Factors perpetuating functional cognitive symptoms after mild traumatic brain injury

INTRODUCTION

Self-reported memory difficulties (forgetting familiar names, misplacing objects) often persist long after a mild traumatic brain injury (mTBI), despite normal neuropsychological test performance. This clinical presentation may be a manifestation of a functional cognitive disorder (FCD). Several mechanisms underlying FCD have been proposed, including metacognitive impairment, memory perfectionism, and misdirected attention, as well as depression or anxiety-related explanations. This study aims to explore these candidate perpetuating factors in mTBI, to advance our understanding of why memory symptoms frequently persist following mTBI.

METHODS

A cross-sectional study of 67 adults (n = 39 with mTBI mean = 25 months ago and n = 28 healthy controls). Participants completed standardized questionnaires (including the Functional Memory Disorder Inventory), a metacognitive task (to quantify discrepancies between their trial-by-trial accuracy and confidence), and a brief neuropsychological test battery. We assessed candidate mechanisms in two ways: (1) between-groups, comparing participants with mTBI to healthy controls, and (2) within-group, examining their associations with functional memory symptom severity (FMDI) in the mTBI group.

RESULTS

Participants with mTBI performed similarly to controls on objective measures of memory ability but reported experiencing much more frequent memory lapses in daily life. Contrary to expectations, metacognitive efficiency did not differentiate the mTBI and control groups and was not associated with functional memory symptoms. Memory perfectionism was strongly associated with greater functional memory symptoms among participants with mTBI but did not differ between groups when accounting for age. Depression and checking behaviors produced consistent results across between-groups and within-group analyses: these factors were greater in the mTBI group compared to the control group and were associated with greater functional memory symptoms within the mTBI group.

CONCLUSIONS

This study highlights promising (e.g., depression, checking behaviors) and unlikely (e.g., metacognitive impairment) mechanisms underlying functional memory symptoms after mTBI, to guide future research and treatment.

Characterizing affiliative touch in humans and its role in advancing haptic design

An emerging view in cognitive neuroscience holds that the extraction of emotional relevance from sensory experience extends beyond the centralized appraisal of sensation in associative brain regions, including frontal and medial-temporal cortices. This view holds that sensory information can be emotionally valenced from the point of contact with the world. This view is supported by recent research characterizing the human affiliative touch system, which carries signals of soft, stroking touch to the central nervous system and is mediated by dedicated C-tactile afferent receptors. This basic scientific research on the human affiliative touch system is informed by, and informs, technology design for communicating and regulating emotion through touch. Here, we review recent research on the basic biology and cognitive neuroscience of affiliative touch, its regulatory effects across the lifespan, and the factors that modulate it. We further review recent work on the design of haptic technologies, devices that stimulate the affiliative touch system, such as wearable technologies that apply the sensation of soft stroking or other skin-to-skin contact, to promote physiological regulation. We then point to future directions in interdisciplinary research aimed at both furthering scientific understanding and application of haptic technology for health and wellbeing.

Gender Impacts the Relationship between Mood Disorder Symptoms and Effortful Avoidance Performance

We must often decide how much effort to exert or withhold to avoid undesirable outcomes or obtain rewards. In depression and anxiety, levels of avoidance can be excessive and reward-seeking may be reduced. Yet outstanding questions remain about the links between motivated action/inhibition and anxiety and depression levels, and whether they differ between men and women. Here, we examined the relationship between anxiety and depression scores, and performance on effortful active and inhibitory avoidance (Study 1) and reward seeking (Study 2) in humans. Undergraduates and paid online workers ([Formula: see text] = 545, [Formula: see text] = 310; [Formula: see text] = 368, [Formula: see text] = 450, [Formula: see text] = 22.58, [Formula: see text] = 17-62) were assessed on the Beck Depression Inventory II (BDI) and the Beck Anxiety Inventory (BAI) and performed an instructed online avoidance or reward-seeking task. Participants had to make multiple presses on active trials and withhold presses on inhibitory trials to avoid an unpleasant sound (Study 1) or obtain points toward a monetary reward (Study 2). Overall, men deployed more effort than women in both avoidance and reward-seeking, and anxiety scores were negatively associated with active reward-seeking performance based on sensitivity scores. Gender interacted with anxiety scores and inhibitory avoidance performance, such that women with higher anxiety showed worse avoidance performance. Our results illuminate effects of gender in the relationship between anxiety and depression levels and the motivation to actively and effortfully respond to obtain positive and avoid negative outcomes.

Cognitive-affective processes and suicidality in response to repetitive transcranial magnetic stimulation for treatment resistant depression

BACKGROUND

Repetitive transcranial magnetic stimulation (rTMS) can elicit 45-55 % response rates and may alleviate suicidality symptoms in treatment resistant depression (TRD). Blunted anticipatory reward sensitivity and negatively biased self-referential processing may predict trajectories of depressive and suicidality symptoms in rTMS for TRD and be modulated during treatment.

METHODS

Fifty-five individuals with TRD received four weeks of low-frequency rTMS applied to the right dorsolateral prefrontal cortex (LFR-rTMS) and were followed until 17 weeks post-baseline. Participants completed behavioral measures of anticipatory reward sensitivity and self-referential processing at baseline and five weeks post-baseline (approximately one-week post-treatment). We examined whether baseline anticipatory reward sensitivity and self-referential processing predicted trajectories of depressive and suicidality symptoms from baseline to follow-up and whether these cognitive-affective variables showed change from baseline to week five.

RESULTS

Anticipatory reward sensitivity and negative self-referential encoding at baseline were associated with higher overall depressive symptoms and suicidality from baseline to 17 weeks post-baseline. At week five, participants self-attributed a higher number of positive traits and a lower number of negative traits and had a lesser tendency to remember negative relative to positive traits they had self-attributed, compared to baseline.

