Brain network functional connectivity changes in patients with anterior knee pain: a resting-state fMRI exploratory study.

BACKGROUND: This study investigates the functional brain connectivity in patients with anterior knee pain (AKP). While biomechanical models are frequently employed to investigate AKP, it is important to recognize that pain can manifest even in the absence of structural abnormalities. Leveraging the capabilities of functional magnetic resonance imaging (fMRI), this research aims to investigate the brain mechanisms present in AKP patients. METHODS: Forty-five female subjects (24 AKP patients, 21 controls) underwent resting-state fMRI and T1-weighted structural MRI. Functional brain connectivity patterns were analyzed, focusing on pain network areas, and the influence of catastrophizing thoughts was evaluated. RESULTS: Comparing patients and controls, several findings emerged. First, patients with AKP exhibited increased correlation between the right supplementary motor area and cerebellum I, as well as decreased correlation between the right insula and the left rostral prefrontal cortex and superior frontal gyrus. Second, in AKP patients with catastrophizing thoughts, there was increased correlation of the left lateral parietal cortex with two regions of the right cerebellum (II and VII) and the right pallidum, and decreased correlation between the left medial frontal gyrus and the right thalamus. Furthermore, the correlation between these regions showed promising results for discriminating AKP patients from controls, achieving a cross-validation accuracy of 80.5%. CONCLUSIONS: Resting-state fMRI revealed correlation differences in AKP patients compared to controls and based on catastrophizing thoughts levels. These findings shed light on neural correlates of chronic pain in AKP, suggesting that functional brain connectivity alterations may be linked to pain experience in this population. RELEVANCE STATEMENT: Etiopathogenesis of pain in anterior knee pain patients might not be limited to the knee, but also to underlying alterations in the central nervous system: cortical changes might lead a perpetuation of pain. KEY POINTS: • Anterior knee pain patients exhibit distinct functional brain connectivity compared to controls, and among catastrophizing subgroups. • Resting-state fMRI reveals potential for discriminating anterior knee pain patients with 80.5% accuracy. • Functional brain connectivity differences improve understanding of pain pathogenesis and objective anterior knee pain identification.

Impaired recollection and initially preserved familiarity in a patient with bilateral fornix transection following third ventricle colloid cyst removal: A two-year follow-up study.

OBJECTIVE: Recognition memory is widely accepted as a dual process-based model, namely familiarity and recollection. However, the location of their specific neurobiological substrates remains unclear. Similar to hippocampal damage, fornix damage has been associated with recollection memory but not familiarity memory deficits. To understand the neural basis of recognition memory, determining the importance of the fornix and its hippocampal connections is essential. METHODS: Recognition memory was examined in a 45-year-old male who underwent a complete bilateral fornix section following the removal of a third ventricle colloid cyst. The application of familiarity and recollection for recognition memory decisions was investigated via an immediate and delayed associative recognition test and an immediate and delayed forced-choice task in the patient and a control group (N = 15) over a two-year follow-up period. Complete demographic, neuropsychological, neuropsychiatric, and neuroradiological characterizations of this patient were performed. RESULTS: Persistent immediate and delayed verbal recollection memory deficits were observed in the patient. Moreover, delayed familiarity-based recognition memory declined gradually over the follow-up period, immediate familiarity-based recognition memory was unaffected, and reduced non-verbal memory improved. CONCLUSION: The present findings support models that the extended hippocampal system, including the fornices, does not appear to play a role in familiarity memory but is particularly important for recollection memory. Moreover, our study suggests that bilateral fornix transection may be associated with relatively functional recovery of non-verbal memory.

How Our Gaze Reacts to Another Person's Tears? Experimental Insights Into Eye Tracking Technology.

