Health-related quality of life in family caregivers of autistic adults

Introduction

Family members of autistic individuals often provide support for their autistic relative throughout the lifespan which can lead to massive burden themselves. Reduced health-related Quality of Life (HRQoL) in family caregivers is assumed; however, only a handful studies on the HRQoL of family caregivers providing care to adult relatives exist as opposed to autistic children. Thus, the current study aimed to (i) investigate the current state of physical and mental HRQoL of family caregivers of autistic adults compared to the general population, and (ii) examine caregiver-related (e.g., age, subjective caregiver burden) and care recipient-related variables (e.g., symptom severity, utilization of formal services) explaining variance in the caregivers' HRQoL.

Methods

N = 149 family caregivers completed a nationwide online survey, including the Short-Form Health Survey (SF-8) in order to assess the HRQoL. T-tests were used to compare the HRQoL of family caregivers with the general population. Bivariate correlational and multiple linear regression analyses were conducted in order to identify predictors explaining variance in family caregivers' HRQoL.

Results

Family caregivers of autistic adults reported significantly lower physical (M = 46.71, SD = 8.72, Cohen's d = 0.42) and mental HRQoL (M = 40.15, SD = 11.28, Cohen's d = 1.35) compared to the general population. Multiple linear regression with the mental HRQoL as the outcome showed a significant model (F(11, 95) = 5.53, p < .001, adj. R2 = .32) with increased subjective burden explaining most of the variance in mental HRQoL (ß = .32, GDW = .141, p < .001). Multiple linear regression analysis with the outcome physical HRQoL did not reveal a statistically significant model (F(11,95) = 1.09, p = .38). However, bivariate analyses also showed a positive correlation with the subjective caregiver burden (r= .20, p < .05).

Discussion

Findings highlight the need to consider HRQoL (and caregiver burden) of family caregivers of autistic adults in several healthcare settings to monitor a potential comprised health status in early stages, with the long-term goal to improve family caregivers' HRQoL.

Barriers and needs in mental healthcare of adults with autism spectrum disorder in Germany: a qualitative study in autistic adults, relatives, and healthcare providers

BACKGROUND

Autism refers to a neurodevelopmental condition with characteristic impairments in social interaction and communication, restrictive and repetitive behaviors, as well as difficulties in sensory information processing and daily living skills. Even though symptoms persist from early childhood throughout the lifespan and often require long-term support, there is a lack of mental health services that sufficiently meet the needs of autistic adults. Previous evidence suggested individual, professional and structural barriers to healthcare for autistic adults. Here, using a peer research approach, we sought to systematically investigate barriers and needs in mental healthcare of autistic adults in Germany at the three relevant levels (individual, professional, structural) and from three relevant perspectives (autistic adults, relatives and healthcare providers), in order to obtain specific recommendations for optimized healthcare.

METHODS

Maximum variation sampling was used to account for the complexity of the research field. Semi-structured, open-ended interviews were conducted with autistic adults (n = 15) and focus groups with relatives/partners (n = 12), and healthcare providers of several professions (n = 15). Data analysis was performed using the codebook approach of thematic analysis.

RESULTS

Poor mental healthcare of autistic adults in Germany was characterized by six central and overarching themes: (i) lack of knowledge about autism, (ii) a need for increased participation/involvement, (iii) consideration of autism-specific needs in treatment, (iv) lack of services, (v) limited access to services, and (vi) improvement of stakeholder collaboration. Themes were similarly reported across participants, emphasizing dissatisfaction in all stakeholders.

CONCLUSIONS

We identified major barriers to mental healthcare for autistic adults in Germany that affect autistic adults, but are also of concern to relatives and healthcare providers. Our results point to specific and generic areas for improvement, independent of stakeholder perspectives, which could guide future development of needs- and evidence-based services, recommendations and guidelines of mental healthcare for people with autism across the lifespan.

TRIAL REGISTRATION

This study protocol was preregistered at the Open Science Framework ( https://osf.io/5x8pg ).

Mixed-methods investigation of barriers and needs in mental healthcare of adults with autism and recommendations for future care (BarrierfreeASD): study protocol

INTRODUCTION

Autism refers to an early-onset neurodevelopmental condition with characteristic impairments and difficulties in practical living skills, which persist across the lifespan such that adults with autism often require substantial support and comprehensive care. Yet, mental health and other services are frequently unavailable for adults with autism despite considerable need for mental healthcare and individual, familial and socioeconomic burdens. This study will (1) examine current needs, barriers and burdens related to ineffective healthcare of adults with autism in Germany, (2) develop specific recommendations for a need-oriented mental healthcare model and (3) evaluate its future implementation.

METHODS AND ANALYSIS

A mixed-methods design with three phases will be conducted. In phase 1, current mental healthcare for adults with autism will be assessed at three levels (individual, structural and professional) and from three perspectives (adults with autism, relatives and healthcare providers) using (1) focus groups/interviews (qualitative data) and (2) large-scale online surveys (quantitative data). Furthermore, service utilisation and related costs will be estimated. In phase 2, recommendations for a future healthcare model will be derived based on phase 1, considering the heterogeneous and complex needs within the autism spectrum and specifying indications for recommended services. In phase 3, these will again be evaluated by the three stakeholder groups using mixed-methods and analysed regarding feasibility of implementation and cost-effectiveness. Our study will, thus, contribute to a better translation of recommendations into practice to reduce disability, burden and costs related to ineffective healthcare and improve mental health outcomes for adults with autism and those who support them.

ETHICS AND DISSEMINATION

This study was approved by the Local Psychological Ethics Commission of the Center for Psychosocial Medicine at the University Medical Center Hamburg-Eppendorf (LPEK-0227). Findings will be disseminated via scientific meetings and peer-reviewed journals. Cooperating partners and associations will be informed about the study's course and findings by regular newsletters and meetings.

TRIAL REGISTRATION NUMBER

This study protocol was preregistered at the Open Science Framework (osf.io/5x8pg).

POS0747 MAPPING THE NATIONWIDE CLINICAL PROFILE AND PATTERNS OF CARE OF SLE IN BRAZIL – FINDINGS FROM THE MACUNAÍMA STUDY

Background:

Systemic lupus erythematosus (SLE) is an autoimmune disease with wide clinical variability. Brazil has vast regional diversity, both from an ethnic and socio-cultural point of view.

Objectives:

To map the clinical profile of SLE in Brazil and explore how this distribution is associated with regional disparities.