LIMITATIONS

The specificity of these results to LFR-rTMS is unknown in the absence of a comparison group, and our relatively small sample size precluded the interpretation of null results.

CONCLUSIONS

Baseline blunted anticipatory reward sensitivity and negative biases in self-referential processing may be risk factors for higher depressive symptoms and suicidality during and after LFR-rTMS, and LFR-rTMS may modulate self-referential processing.

Rate of perceived stability as a measure of balance exercise intensity in people post-stroke

PURPOSE

This study investigates the reproducibility and concurrent validity of the Rate of Perceived Stability (RPS) Scale in people with stroke.

METHODS

On two separate days (2-10 days apart), participants provided their RPS ratings during clinical measures: 1)16 tasks from Community Balance and Mobility Scale (CB&M), 2)6-minute walk test (6MWT), and 3)self-paced gait speed. Intraclass correlations (ICCs) assessed between day test-retest reliability of RPS ratings. Standard error of measurement (SEM) and smallest detectable change (SDC) addressed level of between day agreement. Spearman rank correlations (r_s) quantified relationships between RPS, and general rating of perceived challenge, task-performance scores.

RESULTS

Thirty participants with stroke (50% female) participated. ICC ranged from 0.46 to 0.93 across tasks with 12/19 tasks showing ICCs above 0.75 (good test-retest reliability). SEM was 1-point for each task and SDC ranged from 2 to 4 across tasks. Concurrent validity between RPS and ratings of perceived challenge was good-to-excellent (r_s ranged 0.78-0.94, p < 0.01). Higher RPS (indicative of feeling less stable) was associated with lower balance performance scores on CB&M tasks, negative relationships ranged in strength from fair to good-to-excellent in 10/16 tasks (r_s ranged -0.46 to -0.81, p ≤ 0.01).

CONCLUSIONS

RPS shows promise as a measure of balance intensity in people with stroke.IMPLICATIONS FOR REHABILITATIONThe RPS is a reliable and valid measure of balance intensity in ambulatory people with stroke.The RPS scale may be a useful clinical tool to address the gap in practice of measuring balance intensity during rehabilitation of walking balance post-stroke.

Lateralization of autonomic output in response to limb-specific threat

In times of stress or danger, the autonomic nervous system (ANS) signals the fight or flight response. A canonical function of ANS activity is to globally mobilize metabolic resources, preparing the organism to respond to threat. Yet a body of research has demonstrated that, rather than displaying a homogenous pattern across the body, autonomic responses to arousing events - as measured through changes in electrodermal activity (EDA) - can differ between right and left body locations. Surprisingly, an attempt to identify a function of ANS asymmetry consistent with its metabolic role has not been investigated. In the current study, we investigated whether asymmetric autonomic responses could be induced through limb-specific aversive stimulation. Participants were given mild electric stimulation to either the left or right arm while EDA was monitored bilaterally. In a group-level analyses, an ipsilateral EDA response bias was observed, with increased EDA response in the hand adjacent to the stimulation. This effect was observable in ∼50% of individual particpants. These results demonstrate that autonomic output is more complex than canonical interpretations suggest. We suggest that, in stressful situations, autonomic outputs can prepare either the whole-body fight or flight response, or a simply a limb-localized flick, which can effectively neutralize the threat while minimizing global resource consumption. These findings are consistent with recent theories proposing evolutionary leveraging of neural structures organized to mediate sensory responses for processing of cognitive emotional cues.Significance statementThe present study constitutes novel evidence for an autonomic nervous response specific to the side of the body exposed to direct threat. We identify a robust pattern of electrodermal response at the body location that directly receives aversive tactile stimulation. Thus, we demonstrate for the first time in contemporary research that the ANS is capable of location-specific outputs within single effector organs in response to small scale threat. This extends the canonical view of the role of ANS responses in stressful or dangerous stresses - that of provoking a 'fight or flight' response - suggesting a further role of this system: preparation of targeted limb-specific action, i.e., a flick.

Sense and timing: Localizing objects during emotional distraction

There is substantial evidence demonstrating that emotional information influences perception. Yet across studies, findings of how it does so have been highly inconsistent. In particular, emotional context (task-unrelated emotional information in the environment) has a variable influence on spatial perceptual accuracy, sometimes improving and sometimes impairing the ability to localize objects. Here, we tested the hypothesis that the heterogenous nature of emotional influences on target localization is influenced by the specific combination of sensory modalities used in the task. In the present series of experiments, we used a cross-modal localization task to identify how emotional context influences the accuracy of spatial perception. By presenting nonemotional target stimuli alongside emotional nonspatial distractor items (facial expressions or vocalizations), we were able to systematically investigate how emotional stimuli presented to individual sensory modalities acted to modulate spatial perception at distinct stages of perception and action. In three separate experiments, distractor items were presented prior to or during target presentation or after presentation during the localization response. Intramodal emotional distractors influenced localization accuracy when they overlapped in timing with targets, and the direction of this effect was both modality and valence specific (Experiment I). Additionally, targeted contrasts revealed that auditory but not visual emotional distractors influenced localization of visual targets when presented during the behavioral response, with negative cues improving localization accuracy compared to neutral or positive cues (Experiment II). We suggest such effects reflect distinct patterns of unimodal versus multimodal processing in brain regions involved in early versus late stages of perceptual processing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

In the hands of the beholder: Wearing a COVID-19 mask is associated with its attractiveness

Protective facial masks reduce the spread of COVID-19 infection and save lives. Yet a substantial number of people have been resistant to wearing them. Considerable effort has been invested in convincing people to put on a mask, if not for their own sake than for those more vulnerable. Social and cognitive psychologists know that use and liking go both ways: people use what they like, and they like what they use. Here we asked whether positive attitudes towards facial masks were higher in those who had been wearing them longer. We asked participants in a diverse sample (N = 498 from five countries and more than 30 US states) to rate how attractive and emotionally arousing masks and other objects associated with COVID-19 were in comparison to neutral objects, as well as reporting on their mask-wearing habits. To confirm reliability of findings, the experiment was repeated in a subset of participants 8–10 weeks later. The findings show that regular use of protective masks was linked to their positive appraisal, with a higher frequency and a longer history of wearing a mask predicting increased mask attractiveness. These results extended to other COVID-related objects relative to controls. They also provide critical ecological validity for the idea that emotional appraisal of everyday objects is associated with our experience of using them. Practically, they imply that societal measures to encourage mask wearing may have contributed to positive emotional appraisals in those who put them on, whether due to personal choice or societal pressure.