Crying is an ubiquitous human behavior through which an emotion is expressed on the face together with visible tears and constitutes a slippery riddle for researchers. To provide an answer to the question "How our gaze reacts to another person's tears?," we made use of eye tracking technology to study a series of visual stimuli. By presenting an illustrative example through an experimental setting specifically designed to study the "tearing effect," the present work aims to offer methodological insight on how to use eye-tracking technology to study non-verbal cues. A sample of 30 healthy young women with normal visual acuity performed a within-subjects task in which they evaluated images of real faces with and without tears while their eye movements were tracked. Tears were found to be a magnet for visual attention in the task of facial attribution, facilitating a greater perception of emotional intensity. Moreover, the inspection pattern changed qualitatively and quantitatively, with our participants becoming fully focused on the tears when they were visible. The mere presence of a single tear running down a cheek was associated with an increased emotional inference and greater perception of sincerity. Using normalized and validated tools (Reading the Eyes in the Mind Test and the SALAMANCA screening test for personality disorders), we measured the influence of certain characteristics of the participants on their performance of the experimental task. On the one hand, a higher level of cognitive empathy helped to classify tearful faces with higher emotional intensity and tearless faces with less emotional intensity. On the other hand, we observed that less sincerity was attributed to the tearful faces as the SALAMANCA test scores rose in clusters A (strange and extravagant) and B (immature and emotionally unstable) of our sample. The present findings highlight the advantages of using eye tracking technology to study non-verbal cues and draw attention to methodological issues that should be taken into account. Further exploration of the relationship between empathy and tear perception could be a fruitful avenue of future research using eye tracking.

Effects of a single session of SMR neurofeedback training on anxiety and cortisol levels.

OBJECTIVES: According to some studies, a putatively calming effect of EEG neurofeedback training could be useful as a therapeutic tool in psychiatric practice. With the aim of elucidating this possibility, we tested the efficacy of a single session of ↑sensorimotor (SMR)/↓theta neurofeedback training for mood improvement in 32 healthy men, taking into account trainability, independence and interpretability of the results. METHODS: A pre-post design, with the following dependent variables, was applied: (i) psychometric measures of mood with regards to anxiety, depression, and anger (Profile of Mood State, POMS, and State Trait Anxiety Inventory, STAI); (ii) biological measures (salivary levels of cortisol); (iii) neurophysiological measures (EEG frequency band power analysis). In accordance with general recommendations for research in neurofeedback, a control group receiving sham neurofeedback was included. RESULTS: Anxiety levels decreased after the real neurofeedback and increased after the sham neurofeedback (P<0.01, size effect 0.9 for comparison between groups). Cortisol decreased after the experiment in both groups, though with significantly more pronounced effects in the desired direction after the real neurofeedback (P<0.04; size effect 0.7). The group receiving real neurofeedback significantly enhanced their SMR band (P<0.004; size effect 0.88), without changes in the theta band. The group receiving sham neurofeedback did not show any EEG changes. CONCLUSIONS: The improvement observed in anxiety was greater in the experimental group than in the sham group, confirmed by both subjective (psychometric) measures and objective (biological) measures. This was demonstrated to be associated with the real neurofeedback, though a nonspecific (placebo) effect likely also contributed.

Contribution of executive functions to eating behaviours in obesity and eating disorders.

BACKGROUND: Patients with eating disorders (ED) or obesity show difficulties in tasks assessing decision-making, set-shifting abilities and central coherence. AIMS: The aim of this study was to explore executive functions in eating and weight-related problems, ranging from restricting types of ED to obesity. METHOD: Two hundred and eighty-eight female participants (75 with obesity; 149 with ED: 76 with restrictive eating, 73 with bingeing-purging symptoms; and 64 healthy controls) were administered the Wisconsin Card Sorting Test, the Iowa Gambling Task, and the Group Embedded Figures Test to assess set-shifting, decision-making and central coherence, respectively. RESULTS: Participants with either obesity or ED performed poorly on tests measuring executive functioning compared with healthy controls, even after controlling for age and intelligence. Both participants with obesity and participants with ED showed a preference for global information processing. CONCLUSIONS: The findings suggest that treatments for obesity and ED would benefit from addressing difficulties in cognitive functioning, in addition to the more evident clinical symptoms related to eating, body weight and shape.

Funciones ejecutivas y regulación emocional en obesidad y trastornos alimentarios.

