluation of task switching is also related to actual decision making. In this pre-registered study, we therefore examined whether individual differences in the negative evaluation of task switch cues are related to less voluntary task switching. To this end, participants first performed a cued task switching paradigm where abstract cues signaled task transitions (repetition or alternation). In a second phase, these transition cues were used as prime stimuli in an affective priming procedure to assess participants' affective evaluation of task switching. In a third phase, participants were allowed to freely choose whether to switch or repeat tasks. We found that a more negative evaluation of task switching cues was related to lower switch rates in the voluntary task switching phase. This finding supports neuroeconomic theories of value-based decision making which suggest that people use their subjective value of control to decide whether to engage in (different) tasks.

Novelty exposure induces stronger sensorimotor representations during a manual adaptation task

Active exploration of novel spatial environments enhances memory for subsequently presented explicit, declarative information in humans. These effects have been attributed to novelty promoting dopamine release via mesolimbic dopaminergic pathways in the brain. As procedural motor learning has been linked to dopamine as well, we predict that novelty effects extend to this domain. To test this hypothesis, the present study examined whether spatial novelty exploration benefits subsequent sensorimotor adaptation. Participants explored either two different virtual environments (i.e., novelty condition; n = 210) or two identical environments (i.e., familiar condition; n = 253). They then performed a manual adaptation task in which they had to adapt joystick movements to a visual perturbation. We assessed the rate of adaptation following the introduction of this perturbation, and the rate of deadaptation following its removal. While results showed reliable adaptation patterns and similar adaptation rates across both conditions, individuals in the novelty condition showed slower deadaptation. This suggests that exposure to spatial novelty induced stronger sensorimotor representations during adaptation, potentially through novelty-induced dopaminergic effects in mesocortical and/or nigrostriatal pathways. Novelty exposure may be employed to promote motor learning on tasks that require precision movements in altered sensory contexts, for example, in astronauts moving in microgravity or patients with impaired motor processing.

Cognition in Motion: Evidence for Intact Action Control With Healthy Aging

Objectives

Healthy aging is associated with impairments in motor functioning. Such functioning is not limited to the physical execution of actions, but also involves cognitive processes that allow for goal-directed behavior. The present study examined whether aging affects 2 of such cognitive components that control motor functioning, namely action planning and action adaptation, and whether age effects are associated across components.

Method

A group of 103 participants aged 18–82 years performed 2 tasks that have previously been linked to action planning and adaptation, respectively.

Results

Despite observations that aging was associated with slower and less accurate responses, Bayesian models showed evidence indicating that older age was not associated with poorer action planning and conflict adaptation.

Discussion

These findings challenge the view that healthy aging is associated with a general deficit in motor functioning and suggest that some cognitive aspects of motor control may be relatively spared.

The role of dopamine in action control: Insights from medication effects in Parkinson's disease

Parkinson's disease (PD) is a neurological disorder associated primarily with overt motor symptoms. Several studies show that PD is additionally accompanied by impairments in covert cognitive processes underlying goal-directed motor functioning (e.g., action planning, conflict adaptation, inhibition), and that dopaminergic medication may modulate these action control components. In this review we aim to leverage findings from studies in this domain to elucidate the role of dopamine (DA) in action control. A qualitative review of studies that investigated the effects of medication status (on vs. off) on action control in PD suggests a component-specific role for DA in action control, although the expression of medication effects depends on characteristics of both the patients and experimental tasks used to measure action control. We discuss these results in the light of findings from other research lines examining the role of DA in action control (e.g., animal research, pharmacology), and recommend that future studies use multi-method, within-subject approaches to model DA effects on action control across different components as well as underlying striatal pathways (ventral vs. dorsal).

Cognitive and Affective Theory of Mind in Healthy Aging

BACKGROUND

Previous studies on the effect of healthy aging on Theory of Mind (ToM) have produced mixed results. A possible explanation may be that different ToM components and types of inference have not systematically been considered. This study examined the effect of aging on ToM by assessing both first and second order cognitive and affective components within a single task.

METHODS

We compared performance of young (M = 18.3y) and older adults (M = 61.0y) on the Yoni task. This task allows for a within-subject assessment of both first and second order cognitive and affective ToM.

RESULTS

We observed that older adults had longer reaction times than young adults across cognitive and affective first order items. For second order items, this age difference was larger for affective than cognitive items. Results showed no indications that these findings could be explained by age differences in speed/accuracy trade-offs.

CONCLUSION

Our findings suggest that decision processes underlying ToM are slower in older adults on both first and second order inferences, but that age differences in these processes between cognitive and affective ToM are selective to second order inferences. We propose that the observed age differences may be associated with cortical and mental changes that occur with aging.

