Language network self-inhibition and semantic similarity in first-episode schizophrenia: A computational-linguistic and effective connectivity approach

INTRODUCTION

A central feature of schizophrenia is the disorganization and impoverishment of language. Recently, we observed higher semantic similarity in first-episode-schizophrenia (FES) patients. In this study, we investigate if this aberrant similarity relates to the 'causal' connectivity between two key nodes of the word production system: inferior frontal gyrus (IFG) and the semantic-hub at the ventral anterior temporal lobe (vATL).

METHODS

Resting-state fMRI scans were collected from 60 participants (30 untreated FES and 30 healthy controls). The semantic distance was measured with the CoVec semantic tool based on GloVe. A spectral dynamic causal model with Parametrical Empirical Bayes was constructed modelling the intrinsic self-inhibitory and extrinsic-excitatory connections within the brain regions. We estimated the parameters of a fully connected model with the semantic distance as a covariate.

RESULTS

FES patients chose words with higher semantic similarity when describing the pictures compared to the HC group. Among patients, an increased semantic similarity was related with an increase in intrinsic connections within both the vATL and IFG, suggesting that reduced 'synaptic gain' in these regions likely contribute to aberrant sampling of the semantic space during discourse in schizophrenia.

CONCLUSIONS

Lexical impoverishment relates to increased self-inhibition in both the IFG and vATL. The associated reduction in synaptic gain may relate to reduced precision of locally generated neural activity, forcing the choice of words that are already 'activated' in a lexical network. One approach to improve word sampling may be via promoting synaptic gain via supra-physiological stimulation within the Broca's-vATL network; this proposal needs verification.

Syntactic complexity of spoken language in the diagnosis of schizophrenia: A probabilistic Bayes network model

In the clinical linguistics of schizophrenia, syntactic complexity has received much attention. In this study, we address whether syntactic complexity deteriorates within the six months following the first episode of psychosis in those who develop a diagnosis of schizophrenia. We collected data from a cohort of twenty-six first-episode psychosis and 12 healthy control subjects using the Thought and Language Index interview in response to three pictures from the Thematic Apperception Test at first assessment and after six months (the time of consensus diagnosis). An automated labeling (part-of-speech tagging) for specific syntactic elements calculated large and granular syntactic complexity indices with a focus on clause complexity as a particular case from this spoken language data. Probabilistic reasoning leveraging the conditional independence properties of Bayes networks revealed that consensus diagnosis of schizophrenia predicted a decrease in nominal subjects per clause among individuals with first episode psychosis. From the entire sample, we estimate a 95.4 % probability that a 50 % decrease in mean nominal subjects per clause after six months is explained by the presence of first episode psychosis. Among those with psychosis, a 30 % decrease in this clause-complexity index after six months of experiencing the first episode predicted with 95 % probability a consensus diagnosis of schizophrenia, representing a conditional relationship between a longitudinal decrease in syntactic complexity and a diagnosis of schizophrenia. We conclude that an early drift towards linguistic disorganization/impoverishment of clause complexity-at the granular level of nominal subject per clause-is a distinctive feature of schizophrenia that decreases longitudinally, thus differentiating schizophrenia from other psychotic illnesses with shared phenomenology.

Active Inference, Epistemic Value, and Uncertainty in Conceptual Disorganization in First-Episode Schizophrenia

BACKGROUND AND HYPOTHESIS

Active inference has become an influential concept in psychopathology. We apply active inference to investigate conceptual disorganization in first-episode schizophrenia. We conceptualize speech production as a decision-making process affected by the latent "conceptual organization"-as a special case of uncertainty about the causes of sensory information. Uncertainty is both minimized via speech production-in which function words index conceptual organization in terms of analytic thinking-and tracked by a domain-general salience network. We hypothesize that analytic thinking depends on conceptual organization. Therefore, conceptual disorganization in schizophrenia would be both indexed by low conceptual organization and reflected in the effective connectivity within the salience network.