INTRODUCTION: Introduction: eating disorders (ED) such as anorexia nervosa (AN) or bulimia nervosa (BN), as well as obesity (OB), are related to emotional and neuropsychological impairments on measures of cognitive flexibility, central coherence or decision making. However, little is known about the association among emotional regulation, neuropsychological variables and affect. Objectives: to analyze whether neuropsychological and affect variables can predict emotional regulation in ED and in OB. Methods: thirty females with restricting ED (restricting AN) were assessed, 18 with purging ED (purging AN and BN), 33 with OB and 39 healthy controls matched for intelligence. The Wisconsin Card Sorting Test (WCST) assessed cognitive flexibility, the Group Embedded Figures Test (GEFT) assessed central coherence, the Iowa Gambling Task (IGT) assessed decision making, the Positive and Negative Affect Schedule assessed positive (PANAS-PA) and negative (PANAS-NA) affect, and the Difficulties in Emotion Regulation Scale (DERS) assessed emotional regulation. Results: relative to the healthy control group, ED and OB groups performed worse on IGT (p = 0.002) and GEFT (p = 0.003), had lower scores on PANAS-PA (p = 0.001) and higher scores on DERS (p < 0.001). ED groups had higher scores on PANAS-NA tan both OB and healthy controls (p = 0.001). PANAS-PA, PANAS-NA and IGT accounted for 51.4% of the variance of the DERS (p < 0.001). Conclusions: our study shows a significant association between decision making, affect and emotional regulation in the continuum from AN to OB, and also highlights the importance of including programs focused on decision making and affect in cognitive interventions for ED and OB.

INTRODUCCIÓN: Introducción: los trastornos de la conducta alimentaria (TCA) como la anorexia nerviosa (AN) o la bulimia nerviosa (BN), así como la obesidad (OB), se relacionan con alteraciones neuropsicológicas en flexibilidad cognitiva, coherencia central, toma de decisiones y alteraciones emocionales. Sin embargo, se desconoce la asociación entre regulación emocional, variables neuropsicológicas y variables de afecto. Objetivos: analizar si variables neuropsicológicas y afectivas pueden predecir la regulación emocional en los TCA y en la OB. Métodos: se evaluó a 30 mujeres con TCA restrictivo (AN restrictiva), 18 con TCA purgativo (AN purgativa y BN), 33 OB y 39 controles sanas emparejadas por nivel intelectual. El Wisconsin Card Sorting Test (WCST) evaluó la flexibilidad cognitiva; el Group Embedded Figures Test (GEFT), la coherencia central; el Iowa Gambling Task (IGT), la toma de decisiones; el Positive and Negative Affect Schedule, el afecto positivo (PANAS-PA) y negativo (PANAS-NA); y la Difficulties in Emotion Regulation Scale (DERS), la regulación emocional. Resultados: respecto al grupo control, los grupos TCA y OB rindieron peor en IGT (p = 0,002) y GEFT (p = 0,003) y presentaron menores puntuaciones en PANAS-PA (p = 0,001) y mayores en DERS (p < 0,001). Los grupos TCA puntuaron más alto en PANAS-NA que los grupos OB y control (p = 0,001). El 51,4% de la varianza del DERS fue explicado por PANAS-PA, PANAS-NA e IGT (p < 0,001). Conclusiones: nuestro estudio muestra una asociación entre toma de decisiones y afecto con regulación emocional en el continuo de AN a OB e indica la importancia de incluir programas de toma de decisiones y afecto en las intervenciones cognitivas para TCA y para OB.

Psychobiological response to an anger induction task in schizophrenia: The key role of anxiety.

In this study an anger induction laboratory task was applied to men with schizophrenia, and resulted in significant changes in different psychophysiological parameters that were measured in a pre-post design. We observed a significantly greater self-reported anger mood and negative affection, lower self-reported positive affection, an increase in cardiovascular reactivity (with blood pressure in deeper affection compared to controls), higher salivary testosterone levels, lower salivary cortisol levels, and an increase in right ear items reported in dichotic listening. Furthermore, clinical risk factors related to anger in our patients were analyzed by Stepwise Regression analyses. Trait anger was significantly associated with a higher level of delusional pathology and impulsivity. Regarding the resulted state of anger as an output of the induction, the most relevant finding was that anxiety consistently and significantly predicted the increasing in anger feelings, and, remarkably, it predicted also the increasing in T levels and the cardiovascular reactivity of the patients.

Differential effects of cognition-focused interventions for people with Alzheimer's disease: A meta-analysis.