Methods:

This cross-sectional study (GSK Study 207353) evaluated 300 Brazilian patients ≥18 years old with SLE (American College of Rheumatology [ACR] criteria, 1997) who had been under SLE care for ≥1 year. Five SLE reference teaching facilities were selected, one in each of the following Brazilian regions: North (NO), Northeast (NE), Midwest (CO), Southeast (SE), and South (SU). Each region included 60 patients. Clinical and demographic characteristics, and patterns of care were measured through questionnaires completed by physicians or nurses. The SLE Disease Activity Index (SLEDAI) score described disease activity and the Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI) described damage accrual. To assess the potential association between regional disparities and clinical outcomes, a hospitalisation profile was described. A bootstrapping approach of logistic regression was used to explore potential factors associated with hospitalisation.

Results:

Overall, 92.3% of patients were female, with a mean (standard deviation; SD) age of 41.8 (12.7) years and a mean (SD) disease duration of 11.8 (7.9) years. Overall, 161 (53.7%) patients were of Latino origin; in the NO this proportion was 88%. White patients predominated in the SU (58.3%); and black patients in the SE (31.7%). The mean (SD) number of years of schooling was 11.3 (4.6), and was highest in the NO (14.2 [3.6]) and lowest in the SU (9.0 [4.0]; p<0.001). With regard to the distribution of the SLE clinical profile according to ACR criteria, arthritis was found in 221 patients and predominated in all regions (mean 73.7%), with a lower prevalence in the CO (40%; p<0.001; Figure 1A). The mean (SD) SLEDAI score was 4.33 (5.39) at the time of interview. The main contributing factors to disease activity, according to SLEDAI, were complement consumption (18%), arthritis (15.3%), and alopecia (15%). The SDI scale was scored for cataracts (15%), proteinuria (8.7%), and thrombosis (7.3%). Among the associated comorbidities, hypertension was predominant in the NO (35%; p=0.001). Smoking predominated in the SU (23%; p<0.001); obesity (27%; p=0.059) and dyslipidemia (35%; p=0.023), in the SE. Regarding patterns of care (Figure 1B), antimalarials were most frequently prescribed in the SE (88.3%) and the SU (91.7%). Corticosteroids prevailed in the NO (96.7%). The mean (SD) time between home and care facility was 4.5 (12.6) hours. Patients in the NO reported the longest transport time to reach the care facility (11.5 [25.4] hours; p<0.001). The hospitalisation rate during the study period was 21.3% across all regions, with no statistical difference between centres (p=0.651). Reasons for hospitalisation included disease activity (36 [12%]), infection (19 [6.3%]), surgery (10 [3.3%]), and management of clinical morbidities (6 [2.0%]). Hospitalisation was associated with ethnicity (p<0.016), occupational status (p<0.001), age (p=0.02), and the use of hydroxychloroquine (HCQ) or chloroquine (CQ; p<0.001).

Conclusion:

This nationwide study highlights ethnic, social, and patterns-of-care disparities among Brazilian patients with SLE. The modelling shows evidence that such disparities contribute to the divergent clinical spectrum observed in Brazil.

Funding:

GSK

Figure 1.

Distribution of the A) Brazilian SLE clinical profile according to the ACR Classification Criteria and B) Brazilian prescriptive profile for SLE treatment according to the use of immunosuppressive drugs, biological agents, and corticosteroids during the study (12 months)

ANA, antinuclear antibody

Acknowledgements:

Medical writing assistance was provided by Helen Taylor, Fishawack Indicia Ltd., UK, part of Fishawack Health, and was funded by GSK.

Disclosure of Interests:

Mirhelen Abreu Grant/research support from: GSK, Amgen, Biogen, Libbs, Odirlei Monticielo Speakers bureau: GSK, AbbVie, UCB, Roche, Novartis, Consultant of: GSK, AbbVie, Janssen, Vander Fernandes Speakers bureau: Janssen, Novartis, Roche, AbbVie, Pfizer, Grant/research support from: Novartis, GSK, Pfizer, Alexandre Cristovão Maiorano: None declared, Fernando dos Santos Beserra: None declared, Flavia Lamarao Employee of: GSK, Nathalie David Shareholder of: GSK, Employee of: GSK, Bruna de Veras Employee of: GSK, Blanca Bica: None declared, Domingos Sávio Nunes de Lima Grant/research support from: GSK, Marta Maria das Chagas Medeiros: None declared

POS1430 EPIDEMIOLOGY OF LUPUS NEPHRITIS IN BRAZIL: FINDINGS FROM THE MACUNAÍMA STUDY - A NATIONWIDE MULTICENTRIC STUDY

Background:

Lupus nephritis (LN) is one of the most serious organic manifestations of systemic lupus erythematosus (SLE). Ethnicity can contribute to disparities in the prevalence and disease activity of LN.

Objectives:

To assess the prevalence of LN in Brazilian patients with SLE and to determine factors associated with LN activity across the country.

Methods:

This cross-sectional study (GSK Study 207353) was carried out through face-to-face interviews and review of medical records (12-month study period). Adult patients with SLE (American College of Rheumatology [ACR] criteria, 1997) were included. Five SLE reference teaching centres were selected: North (NO), Northeast (NE), Midwest (CO), Southeast (SE), and South (SU). Patients with another disease whose morbidity surpassed SLE were excluded. LN was defined as reported in the medical record or history of confirmed renal biopsy; disease activity by pre-defined changes in SLE Disease Activity Index (SLEDAI) or the patient’s kidney disease during the study. Activity was assessed during (T0), 6 months before (T6), and 12 months before (T12) the interview. Systemic Lupus International Collaborating Clinics/ACR Damage Index score mapped damage accrual. Two pairings were performed, aiming to discriminate factors associated with LN and its activity, respectively. Matching technique was used to select similar individuals based on propensity scores, obtained from a logistic regression model. A bootstrapping method explored characteristic variables associated with the risk of progressing to LN.

Results:

Overall, 300 Brazilian patients with SLE were included in the study. Two groups were paired: LN group (N=150) and non-LN group (N = 141). The prevalence of LN in the paired sample (N=291) was 51.5%, with a disparity between centres (p<0.001; Figure 1A). Most patients were female (LN: 92.7%; non-LN: 94.3%) and the mean (standard deviation [SD]) age for the LN and non-LN groups was 39.46 (11.86) and 43.96 (12.18), respectively. History of serositis was associated with the presence of LN (42 [28.0%] vs 21 [14.9%] non-LN; p=0.010). Type IV histological class predominated in both groups, with no disparity between centres. Social disparities were noted between groups. Non-active workers prevailed among the LN group (115 [76.7%] vs 98 [69.5%] for non-LN, p=0.024).