STUDY DESIGN

With 1-minute speech samples from a picture description task and resting state fMRI from 30 patients and 30 healthy subjects, we employed dynamic causal and probabilistic graphical models to investigate if the effective connectivity of the salience network underwrites conceptual organization.

STUDY RESULTS

Low analytic thinking scores index low conceptual organization which affects diagnostic status. The influence of the anterior insula on the anterior cingulate cortex and the self-inhibition within the anterior cingulate cortex are elevated given low conceptual organization (ie, conceptual disorganization).

CONCLUSIONS

Conceptual organization, a construct that explains formal thought disorder, can be modeled in an active inference framework and studied in relation to putative neural substrates of disrupted language in schizophrenia. This provides a critical advance to move away from rating-scale scores to deeper constructs in the pursuit of the pathophysiology of formal thought disorder.

More than words: Speech production in first-episode psychosis predicts later social and vocational functioning

Background

Several disturbances in speech are present in psychosis; however, the relationship between these disturbances during the first-episode of psychosis (FEP) and later vocational functioning is unclear. Demonstrating this relationship is critical if we expect speech and communication deficits to emerge as targets for early intervention.

Method

We analyzed three 1-min speech samples using automated speech analysis and Bayes networks in an antipsychotic-naive sample of 39 FEP patients and followed them longitudinally to determine their vocational status (engaged or not engaged in employment education or training-EET vs. NEET) after 6-12 months of treatment. Five baseline linguistic variables with prior evidence of clinical relevance (total and acausal connectives use, pronoun use, analytic thinking, and total words uttered in a limited period) were included in a Bayes network along with follow-up NEET status and Social and Occupational Functioning Assessment Scale (SOFAS) scores to determine dependencies among these variables. We also included clinical (Positive and Negative Syndrome Scale 8-item version (PANSS-8)), social (parental socioeconomic status), and cognitive features (processing speed) at the time of presentation as covariates.

Results

The Bayes network revealed that only total words spoken at the baseline assessment were directly associated with later NEET status and had an indirect association with SOFAS, with a second set of dependencies emerging among the remaining linguistic variables. The primary (speech-only) model outperformed models including parental socioeconomic status, processing speed or both as latent variables.

Conclusion

Impoverished speech, even at subclinical levels, may hold prognostic value for functional outcomes and warrant consideration when providing measurement based care for first-episode psychosis.

Progressive Changes in Glutamate Concentration in Early Stages of Schizophrenia: A Longitudinal 7-Tesla MRS Study

Progressive reduction in glutamatergic transmission has been proposed as an important component of the illness trajectory of schizophrenia. Despite its popularity, to date, this notion has not been convincingly tested in patients in early stages of schizophrenia. In a longitudinal 7T magnetic resonance spectroscopy (1H-MRS), we quantified glutamate at the dorsal anterior cingulate cortex in 21 participants with a median lifetime antipsychotic exposure of less than 3 days and followed them up after 6 months of treatment. Ten healthy controls were also scanned at 2 time points. While patients had significantly lower overall glutamate levels than healthy controls (F(1,27) = 5.23, P = .03), we did not observe a progressive change of glutamate concentration in patients (F(1,18) = 0.47, P = .50), and the group by time interaction was not significant (F(1,27) = 0.86, P = .36). On average, patients with early psychosis receiving treatment showed a 0.02 mM/y increase, while healthy controls showed a 0.06 mM/y reduction of MRS glutamate levels. Bayesian analysis of our observations does not support early, post-onset glutamate loss in schizophrenia. Interestingly, it provides evidence in favor of a lack of progressive glutamate change in our schizophrenia sample—indicating that the glutamate level at the onset of illness was the best predictor of the levels 6 months after treatment. A more nuanced view of glutamatergic physiology, linked to early cortical maturation, may be required to understand glutamate-mediated dynamics in schizophrenia.

Is There a Glutathione Centered Redox Dysregulation Subtype of Schizophrenia?