OBJECTIVE: The efficacy of cognition-focused interventions (CFIs) for the treatment of Alzheimer's disease (AD) has been questioned recently. To date, the specific effects of cognitive rehabilitation (CR), cognitive training (CT), and cognitive stimulation [CS] have not been analyzed due to inconsistencies in the use of the comparison groups. This work aims to analyze the differential effects of CFIs by removing the influence of the comparison group from the estimates of the effects. METHOD: a literature search performed in Pubmed, Proquest, and Embase databases yielded 65 potential studies, of which 33 studies with a sample size of 1,225 individuals were meta-analyzed. Each intervention group was treated as the unit of analysis to remove the confounding effects of the comparison condition. Measures of general cognitive functioning, memory and functional outcomes were compared using the hierarchical robust variance estimator metaregression. Age, education, sex, risk of bias, sample size, duration of intervention, the proportion of drop-outs, pharmacological treatment, and severity of disease were included as covariates. RESULTS: Only CT differed from no cognition-focused interventions (NCFI) for memory outcomes in univariate analyses, but differences became nonsignificant when covariates were included in the model. CR showed a significantly higher effect in outcomes measuring functioning in targeted domains with no differences in standard cognitive tests relative to NCFI. CONCLUSIONS: This work supports previous findings questioning the efficacy of CT or CS for AD. Moving toward CFIs focused on relevant goals and including measures related to the skills, abilities or activities that are the focus of the intervention is encouraged. (PsycINFO Database Record

Efectos organizacionales y activacionales de la testosterona sobre la asunción de riesgos en conductas económicas: una revisión sistemática / Organizational and activational effects of testosterone on risk-taking in economical behavior: A systematic review

Resumen El objetivo de esta revisión sistemática es evaluar la influencia de la testosterona circulante (efectos activacionales) y de la exposición prenatal a ella (efectos organizacionales) sobre la asunción de riesgos en conductas económicas, evaluando los trabajos de investigación existentes hasta la fecha acerca de la temática. La base bibliográfica analizada se obtuvo de distintas bases de datos especializadas en el ámbito de la psicología y las neurociencias. Los resultados obtenidos concluyen en una relación contrastada entre la testosterona circulante y la asunción de riesgo financiero. En lo referente a la exposición prenatal se evidencia un estado inmaduro de la investigación sobre la temática, ya que los pocos artículos disponibles difieren en gran medida en cuanto a metodologías y resultados. Se espera que este trabajo sirva como visión general del estado actual de la cuestión tratada, con vistas a unificar las metodologías y tratar de mejorar la calidad de las futuras investigaciones.

Abstract This systematic review undertook to evaluate the influence of circulating testosterone (activational effects) and the pre-natal exposure to this (organisational effects) as regards risk-taking decisions in financial behaviour. An evaluation was also made on the research work to date on this subject. The bibliographic database analysed was obtained from different databases specialised in the field of psychology and neuroscience. The results obtained show a relationship between circulating testosterone and financial risk-taking. As regards prenatal exposure, research on this topic is still in its infancy, since the few articles found widely differ in methodologies and results. It is hoped that this study will serve as an over view of the current state of the topic, in order to unify the methodologies and to try to improve the quality of future research.

Are cognitive interventions effective in Alzheimer's disease? A controlled meta-analysis of the effects of bias.

UNLABELLED: [Correction Notice: An Erratum for this article was reported in Vol 30(5) of Neuropsychology (see record 2016-25217-001). In the article the first sentence of the third paragraph of the Source of bias subsection in the Statistical Analysis subsection of the Correlational Meta-Analysis section should read "For the control condition bias, three comparison groups were differentiated: (a) a structured cognitive intervention, (b) a placebo control condition, and (c) a pharma control condition without cognitive intervention or no treatment at all."] OBJECTIVE: There is limited evidence about the efficacy of cognitive interventions for Alzheimer's disease (AD). However, aside from the methodological quality of the studies analyzed, the methodology used in previous meta-analyses is itself a risk of bias as different types of effect sizes (ESs) were calculated and combined. This study aimed at examining the results of nonpharmacological interventions for AD with an adequate control of statistical methods and to demonstrate a different approach to meta-analysis. METHOD: ESs were calculated with the independent groups pre/post design. Average ESs for separate outcomes were calculated and moderator analyses were performed so as to offer an overview of the effects of bias. RESULTS: Eighty-seven outcomes from 19 studies (n = 812) were meta-analyzed. ESs were small on average for cognitive and functional outcomes after intervention. Moderator analyses showed no effect of control of bias, although ESs were different from zero only in some circumstances (e.g., memory outcomes in randomized studies). Cognitive interventions showed no more efficacy than placebo interventions, and functional ESs were consistently low across conditions. CONCLUSIONS: cognitive interventions delivered may not be effective in AD probably due to the fact that the assumptions behind the cognitive interventions might be inadequate. Future directions include a change in the type of intervention as well as the use of outcomes other than standardized tests. Additional studies with larger sample sizes and different designs are needed to increase the power of both primary studies and meta-analyses. (PsycINFO Database Record

