Psychomotor retardation: What about the partial responders to magnetic transcranial stimulation in treatment resistant depression ?

OBJECTIVE: Psychomotor retardation is a core clinical component of Major Depressive Disorder responsible for disability and is known as a treatment response marker of biological treatments for depression. Our objective was to describe cognitive and motoric measures changes during a treatment by repetitive Transcranial Magnetic Stimulation (rTMS) within the THETAD-DEP trial for treatment-resistant depression (TRD), and compare those performances at the end of treatment and one month after between responders (>50% improvement on MADRS score), partial responders (25-50%) and non-reponders (no clinically relevant improvement). Our secondary aim was to investigate baseline psychomotor performances associated with non-response and response even partial. METHODS: Fifty-four patients with treatment-resistant unipolar depression and treated by either high frequency 10 Hz rTMS or iTBS for 4 weeks (20 sessions) underwent assessment including French Retardation Rating Scale for Depression (ERD), Verbal Fluency test, and Trail Making Test A. before, just after treatment and one month later. RESULTS: 20 patients were responders (R, 21 partial responders (PR) and 13 non-responders (NR). rTMS treatment improved psychomotor performances in the R and PR groups unlike NR patients whose psychomotor performance was not enhanced by treatment. At baseline, participants, later identified as partial responders, showed significantly higher performances than non-responders. CONCLUSION: Higher cognitivo-motor performances at baseline may be associated with clinical improvement after rTMS treatment. This work highlights the value of objective psychomotor testing for the identification of rTMS responders and partial responders, and thus may be useful for patient selection and protocol individualization such as treatment continuation for early partial responders.

Distinct neural mechanisms for action access and execution in the human brain: insights from an fMRI study.

Goal-directed actions are fundamental to human behavior, whereby inner goals are achieved through mapping action representations to motor outputs. The left premotor cortex (BA6) and the posterior portion of Broca's area (BA44) are two modulatory poles of the action system. However, how these regions support the representation-output mapping within the system is not yet understood. To address this, we conducted a finger-tapping functional magnetic resonance imaging experiment using action categories ranging from specific to general. Our study found distinct neural behaviors in BA44 and BA6 during action category processing and motor execution. During access of action categories, activity in a posterior portion of BA44 (pBA44) decreased linearly as action categories became less specific. Conversely, during motor execution, activity in BA6 increased linearly with less specific categories. These findings highlight the differential roles of pBA44 and BA6 in action processing. We suggest that pBA44 facilitates access to action categories by utilizing motor information from the behavioral context while the premotor cortex integrates motor information to execute the selected action. This finding enhances our understanding of the interplay between prefrontal cortical regions and premotor cortex in mapping action representation to motor execution and, more in general, of the cortical mechanisms underlying human behavior.

Multiplicative joint coding in preparatory activity for reaching sequence in macaque motor cortex.

Although the motor cortex has been found to be modulated by sensory or cognitive sequences, the linkage between multiple movement elements and sequence-related responses is not yet understood. Here, we recorded neuronal activity from the motor cortex with implanted micro-electrode arrays and single electrodes while monkeys performed a double-reach task that was instructed by simultaneously presented memorized cues. We found that there existed a substantial multiplicative component jointly tuned to impending and subsequent reaches during preparation, then the coding mechanism transferred to an additive manner during execution. This multiplicative joint coding, which also spontaneously emerged in recurrent neural networks trained for double reach, enriches neural patterns for sequential movement, and might explain the linear readout of elemental movements.

The effect of quiet eye training on golf putting performance in pressure situation.

To explores the effect and mechanism of quiet eye training on the accuracy of golfers´ putts in pressure situations and provides methods and basis for targeted attention training and control. 22 young golfers in China golf team aged from 13 to 18 were randomly assigned to the experimental group (quiet eye training group) and the control group (technical guidance group) according to gender. Both groups of participants underwent two consecutive weeks of push training (3 sets per day, 20 golf putts per set, rest for 3 min between sets) separately in accordance with the guidance of a professional psychological research group and an expert coach. Eye tracking technology, biofeedback technology, and subjective evaluation methods were used to test and analyze the push process of the two groups of participants before and after training under pressure situations (Eye movement behaviors and the heart rate were recorded by ASL Mobile Eye-XG and NeXus-2 biofeedback, pressure and state anxiety were evaluated by self-rating pressure scale and S-AI. Golf putting performance was recorded by a research graduate assistant). A higher hit ratio as well as lower pressure and SAI level was founded in quiet eye training group in the pressure situation, the quiet eye movement time and total fixation time was longer than technical group. The quiet eye training group has a better putting performance. Quiet eye training can improve the golf putting performance in pressure situations. After quiet eye training, the state anxiety decreased, the quiet eye movement time and the total fixation time increased in pressure situations.