When pairing for disease activity at T12, 73 (50.3%) patients with LN (N=145) had active disease. There was regional disparity in terms of disease activity (Figure 1B), with a predominance of active LN in the NO (28 [68.3%]) and SU (16 [55.2%], p=0.026). Type IV histological class was the component most associated with active LN (active: 32 [43.8%]; non-active: 11 [15.3%], p<0.001). Variation in SLEDAI during the study period discriminated between active and non-active LN. The mean (SD) SLEDAI score at T12 was substantially higher in those with active LN compared with non-active LN (7.18 [4.83] vs 2.47 [4.63], p<0.001). As for the pattern of care, corticosteroids users prevailed in those with active LN (62 [84.9%] vs 45 [62.5%] for non-active LN, p=0.004). There was no disparity in the use of immunosuppressants, with the exception of cyclophosphamide use, noted among 16 (21.9%) patients with active LN and 6 (8.3%) patients with non-active LN (p=0.041). Psychotropic or anticonvulsant use was higher in patients with non-active LN (32 [44.4%] vs 17 [23.3%] patients with active LN, p=0.012). Consultation with a neurologist was verified in 15 (20.8%) patients with non-active LN and 6 (8.2%) with active LN (p=0.055). Hospitalisation occurred in 17 patients with non-active (23.6%) and active (23.3%) LN.

Conclusion:

Disparities in the prevalence of LN and its activity were evident between the regions across Brazil, highlighting differences in clinical factors, regional factors, and patterns of care.

Funding:

GSK

Figure 1.

Prevalence of A) LN among regional centres, comparing them to disease activity profile and prescriptive practice, and B) Active and non-active LN according to prescriptive practiceCQ, chloroquine; HCQ, hydroxychloroquine*At T12

Acknowledgements:

Medical writing assistance was provided by Helen Taylor, Fishawack Indicia Ltd., UK, part of Fishawack Health, and was funded by GSK.

Disclosure of Interests:

Mirhelen Abreu Grant/research support from: GSK, Amgen, Biogen, Libbs, Odirlei Monticielo Speakers bureau: GSK, AbbVie, UCB, Roche, Novartis, Consultant of: GSK, AbbVie, Janssen, Vander Fernandes Speakers bureau: Janssen, Novartis, Roche, AbbVie, Pfizer, Grant/research support from: Novartis, GSK, Pfizer, Alexandre Cristovão Maiorano: None declared, Fernando dos Santos Beserra: None declared, Flavia Lamarao Employee of: GSK, Nathalie David Shareholder of: GSK, Employee of: GSK, Bruna de Veras Employee of: GSK, Blanca Bica: None declared, Domingos Sávio Nunes de Lima Grant/research support from: GSK, Marta Maria das Chagas Medeiros: None declared

Belief of agency changes dynamics in sensorimotor networks

Controlling an event through one's own action usually induces a sense of agency, a feeling that arises when an expected outcome matches the intention. The neural correlates of this feeling remain controversial however, as experimental manipulation of the action-outcome chain often introduces mismatch or prediction errors that strongly correlate with the sense of agency. Here, we took a different approach and manipulated the causal belief (self-attribution vs. computer-attribution) by external cues during matched visuo-motor tapping conditions. With magneto-encephalography, we studied the sense of agency from a network perspective, investigating in source space the modulation of local population activity and changes in functional connectivity with motor cortex. Our results show that during the belief of agency primary motor cortex (M1) shows stronger functional connectivity (mediated by the beta band) to inferior parietal lobe and right middle temporal gyrus (MTG). Furthermore, the local feed-forward activity (gamma band power) in extrastriate body area and MTG disappears with that belief. After changes in action context, left M1 shows stronger connectivity in the alpha band with right premotor cortex and left insular-temporal cortex a network that might support active inference in social action context. Finally, a better tapping performance in this rhythmic task was related to alpha power modulations in the bilateral cerebellum and bilateral fusiform body-area, with power suppression during a more precise performance. These findings highlight the role of multiple networks supporting the sense of agency by changing their relative contribution for different causal beliefs.

Long-term variation in concentrations and mass loads in a semi-arid watershed influenced by historic mercury mining and urban pollutant sources

Urban watersheds are significantly anthropogenically-altered landscapes. Most previous studies cover relatively short periods, without addressing concentrations, loads, and yields in relation to annual climate fluctuations, and datasets on Ag, Se, PBDEs, and PCDD/Fs are rare. Intensive storm-focused sampling and continuous turbidity monitoring were employed to quantify pollution at two locations in the Guadalupe River (California, USA). At a downstream location, we determined loads of suspended sediment (SS) for 14yrs., mercury (HgT), PCBs, and total organic carbon (TOC) (8yrs), total methylmercury (MeHgT) (6yrs), nutrients, and trace elements including Ag and Se (3yrs), DDTs, chlordanes, dieldrin, and PBDEs (2yrs), and PCDD/Fs (1yr). At an upstream location, we determined loads of SS for 4yrs. and HgT, MeHgT, PCBs and PCDD/Fs for 1yr. These data were compared to previous studies, climatically adjusted, and used to critically assess the use of small datasets for estimating annual average conditions. Concentrations and yields in the Guadalupe River appear to be atypical for total phosphorus, DDTs, dieldrin, HgT, MeHgT, Cr, Ni, and possibly Se due to local conditions. Other pollutants appear to be similar to other urban systems. On average, wet season flow varied by 6.5-fold and flow-weighted mean (FWM) concentrations varied 4.4-fold, with an average 7.1-fold difference between minimum and maximum annual loads. Loads for an average runoff year for each pollutant were usually less than the best estimate of long-term average. The arithmetic average of multiple years of load data or a FWM concentration combined with mean annual flow was also usually below the best estimate of long-term average load. Mean annual loads using sampled years were also less than the best estimate of long-term average by a mean of 2.2-fold. Climatic adjustment techniques are needed for computing estimates of long-term average annual loads.

White Matter Microstructure of the Human Mirror Neuron System is Related to Symptom Severity in Adults with Autism

Mirror neuron system (MNS) dysfunctions might underlie deficits in autism spectrum disorders (ASD). Diffusion tensor imaging based probabilistic tractography was conducted in 15 adult ASD patients and 13 matched, healthy controls. Fractional anisotropy (FA) was quantified to assess group differences in tract-related white matter microstructure of both the classical MNS route (mediating "emulation") and the alternative temporo-frontal route (mediating "mimicry"). Multiple linear regression was used to investigate structure-function relationships between MNS connections and ASD symptom severity. There were no significant group differences in tract-related FA indicating an intact classical MNS in ASD. Direct temporo-frontal connections could not be reconstructed challengeing the concept of multiple routes for imitation. Tract-related FA of right-hemispheric parieto-frontal connections was negatively related to autism symptom severity.