Neural Dedifferentiation across the Lifespan in the Motor and Somatosensory Systems

Age-related declines in sensorimotor performance have been linked to dedifferentiation of neural representations (i.e., more widespread activity during task performance in older versus younger adults). However, it remains unclear whether changes in neural representations across the adult lifespan are related between the motor and somatosensory systems, and whether alterations in these representations are associated with age declines in motor and somatosensory performance. To investigate these issues, we collected functional magnetic resonance imaging and behavioral data while participants aged 19-76 years performed a visuomotor tapping task or received vibrotactile stimulation. Despite one finding indicative of compensatory mechanisms with older age, we generally observed that 1) older age was associated with greater activity and stronger positive connectivity within sensorimotor and LOC regions during both visuomotor and vibrotactile tasks; 2) increased activation and stronger positive connectivity were associated with worse performance; and 3) age differences in connectivity in the motor system correlated with those in the somatosensory system. Notwithstanding the difficulty of disentangling the relationships between age, brain, and behavioral measures, these results provide novel evidence for neural dedifferentiation across the adult lifespan in both motor and somatosensory systems and suggest that dedifferentiation in these two systems is related.

Age-Related Reductions in Tactile and Motor Inhibitory Function Start Early but Are Independent

Aging is associated with declines in motor and somatosensory function. Some of these motor declines have been linked to age-related reductions in inhibitory function. Here we examined whether tactile surround inhibition also changes with age and whether these changes are associated with those in the motor domain. We tested a group of 56 participants spanning a wide age range (18-76 years old), allowing us to examine when age differences emerge across the lifespan. Participants performed tactile and motor tasks that have previously been linked to inter- and intra-hemispheric inhibition in the somatosensory and motor systems. The results showed that aging is associated with reductions in inhibitory function in both the tactile and motor systems starting around 40 years of age; however, age effects in the two systems were not correlated. The independent effects of age on tactile and motor inhibitory function suggest that distinct mechanisms may underlie age-related reductions in inhibition in the somatosensory and motor systems.

Early and late indications of item-specific control in a Stroop mouse tracking study

Previous studies indicated that cognitive conflict continues to bias actions even after a movement has been initiated. The present paper examined whether cognitive control also biases actions after movement initiation. To this end, we had participants perform a Stroop task in which we manipulated the item-specific proportion of (in)congruent trials (80% congruent vs. 20% congruent). Importantly, participants responded via mouse movements, allowing us to evaluate various movement parameters: initiation times, movement times, and movement accuracy. Results showed that mouse movements were faster and more accurate during congruent trials compared to incongruent trials. Moreover, we observed that this congruency effect was larger for 80% congruent compared to 20% congruent items, which reflects item-specific cognitive control. Notably, when responses were initiated very fast – rendering virtually no time for stimulus processing before movement onset – this item-specific control was observed only in movement times. However, for relatively slow initiated responses, item specific control was observed both in initiation and in movement times. These findings demonstrate that item-specific cognitive control biases actions before and after movement initiation.

Impulsivity in Parkinson's Disease Is Associated With Alterations in Affective and Sensorimotor Striatal Networks

A subset of patients with Parkinson’s disease (PD) experiences problems with impulse control, characterized by a loss of voluntary control over impulses, drives, or temptations regarding excessive hedonic behavior. The present study aimed to better understand the neural basis of such impulse control disorders (ICDs) in PD. We collected resting-state functional connectivity and structural MRI data from 21 PD patients with ICDs and 30 patients without such disorders. To assess impulsivity, all patients completed the Barratt Impulsiveness Scale and performed an information-gathering task. MRI results demonstrated substantial differences in neural characteristics between PD patients with and without ICDs. Results showed that impulsivity was linked to alterations in affective basal ganglia circuitries. Specifically, reduced frontal–striatal connectivity and GPe volume were associated with more impulsivity. We suggest that these changes affect decision making and result in a preference for risky or inappropriate actions. Results further showed that impulsivity was linked to alterations in sensorimotor striatal networks. Enhanced connectivity within this network and larger putamen volume were associated with more impulsivity. We propose that these changes affect sensorimotor processing such that patients have a greater propensity to act. Our findings suggest that the two mechanisms jointly contribute to impulsive behaviors in PD.

Multi-day Adaptation and Savings in Manual and Locomotor Tasks

Using an individual differences approach, we evaluated whether manual and locomotor adaptation are associated in terms of adaptation and savings across days, and whether they rely on shared underlying mechanisms involving visuospatial working memory or visual field dependence. Participants performed a manual and a locomotor adaptation task during 4 separate test sessions over a 3-month period. Reliable adaptation and savings were observed for both tasks. It was further found that higher visuospatial working memory performance and lower visual field dependence scores were associated with faster learning in the manual and locomotor tasks, respectively. Moreover, adaptation rates were correlated between the 2 tasks in the final test session, suggesting that people may gradually be learning something generalizable about the adaptation process.