Convolutional neural networks reveal properties of reach-to-grasp encoding in posterior parietal cortex.

Deep neural networks (DNNs) are widely adopted to decode motor states from both non-invasively and invasively recorded neural signals, e.g., for realizing brain-computer interfaces. However, the neurophysiological interpretation of how DNNs make the decision based on the input neural activity is limitedly addressed, especially when applied to invasively recorded data. This reduces decoder reliability and transparency, and prevents the exploitation of decoders to better comprehend motor neural encoding. Here, we adopted an explainable artificial intelligence approach - based on a convolutional neural network and an explanation technique - to reveal spatial and temporal neural properties of reach-to-grasping from single-neuron recordings of the posterior parietal area V6A. The network was able to accurately decode 5 different grip types, and the explanation technique automatically identified the cells and temporal samples that most influenced the network prediction. Grip encoding in V6A neurons already started at movement preparation, peaking during movement execution. A difference was found within V6A: dorsal V6A neurons progressively encoded more for increasingly advanced grips, while ventral V6A neurons for increasingly rudimentary grips, with both subareas following a linear trend between the amount of grip encoding and the level of grip skills. By revealing the elements of the neural activity most relevant for each grip with no a priori assumptions, our approach supports and advances current knowledge about reach-to-grasp encoding in V6A, and it may represent a general tool able to investigate neural correlates of motor or cognitive tasks (e.g., attention and memory tasks) from single-neuron recordings.

Perception, action, and the body model.

In 1992, Goodale and Milner proposed to study the visual system based on function, thus dissociating vision for perception (ventral stream) and vision for action (dorsal stream). This became known as the Perception and Action model (PAM). Following the PAM in the visual system, a somatosensory PAM was proposed including a body representation for perception and a separate for action. This review explores the body model of the hand and how it relates to the PAM. The body model refers to the internal representation of the body that is responsible for position sense. Previous research has shown that the representation of the hand features systematic distortions: an overestimation of hand width and an underestimation of finger length. These distortions have been reported using different paradigms, different body parts, and in various settings. Thus, body model distortions appear to be a characteristic of human body representation. If the body model of the hand is distorted, how can actions like reaching and grasping be accurate? We review evidence that body model distortions may in fact provide a functional benefit to our actions, that cortical maps in the somatosensory and motor cortices reflect these distortions, and that actions rely on a distorted body model. We argue that the body model is a product of both the ventral and dorsal somatosensory streams. Further, we suggest that the body model is an example of the inextricable link between the two streams.

Training-related changes in neural beta oscillations associated with implicit and explicit motor sequence learning.

Many motor actions we perform have a sequential nature while learning a motor sequence involves both implicit and explicit processes. In this work, we developed a task design where participants concurrently learn an implicit and an explicit motor sequence across five training sessions, with EEG recordings at sessions 1 and 5. This intra-subject approach allowed us to study training-induced behavioral and neural changes specific to the explicit and implicit components. Based on previous reports of beta power modulations in sensorimotor networks related to sequence learning, we focused our analysis on beta oscillations at motor-cortical sites. On a behavioral level, substantial performance gains were evident early in learning in the explicit condition, plus slower performance gains across training sessions in both explicit and implicit sequence learning. Consistent with the behavioral trends, we observed a training-related increase in beta power in both sequence learning conditions, while the explicit condition displayed stronger beta power suppression during early learning. The initially stronger beta suppression and subsequent increase in beta power specific to the explicit component, correlated with enhanced behavioral performance, possibly reflecting higher cortical excitability. Our study suggests an involvement of motor-cortical beta oscillations in the explicit component of motor sequence learning.

Multiscale entropy in a 10-minute vigilance task.