Interactions Between Body and Social Awareness in Yoga

BACKGROUND/OBJECTIVE

Bodily processes have been intimately linked to social-cognitive and affective functions, such as compassion and empathy. Yet, little is known about how awareness of bodily processes influences social awareness and vice versa, especially in nonobservational but experiential investigations. This study investigated the relationship between psychometrically reported body and social awareness (including altruism, empathy, perspective-taking, and compassion) in 90 yoga and yoga-/mediation-naive control participants. In modern postural yoga, advanced practitioners claim both increased compassion and inner focus.

METHODS

Multiple regression analyses were conducted to predict (1) the level of yoga practice from body awareness and social awareness skills in the yoga group and (2) body awareness from social skills in both groups.

RESULTS

Body awareness and compassion were significant positive and independent predictors of yoga expertise. This finding supports practitioners' anecdotal claims but also implies that both functions tap into different aspects of yoga expertise. When body awareness was predicted, altruism emerged as a significant negative predictor in the yoga group (but not control group) as a function of yoga practice.

CONCLUSION

These results might compellingly suggest that, despite high compassion, heightened bodily self-awareness might increase a self-centred perspective and limit altruistic acts in advanced yoga practitioners.

The Sense of Agency Is More Sensitive to Manipulations of Outcome than Movement-Related Feedback Irrespective of Sensory Modality

The sense of agency describes the ability to experience oneself as the agent of one's own actions. Previous studies of the sense of agency manipulated the predicted sensory feedback related either to movement execution or to the movement's outcome, for example by delaying the movement of a virtual hand or the onset of a tone that resulted from a button press. Such temporal sensorimotor discrepancies reduce the sense of agency. It remains unclear whether movement-related feedback is processed differently than outcome-related feedback in terms of agency experience, especially if these types of feedback differ with respect to sensory modality. We employed a mixed-reality setup, in which participants tracked their finger movements by means of a virtual hand. They performed a single tap, which elicited a sound. The temporal contingency between the participants' finger movements and (i) the movement of the virtual hand or (ii) the expected auditory outcome was systematically varied. In a visual control experiment, the tap elicited a visual outcome. For each feedback type and participant, changes in the sense of agency were quantified using a forced-choice paradigm and the Method of Constant Stimuli. Participants were more sensitive to delays of outcome than to delays of movement execution. This effect was very similar for visual or auditory outcome delays. Our results indicate different contributions of movement- versus outcome-related sensory feedback to the sense of agency, irrespective of the modality of the outcome. We propose that this differential sensitivity reflects the behavioral importance of assessing authorship of the outcome of an action.

Campomanesia adamantium extract induces DNA damage, apoptosis, and affects cyclophosphamide metabolism

Campomanesia adamantium (Cambess.) O. Berg. is originally from Brazil. Its leaves and fruits have medicinal properties such as anti-inflammatory, antidiarrheal and antiseptic properties. However, the mutagenic potential of this species has been reported in few studies. This study describes the mutagenic/antimutagenic, splenic phagocytic, and apoptotic activities of C. adamantium hydroethanolic extract with or without cyclophosphamide in Swiss mice. The animals orally received the hydroethanolic extract at doses of 30, 100, or 300 mg/kg with or without 100 mg/kg cyclophosphamide. Mutagenesis was evaluated by performing the micronucleus assay after treatment for 24, 48, and 72 h, while splenic phagocytic and apoptotic effects were investigated after 72 h. Short-term exposure of 30 and 100 mg/kg extract induced mild clastogenic/aneugenic effects and increased splenic phagocytosis and apoptosis in the liver, spleen, and kidneys. When the extract was administered in combination with cyclophosphamide, micronucleus frequency and apoptosis reduced. Extract components might affect cyclophosphamide metabolism, which possibly leads to increased clearance of this chemotherapeutic agent. C. adamantium showed mutagenic activity and it may decrease the effectiveness of drugs with metabolic pathways similar to those associated with cyclophosphamide. Thus, caution should be exercised while consuming these extracts, especially when received in combination with other drugs.

Linac4 H⁻ ion sources

CERN's 160 MeV H(-) linear accelerator (Linac4) is a key constituent of the injector chain upgrade of the Large Hadron Collider that is being installed and commissioned. A cesiated surface ion source prototype is being tested and has delivered a beam intensity of 45 mA within an emittance of 0.3 π ⋅ mm ⋅ mrad. The optimum ratio of the co-extracted electron- to ion-current is below 1 and the best production efficiency, defined as the ratio of the beam current to the 2 MHz RF-power transmitted to the plasma, reached 1.1 mA/kW. The H(-) source prototype and the first tests of the new ion source optics, electron-dump, and front end developed to minimize the beam emittance are presented. A temperature regulated magnetron H(-) source developed by the Brookhaven National Laboratory was built at CERN. The first tests of the magnetron operated at 0.8 Hz repetition rate are described.

The right temporoparietal junction plays a causal role in maintaining the internal representation of verticality

Perception of the visual vertical is strongly based on our ability to match visual inflow with vestibular, proprioceptive, tactile, and even visceral information that contributes to maintaining an internal representation of the vertical. An important cortical region implicated in multisensory integration is the right temporoparietal junction (rTPJ), which also is involved in higher order forms of body- and space-related cognition. To test whether this region integrates body-related multisensory information necessary for establishing the subjective visual vertical, we combined a psychophysical task (the rod-and-frame test) with transient inhibition of the rTPJ via continuous theta burst stimulation (cTBS). A Gabor patch visual detection task was used as a control visual task. cTBS of early visual cortex (V1-V3) was used to test whether early visual cortices played any role in verticality estimation. We show that inhibition of rTPJ activity selectively impairs the ability to evaluate the rod's verticality when no contextual visual information, such as a frame surrounding the rod, is provided. Conversely, transient inhibition of V1-V3 selectively disrupts the ability to visually detect Gabor patch orientation. This anatomofunctional dissociation supports the idea that the rTPJ plays a causal role in integrating egocentric sensory information encoded in different reference systems (i.e., vestibular and somatic) to maintain an internal representation of verticality.

Stronger Neural Modulation by Visual Motion Intensity in Autism Spectrum Disorders

Theories of autism spectrum disorders (ASD) have focused on altered perceptual integration of sensory features as a possible core deficit. Yet, there is little understanding of the neuronal processing of elementary sensory features in ASD. For typically developed individuals, we previously established a direct link between frequency-specific neural activity and the intensity of a specific sensory feature: Gamma-band activity in the visual cortex increased approximately linearly with the strength of visual motion. Using magnetoencephalography (MEG), we investigated whether in individuals with ASD neural activity reflect the coherence, and thus intensity, of visual motion in a similar fashion. Thirteen adult participants with ASD and 14 control participants performed a motion direction discrimination task with increasing levels of motion coherence. A polynomial regression analysis revealed that gamma-band power increased significantly stronger with motion coherence in ASD compared to controls, suggesting excessive visual activation with increasing stimulus intensity originating from motion-responsive visual areas V3, V6 and hMT/V5. Enhanced neural responses with increasing stimulus intensity suggest an enhanced response gain in ASD. Response gain is controlled by excitatory-inhibitory interactions, which also drive high-frequency oscillations in the gamma-band. Thus, our data suggest that a disturbed excitatory-inhibitory balance underlies enhanced neural responses to coherent motion in ASD.