Schizophrenia continues to be an illness with poor outcome. Most mechanistic changes occur many years before the first episode of schizophrenia; these are not reversible after the illness onset. A developmental mechanism that is still modifiable in adult life may center on intracortical glutathione (GSH). A large body of pre-clinical data has suggested the possibility of notable GSH-deficit in a subgroup of patients with schizophrenia. Nevertheless, studies of intracortical GSH are not conclusive in this regard. In this review, we highlight the recent ultra-high field magnetic resonance spectroscopic studies linking GSH to critical outcome measures across various stages of schizophrenia. We discuss the methodological steps required to conclusively establish or refute the persistence of GSH-deficit subtype and clarify the role of the central antioxidant system in disrupting the brain structure and connectivity in the early stages of schizophrenia. We propose in-vivo GSH quantification for patient selection in forthcoming antioxidant trials in psychosis. This review offers directions for a promising non-dopaminergic early intervention approach in schizophrenia.

Glutathione as a Molecular Marker of Functional Impairment in Patients with At-Risk Mental State: 7-Tesla 1H-MRS Study

A substantial number of individuals with clinical high-risk (CHR) mental state do not transition to psychosis. However, regardless of future diagnostic trajectories, many of these individuals develop poor social and occupational functional outcomes. The levels of glutathione, a crucial cortical antioxidant, may track variations in functional outcomes in early psychosis and prodromal states. Thirteen clinical high-risk and 30 healthy control volunteers were recruited for a 7-Tesla magnetic resonance spectroscopy scan with a voxel positioned within the dorsal anterior cingulate cortex (ACC). Clinical assessment scores were collected to determine if any association was observable with glutathione levels. The Bayesian Spearman's test revealed a positive association between the Social and Occupational Functioning Assessment Scale (SOFAS) and the glutathione concentration in the clinical high-risk group but not in the healthy control group. After accounting for variations in the SOFAS scores, the CHR group had higher GSH levels than the healthy subjects. This study is the first to use 7-Tesla magnetic resonance spectroscopy to test whether ACC glutathione levels relate to social and occupational functioning in a clinically high-risk group and offers preliminary support for glutathione levels as a clinically actionable marker of prognosis in emerging adults presenting with risk features for various severe mental illnesses.

Frontal-striatal connectivity and positive symptoms of schizophrenia: implications for the mechanistic basis of prefrontal rTMS

Repetitive transcranial magnetic stimulation (rTMS), when applied to left dorsolateral prefrontal cortex (LDLPFC), reduces negative symptoms of schizophrenia, but has no effect on positive symptoms. In a small number of cases, it appears to worsen the severity of positive symptoms. It has been hypothesized that high-frequency rTMS of the LDLPFC might increase the dopaminergic neurotransmission by driving the activity of the left striatum in the basal ganglia (LSTR)-increasing striatal dopaminergic activity. This hypothesis relies on the assumption that either the frontal-striatal connection or the intrinsic frontal and/or striatal connections covary with the severity of positive symptoms. The current work aimed to evaluate this assumption by studying the association between positive and negative symptoms severity and the effective connectivity within the frontal and striatal network using dynamic causal modeling of resting state fMRI in a sample of 19 first episode psychosis subjects. We found that the total score of positive symptoms of schizophrenia is strongly associated with the frontostriatal circuitry. Stronger intrinsic inhibitory tone of LDLPFC and LSTR, as well as decreased bidirectional excitatory influence between the LDLPFC and the LSTR is related to the severity of positive symptoms, especially delusions. We interpret that an increase in striatal dopaminergic tone that underlies positive symptoms is likely associated with increased prefrontal inhibitory tone, strengthening the frontostriatal 'brake'. Furthermore, based on our model, we propose that lessening of positive symptoms could be achieved by means of continuous theta-burst or low-frequency (1 Hz) rTMS of the prefrontal area.