Research has shown multiscale entropy, brain signal behavior across time scales, to reliably increase at lower time scales with time-on-task fatigue. However, multiscale entropy has not been examined in short vigilance tasks (i.e., ≤ 10 min). Addressing this gap, we examine multiscale entropy during a 10-minute Psychomotor Vigilance Test (PVT). Thirty-four participants provided neural data while completing the PVT. We compared the first 2 min of the task to the 7th and 8th minutes to avoid end-spurt effects. Results suggested increased multiscale entropy at lower time scales later compared to earlier in the task, suggesting multiscale entropy is a strong marker of time-on-task fatigue onset during short vigils. Separate analyses for Fast and Slow performers reveal differential entropy patterns, particularly over visual cortices. Here, observed brain-behavior linkage between entropy and reaction time for slow performers suggests that entropy assays over sensory cortices might have predictive value for fatigue onset or shifts from on- to off-task states.

A 90- followed by a 30-min nap reduces fatigue whereas a 30- followed by a 90-min nap maintains cognitive performance in night work: A randomized crossover-pilot study.

OBJECTIVE: To investigate the effects of combinations of brief naps (a 90- followed by a 30-min nap vs. a 30- followed by a 90-min nap) on sleep inertia, reducing sleepiness and fatigue, and maintaining performance during night hours. METHODS: This randomized, comparative, repeated-measure, cross-over study investigated subjective and cognitive performance in 12 healthy females, evaluated in three experimental nap conditions: 1) from 22:30 to 00:00 and 02:30 to 03:00 (Pre90-NAP group), 2) from 23:30 to 00:00 and 02:30 to 04:00 (Pre30-NAP) group, and 3) no naps (NO-NAP group). Participants' body temperature, psychomotor vigilance task (PVT) and Uchida-Kraepelin test (UKT) scores, and subjective feelings of drowsiness and fatigue were evaluated. Sleep state was determined by an actigraphy monitoring device worn by participants. RESULTS: Regardless of timing, both 90-min naps were associated with sleep inertia, and both 30-min naps with minimal sleep inertia. Reaction times were shorter and fewer errors were committed at 2 h post-nap in the Pre30-NAP and Pre90-NAP groups compared with those at the same time in the NO-NAP group. Adding a 90-min nap to a 30-min nap reduced subjective fatigue and shortened reaction times, and adding a 30-min nap to a 90-min nap was effective in maintaining performance, suggesting a synergistic effect. CONCLUSIONS: Taking two naps during a night work can mitigate sleepiness and fatigue, and maintain performance. A 90- followed by a 30-min nap reduced fatigue and reaction time, and a 30- followed by a 90-min nap maintained cognitive performance in the early morning.

Variable, sometimes absent, but never negative: Applying multilevel models of variability to the backward crosstalk effect to find theoretical constraints.

When performing two tasks at the same time, the congruency of the second task's features influences performance in the first task. This is called the backward crosstalk effect (BCE), a phenomenon that influences both theories of binding and of dual-task capacity limitations. The question of whether the BCE is found in all participants at all times is relevant for understanding the basis of the effect. For example, if the BCE is based on strategic choices, it can be variable, but if it is automatic and involuntary, it should never vary in whether it is present or not. Variability in observed BCE sizes was already documented and discussed when the group average effect was first reported (Hommel, 1998). Yet the theories discussed at the time did not motivate a more direct analysis of this variability, nor did the readily available statistical tools permit it. Some statistical approaches recently applied in cognitive psychology allow such a variability-focused analysis and some more recent theoretical debates would benefit from this as well. We assessed the variability of the BCE as well as a BCE-like free-choice congruency effect by applying a Bayesian multilevel modeling approach to the data from a dual-tasking experiment. Trials consisted of a two- and a four-response task. We manipulated which task was presented first and whether the response to the four-choice task was free or forced choice. RT data were best predicted by a model in which the BCE is zero in part of the population and drawn from a normal distribution truncated at zero (and thus always positive) in the rest of the population. Choice congruency bias data were best predicted by a model assuming this effect to be drawn from a normal distribution truncated at zero (but, in contrast to the RT data, without the subset of the population where it is zero). The BCE is not an inflexible and universal phenomenon that is directly linked to an inherent structural trait of human cognition. We discuss theoretical constraints implied by these results with a focus on what we can infer about the traits of the factors that influence BCE size. We suggest that future research might add further major constraints by using multi-session experiments to distinguish between-person and within-person variability. Our results show that the BCE is variable. The next step is understanding along which axes it is variable and why it varies.