[Total isolated anomalous pulmonary venous return: Are there any clues for prenatal screening?]

Total anomalous pulmonary venous connection (TAPVC) is a serious congenital anomaly. TAPVC with obstruction of pulmonary venous return is an emergency requiring urgent intervention. Before 2010, very few isolated TAPVC were diagnosed prenatally. It has been suggested in the past literature that the use of Color flow Doppler is particularly useful for the screening of TAPVC prenatally. In fact, although color-Doppler is often useful to confirm a TAPVC diagnosis, it can be quite misleading in the screening process of the condition. Looking at data of missed TAPVC, we describe how to identify TAPVC during routine cardiac screening. Since 2010, our isolated TAPVC prenatal diagnosis rate is more than 40%.

Estimation of Contaminant Loads from the Sacramento-San Joaquin River Delta to San Francisco Bay

Contaminant concentrations from the Sacramento-San Joaquin River watershed were determined in water samples mainly during flood flows in an ongoing effort to describe contaminant loads entering San Francisco Bay, CA, USA. Calculated PCB and total mercury loads during the 6-year observation period ranged between 3.9 and 19 kg/yr and 61 and 410 kg/yr, respectively. Long-term average PCB loads were estimated at 7.7 kg/yr and total mercury loads were estimated at 200 kg/yr. Also monitored were PAHs, PBDEs (two years of data), and dioxins/furans (one year of data) with average loads of 392, 11, and 0.15/0.014 (OCDD/OCDF) kg/yr, respectively. Organochlorine pesticide loads were estimated at 9.9 kg/yr (DDT), 1.6 kg/yr (chlordane), and 2.2 kg/yr (dieldrin). Selenium loads were estimated at 16 300 kg/yr. With the exception of selenium, all average contaminant loads described in the present study were close to or below regulatory load allocations established for North San Francisco Bay.

Tic Phenomenology and Tic Awareness in Adults With Autism

Background: Tics are common in people with autism spectrum disorder (ASD). However, their phenomenology and characteristics have not been studied in detail. Methods: Based on video sequences of 21 adults with ASD without intellectual disability and 16 adults with Gilles de la Tourette syndrome (GTS), tic severity, tic repertoires, and tic awareness were determined. Results: Ten ASD and all GTS participants had tics during video recordings. The ASD group had significantly fewer tics, compared to GTS. Tic distribution and tic repertoires were comparable, but more restricted in ASD. All GTS participants, but only 5 of the 10 ASD participants, were aware of their tics. Conclusions: Tics are common in adults with ASD. They are indistinguishable from tics in GTS and are similarly distributed, but less severe. Tic awareness is limited in ASD.

Mirror me: Imitative responses in adults with autism

Dysfunctions of the human mirror neuron system have been postulated to underlie some deficits in autism spectrum disorders including poor imitative performance and impaired social skills. Using three reaction time experiments addressing mirror neuron system functions under simple and complex conditions, we examined 20 adult autism spectrum disorder participants and 20 healthy controls matched for age, gender and education. Participants performed simple finger-lifting movements in response to (1) biological finger and non-biological dot movement stimuli, (2) acoustic stimuli and (3) combined visual-acoustic stimuli with different contextual (compatible/incompatible) and temporal (simultaneous/asynchronous) relation. Mixed model analyses revealed slower reaction times in autism spectrum disorder. Both groups responded faster to biological compared to non-biological stimuli (Experiment 1) implying intact processing advantage for biological stimuli in autism spectrum disorder. In Experiment 3, both groups had similar 'interference effects' when stimuli were presented simultaneously. However, autism spectrum disorder participants had abnormally slow responses particularly when incompatible stimuli were presented consecutively. Our results suggest imitative control deficits rather than global imitative system impairments.

Right temporoparietal gray matter predicts accuracy of social perception in the autism spectrum

Individuals with an autism spectrum disorder (ASD) show hallmark deficits in social perception. These difficulties might also reflect fundamental deficits in integrating visual signals. We contrasted predictions of a social perception and a spatial-temporal integration deficit account. Participants with ASD and matched controls performed two tasks: the first required spatiotemporal integration of global motion signals without social meaning, the second required processing of socially relevant local motion. The ASD group only showed differences to controls in social motion evaluation. In addition, gray matter volume in the temporal-parietal junction correlated positively with accuracy in social motion perception in the ASD group. Our findings suggest that social-perceptual difficulties in ASD cannot be reduced to deficits in spatial-temporal integration.

Processing of proprioceptive and vestibular body signals and self-transcendence in Ashtanga yoga practitioners

In the rod and frame test (RFT), participants are asked to set a tilted visual linear marker (i.e., a rod), embedded in a square, to the subjective vertical, irrespective of the surrounding frame. People not influenced by the frame tilt are defined as field-independent, while people biased in their rod verticality perception are field-dependent. Performing RFT requires the integration of proprioceptive, vestibular and visual signals with the latter accounting for field-dependency. Studies indicate that motor experts in body-related, balance-improving disciplines tend to be field-independent, i.e., better at verticality perception, suggesting that proprioceptive and vestibular expertise acquired by such exercise may weaken the influence of irrelevant visual signals. What remains unknown is whether the effect of body-related expertise in weighting perceptual information might also be mediated by personality traits, in particular those indexing self-focusing abilities. To explore this issue, we tested field-dependency in a class of body experts, namely yoga practitioners and in non-expert participants. Moreover we explored any link between performance on RFT and self-transcendence (ST), a complex personality construct, which refers to tendency to experience spiritual feelings and ideas. As expected, yoga practitioners (i) were more accurate in assessing the rod's verticality on the RFT, and (ii) expressed significantly higher ST. Interestingly, the performance in these two tests was negatively correlated. More specifically, when asked to provide verticality judgments, highly self-transcendent yoga practitioners were significantly less influenced by a misleading visual context. Our results suggest that being highly self-transcendent may enable yoga practitioners to optimize verticality judgment tasks by relying more on internal (vestibular and proprioceptive) signals coming from their own body, rather than on exteroceptive, visual cues.