Assessing the efficacy of tablet-based simulations for learning pseudo-surgical instrumentation

Nurses and surgeons must identify and handle specialized instruments with high temporal and spatial precision. It is crucial that they are trained effectively. Traditional training methods include supervised practices and text-based study, which may expose patients to undue risk during practice procedures and lack motor/haptic training respectively. Tablet-based simulations have been proposed to mediate some of these limitations. We implemented a learning task that simulates surgical instrumentation nomenclature encountered by novice perioperative nurses. Learning was assessed following training in three distinct conditions: tablet-based simulations, text-based study, and real-world practice. Immediately following a 30-minute training period, instrument identification was performed with comparable accuracy and response times following tablet-based versus text-based training, with both being inferior to real-world practice. Following a week without practice, response times were equivalent between real-world and tablet-based practice. While tablet-based training does not achieve equivalent results in instrument identification accuracy as real-world practice, more practice repetitions in simulated environments may help reduce performance decline. This project has established a technological framework to assess how we can implement simulated educational environments in a maximally beneficial manner.

Warped rhythms: Epileptic activity during critical periods disrupts the development of neural networks for human communication

It is well established that temporal lobe epilepsy-the most common and well-studied form of epilepsy-can impair communication by disrupting social-emotional and language functions. In pediatric epilepsy, where seizures co-occur with the development of critical brain networks, age of onset matters: The earlier in life seizures begin, the worse the disruption in network establishment, resulting in academic hardship and social isolation. Yet, little is known about the processes by which epileptic activity disrupts developing human brain networks. Here we take a synthetic perspective-reviewing a range of research spanning studies on molecular and oscillatory processes to those on the development of large-scale functional networks-in support of a novel model of how such networks can be disrupted by epilepsy. We seek to bridge the gap between research on molecular processes, on the development of human brain circuitry, and on clinical outcomes to propose a model of how epileptic activity disrupts brain development.

Emotional Objectivity: Neural Representations of Emotions and Their Interaction with Cognition

Recent advances in our understanding of information states in the human brain have opened a new window into the brain's representation of emotion. While emotion was once thought to constitute a separate domain from cognition, current evidence suggests that all events are filtered through the lens of whether they are good or bad for us. Focusing on new methods of decoding information states from brain activation, we review growing evidence that emotion is represented at multiple levels of our sensory systems and infuses perception, attention, learning, and memory. We provide evidence that the primary function of emotional representations is to produce unified emotion, perception, and thought (e.g., “That is a good thing”) rather than discrete and isolated psychological events (e.g., “That is a thing. I feel good”). The emergent view suggests ways in which emotion operates as a fundamental feature of cognition, by design ensuring that emotional outcomes are the central object of perception, thought, and action.

Affectively Biased Competition: Sustained Attention is Tuned to Rewarding Expressions and is Not Modulated by Norepinephrine Receptor Gene Variant

It is well established that emotionally salient stimuli evoke greater visual cortex activation than neutral ones, and can distract attention from competing tasks. Yet less is known about underlying neurobiological processes. As a proxy of population level biased competition, EEG steady-state visual evoked potentials are sensitive to competition effects from salient stimuli. Here we wished to examine whether individual differences in norepinephrine activity play a role in emotionally-biased competition.

Our previous research has found robust effects of a common variation in the ADRA2B gene, coding for alpha2B norepinephrine (NE) receptors, on emotional modulation of attention and memory. In the present study, EEG was collected while 87 carriers of the ADRA2B deletion variant and 95 non-carriers (final sample) performed a change detection task in which target gratings (gabor patches) were superimposed directly over angry, happy, and neutral faces. Participants indicated the number of phase changes (0–3) in the target. Overlapping targets and distractors were flickered at a distinct driving frequencies. Relative EEG power for faces vs. targets at the driving frequency served as an index of cortical resources allocated to each of the competing stimuli. Deletion carriers and non-carriers were randomly assigned to Discovery and Replication samples and reliability of results across samples was assessed before the groups were combined for greater power.

Overall happy faces evoked higher competition than angry or neutral faces; however, we observed no hypothesized effects of ADRA2B. Increased competition from happy faces was not due to the effect of low-level visual features or individuals low in social anxiety. Our results indicate that emotionally biased competition during sustained attention, while reliably observed in young adults, is not influenced by commonly observed individual differences linked to NE receptor function. They further indicate an overall pattern of affectively-biased competition for happy faces, which we interpret in relation to previously observed boundary conditions.

Episodic autobiographical memory is associated with variation in the size of hippocampal subregions

Striking individual differences exist in the human capacity to recollect past events, yet, little is known about the neural correlates of such individual differences. Studies investigating hippocampal volume in relation to individual differences in laboratory measures of episodic memory in young adults suggest that whole hippocampal volume is unrelated (or even negatively associated) with episodic memory. However, anatomical and functional specialization across hippocampal subregions suggests that individual differences in episodic memory may be linked to particular hippocampal subregions, as opposed to whole hippocampal volume. Given that the DG/CA_2/3 circuitry is thought to be especially critical for supporting episodic memory in humans, we predicted that the volume of this region would be associated with individual variability in episodic memory. This prediction was supported using high-resolution MRI of the hippocampal subfields and measures of real-world (autobiographical) episodic memory. In addition to the association with DG/CA_2/3 , we further observed a relationship between episodic autobiographical memory and subiculum volume, whereas no association was observed with CA₁ or with whole hippocampal volume. These findings provide insight into the possible neural substrates that mediate individual differences in real-world episodic remembering in humans.

