Using Wearable Inertial Sensors to Estimate Clinical Scores of Upper Limb Movement Quality in Stroke.

Neurorehabilitation is progressively shifting from purely in-clinic treatment to therapy that is provided in both clinical and home-based settings. This transition generates a pressing need for assessments that can be performed across the entire continuum of care, a need that might be accommodated by application of wearable sensors. A first step toward ubiquitous assessments is to augment validated and well-understood standard clinical tests. This route has been pursued for the assessment of motor functioning, which in clinical research and practice is observation-based and requires specially trained personnel. In our study, 21 patients performed movement tasks of the Action Research Arm Test (ARAT), one of the most widely used clinical tests of upper limb motor functioning, while trained evaluators scored each task on pre-defined criteria. We collected data with just two wrist-worn inertial sensors to guarantee applicability across the continuum of care and used machine learning algorithms to estimate the ARAT task scores from sensor-derived features. Tasks scores were classified with approximately 80% accuracy. Linear regression between summed clinical task scores (across all tasks per patient) and estimates of sum task scores yielded a good fit (R 2 = 0.93; range reported in previous studies: 0.61-0.97). Estimates of the sum scores showed a mean absolute error of 2.9 points, 5.1% of the total score, which is smaller than the minimally detectable change and minimally clinically important difference of the ARAT when rated by a trained evaluator. We conclude that it is feasible to obtain accurate estimates of ARAT scores with just two wrist worn sensors. The approach enables administration of the ARAT in an objective, minimally supervised or remote fashion and provides the basis for a widespread use of wearable sensors in neurorehabilitation.

Microsaccade dynamics in the attentional repulsion effect.

A briefly flashed peripheral cue has been shown to repulse the perceived position of a subsequently presented foveal probe - a bias called the Attentional Repulsion Effect (ARE). While this bias has originally been assumed to reflect attentional capturing by the cue, its attentional nature has recently been questioned. To investigate the ARE's attentional properties, we recorded microsaccades as an attentional marker in the ARE paradigm. Microsaccades, small fixational eye movements performed during fixation, have previously been described to reflect the dynamics of spatial attention deployment. Our results favor an attentional explanation for the ARE: In trials in which an ARE was found, microsaccades were directed more often toward the cue, presumably reflecting the covert shift of attention. In contrast, more cue-incongruent microsaccades were observed in trials in which no ARE was found. Therefore, both repulsion as well as measured microsaccade modulations, are most likely an outcome of the preceding shifts of covert attention.

Attentional capture by context cues, not inhibition of cue singletons, explains same location costs.

Recent attentional capture studies with the spatial cueing paradigm often found that target-dissimilar precues resulted in longer RTs on valid than invalid cue trials. These same location costs were accompanied by a contralateral positivity over posterior electrodes from 200 to 300 ms, similar to a PD component. Same location costs and the PD have been linked to the inhibition of cues with a unique feature (singleton cues) that do not match the target feature. In some studies reporting same location costs, the cue was surrounded by other cues (i.e., the context cues) that matched the physical or relative feature of the target. We hypothesized that the context cues might have captured attention and might have elicited data patterns that mimicked the inhibitory effects. To disentangle inhibition of the singleton cue from capture by the context cues, we added gray cues to the cue array, which we considered neutral because gray matched neither the target nor the nontarget color. In four experiments, the results consistently showed that the context cues in the nonmatching cue condition captured attention, as reflected in shorter RTs compared to neutral cues and a substantial N2pc to lateralized context cues. By contrast, the evidence for inhibition of the singleton cue was rather weak. Therefore, same location costs and lateralized positivity in the event-related potential of participants in several recent studies probably reflected attentional capture by the context cues, not inhibition of the singleton cue. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Optimal task-sets override attentional capture by rare cues.

Many studies converge on the conclusion that spatially irrelevant precues do not capture attention when cue and target features do not match. However, a recent study reported that rare onset cues captured attention even though observers searched for a nonmatching color target. Hence, attentional capture by rare onsets cues might be cognitively impenetrable (Folk & Remington, 2015). Although we replicated these findings (Experiment 1), we hypothesized that capture by rare onset cues can be prevented when the target display promotes a stronger task-set for the target or suppression of the cue features (i.e., a white onset). Therefore, we presented the color target together with a single white nontarget, and indeed found that the rare onset cues failed to capture (Experiment 2). Moreover, we examined the previous suggestion that frequency effects are limited to onset cues by presenting rare color cues with nonmatching color targets (Experiment 3). We observed capture by rare color cues, but again, capture could be prevented when a nontarget in the cue color was added to the target display (Experiment 4). Overall, these findings suggest that capture by rare cues can be prevented when the suppressive bias against nontarget features is optimally directed against the cue properties. (PsycINFO Database Record

Detection costs and contingent attentional capture.

Peripheral cues reduce reaction times (RTs) to targets at the cued location with short cue-target SOAs (cueing benefits) but increase RTs at long SOAs (cueing costs or inhibition of return). In detection tasks, cueing costs occur at shorter SOAs and are larger compared with identification tasks. To account for effects of task, detection cost theory claims that the integration of cue and target into an object file makes it more difficult to detect the target as a new event, which is the principal task-requirement in detection tasks. The integration of cue and target is expected to increase when cue and target are similar. We provided evidence for detection cost theory in the modified spatial cueing paradigm. Two types of cues (onset, color) were paired with two types of targets (onset, color) in separate blocks of trials. In the identification task, we found cueing benefits with matching (i.e., similar) cue-target pairs (onset-onset, color-color) and no cueing effects with nonmatching cue-target pairs (onset-color, color-onset), which replicates previous work. In the detection task, cueing effects with matching cues were reduced and even turned into cueing costs for onset cues with onset targets, suggesting that cue-target integration made it more difficult to detect targets at the cued location as new events. In contrast, the results for nonmatching cue-target pairs were not affected by task. Furthermore, the pattern of false alarms in the detection task provides a measure of similarity that may explain the size of cueing benefits and costs.

Attentional guidance by relative features: Behavioral and electrophysiological evidence.

Our ability to select task-relevant information from cluttered visual environments is widely believed to be due to our ability to tune attention to the particular elementary feature values of a sought-after target (e.g., red, orange, yellow). By contrast, recent findings showed that attention is often tuned to feature relationships, that is, features that the target has relative to irrelevant features in the context (e.g., redder, yellower). However, the evidence for such a relational account is so far exclusively based on behavioral measures that do not allow a safe inference about early perceptual processes. The present study provides a critical test of the relational account, by measuring an electrophysiological marker in the EEG of participants (N2pc) in response to briefly presented distractors (cues) that could either match the physical features of the target or its relative features. In a first experiment, the target color and nontarget color were kept constant across trials. In line with a relational account, we found that only cues with the same relative color as the target were attended, regardless of whether the cues had the same physical color as the target. In a second experiment, we demonstrate that attention is biased to the exact target feature value when the target is embedded in a randomly varying context. Taken together, these results provide the first electrophysiological evidence that attention can modulate early perceptual processes differently; in a context-dependent manner versus a context-independent manner, resulting in marked differences in the range of colors that can attract attention.