Small Words That Matter: Linguistic Style and Conceptual Disorganization in Untreated First-Episode Schizophrenia

This study aimed to shed light on the linguistic style affecting the communication discourse in first-episode schizophrenia (FES) by investigating the analytic thinking index in relation to clinical scores of conceptual and thought disorganization (Positive and Negative Syndrome Scale, PANSS-P2 and Thought and Language Index, TLI). Using robust Bayesian modeling, we report three major findings: (1) FES subjects showed reduced analytic thinking, exhibiting a less categorical linguistic style than healthy control (HC) subjects (Bayes factor, BF10 > 1000), despite using the same proportion of function and content words as HCs; (2) the lower the analytic thinking score, the higher the symptoms scores of conceptual disorganization (PANSS-P2, BF = 22.66) and global disorganization of thinking (TLI, BF10 = 112.73); (3) the linguistic style is a better predictor of conceptual disorganization than the cognitive measure of processing speed in schizophrenia (SZ). These findings provide an objectively detectable linguistic style with a focus on Natural Language Processing Analytics of transcribed speech samples of patients with SZ that require no clinical judgment. These findings also offer a crucial insight into the primacy of linguistic structural disruption in clinically ascertained disorganized thinking in SZ. Our work contributes to an emerging body of literature on the psychopathology of SZ using a first-order lexeme-level analysis and a hypothesis-driven approach. At a utilitarian level, this has implications for improving educational and social outcomes in patients with SZ.

Glutamate and Dysconnection in the Salience Network: Neurochemical, Effective Connectivity, and Computational Evidence in Schizophrenia

BACKGROUND

Functional dysconnection in schizophrenia is underwritten by a pathophysiology of the glutamate neurotransmission that affects the excitation-inhibition balance in key nodes of the salience network. Physiologically, this manifests as aberrant effective connectivity in intrinsic connections involving inhibitory interneurons. In computational terms, this produces a pathology of evidence accumulation and ensuing inference in the brain. Finally, the pathophysiology and aberrant inference would partially account for the psychopathology of schizophrenia as measured in terms of symptoms and signs. We refer to this formulation as the 3-level hypothesis.

METHODS

We tested the hypothesis in core nodes of the salience network (the dorsal anterior cingulate cortex [dACC] and the anterior insula) of 20 patients with first-episode psychosis and 20 healthy control subjects. We established 3-way correlations between the magnetic resonance spectroscopy measures of glutamate, effective connectivity of resting-state functional magnetic resonance imaging, and correlations between measures of this connectivity and estimates of precision (inherent in evidence accumulation in the Stroop task) and psychopathology.

RESULTS

Glutamate concentration in the dACC was associated with higher and lower inhibitory connectivity in the dACC and in the anterior insula, respectively. Crucially, glutamate concentration correlated negatively with the inhibitory influence on the excitatory neuronal population in the dACC of subjects with first-episode psychosis. Furthermore, aberrant computational parameters of the Stroop task performance were associated with aberrant inhibitory connections. Finally, the strength of connections from the dACC to the anterior insula correlated negatively with severity of social withdrawal.

CONCLUSIONS

These findings support a link between glutamate-mediated cortical disinhibition, effective-connectivity deficits, and computational performance in psychosis.

Morphological Profiling of Schizophrenia: Cluster Analysis of MRI-Based Cortical Thickness Data

The diagnosis of schizophrenia is thought to embrace several distinct subgroups. The manifold entities in a single clinical patient group increase the variance of biological measures, deflate the group-level estimates of causal factors, and mask the presence of treatment effects. However, reliable neurobiological boundaries to differentiate these subgroups remain elusive. Since cortical thinning is a well-established feature in schizophrenia, we investigated if individuals (patients and healthy controls) with similar patterns of regional cortical thickness form naturally occurring morphological subtypes. K-means algorithm clustering was applied to regional cortical thickness values obtained from 256 structural MRI scans (179 patients with schizophrenia and 77 healthy controls [HCs]). GAP statistics revealed three clusters with distinct regional thickness patterns. The specific patterns of cortical thinning, clinical characteristics, and cognitive function of each clustered subgroup were assessed. The three clusters based on thickness patterns comprised of a morphologically impoverished subgroup (25% patients, 1% HCs), an intermediate subgroup (47% patients, 46% HCs), and an intact subgroup (28% patients, 53% HCs). The differences of clinical features among three clusters pertained to age-of-onset, N-back performance, duration exposure to treatment, total burden of positive symptoms, and severity of delusions. Particularly, the morphologically impoverished group had deficits in N-back performance and less severe positive symptom burden. The data-driven neuroimaging approach illustrates the occurrence of morphologically separable subgroups in schizophrenia, with distinct clinical characteristics. We infer that the anatomical heterogeneity of schizophrenia arises from both pathological deviance and physiological variance. We advocate using MRI-guided stratification for clinical trials as well as case-control investigations in schizophrenia.