The Blur of Pleasure: Appetitively Appealing Stimuli Decrease Subjective Temporal Perceptual Acuity

Anecdotal reports that time “flies by” or “slows down” during emotional events are supported by evidence that the motivational relevance of stimuli influences subsequent duration judgments. Yet it is unknown whether the subjective quality of events as they unfold is altered by motivational relevance. In a novel paradigm, we measured the subjective experience of moment-to-moment visual perception. Participants judged the temporal smoothness of high-approach positive images (desserts), negative images (e.g., of bodily mutilation), and neutral images (commonplace scenes) as they faded to black. Results revealed approach-motivated blurring, such that positive stimuli were judged as smoother and negative stimuli as choppier relative to neutral stimuli. Participants’ ratings of approach motivation predicted perceived fade smoothness after we controlled for low-level stimulus features. Electrophysiological data indicated that approach-motivated blurring modulated relatively rapid perceptual activation. These results indicate that stimulus value influences subjective temporal perceptual acuity; approach-motivating stimuli elicit perception of a “blurred” frame rate characteristic of speeded motion.

SOAP Opera: Self as Object and Agent in Prioritizing Attention

A growing body of evidence has demonstrated that multiple sources of salience tune attentional sets toward aspects of the environment, including affectively and motivationally significant categories of stimuli such as angry faces and reward-associated target locations. Recent evidence further indicates that objects that have gained personal significance through ownership can elicit similar attentional prioritization. Here we discuss current research on sources of attentional prioritization that shape our awareness of the visual world from moment to moment and the underlying neural systems and contextualize what is known about attentional prioritization of our possessions within that research. We review behavioral and neuroimaging research on the influence of self-relevance and ownership on cognition and discuss challenges to this literature stemming from different modes of conceptualizing and operationalizing the self. We argue that ownership taps into both “self-as-object,” which characterizes the self as an object with a constellation of traits and attributes, and “self-as-subject,” which characterizes the self as an agentic perceiver and knower. Despite an abundance of research probing neural and behavioral indices of self-as-object and its effects on attention, there exists a paucity of research on the influence of self-relevance of attention when self is operationalized from the perspective of a first-person subject. To begin to address this gap, we propose the Self as Ownership in Attentional Prioritization (SOAP) framework to explain how ownership increases salience through attention to external representations of self-identity (i.e., self as object) and attention to contextually mediated permission to act (i.e., self as subject).

Iconic faces are not real faces: enhanced emotion detection and altered neural processing as faces become more iconic

Iconic representations are ubiquitous; they fill children's cartoons, add humor to newspapers, and bring emotional tone to online communication. Yet, the communicative function they serve remains unaddressed by cognitive psychology. Here, we examined the hypothesis that iconic representations communicate emotional information more efficiently than their realistic counterparts. In Experiment 1, we manipulated low-level features of emotional faces to create five sets of stimuli that ranged from photorealistic to fully iconic. Participants identified emotions on briefly presented faces. Results showed that, at short presentation times, accuracy for identifying emotion on more "cartoonized" images was enhanced. In addition, increasing contrast and decreasing featural complexity benefited accuracy. In Experiment 2, we examined an event-related potential component, the P1, which is sensitive to low-level visual stimulus features. Lower levels of contrast and complexity within schematic stimuli were also associated with lower P1 amplitudes. These findings support the hypothesis that iconic representations differ from realistic images in their ability to communicate specific information, including emotion, quickly and efficiently, and that this effect is driven by changes in low-level visual features in the stimuli.

I saw mine first: A prior-entry effect for newly acquired ownership

Previous research has shown that attentional sets can be tuned to implicitly prioritize awareness of universally aversive or rewarding stimuli. But can mere ownership modulate implicit attentional prioritization as well? In Experiments 1 and 2, participants learned whether everyday objects belonged to them (self-owned) or the experimenter (other-owned) and completed a temporal order judgment task in which pairs of stimuli appeared onscreen with staggered timing. Results revealed a prior-entry effect, in which participants were more likely to report seeing a self-owned object first when 2 objects appeared simultaneously. In Experiment 3, no ownership status was assigned and no such effect was observed. Individual differences in the prior-entry effect were unrelated to independent self-construal, positive associations for self-owned objects, or loss aversion. These results suggest that attentional prioritization is not limited to universally salient stimuli. Rather, self-relevance, even when recently acquired, can engage an implicit attentional set that biases our perception of the environment. (PsycINFO Database Record

Dynamics of neural recruitment surrounding the spontaneous arising of thoughts in experienced mindfulness practitioners

Thoughts arise spontaneously in our minds with remarkable frequency, but tracking the brain systems associated with the early inception of a thought has proved challenging. Here we addressed this issue by taking advantage of the heightened introspective ability of experienced mindfulness practitioners to observe the onset of their spontaneously arising thoughts. We found subtle differences in timing among the many regions typically recruited by spontaneous thought. In some of these regions, fMRI signal peaked prior to the spontaneous arising of a thought - most notably in the medial temporal lobe and inferior parietal lobule. In contrast, activation in the medial prefrontal, temporopolar, mid-insular, lateral prefrontal, and dorsal anterior cingulate cortices peaked together with or immediately following the arising of spontaneous thought. We propose that brain regions that show antecedent recruitment may be preferentially involved in the initial inception of spontaneous thoughts, while those that show later recruitment may be preferentially involved in the subsequent elaboration and metacognitive processing of spontaneous thoughts. Our findings highlight the temporal dynamics of neural recruitment surrounding the emergence of spontaneous thoughts and may help account for some of spontaneous thought's peculiar qualities, including its wild diversity of content and its links to memory and attention.

