When practice does not make a perfect - paradoxical learning curve in schizophrenia and bipolar disorder revealed by different serial reaction time task variants.

Introduction: Our previous studies identified a paradoxical implicit motor learning curve in schizophrenia (SZ) and bipolar disorder (BD) patients. This study aimed to verify whether those previously observed deficits may be captured by a new version of the ambidextrous serial reaction time task (SRTT), prepared for use in the MRI. Methods: This study involved 186 participants. A total of 97 participants (33 BD, 33 SZ, and 31 healthy controls, HCs) completed the original, unlimited time response variant of SRTT. A total of 90 individuals (30 BD, 30 SZ, and 30 HCs) underwent a newer, limited response time version of this procedure. Results: There was no significant difference in terms of implicit motor learning indices between both limited and unlimited response time SRTT. Compared to HCs, SZ, and BD patients presented decreased indices of implicit motor learning. Both clinical groups showed a paradoxical learning pattern that differed significantly from the HCs. Moreover, in the SZ group, the pattern depended on the hand performing SRTT. Discussion: The limited response time SRTT variant allowed us to replicate the findings of disrupted implicit motor learning in SZ and BD. The use of this paradigm in further neuroimaging studies may help to determine the neuronal underpinnings of this cognitive dysfunction in the abovementioned clinical groups.

The connectional anatomy of visual mental imagery: evidence from a patient with left occipito-temporal damage.

Most of us can use our "mind's eye" to mentally visualize things that are not in our direct line of sight, an ability known as visual mental imagery. Extensive left temporal damage can impair patients' visual mental imagery experience, but the critical locus of lesion is unknown. Our recent meta-analysis of 27 fMRI studies of visual mental imagery highlighted a well-delimited region in the left lateral midfusiform gyrus, which was consistently activated during visual mental imagery, and which we called the Fusiform Imagery Node (FIN). Here, we describe the connectional anatomy of FIN in neurotypical participants and in RDS, a right-handed patient with an extensive occipito-temporal stroke in the left hemisphere. The stroke provoked right homonymous hemianopia, alexia without agraphia, and color anomia. Despite these deficits, RDS had normal subjective experience of visual mental imagery and reasonably preserved behavioral performance on tests of visual mental imagery of object shape, object color, letters, faces, and spatial relationships. We found that the FIN was spared by the lesion. We then assessed the connectional anatomy of the FIN in the MNI space and in the patient's native space, by visualizing the fibers of the inferior longitudinal fasciculus (ILF) and of the arcuate fasciculus (AF) passing through the FIN. In both spaces, the ILF connected the FIN with the anterior temporal lobe, and the AF linked it with frontal regions. Our evidence is consistent with the hypothesis that the FIN is a node of a brain network dedicated to voluntary visual mental imagery. The FIN could act as a bridge between visual information and semantic knowledge processed in the anterior temporal lobe and in the language circuits.

Relationship between neurological and cerebellar soft signs, and implicit motor learning in schizophrenia and bipolar disorder.

BACKGROUND: Schizophrenia (SZ) and bipolar disorder (BD) patients share deficits in motor functions in the form of neurological (NSS) and cerebellar soft signs (CSS), and implicit motor learning disturbances. Here, we use cluster analysis method to assess (1) the relationship between those abnormalities in SZ and BD and (2) the differences between those groups. METHODS: 33 SZ patients, 33 BD patients as well as 31 healthy controls (HC) took part in the study. We assessed CSS with the International Cooperative Ataxia Rating Scale (ICARS) and NSS with the Neurological Evaluation Scale (NES). Implicit motor learning was evaluated with the Serial Reaction Time Task (SRTT). Participants were divided into clusters (Ward's method) based on the mean response time and mean error rate in SRTT. The difference in ICARS and NES scores, and SRTT variables between clusters were evaluated. We have measured associations between SRTT parameters and both ICARS and NES total scores and subscores. RESULTS: Cluster analysis based on the SRTT parameters allowed to extract three clusters. Those were characterized by the increasing disruption of motor functioning (psychomotor retardation, the severity of NSS and CSS) regardless of the diagnosis. Cluster 1 covered almost all of HC and was characterized by faster reaction times and small number of errors. BD and SZ patients represented in cluster 1, although fully functional in performing the SRTT, showed higher rates of NSS and CSS. Patients with BD and SZ were set apart in clusters 2 and 3 in a similar proportion. Cluster 2 presented significantly slower reaction times but with the comparable number of errors to cluster 1. Cluster 3 consisted of participants with normal or decreased reaction time and significantly increased number of errors. None of the clusters were predominantly composed of the patients representing one psychiatric diagnosis. CONCLUSIONS: To our best knowledge, we are presenting the first data indicating the relationship between implicit motor learning and NSS and CSS in SZ and BD patients' groups. Lack of clusters predominantly represented by patients with the diagnosis of SZ or BD may refer to the model of schizophrenia-bipolar disorder boundary, pointing out the similarities between those two disorders.

