Entangled brains and the experience of pains

The International Association for the Study of Pain (IASP) revised its definition of pain to "an unpleasant sensory and emotional experience." Three recent recommendations for understanding pain if there are no clear brain correlates include eliminativism, multiple realizability, and affordance-based approaches. I adumbrate a different path forward. Underlying each of the proposed approaches and the new IASP definition is the suspicion that there are no specific correlates for pain. I suggest that this basic assumption is misguided. As we learn more about brain function, it is becoming clear that many areas process many different types of information at the same time. In this study, I analogize how animal brains navigate in three-dimensional space with how the brain creates pain. Underlying both cases is a large-scale combinatorial system that feeds back on itself through a diversity of convergent and divergent bi-directional connections. Brains are not like combustion engines, with energy driving outputs via the structure of the machine, but are instead more like whirlpools, which are essentially dynamic patterns in some substrates. We should understand pain experiences as context-dependent, spatiotemporal trajectories that reflect heterogeneous, multiplex, and dynamically adaptive brain cells.

Neural correlates of psychodynamic and non-psychodynamic therapies in different clinical populations through fMRI: A meta-analysis and systematic review

Background

The COVID-19 pandemic has exacerbated the ongoing crisis in psychiatric and psychological care, contributing to what we have identified as a new psychological and psychiatric pandemic. Psychotherapy is an effective method for easing the psychological suffering experienced also by the various impacts of COVID-19. This treatment can be examined from a neurological perspective, through the application of brain imaging techniques. Specifically, the meta-analysis of imaging studies can aid in expanding researchers' understanding of the many beneficial applications of psychotherapy.

Objectives

We examined the functional brain changes accompanying different mental disorders with functional Magnetic Resonance Imaging (fMRI), through a meta-analysis, and systematic review in order to better understand the general neural mechanism involved in psychotherapy and the potential neural difference between psychodynamic and non-psychodynamic approaches.

Data sources

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were employed for our systematic review and meta-analysis. We conducted a computer-based literature search, following the Population, Intervention, Comparison and Outcomes (PICO) approach, to retrieve all published articles in English regarding the above-described topics from PubMed (MEDLINE), Scopus, and Web of Science.

Study eligibility criteria participants and interventions

We combined terms related to psychotherapy and fMRI: ("psychotherapy" [All Fields] OR "psychotherapy" [MeSH Terms] OR "psychotherapy" [All Fields] OR "psychotherapies" [All Fields] OR "psychotherapy s" [All Fields]) AND ("magnetic resonance imaging" [MeSH Terms]) OR ("magnetic"[All Fields] AND "resonance"[All Fields] AND "imaging"[All Fields]) OR ("magnetic resonance imaging"[All Fields] OR "fmri"[All Fields]). We considered (1) whole brain fMRI studies; (2) studies in which participants have been involved in a clinical trial with psychotherapy sessions, with pre/post fMRI; (3) fMRI results presented in coordinate-based (x, y, and z) in MNI or Talairach space; (4) presence of neuropsychiatric patients. The exclusion criteria were: (1) systematic review or meta-analysis; (2) behavioral study; (3) single-case MRI or fMRI study; and (4) other imaging techniques (i.e., PET, SPECT) or EEG.

Results

After duplicates removal and assessment of the content of each published study, we included 38 sources. The map including all studies that assessed longitudinal differences in brain activity showed two homogeneous clusters in the left inferior frontal gyrus, and caudally involving the anterior insular cortex (p < 0.0001, corr.). Similarly, studies that assessed psychotherapy-related longitudinal changes using emotional or cognitive tasks (TASK map) showed a left-sided homogeneity in the anterior insula (p < 0.000) extending to Broca's area of the inferior frontal gyrus (p < 0.0001) and the superior frontal gyrus (p < 0.0001). Studies that applied psychodynamic psychotherapy showed Family-Wise Error (FWE) cluster-corrected (p < 0.05) homogeneity values in the right superior and inferior frontal gyri, with a small cluster in the putamen. No FWE-corrected homogeneity foci were observed for Mindful- based and cognitive behavioral therapy psychotherapy. In both pre- and post-therapy results, studies showed two bilateral clusters in the dorsal anterior insulae (p = 0.00001 and p = 0.00003, respectively) and involvement of the medial superior frontal gyrus (p = 0.0002).

Limitations

Subjective experiences, such as an individual's response to therapy, are intrinsically challenging to quantify as objective, factual realities. Brain changes observed both pre- and post-therapy could be related to other factors, not necessary to the specific treatment received. Therapeutic modalities and study designs are generally heterogeneous. Differences exist in sample characteristics, such as the specificity of the disorder and number and duration of sessions. Moreover, the sample size is relatively small, particularly due to the paucity of studies in this field and the little contribution of PDT.