Tuning to the Positive: Age-Related Differences in Subjective Perception of Facial Emotion

Facial expressions aid social transactions and serve as socialization tools, with smiles signaling approval and reward, and angry faces signaling disapproval and punishment. The present study examined whether the subjective experience of positive vs. negative facial expressions differs between children and adults. Specifically, we examined age-related differences in biases toward happy and angry facial expressions. Young children (5–7 years) and young adults (18–29 years) rated the intensity of happy and angry expressions as well as levels of experienced arousal. Results showed that young children—but not young adults—rated happy facial expressions as both more intense and arousing than angry faces. This finding, which we replicated in two independent samples, was not due to differences in the ability to identify facial expressions, and suggests that children are more tuned to information in positive expressions. Together these studies provide evidence that children see unambiguous adult emotional expressions through rose-colored glasses, and suggest that what is emotionally relevant can shift with development.

Soldiers With Posttraumatic Stress Disorder See a World Full of Threat: Magnetoencephalography Reveals Enhanced Tuning to Combat-Related Cues

BACKGROUND

Posttraumatic stress disorder (PTSD) is linked to elevated arousal and alterations in cognitive processes. Yet, whether a traumatic experience is linked to neural and behavioral differences in selective attentional tuning to traumatic stimuli is not known. The present study examined selective awareness of threat stimuli and underlying temporal-spatial patterns of brain activation associated with PTSD.

METHODS

Participants were 44 soldiers from the Canadian Armed Forces, 22 with PTSD and 22 without. All completed neuropsychological tests and clinical assessments. Magnetoencephalography data were collected while participants identified two targets in a rapidly presented stream of words. The first target was a number and the second target was either a combat-related or neutral word. The difference in accuracy for combat-related versus neutral words was used as a measure of attentional bias.

RESULTS

All soldiers showed a bias for combat-related words. This bias was enhanced in the PTSD group, and behavioral differences were associated with distinct patterns of brain activity. At early latencies, non-PTSD soldiers showed activation of midline frontal regions associated with fear regulation (90-340 ms after the second target presentation), whereas those with PTSD showed greater visual cortex activation linked to enhanced visual processing of trauma stimuli (200-300 ms).

CONCLUSIONS

These findings suggest that attentional biases in PTSD are linked to deficits in very rapid regulatory activation observed in healthy control subjects. Thus, sufferers with PTSD may literally see a world more populated by traumatic cues, contributing to a positive feedback loop that perpetuates the effects of trauma.

The neural correlates of memory for a life-threatening event: An fMRI study of passengers from flight AT236

We investigated the neural correlates of remote traumatic reexperiencing in survivors of a life-threatening incident: the near crash of Air Transat (AT) Flight 236. Survivors' brain activity was monitored during video-cued recollection of the AT disaster, September 11^th, 2001 (9/11), and a comparatively non-emotional (neutral) event. Passengers showed a robust memory enhancement effect for the AT incident relative to the 9/11 and neutral events. This traumatic memory enhancement was associated with activation in the amygdala, medial temporal lobe, anterior and posterior midline, and visual cortex in passengers. This brain-behavior relationship also held in relation to 9/11, which had elevated significance for passengers given its temporal proximity to the AT disaster. This pattern was not observed in a comparison group of non-traumatized individuals who were also scanned. These findings suggest that remote, traumatic memory is mediated by amygdalar activity, which likely enhances vividness via influences on hippocampal and ventral visual systems.

Temporal-spatial neural activation patterns linked to perceptual encoding of emotional salience

It is well known that we continuously filter incoming sensory information, selectively allocating attention to what is important while suppressing distracting or irrelevant information. Yet questions remain about spatiotemporal patterns of neural processes underlying attentional biases toward emotionally significant aspects of the world. One index of affectively biased attention is an emotional variant of an attentional blink (AB) paradigm, which reveals enhanced perceptual encoding for emotionally salient over neutral stimuli under conditions of limited executive attention. The present study took advantage of the high spatial and temporal resolution of magnetoencephalography (MEG) to investigate neural activation related to emotional and neutral targets in an AB task. MEG data were collected while participants performed a rapid stimulus visual presentation task in which two target stimuli were embedded in a stream of distractor words. The first target (T1) was a number and the second (T2) either an emotionally salient or neutral word. Behavioural results replicated previous findings of greater accuracy for emotionally salient than neutral T2 words. MEG source analyses showed that activation in orbitofrontal cortex, characterized by greater power in the theta and alpha bands, and dorsolateral prefrontal activation were associated with successful perceptual encoding of emotionally salient relative to neutral words. These effects were observed between 250 and 550 ms, latencies associated with discrimination of perceived from unperceived stimuli. These data suggest that important nodes of both emotional salience and frontoparietal executive systems are associated with the emotional modulation of the attentional blink.

Deletion variant in the ADRA2B gene increases coupling between emotional responses at encoding and later retrieval of emotional memories

A deletion variant of the ADRA2B gene that codes for the α2b adrenoceptor has been linked to greater susceptibility to traumatic memory as well as attentional biases in perceptual encoding of negatively valenced stimuli. The goal of the present study was to examine whether emotional enhancements of memory associated with the ADRA2B deletion variant were predicted by encoding, as indexed by the subjectively perceived emotional salience (i.e., arousal) of events at the time of encoding. Genotyping was performed on 186 healthy young adults who rated positive, negative, and neutral scenes for level of emotional arousal and subsequently performed a surprise recognition memory task 1 week later. Experience of childhood trauma was also measured, as well as additional genetic variations associated with emotional biases and episodic memory. Results showed that subjective arousal was linked to memory accuracy and confidence for ADRA2B deletion carriers but not for non-carriers. Our results suggest that carrying the ADRA2B deletion variant enhances the relationship between arousal at encoding and subsequent memory for moderately arousing events.