Color Naming and Categorization Depend on Distinct Functional Brain Networks.

Naming a color can be understood as an act of categorization, that is, identifying it as a member of a category of colors that are referred to by the same name. But are naming and categorization equivalent cognitive processes and consequently rely on same neural substrates? Here, we used task and resting-state functional magnetic resonance imaging as well as behavioral measures to identify functional brain networks that modulated naming and categorization of colors. We first identified three bilateral color-sensitive regions in the ventro-occipital cortex. We then showed that, across participants, color naming and categorization response times (RTs) were correlated with different resting state connectivity networks seeded from the color-sensitive regions. Color naming RTs correlated with the connectivity between the left posterior color region, the left middle temporal gyrus, and the left angular gyrus. In contrast, color categorization RTs correlated with the connectivity between the bilateral posterior color regions, and left frontal, right temporal and bilateral parietal areas. The networks supporting naming and categorization had a minimal overlap, indicating that the 2 processes rely on different neural mechanisms.

When colours split from objects: The disconnection of colour perception from colour language and colour knowledge.

We investigated object-colour knowledge in RDS, a patient with impaired colour naming after a left occipito-temporal stroke. RDS's colour perception, object naming and verbal colour-knowledge (the ability to verbally say the typical colour of an object) were relatively spared. RDS was also able to state if an object was appropriately coloured or not. However, he could neither match colour names to coloured objects, nor match colour patches to grey-scale objects. Thus, RDS's colour-naming deficit was associated with an impaired ability to conceptually relate visually presented object shapes and colours. These results suggest that objects in their typical colour are processed holistically in the visual modality, and that abilities important for colour naming may also be involved in abstracting colours from visual objects. We discuss these findings in the context of developmental psychology and linguistic anthropology, and propose a model of neuro-functional organization of object-colour knowledge.

What Cognitive Neurology Teaches Us about Our Experience of Color.

Color provides valuable information about the environment, yet the exact mechanisms explaining how colors appear to us remain poorly understood. Retinal signals are processed in the visual cortex through high-level mechanisms that link color perception with top-down expectations and knowledge. Here, we review the neuroimaging evidence about color processing in the brain, and how it is affected by acquired brain lesions in humans. Evidence from patients with brain-damage suggests that high-level color processing may be divided into at least three modules: perceptual color experience, color naming, and color knowledge. These modules appear to be functionally independent but richly interconnected, and serve as cortical relays linking sensory and semantic information, with the final goal of directing object-related behavior. We argue that the relations between colors and their objects are key mechanisms to understand high-level color processing.

Color Categorization Independent of Color Naming.

Color is continuous, yet we group colors into discrete categories associated with color names (e.g., yellow, blue). Color categorization is a case in point in the debate on how language shapes human cognition. Evidence suggests that color categorization depends on top-down input from the language system to the visual cortex. We directly tested this hypothesis by assessing color categorization in a stroke patient, RDS, with a rare, selective deficit in naming visually presented chromatic colors, and relatively preserved achromatic color naming. Multimodal MRI revealed a left occipito-temporal lesion that directly damaged left color-biased regions, and functionally disconnected their right-hemisphere homologs from the language system. The lesion had a greater effect on RDS's chromatic color naming than on color categorization, which was relatively preserved on a nonverbal task. Color categorization and naming can thus be independent in the human brain, challenging the mandatory involvement of language in adult human cognition.

The biological bases of colour categorisation: From goldfish to the human brain.

How are colour categories related to perception and language? To answer this question, we review research on the neural correlates of colour categories, and categorical responses in preverbal infants and non-human animals. With respect to language, the reviewed findings suggest that colour categorisation often involves automatic language processing. At the same time, evidence from non-human animals, infants, and patients with brain lesions indicates that colour categorisation may also occur in the absence of language. Concerning perception, there is little convincing evidence that the bottom-up processes of colour perception are the origin of colour categories. Instead, colour categorisation might simply build upon the continuous colour perception and interact with perception through the direction of attention to colour differences that are relevant to categorisation. We make three suggestions for future research. First, future research in all areas requires methodological improvements, in particular in stimulus control. Second, future research should overcome the universalist-realist debate and go beyond a simple contrast between perception and language. Third, the link between object colours and colour categories provides an alternative approach that might reveal the ecological origin of colour categories. The ecological approach promises establishing evolutionary and developmental continuity between categorical responses in non-human animals, infants and adult humans.

Mental rotation task in bipolar disorder. / Test rotacji mentalnych w chorobie afektywnej dwubiegunowej.