Conclusions and implications of key findings

All psychological interventions seem to influence the brain from a functional point of view, showing their efficacy from a neurological perspective. Frontal, prefrontal regions, insular cortex, superior and inferior frontal gyrus, and putamen seem involved in these neural changes, with the psychodynamic more linked to the latter three regions.

Prelimbic proBDNF Facilitates Retrieval-Dependent Fear Memory Destabilization by Regulation of Synaptic and Neural Functions in Juvenile Rats

Fear regulation changes as a function of the early life is a key developmental period for the continued maturation of fear neural circuitry. The mechanisms of fear retrieval-induced reconsolidation have been investigated but remain poorly understood. The involvement of prelimbic proBDNF in fear memory extinction and its mediated signaling have been reported previously. Specifically, blocking the proBDNF/p75^NTR pathway during the postnatal stage disrupts synaptic development and neuronal activity in adulthood. Given the inherent high expression of proBDNF during the juvenile period, we tested whether the prelimbic proBDNF regulated synaptic and neuronal functions allowing to influencing retrieval-dependent memory processing. By examining the freezing behavior of auditory fear-conditioned rats, we found the high level of the prelimbic proBDNF in juvenile rats enhanced the destabilization of the retrieval-dependent weak but not strong fear memory through activating p75^NTR-GluN2B signaling. This modification of fear memory traces was attributed to the increment in the proportion of thin-type spine and promotion in synaptic function, as evidenced by the facilitation of NMDA-mediated EPSCs and GluN2B-dependent synaptic depression at the prelimbic projection. Furthermore, the strong prelimbic theta- and gamma-oscillation coupling predicted the suppressive effect of juvenile proBDNF on the recall of postretrieval memory. Our results critically emphasize the importance of developmental proBDNF for modification of retrieval-dependent memory and provide a potential critical targeting to inhibit threaten memories associated with neurodevelopment disorders.

Longitudinal Study of Cognitive and Emotional Alterations in Amyotrophic Lateral Sclerosis: Clinical and Imaging Data

Objectives: Extra-motor manifestations occur in 50% of patients with amyotrophic lateral sclerosis (ALS). These mainly concern cognition, emotional processing and behavior. Depression and anxiety are less frequent. Little is known about how these manifestations change as the disease progresses. Similarly, although cortical thinning has been well-documented at disease onset, there are scant data about cortical thinning over time and how this correlates with extra-motor manifestations. The present study therefore assessed cognitive, emotional and psychological state and cortical thinning in a group of patients with ALS at baseline and after a follow-up period.

Methods: We assessed executive functions, facial emotion recognition, depressive and anxious symptoms, and cortical thinning in 43 patients with ALS at baseline, comparing them with 28 healthy controls, and 21 of them 9 months later. We looked for links among the extra-motor manifestations and correlations with cortical thickness.

Results: At baseline, patients had poor executive function and recognition of complex emotions from the eyes, and more anxious and depressive symptoms than controls. At follow-up, only inhibition abilities had worsened. Cortical thinning was observed in bilateral pre-central regions and other parts of the cerebral cortex at baseline. Over time, it worsened in motor and extra-motor areas. Executive functions correlated with thinning in the middle and inferior frontal gyrus and orbitofrontal cortex.

Conclusions: During follow-up, there was little deterioration in extra-motor manifestations and psychological state, despite continuing cortical thinning. Patients with affective Theory of Mind (ToM) changes seemed less depressed than the others. Impaired mental flexibility was subtended by prefrontal regions with cortical thinning.

Subject- and task-independent neural correlates and prediction of decision confidence in perceptual decision making

Objective.In many real-world decision tasks, the information available to the decision maker is incomplete. To account for this uncertainty, we associate a degree of confidence to every decision, representing the likelihood of that decision being correct. In this study, we analyse electroencephalography (EEG) data from 68 participants undertaking eight different perceptual decision-making experiments. Our goals are to investigate (1) whether subject- and task-independent neural correlates of decision confidence exist, and (2) to what degree it is possible to build brain computer interfaces that can estimate confidence on a trial-by-trial basis. The experiments cover a wide range of perceptual tasks, which allowed to separate the task-related, decision-making features from the task-independent ones.Approach.Our systems train artificial neural networks to predict the confidence in each decision from EEG data and response times. We compare the decoding performance with three training approaches: (1) single subject, where both training and testing data were acquired from the same person; (2) multi-subject, where all the data pertained to the same task, but the training and testing data came from different users; and (3) multi-task, where the training and testing data came from different tasks and subjects. Finally, we validated our multi-task approach using data from two additional experiments, in which confidence was not reported.Main results.We found significant differences in the EEG data for different confidence levels in both stimulus-locked and response-locked epochs. All our approaches were able to predict the confidence between 15% and 35% better than the corresponding reference baselines.Significance.Our results suggest that confidence in perceptual decision making tasks could be reconstructed from neural signals even when using transfer learning approaches. These confidence estimates are based on the decision-making process rather than just the confidence-reporting process.