Ebstein's anomaly and tricuspid valve dysplasia: prognosis after diagnosis in utero

Tricuspid valve malformation is a rare congenital heart disease. Prenatal diagnosis of Ebstein's anomaly (EA) and tricuspid valve dysplasia (TVD) is associated with high mortality. There are conflicting reports concerning accurate prognostication after diagnosis in utero. The aim of our study was to assess prognostic factors based on our experience. We reviewed 37 fetuses between 1984 and June 2010 comprising 26 cases of EA and 11 cases of TVD. There were 10 terminations, 5 intrauterine deaths, 8 neonatal deaths, and 14 survivors. We found that the major prognostic factor for outcome was the flow pattern through the pulmonary valve on the first echocardiogram. Retrograde flow was strongly correlated with fetal or neonatal death (p = 8 × 10(-5)), and anterograde flow predicted good outcome (p = 8 × 10(-5)). In contrast, cardiothoracic indexes, right to left-ventricular ratio, and Celermajer index were not useful prognostic markers. The Simpson Andrews Sharland score, which was more complex, was well correlated with our series. Flow through the pulmonary valve on the first echocardiogram is a simple and excellent prognostic factor when major tricuspid valve disease is diagnosed in utero. Fetuses should be monitored throughout pregnancy, particularly those with retrograde ductus arteriosus, because several hemodynamic factors may worsen the prognosis.

New frontiers in the neuroscience of the sense of agency

The sense that I am the author of my own actions, including the ability to distinguish my own from other people's actions, is a fundamental building block of our sense of self, on the one hand, and successful social interactions, on the other. Using cognitive neuroscience techniques, researchers have attempted to elucidate the functional basis of this intriguing phenomenon, also trying to explain pathological abnormalities of action awareness in certain psychiatric and neurological disturbances. Recent conceptual, technological, and methodological advances suggest several interesting and necessary new leads for future research on the neuroscience of agency. Here I will describe new frontiers for the field such as the need for novel and multifactorial paradigms, anatomically plausible network models for the sense of agency, investigations of the temporal dynamics during agentic processing and ecologically valid virtual reality (VR) applications.

Internet-based program for coping with cancer: a randomized controlled trial with hematologic cancer patients

OBJECTIVE

Psychosocial patient care in oncology is no longer limited to the inpatient setting. Outpatient services are in demand. Internet-based interventions could aid in optimizing service delivery across disciplines. The effectiveness of an Internet-based program for hematologic cancer patients was tested in a randomized controlled trial under field experimental conditions.

METHODS

A 4-week cognitive-behavioral program for coping with cancer was offered to hematologic cancer patients online. One hundred eighty-six registrants were randomly assigned to an intervention group (n = 105) or a waiting list (n = 81). The outcome measures, 'mental adjustment' (MAC) and 'psychological distress' (BSI), were assessed at registration and after 4 weeks. Patient satisfaction was assessed (ZUF-8), and complete-cases and intention-to-treat analyses were performed.

RESULTS

At registration, the majority of participants displayed clinically significant distress (BSI) and lacked alternative access concerning psychosocial care. One hundred eleven patients filled out the post questionnaire at 4 weeks. In contrast to the waiting list, the intervention group displayed a significant increase in fighting spirit (d = 0.42; CI 95%, 0.04 to 0.80). The effect was confirmed by intention-to-treat analysis (d = 0.33; CI 95%, 0.04 to 0.62). Otherwise, no effects were observed. Patient satisfaction with the program was high.

CONCLUSION

The results demonstrate the potential efficacy of Internet-based programs while highlighting their limitations. Future research is needed to clarify and optimize efficacy, taking different program components and patient characteristics into particular consideration.

The feeling of agency: empirical indicators for a pre-reflective level of action awareness

The sense of agency has been defined as the sense that I am the author of my own actions. This sense, however, is usually not reflected upon but instead pre-reflectively experienced. Experimental approaches usually measure the sense of agency by judgments or verbal reports, despite evidence that the sense of agency is not sufficiently assessed on such a reflective level. Here we sought to identify non-verbal measures of the sense of agency, particularly testing the relevance of physiological activity such as skin conductance and heart rate. Manipulating the visual feedback to an executed movement, we investigated how well physiological activity and other movement parameters differed between real and false feedback (i.e., between actual agency and non-agency), and how they related to accuracy of agency judgments. Skin conductance and heart rate did not differ between agency and non-agency situations; neither did they inform agency judgments. In contrast, movement onsets – particularly, discrepancies between feedback and movement onsets – were related to agency judgments. Overall, our results indicate weak visceral–somatic associations with the sense of agency. Thus, physiological activity did not prove to be an empirical indicator for the feeling of agency.

Disturbances of self-other distinction after stimulation of the extrastriate body area in the human brain

In a recent experiment with functional magnetic-resonance imaging, we found that brain activity in the extrastriate body area (EBA) distinguished between observed self- and other-generated movements, being significantly higher during observation of someone else's movement. Here, we investigated further the role of EBA in self-other distinctions using low-frequency repetitive transcranial magnetic stimulation (rTMS). As compared with rTMS applied over a control site, rTMS applied over the EBA increased reaction times, without affecting accuracy, for the detection of other-generated movements. Performance on a control motion-direction detection task was unaffected. These findings provide additional evidence for the role of the EBA in processing information necessary for identifying ourselves as agents of self-generated movements.

Brief report: altered horizontal binding of single dots to coherent motion in autism

Individuals with autism often show a fragmented way of perceiving their environment, suggesting a disorder of information integration, possibly due to disrupted communication between brain areas. We investigated thirteen individuals with high-functioning autism (HFA) and thirteen healthy controls using the metastable motion quartet, a stimulus consisting of two dots alternately presented at four locations of a hypothetical square, thereby inducing an apparent motion percept. This percept is vertical or horizontal, the latter requiring binding of motion signals across cerebral hemispheres. Decreasing the horizontal distance between dots could facilitate horizontal percepts. We found evidence for altered horizontal binding in HFA: Individuals with HFA needed stronger facilitation to experience horizontal motion. These data are interpreted in light of reduced cross-hemispheric communication.