OBJECTIVES: Bipolar disorder (BD) significantly affects level of cognitive and motor functioning. Studies on cognitive function in BD shows i.a. deficits in visuospatial processing and visuospatial memory. However, studies have not used Mental Rotation Task to evaluate these functions so far. Our aim is to introduce this method to assess abovementioned deficits in euthymic BD patients. METHODS: 31 euthymic BD patients and 27 healthy volunteers matched for age and years of education were recruited. All participants performed digital version of Mental Rotation Task. In this task, participants were asked to compare two figures rotated against each other and declare its similarity or difference indicating whether the figures are identical or whether they constitute their own mirror image. RESULTS: The test revealed significantly longer reaction times in the group of BD patients when images were rotated by - 90, - 45, 45, 90 degrees, or not rotated at all. There was no significant difference in condition of - 135, 135 or 180 degrees. The accuracy rate was significantly lower in the patient group than in the control group for the entire test and in each condition. The correlation between the average response time and the accuracy rate turned out to be insignificant. CONCLUSIONS: Our results are consistent with studies presenting visuospatial deficits in bipolar disorder. In this study we show for the first time that mental rotation deficits are present in euthymic state of BD patients.

Structural reorganization of the early visual cortex following Braille training in sighted adults.

Training can induce cross-modal plasticity in the human cortex. A well-known example of this phenomenon is the recruitment of visual areas for tactile and auditory processing. It remains unclear to what extent such plasticity is associated with changes in anatomy. Here we enrolled 29 sighted adults into a nine-month tactile Braille-reading training, and used voxel-based morphometry and diffusion tensor imaging to describe the resulting anatomical changes. In addition, we collected resting-state fMRI data to relate these changes to functional connectivity between visual and somatosensory-motor cortices. Following Braille-training, we observed substantial grey and white matter reorganization in the anterior part of early visual cortex (peripheral visual field). Moreover, relative to its posterior, foveal part, the peripheral representation of early visual cortex had stronger functional connections to somatosensory and motor cortices even before the onset of training. Previous studies show that the early visual cortex can be functionally recruited for tactile discrimination, including recognition of Braille characters. Our results demonstrate that reorganization in this region induced by tactile training can also be anatomical. This change most likely reflects a strengthening of existing connectivity between the peripheral visual cortex and somatosensory cortices, which suggests a putative mechanism for cross-modal recruitment of visual areas.

Disrupted implicit motor sequence learning in schizophrenia and bipolar disorder revealed with ambidextrous Serial Reaction Time Task.

BACKGROUND: Impairment of implicit motor sequence learning was shown in schizophrenia (SZ) and, most recently, in bipolar disorder (BD), and was connected to cerebellar abnormalities. The goal of this study was to compare implicit motor sequence learning in BD and SZ. METHODS: We examined 33 patients with BD, 33 patients with SZ and 31 healthy controls with a use of ambidextrous Serial Reaction Time Task (SRTT), which allows exploring asymmetries in performance depending on the hand used. RESULTS: BD and SZ patients presented impaired implicit motor sequence learning, although the pattern of their impairments was different. While BD patients showed no signs of implicit motor sequence learning for both hands, the SZ group presented some features of motor learning when performing with the right, but not with the left hand. CONCLUSIONS: To our best knowledge this is the first study comparing implicit motor sequence learning in BD and SZ. We show that both diseases share impairments in this domain, however in the case of SZ this impairment differs dependently on the hand performing SRTT. We propose that implicit motor sequence learning impairments constitute an overlapping symptom in BD and SZ and suggest further neuroimaging studies to verify cerebellar underpinnings as its cause.

Universal Visual Features Might Be Necessary for Fluent Reading. A Longitudinal Study of Visual Reading in Braille and Cyrillic Alphabets.

It has been hypothesized that efficient reading is possible because all reading scripts have been matched, through cultural evolution, to the natural capabilities of the visual cortex. This matching has resulted in all scripts being made of line-junctions, such as T, X, or L. Our aim was to test a critical prediction of this hypothesis: visual reading in an atypical script that is devoid of line-junctions (such as the Braille alphabet read visually) should be much less efficient than reading in a "normal" script (e.g., Cyrillic). Using a lexical decision task, we examined Visual Braille reading speed and efficiency in sighted Braille teachers. As a control, we tested learners of a natural visual script, Cyrillic. Both groups participated in a two semester course of either visual Braille or Russian while their reading speed and accuracy was tested at regular intervals. The results show that visual Braille reading is slow, prone to errors and highly serial, even in Braille readers with years of prior reading experience. Although subjects showed some improvements in their visual Braille reading accuracy and speed following the course, the effect of word length on reading speed (typically observed in beginning readers) was remained very sizeable through all testing sessions. These results are in stark contrast to Cyrillic, a natural script, where only 3 months of learning were sufficient to achieve relative proficiency. Taken together, these results suggest that visual features such as line junctions and their combinations might be necessary for efficient reading.