Knowing when to stop: Aberrant precision and evidence accumulation in schizophrenia

Predictive coding and active inference formulations of the dysconnection hypothesis suggest that subjects with schizophrenia (SZ) hold unduly precise prior beliefs to compensate for a failure of sensory attenuation. This implies that SZ subjects should both initiate responses prematurely during evidence-accumulation tasks and fail to inhibit their responses at long stop-signal delays. SZ and healthy control subjects were asked to report the timing of billiards-ball collisions and were occasionally required to withhold their responses. SZ subjects showed larger temporal estimation errors, which were associated with premature responses and decreased response inhibition. To account for these effects, we used hierarchical (Bayesian) drift-diffusion models (HDDM) and model selection procedures to adjudicate among four hypotheses. HDDM revealed that the precision of prior beliefs (i.e., starting point) rather than increased sensory precision (i.e., drift rate) drove premature responses and impaired response inhibition in patients with SZ. From the perspective of active inference, we suggest that premature predictions in SZ are responses that, heuristically, are traded off against accuracy to ensure action execution. On the basis of previous work, we suggest that the right insular cortex might mediate this trade-off.

Manipulating the Alpha Level Cannot Cure Significance Testing

We argue that making accept/reject decisions on scientific hypotheses, including a recent call for changing the canonical alpha level from p = 0.05 to p = 0.005, is deleterious for the finding of new discoveries and the progress of science. Given that blanket and variable alpha levels both are problematic, it is sensible to dispense with significance testing altogether. There are alternatives that address study design and sample size much more directly than significance testing does; but none of the statistical tools should be taken as the new magic method giving clear-cut mechanical answers. Inference should not be based on single studies at all, but on cumulative evidence from multiple independent studies. When evaluating the strength of the evidence, we should consider, for example, auxiliary assumptions, the strength of the experimental design, and implications for applications. To boil all this down to a binary decision based on a p-value threshold of 0.05, 0.01, 0.005, or anything else, is not acceptable.

Successful and unsuccessful response inhibitions differentially affect the effective connectivity between insular, presupplementary-motor, and striatal areas

Successful response inhibition depends upon the delay between the cues that signal a response and its subsequent inhibition. Previous studies report activity in the right presupplementary motor area (rPreSMA), right anterior insula (rAI), and the right striatum (rSTR) when subjects attempt to inhibit responses. Although these regions are anatomically connected, how they interact during successful and unsuccessful inhibitions has not been studied. In this work, we used a temporal prediction task, functional MRI, and dynamic causal modeling to solve this question. We found selective direct activation of both the rPreSMA and the rAI during successful and unsuccessful inhibitions which also were associated with opposite modulatory effects on insular-striatal and presupplementary-motor striatal descending connections. Moreover, inputs to the rPreSMA during successful inhibitions were propagated to the rAI whereas inputs to the rAI during unsuccessful inhibitions were propagated to the rPreSMA. We interpret that the direct perturbation in the rPreSMA and the modulation of the rPreSMA → rSTR connections would facilitate response inhibition whereas weak insular activity would cause response inhibition to fail despite the existence of strong rAI → rSTR modulations. We discuss that descending connections could be nonlinearly modulated via activity of either the right inferior frontal gyrus or the left anterior cingulate cortex. From a predictive coding perspective, rAI activity during successful and unsuccessful inhibition would signal interoceptive information when subjects unexpectedly need to change behaviors. (PsycINFO Database Record