First Report of Potato mop-top virus in North Dakota

Potato mop-top virus (PMTV) is the type member of the genus Pomovirus. PMTV is an important pathogen of potato, causing significant economic losses in Northern Europe, North and South America, and Asia (3). PMTV in the United States was first reported in Maine (2). PMTV is vectored by the plasmodiophoromycete Spongospora subterranea cv. subterranea, which causes powdery scab of potato (1). S. subterranea and PMTV are usually associated with cool and humid environments. In the spring of 2010, six potato tubers of cv. Russet Burbank were received from a commercial potato farm in Grand Forks County in North Dakota. The tubers had multiple, internal, concentric, necrotic arcs and circles. The presence of PMTV in the necrotic lesions was verified by a positive double-antibody sandwich-ELISA (Agden Ltd., Ayr, Scotland). The tuber lesions had an absorbance value (405 nm) at least two times greater than that of the negative control sample, which consisted of a healthy tuber. Total RNA was extracted from lesions of six different tubers that tested positive by ELISA using a Total RNA Isolation kit (Promega Corp. Madison, WI). These extracts were tested for PMTV by reverse transcription (RT)-PCR using two different sets of primers. The primer set H360/C819 targeted the coat protein (CP) of PMTV and yielded an amplicon of 460 bp (4). The amplicons generated from the necrotic lesions were cloned (TOPO Cloning; Invitrogen, Carlsbad, CA) and sequenced. Another set of primers, pmtF4/pmtR4, designed to bind to a region in RNA 2 of PMTV, yielded a 417-bp amplicon that also was cloned and sequenced (3). The sequences from all six tuber lesions were identical for the respective primer sets. A consensus sequence for each primer pair was submitted to GenBank (Accession No. HM776171 for primers pmtF4/pmtR4 and No. HM776172 for primers H360/C819). The sequences obtained from the H360/C819 and pmtF4/pmtR4 amplicons were 99% identical to the corresponding regions of PMTV isolates from Northern Europe (GenBank Accession Nos. AM503629 and AJ277556, respectively). Freeze-dried, necrotic tuber tissue from all six tubers was also tested at a USDA Laboratory in Prosser, WA by RT-PCR with the H360/C819 primer pair (4), confirming the results above. Cloning and sequencing of one of the amplicons revealed 100% similarity to the sequence described above for these primers (GenBank Accession No. HM776172), confirming the presence of PMTV in the symptomatic tubers. None of the symptomatic tubers tested positive for Tobacco rattle virus, Tomato spotted wilt virus, Alfalfa mosaic virus, Potato leafroll virus, or the necrotic strains of Potato virus Y by RT-PCR. To our knowledge this is the first report of PMTV in North Dakota. References: (1) R. A. C. Jones and B. D. Harrsion. Ann. Appl. Biol. 63:1, 1969. (2) D. H. Lambert et al. Plant Dis. 87:872, 2003. (3) J. Santala et al. Ann. Appl. Biol. Online publication. DOI: 10.1111/j.1744-7348.2010.00423.x (4) H. Xu et al. Plant Dis. 88:363, 2004.

Reducing tuber damage by potato tuberworm (Lepidoptera: Gelechiidae) with cultural practices and insecticides

Cultural practices and insecticide treatments and combinations were evaluated for effect on tuber damage by potato tuberworm, Phthorimaea operculella (Zeller) (Lepidoptera: Gelechiidae) in the Columbia basin of eastern Oregon and Washington. A range of intervals between initial application of several insecticides and vine-kill were tested to determine how early to implement a program to control potato tuberworm tuber damage. Esfenvalerate, methamidophos, and methomyl were applied at recommended intervals, with programs beginning from 28 to 5 d before vine-kill. All insecticide treatments significantly reduced tuber damage compared with the untreated control, but there was no apparent advantage to beginning control efforts earlier than later in the season. Esfenvalerate and indoxacarb at two rates and a combination of the two insecticides were applied weekly beginning 4 wk before and at vine-kill, and indoxacarb was applied at and 1 wk postvine-kill as chemigation treatments. Application of insecticides at and after vine-kill also reduced tuberworm infestation. 'Russet Norkotah' and 'Russet Burbank' plants were allowed to naturally senesce or were chemically defoliated. They received either no irrigation or were irrigated by center-pivot with 0.25 cm water daily from vine-kill until harvest 2 wk later. Daily irrigation after vine-kill reduced tuber damage, and chemical vine-kill tended to reduce tuber damage compared with natural senescence. Covering hills with soil provides good protection but must be done by vine-kill. Data from these trials indicate that the most critical time for initiation of control methods is immediately before and at vine-kill.

Sense of agency and mentalizing: dissociation of subdomains of social cognition in patients with schizophrenia

The sense of agency, i.e., the sense that "I am the one who is causing an action", and mentalizing, the ability to understand the mental states of other individuals, are key domains of social cognition. It has been hypothesized that an intact sense of agency is an important precondition for higher-level mentalizing abilities. A substantial body of evidence shows that both processes rely on similar brain areas and are severely impaired in schizophrenia, suggesting a close link between agency and mentalizing. Yet this relationship has not been explicitly tested. We investigated 40 individuals with schizophrenia and 40 healthy controls on an agency and mentalizing task. On the agency task, participants carried out simple mouse movements and judged the partially manipulated visual feedback as either self- or other-generated. On the mentalizing task, participants inferred mental states from pictures that depicted others' eyes ("Reading the mind in the eyes test"). Neuropsychological, psychopathological and social functioning levels were also evaluated. Both sense of agency and mentalizing were impaired in schizophrenia patients compared to healthy controls. However, testing for a relationship revealed no significant correlations between the two processes, either in the schizophrenia or the control group. The present findings demonstrate a dissociation of agency and mentalizing deficits in schizophrenia, suggesting that the multifaceted construct of social cognition consists of independent subdomains in healthy and psychiatrically ill individuals.

Animated brain: a functional neuroimaging study on animacy experience

Previous research used animated geometric figures to investigate social cognitive processes involved in ascribing mental states to others (e.g. mentalizing). The relationship between animacy perception and brain areas commonly involved in social cognition, as well as the influence of particular motion patterns on animacy experience, however, remains to be further elucidated. We used a recently introduced paradigm for the systematic variation of motion properties, and employed functional magnetic resonance imaging to identify the neural mechanisms underlying animacy experience. Based on individual ratings of increased animacy experience the following brain regions of the "social neural network" (SNN), known to be involved in social cognitive processes, were recruited: insula, superior temporal gyrus, fusiform gyrus, parahippocampal gyrus and the ventromedial prefrontal cortex bilaterally. Decreased animacy experience was associated with increased neural activity in the inferior parietal and inferior frontal gyrus, key constituents of the human "mirror neuron system" (hMNS). These findings were corroborated when analyses were based on movement patterns alone, irrespective of subjective experience. Additionally to the areas found for increased animacy experience, an increase in interactive movements elicited activity in the amygdala and the temporal pole. In conclusion, the results suggest that the hMNS is recruited during a low-level stage of animacy judgment representing a basic disposition to detect the salience of movements, whereas the SNN appears to be a high-level processing component serving evaluation in social and mental inference.