Braille in the Sighted: Teaching Tactile Reading to Sighted Adults.

Blind people are known to have superior perceptual abilities in their remaining senses. Several studies suggest that these enhancements are dependent on the specific experience of blind individuals, who use those remaining senses more than sighted subjects. In line with this view, sighted subjects, when trained, are able to significantly progress in relatively simple tactile tasks. However, the case of complex tactile tasks is less obvious, as some studies suggest that visual deprivation itself could confer large advantages in learning them. It remains unclear to what extent those complex skills, such as braille reading, can be learnt by sighted subjects. Here we enrolled twenty-nine sighted adults, mostly braille teachers and educators, in a 9-month braille reading course. At the beginning of the course, all subjects were naive in tactile braille reading. After the course, almost all were able to read whole braille words at a mean speed of 6 words-per-minute. Subjects with low tactile acuity did not differ significantly in braille reading speed from the rest of the group, indicating that low tactile acuity is not a limiting factor for learning braille, at least at this early stage of learning. Our study shows that most sighted adults can learn whole-word braille reading, given the right method and a considerable amount of motivation. The adult sensorimotor system can thus adapt, to some level, to very complex tactile tasks without visual deprivation. The pace of learning in our group was comparable to congenitally and early blind children learning braille in primary school, which suggests that the blind's mastery of complex tactile tasks can, to a large extent, be explained by experience-dependent mechanisms.

Massive cortical reorganization in sighted Braille readers.

The brain is capable of large-scale reorganization in blindness or after massive injury. Such reorganization crosses the division into separate sensory cortices (visual, somatosensory...). As its result, the visual cortex of the blind becomes active during tactile Braille reading. Although the possibility of such reorganization in the normal, adult brain has been raised, definitive evidence has been lacking. Here, we demonstrate such extensive reorganization in normal, sighted adults who learned Braille while their brain activity was investigated with fMRI and transcranial magnetic stimulation (TMS). Subjects showed enhanced activity for tactile reading in the visual cortex, including the visual word form area (VWFA) that was modulated by their Braille reading speed and strengthened resting-state connectivity between visual and somatosensory cortices. Moreover, TMS disruption of VWFA activity decreased their tactile reading accuracy. Our results indicate that large-scale reorganization is a viable mechanism recruited when learning complex skills.

Neurological and cerebellar soft signs do not discriminate schizophrenia from bipolar disorder patients.

Patients with schizophrenia (SZ) and bipolar disorder (BD) share subtle motor abnormalities called the neurological soft signs (NSS). Since in both diseases there is evidence for alterations in cerebellar functions, structure and connectivity, we expected that the cerebellar soft signs (CSS), analogue of NSS focusing strictly on cerebellar symptoms, would be also a common trait in SZ and BD. We examined 30 patients with BD, 30 patients with SZ and 28 control subjects using the Neurological Evaluation Scale (NES, for NSS) and International Cooperative Ataxia Rating Scale (ICARS, for CSS). SZ and BD did not differ in total and subscales' scores in both NES and ICARS. Subscale analysis revealed that SZ performed significantly worse than controls in all the subscales of both NES and ICARS. BD patients scored significantly worse than controls in all NES subscales and in oculomotor and kinetic subscales of the ICARS, while other ICARS subscales did not differentiate those two groups. To our knowledge this is the first study to show that CSS constitute common symptoms in BD and SZ. We recommend a special focus on those diseases in further research regarding structural and functional changes of cerebellum and their clinical outcome.

Implicit motor learning in bipolar disorder.

OBJECTIVES: A growing number of publications describe cerebellar abnormalities in patients with bipolar disorder (BD). The aim of the following paper was to examine the functional aspects of that issue by focusing on implicit learning - a cognitive function with significant cerebellar underpinnings. METHODS: 27 patients with BD and 26 healthy controls (HC), matched for age and sex took part in the study. Implicit motor learning was assessed by the serial reaction time task (SRTT), in which participants were unconsciously learning a sequence of motor reactions. The indicators of procedural learning were the decrease of reaction time (RT) across the repetition of the sequence and the rebound of RT when the sequence changed into a random set of stimuli. RESULTS: BD patients did not present any indicators of the implicit learning, their RT increased across repetitions of the sequence and it decreased when the sequence changed to random. Contrary, in the control group RT decreased across the sequence repetitions and increased when the stimuli begun to appear randomly. LIMITATIONS: A low subject count and a non-drug naïve patients group, medicated with atypical antipsychotic and mood stabilizers, are the most significant limitations of this study. CONCLUSIONS: BD patients did not acquire procedural knowledge while performing the task, whereas HC did. To our knowledge this is the first study that shows the impairment of implicit motor learning in patients with BD. This indicates the possible cerebellar dysfunction in this disease and may provide a new neuropsychiatric approach to bipolar disorder.