Neural Correlates of Cognitive Performance in Alzheimer's Disease- and Lewy Bodies-Related Cognitive Impairment

BACKGROUND

Clinicopathological studies have demonstrated that the neuropsychological profiles and outcomes are different between two dementia subtypes, namely Alzheimer's disease (AD) and Lewy bodies-related disease.

OBJECTIVE

We investigated the neural correlates of cognitive dysfunction in patients with AD-related cognitive impairment (ADCI) and those with Lewy bodies-related cognitive impairment (LBCI).

METHODS

We enrolled 216 ADCI patients, 183 LBCI patients, and 30 controls. Cortical thickness and diffusion tensor imaging analyses were performed to correlate gray matter and white matter (WM) abnormalities to cognitive composite scores for memory, visuospatial, and attention/executive domains in the ADCI spectrum (ADCI patients and controls) and the LBCI spectrum (LBCI patients and controls) separately.

RESULTS

Memory dysfunction correlated with cortical thinning and increased mean diffusivity in the AD-prone regions, particularly the medial temporal region, in ADCI. Meanwhile, it only correlated with increased mean diffusivity in the WM adjacent to the anteromedial temporal, insula, and basal frontal cortices in LBCI. Visuospatial dysfunction correlated with cortical thinning in posterior brain regions in ADCI, while it correlated with decreased fractional anisotropy in the corpus callosum and widespread WM regions in LBCI. Attention/executive dysfunction correlated with cortical thinning and WM abnormalities in widespread brain regions in both disease spectra; however, ADCI had more prominent correlation with cortical thickness and LBCI did with fractional anisotropy values.

CONCLUSIONS

Our study demonstrated that ADCI and LBCI have different neural correlates with respect to cognitive dysfunction. Cortical thinning had greater effects on cognitive dysfunction in the ADCI, while WM disruption did in the LBCI.

Neural Representation of Loudness: Cortical Evoked Potentials in an Induced Loudness Reduction Experiment

Loudness context effects comprise differences in judgments of the loudness of a target stimulus depending on the presence of a preceding inducer tone. Interstimulus intervals (ISIs) between inducer tone and target tone of about 200 ms and above cause an induced loudness reduction (ILR) of the target tone. As the ILR increases, respectively, the perceived loudness of the target stimuli decreases with increasing ISI. This in turn means that identical stimuli in a different context have a differently perceived loudness. A correlation between specific characteristics in the electroencephalography responses and perceived loudness in an ILR experiment would therefore provide a neurophysiological indication of loudness processing beyond a neural representation of stimulus intensity only. To examine if such a correlation exists, we investigated cortical electroencephalography responses in a latency range from 75 to 510 ms during a psychoacoustical ILR experiment with different ISIs. With increasing ISI, the strength of the N1-P2 deflection of the respective electroencephalography response decreases similarly to the loudness perception of the target tone pulse. This indicates a representation based on loudness rather than on intensity at the corresponding processing stage.

Decoding visual roughness perception: an fMRI study

The neural substrates of tactile roughness perception have been investigated by many neuroimaging studies, while relatively little effort has been devoted to the investigation of neural representations of visually perceived roughness. In this human fMRI study, we looked for neural activity patterns that could be attributed to five different roughness intensity levels when the stimuli were perceived visually, i.e., in absence of any tactile sensation. During functional image acquisition, participants viewed video clips displaying a right index fingertip actively exploring the sandpapers that had been used for the behavioural experiment. A whole brain multivariate pattern analysis found four brain regions in which visual roughness intensities could be decoded: the bilateral posterior parietal cortex (PPC), the primary somatosensory cortex (S1) extending to the primary motor cortex (M1) in the right hemisphere, and the inferior occipital gyrus (IOG). In a follow-up analysis, we tested for correlations between the decoding accuracies and the tactile roughness discriminability obtained from a preceding behavioural experiment. We could not find any correlation between both although, during scanning, participants were asked to recall the tactilely perceived roughness of the sandpapers. We presume that a better paradigm is needed to reveal any potential visuo-tactile convergence. However, the present study identified brain regions that may subserve the discrimination of different intensities of visual roughness. This finding may contribute to elucidate the neural mechanisms related to the visual roughness perception in the human brain.