First Report of Tobacco rattle virus Associated with Corky Ringspot in Potatoes Grown in North Dakota

Tobacco rattle virus (TRV) belongs to the genus Tobravirus and causes a stem mottle of potato (Solanum tuberosum) foliage and necrotic arcs and rings in tubers referred to as corky ringspot. This virus is generally transmitted by a number of species of stubby-root nematode. The virus is widespread and has been reported in California, Colorado, Florida, Idaho, Michigan, Oregon, Washington, Minnesota, and Wisconsin (2). In the spring of 2009, we received potato tubers of cv. Russet Burbank with internal necrotic arcs very similar to those caused by TRV from potato storages located in Grand Forks and Dickey counties of North Dakota. Total RNA was extracted from the necrotic lesions of two tubers from each location using the Total RNA Isolation kit (Promega Corp., Madison WI). These extracts were tested for TRV by reverse transcription (RT)-PCR using primers complementary to nucleotides 6555 to 6575 (Primer A) and identical to nucleotides 6113 to 6132 (Primer B) within the 3' terminus of TRV-SYM RNA-1 (GenBank Accession No. X06172) (3). The expected 463-bp amplicons from two separate tuber samples from each county were cloned (TOPO Cloning; Invitrogen, Carlsbad, CA) and sequenced. The sequences obtained from the four clones at both locations were found to be identical to each other and were 99% identical to the corresponding regions of TRV isolates from Michigan and Florida (GenBank Accession Nos. EU315226.1 and AF055912.1, respectively). Since sequences from all four clones were identical, only one of the sequences was submitted to Genbank (Accession No. GQ223114) and thus represents a consensus sequence. The extracts also tested positive in RT-PCR with a second set of primers corresponding to sequences in TRV RNA-2 yielding a 3.8-kbp amplicon (1). No evidence was found by RT-PCR for several other viruses that cause tuber necrosis in potato (Potato mop top virus, Tomato spotted wilt virus, Alfalfa mosaic virus, and tuber necrosis strains of Potato virus Y). The virus was mechanically transmitted by inoculating sap from symptomatic tubers from both counties to tobacco cv. Samsun NN, which showed typical bright yellow patches and spots on leaves 2 weeks postinoculation. TRV was confirmed in tobacco by RT-PCR from total RNA extracted from tobacco leaves with both sets of the aforementioned primers. To our knowledge, this is the first report of TRV in North Dakota and the first report of corky ringspot disease of potato in this state. References: (1) J. M. Crosslin et al. Virus Res. 96:99, 2003. (2) N. C. Gudmestad et al. Plant Dis. 92:1254, 2008. (3) D. J. Robinson. J. Virol. Methods 40:57, 1992.

Mercury concentrations and loads in a large river system tributary to San Francisco Bay, California, U.S.A

In order to estimate total mercury (HgT) loads entering San Francisco Bay, U.S.A., via the Sacramento-San Joaquin River system, unfiltered water samples were collected between January 2002 and January 2006 during high flow events and analyzed for HgT. Unfiltered HgT concentrations ranged from 3.2 to 75 ng/L and showed a strong correlation (r2 = 0.8, p < 0.001, n=78) to suspended sediment concentrations (SSC). During infrequent large floods, HgT concentrations relative to SSC were approximately twice as high as observed during smaller floods. This difference indicates the transport of more Hg-contaminated particles during high discharge events. Daily HgT loads in the Sacramento-San Joaquin River at Mallard Island ranged from below the limit of detection to 35 kg. Annual HgT loads varied from 61 +/- 22 kg (n=5) in water year (WY) 2002 to 470 +/- 170 kg (n=25) in WY 2006. The data collected will assist in understanding the long-term recovery of San Francisco Bay from Hg contamination and in implementing the Hg total maximum daily load, the long-term cleanup plan for Hg in the Bay.

Gamma-band activity in the human superior temporal sulcus during mentalizing from nonverbal social cues

The posterior superior temporal sulcus (pSTS) is a key structure for our ability to infer others' mental states based on social cues including facial expressions, body posture, and gestures ("mentalizing"), but the neural mechanisms of this ability remain largely unknown. We recorded electrocorticogram directly from the pSTS in humans to show that enhanced neural oscillations in the gamma frequency range (35-55 Hz) accompany mentalizing. One patient with a lesion in pSTS was tested behaviorally on this task; he was unable to infer a virtual character's preferences from nonverbal social cues. Enhanced coherent gamma oscillations in the patients with intact pSTS may reflect a process by which social signals are bound into a unified representation to support mentalizing. This may be relevant for other social cognitive processes, as well as to the study of autism spectrum disorders, for which both mentalizing deficits and abnormal gamma activity have been reported.

Differential involvement of the posterior temporal cortex in mentalizing but not perspective taking

Understanding and predicting other people's mental states and behavior are important prerequisites for social interactions. The capacity to attribute mental states such as desires, thoughts or intentions to oneself or others is referred to as mentalizing. The right posterior temporal cortex at the temporal-parietal junction has been associated with mentalizing but also with taking someone else's spatial perspective onto the world--possibly an important prerequisite for mentalizing. Here, we directly compared the neural correlates of mentalizing and perspective taking using the same stimulus material. We found significantly increased neural activity in the right posterior segment of the superior temporal sulcus only during mentalizing but not perspective taking. Our data further clarify the role of the posterior temporal cortex in social cognition by showing that it is involved in processing information from socially salient visual cues in situations that require the inference about other people's mental states.

The "sense of agency" and its underlying cognitive and neural mechanisms

The sense of agency is a central aspect of human self-consciousness and refers to the experience of oneself as the agent of one's own actions. Several different cognitive theories on the sense of agency have been proposed implying divergent empirical approaches and results, especially with respect to neural correlates. A multifactorial and multilevel model of the sense of agency may provide the most constructive framework for integrating divergent theories and findings, meeting the complex nature of this intriguing phenomenon.

Being with virtual others: studying social cognition in temporal lobe epilepsy

Social cognitive neuroscience has highlighted the importance of frontotemporal neurocircuitry for social cognition. Temporal lobe epilepsy (TLE) impacts these brain areas and their functional connections and might therefore specifically affect social perceptual and cognitive skills. In the study described here, an established paradigm was used to evaluate the social cognitive skills of female patients with left TLE. Study participants were shown dynamic animations in which virtual characters either looked at the human observer directly or looked away toward someone else, thus manipulating self-involvement. The virtual characters then exhibited different facial expressions that were either socially relevant or arbitrary. Participants were asked to rate the communicative intentions of the virtual character. Patients' ratings of communicative intent appeared to be linked to their own self-involvement in the interaction, whereas healthy volunteers' ratings of facial expressions were independent of self-involvement. Potential mechanisms for the observed differences are discussed.