The sense of agency in near and far space.

The sense of agency is the ability to recognize that we are the actors of our actions and their consequences. We explored whether and how spatial cues may modulate the agency experience by manipulating the ecological validity of the experimental setup (real-space or computer-based setup) and the distance of the action-outcome (near or far). We tested 58 healthy adults collecting explicit agency judgments and the perceived time interval between movements and outcomes (to quantify the intentional binding phenomenon, an implicit index of agency). Participants show greater implicit agency for voluntary actions when there is a temporal and spatial action-outcome contingency. Conversely, participants reported similar explicit agency for outcomes appearing in the near and far space. Notably, these effects were independent of the ecological validity of the setting. These results suggest that spatial proximity, realistic or illusory, is essential for feeling implicitly responsible for the consequences of our actions.

Action initiation and action inhibition follow the same time course when compared under matched experimental conditions.

The ability to initiate an action quickly when needed and the ability to cancel an impending action are both fundamental to action control. It is often presumed that they are qualitatively distinct processes, yet they have largely been studied in isolation and little is known about how they relate to one another. Comparing previous experimental results shows a similar time course for response initiation and response inhibition. However, the exact time course varies widely depending on experimental conditions, including the frequency of different trial types and the urgency to respond. For example, in the stop-signal task, where both action initiation and action inhibition are involved and could be compared, action inhibition is typically found to be much faster. However, this apparent difference is likely due to there being much greater urgency to inhibit an action than to initiate one in order to avoid failing at the task. This asymmetry in the urgency between action initiation and action inhibition makes it impossible to compare their relative time courses in a single task. Here, we demonstrate that when action initiation and action inhibition are measured separately under conditions that are matched as closely as possible, their speeds are not distinguishable and are positively correlated across participants. Our results raise the possibility that action initiation and action inhibition may not necessarily be qualitatively distinct processes but may instead reflect complementary outcomes of a single decision process determining whether or not to act.NEW & NOTEWORTHY The time courses of initiating an action and canceling an action have largely been studied in isolation, and little is known about their relationship. Here, we show that when measured under comparable conditions the speeds of action initiation and action inhibition are the same. This finding raises the possibility that these two functions may be more closely related than previously assumed, with potentially important implications for their underlying neural basis.

Visual-motor integration in children with unilateral cerebral palsy: application of the computer-aided measure of visual-motor integration.

BACKGROUND: Children with unilateral cerebral palsy (UCP) are encouraged to participate in the regular school curriculum. However, even when using the less-affected hand for handwriting, children with UCP still experience handwriting difficulties. Visual-motor integration (VMI) is a predictor of handwriting quality. Investigating VMI in children with UCP is important but still lacking. Conventional paper-based VMI assessments is subjective and use all-or-nothing scoring procedures, which may compromise the fidelity of VMI assessments. Moreover, identifying important shapes that are predictive of VMI performance might benefit clinical decision-making because different geometric shapes represent different developmental stepping stones of VMI. Therefore, a new computer-aided measure of VMI (the CAM-VMI) was developed to investigate VMI performance in children with UCP and to identify shapes important for predicting their VMI performance. METHODS: Twenty-eight children with UCP and 28 typically-developing (TD) children were recruited. All participants were instructed to complete the CAM-VMI and Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery-VMI). The test items of the CAM-VMI consisted of nine simple geometric shapes related to writing readiness. Two scores of the CAM-VMI, namely, Error and Effort, were obtained by image registration technique. The performances on the Beery-VMI and the CAM-VMI of children with UCP and TD children were compared by independent t-test. A series of stepwise regression analyses were used to identify shapes important for predicting VMI performance in children with UCP. RESULTS: Significant group differences were found in both the CAM-VMI and the Beery-VMI results. Furthermore, Error was identified as a significant aspect for predicting VMI performance in children with UCP. Specifically, the square item was the only significant predictor of VMI performance in children with UCP. CONCLUSIONS: This study was a large-scale study that provided direct evidence of impaired VMI in school-aged children with UCP. Even when using the less-affected hand, children with UCP could not copy the geometric shapes as well as TD children did. The copied products of children with UCP demonstrated poor constructional accuracy and inappropriate alignment. Furthermore, the predictive model suggested that the constructional accuracy of a copied square is an important predictor of VMI performance in children with UCP.