Testing the Benefits of Neurofeedback on Selective Attention Measured Through Dichotic Listening.

The electrophysiological changes after a single session of neurofeedback training (↑SMR/↓Theta) and its effects on executive attention during a dichotic listening test with forced attentional procedures were measured in a sample of 20 healthy women. A pre-post moment test double blind design, with the inclusion of a group receiving sham neurofeedback, allowed for minimization of alien influences. The interaction of Moment × Group was significant, indicating an enhancement of SMR band after the real neurofeedback. The dichotic listening scores were correlated with the amplitude of Beta band in baseline conditions. The performance on the forced left attentional condition in dichotic listening was significantly improved and correlated positively with the post-training enhancement of the SMR band. The sham neurofeedback group also improved DL scores, so a clear affirmation about the benefits of neurofeedback training over cognitive performance could not be unambiguously established. It is concluded that the protocol showed a good independence and acceptable trainability in modifying the EEG results, but there was limited interpretability regarding cognitive outcomes.

Deceit and facial expression in children: the enabling role of the "poker face" child and the dependent personality of the detector.

This study presents the relation between the facial expression of a group of children when they told a lie and the accuracy in detecting the lie by a sample of adults. To evaluate the intensity and type of emotional content of the children's faces, we applied an automated method capable of analyzing the facial information from the video recordings (FaceReader 5.0 software). The program classified videos as showing a neutral facial expression or an emotional one. There was a significant higher mean of hits for the emotional than for the neutral videos, and a significant negative correlation between the intensity of the neutral expression and the number of hits from the detectors. The lies expressed with emotional facial expression were more easily recognized by adults than the lies expressed with a "poker face"; thus, the less expressive the child the harder it was to guess. The accuracy of the lie detectors was then correlated with their subclinical traits of personality disorders, to find that participants scoring higher in the dependent personality were significantly better lie detectors. A non-significant tendency for women to discriminate better was also found, whereas men tended to be more suspicious than women when judging the children's veracity. This study is the first to automatically decode the facial information of the lying child and relate these results with personality characteristics of the lie detectors in the context of deceptive behavior research. Implications for forensic psychology were suggested: to explore whether the induction of an emotion in a child during an interview could be useful to evaluate the testimony during legal trials.

Neuropsychological impairments in anorexia nervosa: a spanish sample pilot study.

This work was aimed at obtaining a profile of neuropsychological impairments in young Spanish participants with anorexia nervosa (AN) to demonstrate that right-hemisphere and frontal capacity impairments are present not only in the acute phase but also after weight recovery in a Spanish sample compared with a healthy control group. Twelve patients with AN in the acute phase (body mass index [BMI] < 17) were compared both to 16 healthy control subjects and 12 weight-recovered AN participants (BMI ≥ 17) matched by age, IQ, and educational level by utilizing a wide neuropsychological battery. Differences were found between AN groups only for long-term verbal memory, which worsens as BMI increases. Among participants with AN as a group, results showed differences in speed of information processing, working memory, visual memory, and inhibition, unrelated to attentional capabilities. We cannot support the hypothesis of a specific right cerebral dysfunction in patients with AN. A general cognitive dysfunction, primarily in information processing, working memory, visual and verbal memory, as well as frontal impairments such as impulsivity and poor behavioral control, appeared unrelated to BMI. We support previous works affirming that neuropsychological impairments in AN are not a consequence of the illness but a risk factor for it to develop.