Genes for Emotion-Enhanced Remembering Are Linked to Enhanced Perceiving

Emotionally enhanced memory and susceptibility to intrusive memories after trauma have been linked to a deletion variant (i.e., a form of a gene in which certain amino acids are missing) of ADRA2B, the gene encoding subtype B of the α2-adrenergic receptor, which influences norepinephrine activity. We examined in 207 participants whether variations in this gene are responsible for individual differences in affective influences on initial encoding that alter perceptual awareness. We examined the attentional blink, an attentional impairment during rapid serial visual presentation, for negatively arousing, positively arousing, and neutral target words. Overall, the attentional blink was reduced for emotional targets for ADRA2B-deletion carriers and noncarriers alike, which reveals emotional sparing (i.e., reduction of the attentional impairment for words that are emotionally significant). However, deletion carriers demonstrated a further, more pronounced emotional sparing for negative targets. This finding demonstrates a contribution of genetics to individual differences in the emotional subjectivity of perception, which in turn may be linked to biases in later memory.

Shared neural substrates of emotionally enhanced perceptual and mnemonic vividness

It is well-known that emotionally salient events are remembered more vividly than mundane ones. Our recent research has demonstrated that such memory vividness (Mviv) is due in part to the subjective experience of emotional events as more perceptually vivid, an effect we call emotionally enhanced vividness (EEV). The present study built on previously reported research in which fMRI data were collected while participants rated relative levels of visual noise overlaid on emotionally salient and neutral images. Ratings of greater EEV were associated with greater activation in the amygdala and visual cortex. In the present study, we measured BOLD activation that predicted recognition Mviv for these same images 1 week later. Results showed that, after controlling for differences between scenes in low-level objective features, hippocampus activation uniquely predicted subsequent Mviv. In contrast, amygdala and visual cortex regions that were sensitive to EEV were also modulated by subsequent ratings of Mviv. These findings suggest shared neural substrates for the influence of emotional salience on perceptual and mnemonic vividness, with amygdala and visual cortex activation at encoding contributing to the experience of both perception and subsequent memory.

Affective salience can reverse the effects of stimulus-driven salience on eye movements in complex scenes

In natural vision both stimulus features and cognitive/affective factors influence an observer's attention. However, the relationship between stimulus-driven ("bottom-up") and cognitive/affective ("top-down") factors remains controversial: Can affective salience counteract strong visual stimulus signals and shift attention allocation irrespective of bottom-up features? Is there any difference between negative and positive scenes in terms of their influence on attention deployment? Here we examined the impact of affective factors on eye movement behavior, to understand the competition between visual stimulus-driven salience and affective salience and how they affect gaze allocation in complex scene viewing. Building on our previous research, we compared predictions generated by a visual salience model with measures indexing participant-identified emotionally meaningful regions of each image. To examine how eye movement behavior differs for negative, positive, and neutral scenes, we examined the influence of affective salience in capturing attention according to emotional valence. Taken together, our results show that affective salience can override stimulus-driven salience and overall emotional valence can determine attention allocation in complex scenes. These findings are consistent with the hypothesis that cognitive/affective factors play a dominant role in active gaze control.

Withholding response in the face of a smile: age-related differences in prefrontal sensitivity to Nogo cues following happy and angry faces

The modulation of control processes by stimulus salience, as well as associated neural activation, changes over development. We investigated age-related differences in the influence of facial emotion on brain activation when an action had to be withheld, focusing on a developmental period characterized by rapid social-emotional and cognitive change. Groups of kindergarten and young school-aged children and a group of young adults performed a modified Go/Nogo task. Response cues were preceded by happy or angry faces. After controlling for task performance, left orbitofrontal regions discriminated trials with happy vs. angry faces in children but not in adults when a response was withheld, and this effect decreased parametrically with age group. Age-related changes in prefrontal responsiveness to facial expression were not observed when an action was required, nor did this region show age-related activation changes with the demand to withhold a response in general. Such results reveal age-related differences in prefrontal activation that are specific to stimulus valence and depend on the action required.

Affect-biased attention as emotion regulation

The affective biasing of attention is not typically considered to be a form of emotion regulation. In this article, we argue that 'affect-biased attention' - the predisposition to attend to certain categories of affectively salient stimuli over others - provides an important component of emotion regulation. Affect-biased attention regulates subsequent emotional responses by tuning one's filters for initial attention and subsequent processing. By reviewing parallel research in the fields of emotion regulation and affect-biased attention, as well as clinical and developmental research on individual differences in attentional biases, we provide convergent evidence that habitual affective filtering processes, tuned and re-tuned over development and situation, modulate emotional responses to the world. Moreover, they do so in a manner that is proactive rather than reactive.

Genetic differences in emotionally enhanced memory

Understanding genetic contributions to individual differences in the capacity for emotional memory has tremendous implications for understanding normal human memory as well as pathological reactions to traumatic stress. Research in the last decade has identified genetic polymorphisms thought to influence cognitive/affective processes that may contribute to emotional memory capacity. In this paper, we review key polymorphisms linked to emotional and mnemonic processing and their influence on neuromodulator activity in the amygdala and other emotion-related structures. We discuss their potential roles in specific cognitive processes involved in memory formation, and review links between these genetic variants, brain activation, and specific patterns of attention, perception, and memory consolidation that may be linked to individual differences in memory vividness. Finally we propose a model predicting an influence of noradrenergic, serotonergic, and dopaminergic processes on emotional perception, as well as on memory consolidation and self-regulation. Outside of the laboratory, it is likely that real-life effects of arousal operate along a continuum that incorporates other "non-emotional" aspects of memory. For this reason we further discuss additional literature on genetic variations that influence general episodic memory processes, rather than being specific to emotional enhancement of memory. We conclude that specific neuromodulators contribute to an amygdala-driven memory system that is relatively involuntary, embodied, and sensorily vivid.