Movement-goal relevant object shape properties act as poor but viable cues for the attribution of motor errors to external objects.

When a context change is detected during motor learning, motor memories-internal models for executing movements within some context-may be created or existing motor memories may be activated and modified. Assigning credit to plausible causes of errors can allow for fast retrieval and activation of a motor memory, or a combination of motor memories, when the presence of such causes is detected. Features of the movement-context intrinsic to the movement dynamics, such as posture of the end effector, are often effective cues for detecting context change whereas features extrinsic to the movement dynamics, such as the colour of an object being moved, are often not. These extrinsic cues are typically not relevant to the motor task at hand and can be safely ignored by the motor system. We conducted two experiments testing if extrinsic but movement-goal relevant object-shape cues during an object-transport task can act as viable contextual cues for error assignment to the object, and the creation of new, object-shape-associated motor memories. In the first experiment we find that despite the object-shape cues, errors are primarily attributed to the hand transporting the object. In a second experiment, we find participants can execute differing movements cued by the object shape in a dual adaptation task, but the extent of adaptation is small, suggesting that movement-goal relevant object-shape properties are poor but viable cues for creating context specific motor memories.

Coordination of gaze and action during high-speed steering and obstacle avoidance.

When humans navigate through complex environments, they coordinate gaze and steering to sample the visual information needed to guide movement. Gaze and steering behavior have been extensively studied in the context of automobile driving along a winding road, leading to accounts of movement along well-defined paths over flat, obstacle-free surfaces. However, humans are also capable of visually guiding self-motion in environments that are cluttered with obstacles and lack an explicit path. An extreme example of such behavior occurs during first-person view drone racing, in which pilots maneuver at high speeds through a dense forest. In this study, we explored the gaze and steering behavior of skilled drone pilots. Subjects guided a simulated quadcopter along a racecourse embedded within a custom-designed forest-like virtual environment. The environment was viewed through a head-mounted display equipped with an eye tracker to record gaze behavior. In two experiments, subjects performed the task in multiple conditions that varied in terms of the presence of obstacles (trees), waypoints (hoops to fly through), and a path to follow. Subjects often looked in the general direction of things that they wanted to steer toward, but gaze fell on nearby objects and surfaces more often than on the actual path or hoops. Nevertheless, subjects were able to perform the task successfully, steering at high speeds while remaining on the path, passing through hoops, and avoiding collisions. In conditions that contained hoops, subjects adapted how they approached the most immediate hoop in anticipation of the position of the subsequent hoop. Taken together, these findings challenge existing models of steering that assume that steering is tightly coupled to where actors look. We consider the study's broader implications as well as limitations, including the focus on a small sample of highly skilled subjects and inherent noise in measurement of gaze direction.

Longitudinal point-of-care assessment of psychomotor vigilance in children in the epilepsy monitoring unit.

The epilepsy monitoring unit (EMU) is a complex and dynamic operational environment, where the cognitive and behavioural consequences of medical and environmental changes often go unnoticed. The psychomotor vigilance task (PVT) has been used to detect changes in cognition and behaviour in numerous contexts, including among astronauts on spaceflight missions, pilots, and commercial drivers. Here, we piloted serial point-of-care administration of the PVT in children undergoing invasive monitoring in the EMU. Seven children completed the PVT throughout their hospital admission and their performance was associated with daily seizure counts, interictal epileptiform discharges, number of antiseizure medications (ASMs) administered, and sleep quality metrics. Using mixed-effects models, we found that PVT reaction time and accuracy were adversely affected by greater number of ASMs and interictal epileptiform activity. We show that serial point-of-care PVT is simple and feasible in the EMU and may enable greater understanding of individual patient responses to medical and environmental alterations, inform clinical decision-making, and support quality-improvement and research initiatives.

Switching between different cognitive strategies induces switch costs as evidenced by switches between manual and mental object rotation.