The sad, the angry, and the asymmetrical brain: dichotic listening studies of negative affect and depression.

Dichotic Listening (DL) is a valuable tool to study emotional brain lateralization. Regarding the perception of sadness and anger through affective prosody, the main finding has been a left ear advantage (LEA) for the sad but contradictory data for the anger prosody. Regarding an induced mood in the laboratory, its consequences upon DL were a diminished right ear advantage (REA) for the induction of sadness and an increased REA for the induction of anger. The global results fit with the approach-withdrawal motivational model of emotional processing, pointing to sadness as a right hemisphere emotion but anger processed bilaterally or even in the left hemisphere, depending on the subject's preferred mode of expression. On the other hand, the study of DL in clinically depressed patients found an abnormally larger REA in verbal DL tasks which was predictive of therapeutic pharmacological response. However, the mobilization of the available left hemisphere resources in these responders (reflected in a higher REA) would indicate a remission of the episode but would not assure the absence of new relapses.

What happens when we get angry? Hormonal, cardiovascular and asymmetrical brain responses.

This study aimed to evaluate neuroendocrine and cardiovascular responses together with changes in brain asymmetry following an anger mood induction laboratory task. Previous research has shown an increase in heart rate and blood pressure when anger is experienced. Increased testosterone and decreased cortisol in response to anger and aggressive behavior have also been reported. With regard to asymmetrical frontal brain activity and emotion, the valence model links negative affect (as anger) to the right hemisphere while the motivational direction model links approach-related emotions (as anger) to the left hemisphere. From the subjective perception and from the neuroendocrine and cardiovascular response of the subjects, we can conclude that the self-referent statement anger induction method by Engebretson et al. (1999) was able to generate an experience of an anger affect in 30 healthy men. Another question was to analyze the consequences of that experience upon perceptual asymmetry when measured with a non-emotional laterality task. Regarding dichotic listening, an enhanced REA (right ear advantage) was observed after anger which indicates greater left hemisphere activity, supporting the motivational direction model.

Corpus callosum function in verbal dichotic listening: inferences from a longitudinal follow-up of Relapsing-Remitting Multiple Sclerosis patients.

This study conducted a follow-up of 13 early-onset slightly disabled Relapsing-Remitting Multiple Sclerosis (RRMS) patients within an year, evaluating both CC area measurements in a midsagittal Magnetic Resonance (MR) image, and Dichotic Listening (DL) testing with stop consonant vowel (C-V) syllables. Patients showed a significant progressive loss of posterior CC areas (isthmus and splenium) related to increasing EDSS scores and an enhancing right ear advantage (REA) over time. A significant correlation between posterior CC areas and DL scores emerged in both evaluations, being negative for the right and positive for the left ear. The pattern of correlations suggests that the CC can serve an inhibitory and also excitatory influence on the contralateral hemisphere when studying the phonological processing of language. STATEMENT OF SIGNIFICANCE TO THE NEUROSCIENCE OF LANGUAGE: The scope of the manuscript is language lateralization. The task used in the experiment is a verbal dichotic listening task, tapping the most basic phonological aspects of language. Finally, the available research is scarce when focusing on the interhemispheric excitation or inhibition of the corpus callosum in linguistic functioning.

A comparison of the effects for sustained versus shifted attention on dichotic listening performance.

We measured the effect of two types of directed attention instructions, sustained by a verbal cue or shifted by a tone cue with different time intervals (150, 450, and 750 ms), on a consonant-vowel dichotic listening (C-V DL) test for a large group of right- and left-handed participants of both sexes. An increasing of the hits and a decreasing of the intrusions from the baseline DL test scores was evident for both types of attentional manipulations, with no differences regarding sex or handedness. Increasing the time from 150 to 450 ms benefited the focusing of attention but this advantage was markedly attenuated at the longer 750-ms interval. The improving effect was seen for the hits of both the left and right ears and so a right ear advantage was evident for the three time intervals.

Increased cortisol and decreased right ear advantage (REA) in dichotic listening following a negative mood induction.