Temporal Prediction Errors Affect Short-Term Memory Scanning Response Time

Abstract. The Sternberg short-term memory scanning task has been used to unveil cognitive operations involved in time perception. Participants produce time intervals during the task, and the researcher explores how task performance affects interval production – where time estimation error is the dependent variable of interest. The perspective of predictive behavior regards time estimation error as a temporal prediction error (PE), an independent variable that controls cognition, behavior, and learning. Based on this perspective, we investigated whether temporal PEs affect short-term memory scanning. Participants performed temporal predictions while they maintained information in memory. Model inference revealed that PEs affected memory scanning response time independently of the memory-set size effect. We discuss the results within the context of formal and mechanistic models of short-term memory scanning and predictive coding, a Bayes-based theory of brain function. We state the hypothesis that our finding could be associated with weak frontostriatal connections and weak striatal activity.

Temporal Uncertainty and Temporal Estimation Errors Affect Insular Activity and the Frontostriatal Indirect Pathway during Action Update: A Predictive Coding Study

Action update, substituting a prepotent behavior with a new action, allows the organism to counteract surprising environmental demands. However, action update fails when the organism is uncertain about when to release the substituting behavior, when it faces temporal uncertainty. Predictive coding states that accurate perception demands minimization of precise prediction errors. Activity of the right anterior insula (rAI) is associated with temporal uncertainty. Therefore, we hypothesize that temporal uncertainty during action update would cause the AI to decrease the sensitivity to ascending prediction errors. Moreover, action update requires response inhibition which recruits the frontostriatal indirect pathway associated with motor control. Therefore, we also hypothesize that temporal estimation errors modulate frontostriatal connections. To test these hypotheses, we collected fMRI data when participants performed an action-update paradigm within the context of temporal estimation. We fit dynamic causal models to the imaging data. Competing models comprised the inferior occipital gyrus (IOG), right supramarginal gyrus (rSMG), rAI, right presupplementary motor area (rPreSMA), and the right striatum (rSTR). The winning model showed that temporal uncertainty drove activity into the rAI and decreased insular sensitivity to ascending prediction errors, as shown by weak connectivity strength of rSMG→rAI connections. Moreover, temporal estimation errors weakened rPreSMA→rSTR connections and also modulated rAI→rSTR connections, causing the disruption of action update. Results provide information about the neurophysiological implementation of the so-called horse-race model of action control. We suggest that, contrary to what might be believed, unsuccessful action update could be a homeostatic process that represents a Bayes optimal encoding of uncertainty.

Temporal prediction errors modulate task-switching performance

We have previously shown that temporal prediction errors (PEs, the differences between the expected and the actual stimulus’ onset times) modulate the effective connectivity between the anterior cingulate cortex and the right anterior insular cortex (rAI), causing the activity of the rAI to decrease. The activity of the rAI is associated with efficient performance under uncertainty (e.g., changing a prepared behavior when a change demand is not expected), which leads to hypothesize that temporal PEs might disrupt behavior-change performance under uncertainty. This hypothesis has not been tested at a behavioral level. In this work, we evaluated this hypothesis within the context of task switching and concurrent temporal predictions. Our participants performed temporal predictions while observing one moving ball striking a stationary ball which bounced off with a variable temporal gap. Simultaneously, they performed a simple color comparison task. In some trials, a change signal made the participants change their behaviors. Performance accuracy decreased as a function of both the temporal PE and the delay. Explaining these results without appealing to ad hoc concepts such as “executive control” is a challenge for cognitive neuroscience. We provide a predictive coding explanation. We hypothesize that exteroceptive and proprioceptive minimization of PEs would converge in a fronto-basal ganglia network which would include the rAI. Both temporal gaps (or uncertainty) and temporal PEs would drive and modulate this network respectively. Whereas the temporal gaps would drive the activity of the rAI, the temporal PEs would modulate the endogenous excitatory connections of the fronto-striatal network. We conclude that in the context of perceptual uncertainty, the system is not able to minimize perceptual PE, causing the ongoing behavior to finalize and, in consequence, disrupting task switching.