Switching between tasks entails costs when compared to repeating the same task. It is unclear whether switch costs also occur when repeating the same task but switching the underlying cognitive strategy (CS). Here, we investigated whether CS switch costs exist despite overlap in mental processing between CSs and a lack of abstract goal (always "solve task X") or answer key binding switches. Specifically, we asked participants to judge the identity of two misaligned objects by either mental or manual computer-mediated object rotation. In each trial of Block 1, to measure switch costs without choice-related cognitive processes, a cue indicated which CS (mental/manual) to use. In Block 2, the CS was freely chosen. Participants exhibited considerable CS switch costs for both cued and freely chosen switches. Moreover, Block 1 switch costs moderately predicted Block 2 switch frequency, while an overall tendency for CS repetition was observed. In sum, we found that switch costs are not confined to situations in which tasks are switched but generalize to situations in which the task stays identical and the CS is switched instead. The results have implications for modern computerized cognitive environments in which a multitude of cognitive strategies is available for the same task.

Motor learning and performance in schizophrenia and aging: two different patterns of decline.

Psychomotor slowing has consistently been observed in schizophrenia, however research on motor learning in schizophrenia is limited. Additionally, motor learning in schizophrenia has never been compared with the waning of motor learning abilities in the elderly. Therefore, in an extensive study, 30 individuals with schizophrenia, 30 healthy age-matched controls and 30 elderly participants were compared on sensorimotor learning tasks including sequence learning and adaptation (both explicit and implicit), as well as tracking and aiming. This paper presents new findings on an explicit motor sequence learning task, an explicit verbal learning task and a simple aiming task and summarizes all previously published findings of this large investigation. Individuals with schizophrenia and elderly had slower Movement Time (MT)s compared with controls in all tasks, however both groups improved over time. Elderly participants learned slower on tracking and explicit sequence learning while individuals with schizophrenia adapted slower and to a lesser extent to movement perturbations in adaptation tasks and performed less well on cognitive tests including the verbal learning task. Results suggest that motor slowing is present in schizophrenia and the elderly, however both groups show significant but different motor skill learning. Cognitive deficits seem to interfere with motor learning and performance in schizophrenia while task complexity and decreased movement precision interferes with motor learning in the elderly, reflecting different underlying patterns of decline in these conditions. In addition, evidence for motor slowing together with impaired implicit adaptation supports the influence of cerebellum and the cerebello-thalamo-cortical-cerebellar (CTCC) circuits in schizophrenia, important for further understanding the pathophysiology of the disorder.

Autokinesis Reveals a Threshold for Perception of Visual Motion.

In natural viewing conditions, the brain can optimally integrate retinal and extraretinal signals to maintain a stable visual perception. These mechanisms, however, may fail in circumstances where extraction of a motion signal is less viable such as impoverished visual scenes. This can result in a phenomenon known as autokinesis in which one may experience apparent motion of a small visual stimulus in an otherwise completely dark environment. In this study, we examined the effect of autokinesis on visual perception of motion in human observers. We used a novel method with optical tracking in which the visual motion was reported manually by the observer. Experiment results show at lower speeds of motion, the perceived direction of motion was more aligned with the effect of autokinesis, whereas in the light or at higher speeds in the dark, it was more aligned with the actual direction of motion. These findings have important implications for understanding how the stability of visual representation in the brain can affect accurate perception of motion signals.

Perceptual decoupling or trigger happiness: the effect of response delays and shorter presentation times on a go-no-go task with a high go prevalence.

In the current investigation, we modified the high Go, low No-Go Sustained Attention to Response Task (SART). Some researchers argue a commission error, an inappropriate response to a No-Go stimulus, in the SART is due to the participant being inattentive, or perceptually decoupled, during stimulus onset. Response delays in the SART reduce commission errors. A response delay may therefore enable a participant who is initially inattentive to recouple their attention in time to appropriately perceive the stimulus and withhold a response to a No-Go stimulus. However, shortening stimulus display duration in the SART should limit the possibility of the participant identifying the stimulus later, if they are initially not attending the stimulus. A response delay should not reduce commission errors if stimulus duration is kept to the minimum duration enabling stimulus recognition. In two experiments, we shortened stimulus onset to offset duration and added response delays of varying lengths. In both experiments, even when stimulus duration was shortened, response delays notably reduced commission errors if the delay was greater than 250 ms. In addition, using the Signal Detection Theory perspective in which errors of commission in the SART are due to a lenient response bias-trigger happiness, we predicted that response delays would result in a shift to a more conservative response bias in both experiments. These predictions were verified. The errors of commission in the SART may not be a measures of conscious awareness per se, but instead indicative of the level of participant trigger happiness-a lenient response bias.