The changing face of emotion: age-related patterns of amygdala activation to salient faces

The present study investigated age-related differences in the amygdala and other nodes of face-processing networks in response to facial expression and familiarity. fMRI data were analyzed from 31 children (3.5-8.5 years) and 14 young adults (18-33 years) who viewed pictures of familiar (mothers) and unfamiliar emotional faces. Results showed that amygdala activation for faces over a scrambled image baseline increased with age. Children, but not adults, showed greater amygdala activation to happy than angry faces; in addition, amygdala activation for angry faces increased with age. In keeping with growing evidence of a positivity bias in young children, our data suggest that children find happy faces to be more salient or meaningful than angry faces. Both children and adults showed preferential activation to mothers' over strangers' faces in a region of rostral anterior cingulate cortex associated with self-evaluation, suggesting that some nodes in frontal evaluative networks are active early in development. This study presents novel data on neural correlates of face processing in childhood and indicates that preferential amygdala activation for emotional expressions changes with age.

Neurophysiological correlates of executive function: a comparison of European-canadian and chinese-canadian 5-year-old children

This study explored the neurophysiological correlates of executive function (EF) in young children from two different cultural backgrounds. Twenty European-Canadian and 17 Chinese-Canadian 5-year-olds participated in a go/no-go task, during which high-density electroencephalographic (EEG) data were recorded. No cultural group differences were observed in children's behavioral performance on the task, but marked differences were revealed by ERP analyses, which focused on the amplitude and latency of the N2 waveform. Chinese-Canadian children showed larger (i.e., more negative) N2 amplitudes than European-Canadian children on the right side of the scalp on no-go trials, as well as on the left side of the scalp on go trials, and for all children, larger N2 amplitudes were associated with faster median reaction times. Source analyses of the N2 were consistent with the hypothesis that compared to European-Canadian children, Chinese-Canadian children showed more activation in dorsomedial, ventromedial, and (bilateral) ventrolateral prefrontal cortex. These findings reveal that EEG can provide a measure of cultural differences in neurocognitive function that is more sensitive than behavioral data alone; that Chinese-Canadian children show a pattern of hemispheric differentiation in the context of this task than that is more pronounced than that of age-matched European-Canadian children; that the asymmetrically lateralized N2 may be a reliable marker of both effortful inhibition (on the right) and effortful approach (on the left); and that the neural correlates of EF may vary across samples of healthy participants, even in children.

Neurophysiological correlates of executive function: a comparison of European-canadian and chinese-canadian 5-year-old children

This study explored the neurophysiological correlates of executive function (EF) in young children from two different cultural backgrounds. Twenty European-Canadian and 17 Chinese-Canadian 5-year-olds participated in a go/no-go task, during which high-density electroencephalographic (EEG) data were recorded. No cultural group differences were observed in children's behavioral performance on the task, but marked differences were revealed by ERP analyses, which focused on the amplitude and latency of the N2 waveform. Chinese-Canadian children showed larger (i.e., more negative) N2 amplitudes than European-Canadian children on the right side of the scalp on no-go trials, as well as on the left side of the scalp on go trials, and for all children, larger N2 amplitudes were associated with faster median reaction times. Source analyses of the N2 were consistent with the hypothesis that compared to European-Canadian children, Chinese-Canadian children showed more activation in dorsomedial, ventromedial, and (bilateral) ventrolateral prefrontal cortex. These findings reveal that EEG can provide a measure of cultural differences in neurocognitive function that is more sensitive than behavioral data alone; that Chinese-Canadian children show a pattern of hemispheric differentiation in the context of this task than that is more pronounced than that of age-matched European-Canadian children; that the asymmetrically lateralized N2 may be a reliable marker of both effortful inhibition (on the right) and effortful approach (on the left); and that the neural correlates of EF may vary across samples of healthy participants, even in children.

Group specific optimisation of fMRI processing steps for child and adult data

Motion is a major issue in functional magnetic resonance imaging (fMRI) dataseries and causes artifacts or increased overall noise obscuring signals of interest. It is particularly important to be able to control for and correct these artifacts when dealing with child data. We analysed the data from 35 children (4-8 years old) and 13 adults (18-30 years old) during an emotional face paradigm. The children were split into low and high motion groups on the basis of having less or more than an estimated maximal movement of one voxel (3.75 mm) and one degree of rotation in any motion direction between any pair of scans in the run. Several different preprocessing steps were evaluated for their ability to correct for the excess motion using agnostic canonical variates analysis (aCVA) in the NPAIRS (Nonparametric, Prediction, Activation, Influence, Reproducibility, re-Sampling) framework. The adult dataset was reasonably stable whereas the motion-prone child datasets benefited greatly from motion parameter regression (MPR). Motion parameter regression had a strong beneficial impact on all datasets, a result that was largely unaffected by other preprocessing choices; however, motion correction on its own did not have as much impact. The low motion child group subjected to MPR had reproducibility values at par with those of the adult group, but needed almost twice as many subjects to achieve this result, indicating weaker responses in young children. The aCVA showed greater sensitivity to the task response pattern than the mixed effects general linear model (mGLM) in the expected face processing regions, although the mGLM showed more responses in some other areas. This work illustrates that preprocessing choices must be made in a group-specific fashion to optimise fMRI results.