Dynamical predictions of insular hubs for social cognition and their application to stroke

The insular cortex (IC) is considered a rich hub for context-sensitive emotions/social cognition. Patients with focal IC stroke provide unique opportunities to study socio-emotional processes. Nevertheless, Couto et al. (2013b) have recently reported controversial results regarding IC involvement in emotion and social cognition. Similarly, patients with similar lesions show high functional variability, ranging from almost totally preserved to strongly impaired behavior. Critical evidence suggests that the variability of these patients in the above domains can be explained by enhanced neuroplasticity, compensatory processes, and functional remapping after stroke. Therefore, socio-emotional processes would depend on long-distance connections between the IC and frontotemporal regions. We propose that predictive coding and effective connectivity represent a novel approach to explore functional connectivity and assess compensatory, contralateral, and subsidiary network differences among focal stroke patients. This approach would help explain why socio-emotional performance is so variable within this population.

Temporal prediction errors modulate cingulate-insular coupling

Prediction error (i.e., the difference between the expected and the actual event's outcome) mediates adaptive behavior. Activity in the anterior mid-cingulate cortex (aMCC) and in the anterior insula (aINS) is associated with the commission of prediction errors under uncertainty. We propose a dynamic causal model of effective connectivity (i.e., neuronal coupling) between the aMCC, the aINS, and the striatum in which the task context drives activity in the aINS and the temporal prediction errors modulate extrinsic cingulate-insular connections. With functional magnetic resonance imaging, we scanned 15 participants when they performed a temporal prediction task. They observed visual animations and predicted when a stationary ball began moving after being contacted by another moving ball. To induced uncertainty-driven prediction errors, we introduced spatial gaps and temporal delays between the balls. Classical and Bayesian fMRI analyses provided evidence to support that the aMCC-aINS system along with the striatum not only responds when humans predict whether a dynamic event occurs but also when it occurs. Our results reveal that the insula is the entry port of a three-region pathway involved in the processing of temporal predictions. Moreover, prediction errors rather than attentional demands, task difficulty, or task duration exert an influence in the aMCC-aINS system. Prediction errors debilitate the effect of the aMCC on the aINS. Finally, our computational model provides a way forward to characterize the physiological parallel of temporal prediction errors elicited in dynamic tasks.

Metamizol, a non-opioid analgesic, acts via endocannabinoids in the PAG-RVM axis during inflammation in rats

The most commonly used drugs against pain act by inhibiting the cyclooxygenases (COXs). Metamizol (dipyrone) inhibits the COXs and is widely used in Europe and Latin America as a non-opioid analgesic. One target of metamizol and other non-opioid analgesics is the periaqueductal grey matter (PAG), where they trigger descending inhibition of spinal nociceptive transmission. Also, cannabinoids exert an analgesic action at several structures in the peripheral and central nervous system, including the PAG. The present study investigates whether the antinociceptive action of metamizol in the lateral-ventrolateral (LVL) PAG during inflammation is related to endocannabinoids. In anaesthetized rats, unitary action potentials were recorded from spinal nociceptive neurons with receptive fields in the ipsilateral hind paw. Inflammation of the paw induced neuronal hyperexcitability, which was attenuated by intra-LVL-PAG microinjection of metamizol either at the beginning of inflammation or when hyperexcitability was fully established. In both cases, the antinociceptive effect of metamizol was reduced by a microinjection of AM251, an antagonist at the CB1 cannabinoid receptor, either into the LVL-PAG or into the rostral ventromedial medulla (RVM). The RVM is a downstream structure that funnels PAG-derived descending inhibition into the spinal cord. These results show that endocannabinoids and their CB1 receptor (1) contribute at the LVL-PAG to the antinociceptive effects of metamizol, and possibly other non-opioid analgesics; and (2) participate in the PAG-derived activation of RVM descending antinociceptive influences.