Post-error slowing in sequential action: an aging study

PREVIOUS STUDIES DEMONSTRATED SIGNIFICANT DIFFERENCES IN THE LEARNING AND PERFORMANCE OF DISCRETE MOVEMENT SEQUENCES ACROSS THE LIFESPAN: Young adults (18-28 years) showed more indications for the development of (implicit) motor chunks and explicit sequence knowledge than middle-aged (55-62 years; Verwey et al., 2011) and elderly participants (75-88 years; Verwey, 2010). Still, even in the absence of indications for motor chunks, the middle-aged and elderly participants showed some performance improvement too. This was attributed to a sequence learning mechanism in which individual reactions are primed by implicit sequential knowledge. The present work further examined sequential movement skill across these age groups. We explored the consequences of making an error on the execution of a subsequent sequence, and investigated whether this is modulated by aging. To that end, we re-analyzed the data from our previous studies. Results demonstrate that sequencing performance is slowed after an error has been made in the previous sequence. Importantly, for young adults and middle-aged participants the observed slowing was also accompanied by increased accuracy after an error. We suggest that slowing in these age groups involves both functional and non-functional components, while slowing in elderly participants is non-functional. Moreover, using action sequences (instead of single key-presses) may allow to better track the effects on performance of making an error.

Cognitive and neural foundations of discrete sequence skill: a TMS study

Executing discrete movement sequences typically involves a shift with practice from a relatively slow, stimulus-based mode to a fast mode in which performance is based on retrieving and executing entire motor chunks. The dual processor model explains the performance of (skilled) discrete key-press sequences in terms of an interplay between a cognitive processor and a motor system. In the present study, we tested and confirmed the core assumptions of this model at the behavioral level. In addition, we explored the involvement of the pre-supplementary motor area (pre-SMA) in discrete sequence skill by applying inhibitory 20 min 1-Hz off-line repetitive transcranial magnetic stimulation (rTMS). Based on previous work, we predicted pre-SMA involvement in the selection/initiation of motor chunks, and this was confirmed by our results. The pre-SMA was further observed to be more involved in more complex than in simpler sequences, while no evidence was found for pre-SMA involvement in direct stimulus-response translations or associative learning processes. In conclusion, support is provided for the dual processor model, and for pre-SMA involvement in the initiation of motor chunks.

Control of automated behavior: insights from the discrete sequence production task

Work with the discrete sequence production (DSP) task has provided a substantial literature on discrete sequencing skill over the last decades. The purpose of the current article is to provide a comprehensive overview of this literature and of the theoretical progress that it has prompted. We start with a description of the DSP task and the phenomena that are typically observed with it. Then we propose a cognitive model, the dual processor model (DPM), which explains performance of (skilled) discrete key-press sequences. Key features of this model are the distinction between a cognitive processor and a motor system (i.e., motor buffer and motor processor), the interplay between these two processing systems, and the possibility to execute familiar sequences in two different execution modes. We further discuss how this model relates to several related sequence skill research paradigms and models, and we outline outstanding questions for future research throughout the paper. We conclude by sketching a tentative neural implementation of the DPM.

Evidence for graded central processing resources in a sequential movement task

In the present experiment, we examined slowing of the individual key presses of a familiar keying sequence by four different versions of a concurrent tone counting task. This was done to determine whether the same cognitive processor that has previously been assumed by the dual processor model (DPM) to initiate familiar keying sequences and assist in their execution, is involved also in the central processes of a very different task (viz. identifying tones and counting target tones). The present results confirm this hypothesis. They also suggest that in this particular situation the central processing resources underlying the cognitive processor can be distributed across the central processes of different tasks in a graded manner, rather than that they continue to behave like a single, central processor that serially switches between the central processes of the concurrently performed tasks. We argue that the production of highly practiced movement sequences can be considered automatic in the sense that execution of familiar movement sequences can continue without cognitive control once they have been initiated.

Motor skill learning in the middle-aged: limited development of motor chunks and explicit sequence knowledge

The present study examined whether middle-aged participants, like young adults, learn movement patterns by preparing and executing integrated sequence representations (i.e., motor chunks) that eliminate the need for external guidance of individual movements. Twenty-four middle-aged participants (aged 55-62) practiced two fixed key press sequences, one including three and one including six key presses in the discrete sequence production task. Their performance was compared with that of 24 young adults (aged 18-28). In the middle-aged participants motor chunks as well as explicit sequence knowledge appeared to be less developed than in the young adults. This held especially with respect to the unstructured 6-key sequences in which most middle-aged did not develop independence of the key-specific stimuli and learning seems to have been based on associative learning. These results are in line with the notion that sequence learning involves several mechanisms and that aging affects the relative contribution of these mechanisms.