The time course of social-emotional processing in early childhood: ERP responses to facial affect and personal familiarity in a Go-Nogo task

To date, little is known about the neural underpinnings of social-emotional processes in young children. The present study investigated the time course of children's ERP responses to facial expression and personal familiarity, and the effect of these variables on ERP measures of effortful attention in a Go-Nogo task. Dense-array EEG was collected from 48 4-6-year-old children who were presented with pictures of their mothers' and strangers' happy and angry faces. ERPs were scored following face presentation and following a subsequent cue signaling a Go or Nogo response. Responses to face presentation showed early perceptual components that were larger following strangers' faces, suggesting facilitated rapid processing of personally important faces. A mid-latency frontocentral negativity was greatest following angry mothers' faces, indicating increased attentional monitoring and/or recognition memory evoked by an angry parent. Finally a right-lateralized late positive component was largest following angry faces, suggesting extended processing of negatively valenced social stimuli in general. Following the Go-Nogo response cue, a right-lateralized mid-latency negativity thought to measure effortful attention was larger in Nogo than Go trials, and following angry than happy faces, possibly reflecting increased effortful control required in those conditions. The present study suggests that overlapping but differentiated networks for both rapid and elaborative processing of important socio-affective information are established by 4-6 years. Moreover, the extended spatial and temporal distribution of components suggests a pattern of response to social stimuli in which more rapid processes may index personal familiarity, whereas temporally extended processes are sensitive to affective valence on both familiar and unfamiliar faces.

Event-related potential measures of emotion regulation in early childhood

Emotion regulation in adults may be mediated by frontal cortical activities that adjust attention in response to challenging emotions. We examined event-related potentials across emotional conditions to assess normative patterns and individual differences in cortical mechanisms of emotion regulation in 4-6-year-olds. The children viewed pictures of angry, neutral, and happy faces during a Go/No-go task. Angry faces generated the greatest (frontocentral) N2 amplitudes and fastest N2 latencies, and happy faces produced the smallest amplitudes and slowest latencies. Frontal electrodes showed larger N2s to angry faces in the Go condition. The P3b was also largest for angry faces. More fearful children showed faster latency N2s to angry faces. These results are interpreted in terms of early-developing mechanisms for regulating anxiety and processing emotional information.

A new technique for securing a foley catheter

We describe a new technique to secure a urethral catheter using a horizontal drain tube stabilizer. This device is reliable, inexpensive, and more comfortable for patients than either adhesive tape or leg straps.

The diagnostic meaning of "nervous breakdown" among lay populations

Two studies investigated the nature of nervous breakdown (NB): a mental illness commonly referred to by individuals not professionally related to the field of mental health. The clinical profile of NB was first surveyed among 121 undergraduates using a symptom checklist. Descriptive statistics and analysis of variance indicated NB is a time-limited condition that presents with primarily anxious and depressed features, associated with a series of external precipitating stressors (e.g., interpersonal, employment, and financial losses). Dimensions significantly uncharacteristic of NB included psychoticism, somatization, phobic anxiety, and mania. These results were replicated in a community sample of 189 adults from urban and suburban areas of a large metropolitan city. Respondents held a relatively unitary view of NB: Combined-sample cluster analysis (N = 310) revealed 2 groups with similar symptom profiles that differed primarily with regard to level of distress associated with disorder. Thus, among this population, NB is not an amorphous term for generalized psychiatric disturbance.

Empathic joy and the empathy-altruism hypothesis

Three experiments tested whether empathy evokes egoistic motivation to share vicariously in the victim's joy at improvement (the empathic-joy hypothesis) instead of altruistic motivation to increase the victim's welfare (the empathy-altruism hypothesis). In Experiment 1, Ss induced to feel either low or high empathy for a young woman in need were given a chance to help her. Some believed that if they helped they would receive feedback about her improvement; others did not. In Experiments 2 and 3, Ss induced to feel either low or high empathy were given a choice of getting update information about a needy person's condition. Before choosing, they were told the likelihood of the person's condition having improved--and of their experiencing empathic joy--was 20%, was 50%, or was 80%. Results of none of the experiments patterned as predicted by the empathic-joy hypothesis; instead, results of each were consistent with the empathy-altruism hypothesis.

Empathic joy and the empathy-altruism hypothesis

Three experiments tested whether empathy evokes egoistic motivation to share vicariously in the victim's joy at improvement (the empathic-joy hypothesis) instead of altruistic motivation to increase the victim's welfare (the empathy-altruism hypothesis). In Experiment 1, Ss induced to feel either low or high empathy for a young woman in need were given a chance to help her. Some believed that if they helped they would receive feedback about her improvement; others did not. In Experiments 2 and 3, Ss induced to feel either low or high empathy were given a choice of getting update information about a needy person's condition. Before choosing, they were told the likelihood of the person's condition having improved--and of their experiencing empathic joy--was 20%, was 50%, or was 80%. Results of none of the experiments patterned as predicted by the empathic-joy hypothesis; instead, results of each were consistent with the empathy-altruism hypothesis.

Long-term evaluation of naproxen suspension in juvenile chronic arthritis

Twenty-six children suffering from juvenile chronic arthritis were entered into a 6-month open evaluation of naproxen suspension. Sixteen patients completed 6-months' treatment, 6 were lost to follow-up and 4 dropped out, 2 because of side-effects (rash, and burning on swallowing the formulation), 1 for lack of efficacy and 1 because of no further need of treatment. Pain severity scores were significantly reduced from admission levels at all monthly follow-up visits and significant overall improvement since the last visit was noted up to third month of treatment, as assessed by doctor and parent/patient. Transient indigestion was reported by 2 patients. No clinically significant trends were noted in any of the laboratory investigations carried out. The results add to the accumulation of data on the use of naproxen in children and underline its long-term efficacy and tolerance.