Regional Homogeneity Predicts Creative Insight: A Resting-State fMRI Study

Creative insight plays an important role in our daily life. Previous studies have investigated the neural correlates of creative insight by functional magnetic resonance imaging (fMRI), however, the intrinsic resting-state brain activity associated with creative insight is still unclear. In the present study, we used regional homogeneity (ReHo) as an index in resting-state fMRI (rs-fMRI) to identify brain regions involved in individual differences in creative insight, which was compued by the response time (RT) of creative Chinese character chunk decomposition. The findings indicated that ReHo in the anterior cingulate cortex (ACC)/caudate nucleus (CN) and angular gyrus (AG)/superior temporal gyrus (STG)/inferior parietal lobe (IPL) negatively predicted creative insight. Furthermore, these findings suggested that spontaneous brain activity in multiple regions related to breaking and establishing mental sets, goal-directed solutions exploring, shifting attention, forming new associations and emotion experience contributes to creative insight. In conclusion, the present study provides new evidence to further understand the cognitive processing and neural correlates of creative insight.

Do we need another neural correlate of contour integration?

Gilad and colleagues use an elegant combination of voltage-sensitive dyes and high temporal and spatial resolution optical imaging to visualize a differential response to collinear contour elements in monkey V1. This result adds to the literature on the neural correlates of contour integration, but does not yet tackle (or seek to tackle) the question as to whether contour integration is mediated by lateral connections within an area (e.g., V1), through pooling of feedfoward connections, or feedback mechanisms. Moreover, while Gilad et al. find that their differential response is correlated with the behavioral performance of each monkey, there are reasons to suspect that the correlation they observe is a consequence of processing in higher regions, and that the differential V1 response may not play a critical role in integrating contour elements, or in generating the monkey's response. Moreover, this differential V1 response was not observed in a monkey who was not trained on the task, a result that can only be reconciled, if one assumes that the monkey could not see the contour prior to training. If valid, this could raise doubts as to whether the study of contour integration really provides insights into the processes by which normal visual perception is achieved.

Changes in cerebral blood flow after cognitive behavior therapy in patients with panic disorder: a SPECT study

AIM

Inconsistent results continue to be reported in studies that examine the neural correlates of cognitive behavioral therapy (CBT) in patients with panic disorder. We examined the changes in regional cerebral blood flow (rCBF) associated with the alleviation of anxiety by CBT in panic patients.

METHODS

The change in rCBF and clinical symptoms before and after CBT were assessed using single photon emission computed tomography and various clinical measures were analyzed.

RESULTS

Fourteen subjects who completed CBT showed significant improvements in symptoms on clinical measures, including the Panic and Agoraphobic Scale and the Anxiety Sensitivity Index-Revised. After CBT, increased rCBF was detected in the left postcentral gyrus (BA 43), left precentral gyrus (BA 4), and left inferior frontal gyrus (BA 9 and BA 47), whereas decreased rCBF was detected in the left pons. Correlation analysis of the association between the changes in rCBF and changes in each clinical measure did not show significant results.

CONCLUSION

We found changes in the rCBF associated with the successful completion of CBT. The present findings may help clarify the effects of CBT on changes in brain activity in panic disorder.

General and specific consciousness: a first-order representationalist approach

It is widely acknowledged that a complete theory of consciousness should explain general consciousness (what makes a state conscious at all) and specific consciousness (what gives a conscious state its particular phenomenal quality). We defend first-order representationalism, which argues that consciousness consists of sensory representations directly available to the subject for action selection, belief formation, planning, etc. We provide a neuroscientific framework for this primarily philosophical theory, according to which neural correlates of general consciousness include prefrontal cortex, posterior parietal cortex, and non-specific thalamic nuclei, while neural correlates of specific consciousness include sensory cortex and specific thalamic nuclei. We suggest that recent data support first-order representationalism over biological theory, higher-order representationalism, recurrent processing theory, information integration theory, and global workspace theory.

Interplay of electroencephalogram phase and auditory-evoked neural activity

Auditory-evoked potentials (AEPs) were triggered in real time as a function of ongoing electroencephalogram (EEG) phase. Phase triggering on-line or retrospective phase-selective averaging introduces phase artifacts such as spurious troughs or peaks, which mask mid-latency and affect the amplitude of late AEPs. We developed a method to control for phase artifacts by phase-selective averaging of trials, recorded without stimulation, and used this to uncover a previously unknown phase dependency of AEPs. Not only are such findings inconsistent with the standard additive evoked potential model, but we identified clear neural correlates at fixed latencies, which are inconsistent with the recently proposed phase-resetting model. Our findings suggest that a new conceptualization is required to account for the interplay between the correlates of neural-evoked activity and modulation of ongoing EEG that together constitute evoked potentials.