This study aimed to evaluate neuroendocrine responses and changes in perceptual asymmetry following an induced negative affect. Cortisol increasing in response to negative affect has been reported, while current brain models of emotion processing link negative affect to the right hemisphere. In this study, the Velten Mood Induction Procedure was used to generate neutral or negative affect in 44 healthy subjects. The PANAS scales were used to assess self-reported mood. A consonant-vowel dichotic listening (DL) test was applied after the neutral and negative affect inductions, and levels of salivary cortisol were determined by radioimmunoassay. For the negative affect condition, and congruent with the hypothesis tested, PANAS positive scores diminished (p<0.001) and PANAS negative scores increased (p<0.001), yielding an inverse correlation between them. A significant increase in cortisol levels was also seen (p<0.04). When taking cortisol reactivity into account, PANAS negative scores were higher for high-than for low-cortisol responders (p<0.02). Regarding DL, an increase in left ear items (p<0.04) and a decrease in right ear items (p<0.03) reported for those subjects who obtained a right ear advantage in the neutral condition. An explanation in terms of Kinsbourne's model for attentional-activation influences on DL is postulated and implications for the issue of affective illness are also discussed.

Spectroscopic axonal damage of the right locus coeruleus relates to selective attention impairment in early stage relapsing-remitting multiple sclerosis.

Lower levels of N-acetylaspartate (NAA), a marker of axonal damage, have been found in the normal-appearing white matter (NAWM) of relapsing-remitting multiple sclerosis (RRMS) patients with low physical disability. However, its relation to the clinical status of these patients remains unclear. We explored the association between NAA levels [normalized to creatine (Cr), NAA/Cr] and a cognitive feature that is not measured by the standard scales that address functional disability [e.g. Expanded Disability Scale Score (EDSS)] in early RRMS. Given that a considerable number of RRMS patients present attentional dysfunction early in the disease and assuming a functional-anatomical oriented guide, it was hypothesized that patients with worse attentional performance would show lower NAWM NAA/Cr values in the locus coeruleus nuclei of the pontine ascendant reticular activating system. Proton magnetic resonance spectroscopy (1H-MRS) examinations with concurrent clinical evaluation were acquired for 19 RRMS patients with a mean evolution time of 24 months (range 10-60) and mild disability (EDSS 0-3.5, median = 1). 1H-MRS was obtained with spectroscopic imaging and measures were taken from the right and left hemipons. Attention was measured by means of the dichotic listening (DL) paradigm to increase the sensitivity of the testing to subtle attentional deficits. A consonant-vowel DL test was measured with and without attentional instructions. For the attentional condition, the test was digitally manipulated to cue automatically to the ear to be attended, thus allowing the obtention of both a linguistic lateralization index (LI) and an index of integrity of attentional shifts (ASI). Attentional impairment was demonstrated in 47.3% of the patients. Pontine NAA/Cr levels accounted for 39% of the ASI variability (beta = 0.65, P < 0.002) but did not relate to the LI. Moreover, when NAA/Cr levels were considered separately as left and right hemipons values in a multivariate stepwise linear regression model, the right NAA/Cr ratio alone explained 43% of the ASI variability (beta = 0.68, P < 0.001). Since the RRMS patients with greater attentional disturbances exhibited the lowest NAA/Cr levels, it is concluded that NAA provides a specific measure of pathological changes that are also relevant for cognitive functions. The use of both 1H-MRS and DL showed the connection between axonal damage at right locus coeruleus and auditive selective attention dysfunction in early-stage RRMS.

Dichotic listening and corpus callosum magnetic resonance imaging in relapsing-remitting multiple sclerosis with emphasis on sex differences.

Twenty-five early-onset relapsing-remitting multiple sclerosis patients (12 women and 13 men) with mild disability were compared with 25 matched controls in a dichotic listening (DL) test under nonforced and forced attentional-shift conditions. Patients showed left ear impairment and no left ear advantage in the forced-left condition. Four corpus callosum (CC) regions were measured in patients on a midsaggital magnetic resonance imaging scan. The right ear score was negatively correlated whereas the left ear score was positively correlated with CC regions (significant only for the nonforced condition). Moreover, in men, the correlations with DL scores were linked mainly to the splenium and posterior isthmus, and in women, they were stronger for anterior isthmus and posterior body. An inverse correlation between months of disease evolution and CC area was found only in women.