Rationale and methodology for examining the combination of aerobic exercise and cognitive rehabilitation on new learning and memory in persons with multiple sclerosis and mobility disability: Protocol for a randomized controlled trial.

BACKGROUND: This paper describes the protocol for a Phase I/II, parallel-group, single-blind randomized controlled trial (RCT). The RCT investigates the combined effects of 12-weeks of aerobic exercise training (AET) integrated with virtual reality (VR) and cognitive rehabilitation (CR) on new learning and memory in 78 persons with multiple sclerosis (MS) who have mobility disability and objective impairments in learning and memory. METHODS: Participants will undergo baseline assessments consisting of neuropsychological testing, neuroimaging, self-report questionnaires, and cardiorespiratory fitness. Participants will then be randomized into one of two conditions using concealed allocation: aerobic cycling exercise that incorporates VR combined with CR or stretching and toning (i.e., active control; S/T) combined with CR. Participants will be masked regarding the intent of the conditions. After 7-weeks of exercise alone, the 5-week Kessler Foundation modified Story Memory Technique (KF-mSMT®) will be integrated into the training. After the 12-week training period, participants will complete the same measures as at baseline administered by treatment-blinded assessors. Primary study outcomes include new learning and memory (NLM) measured by a small battery of neuropsychological assessments that assess list learning (California Verbal Learning Test-II), prose memory (Memory Assessment Scale), visuospatial memory (Brief Visuospatial Memory Test-Revised), and everyday memory (Ecological Memory Simulations). Secondary study outcomes include neuroimaging outcomes of hippocampal structure, function, and connectivity. CONCLUSION: If successful, this trial will provide the first Class I evidence supporting the unique combination of aerobic cycling exercise with VR and CR for treating MS-related learning and memory impairments in persons with mobility disability.

The effects of cognitive rehabilitation combined with aerobic exercise or stretching-and-toning on new learning and memory in persons with moderate-to-severe TBI: Protocol for a randomized controlled trial.

This paper describes the protocol for a Phase I/II, parallel-group, blinded randomized controlled trial that compares the effects of 12-weeks of combined learning and memory rehabilitation with either aerobic cycling exercise or stretching on cognitive, neuroimaging, and everyday life outcomes in 60 persons with moderate-to-severe traumatic brain injury (TBI) who demonstrate impairments in new learning. Briefly, participants will undergo baseline testing consisting of neuropsychological testing, neuroimaging, daily life measures, and cardiorespiratory fitness. Following baseline testing, participants will be randomized to one of 2 conditions (30 participants per condition) using concealed allocation. Participants will be masked as to the intent of the conditions. The conditions will both involve supervised administration of an enhanced, 8-week version of the Kessler Foundation modified Story Memory Technique, embedded within either 12-weeks of supervised and progressive aerobic cycling exercise training (experimental condition) or 12-weeks of supervised stretching-and-toning (active control condition). Following the 12-week intervention period, participants will complete the same measures as at baseline that will be administered by treatment-blinded assessors. The primary study outcome is new learning and memory impairment based on California Verbal Learning Test (CVLT)-III slope, the secondary outcomes include neuroimaging measures of hippocampal volume, activation, and connectivity, and the tertiary outcomes involve measures of daily living along with other cognitive outcomes. We further will collect baseline sociodemographic data for examining predictors of response heterogeneity. If successful, this trial will provide the first Class I evidence supporting combined memory rehabilitation and aerobic cycling exercise training for treating TBI-related new learning and memory impairment.

Think again: the role of reappraisal in reducing negative valence bias.

Stimuli such as surprised faces are ambiguous in that they are associated with both positive and negative outcomes. Interestingly, people differ reliably in whether they evaluate these and other ambiguous stimuli as positive or negative, and we have argued that a positive evaluation relies in part on a biasing of the appraisal processes via reappraisal. To further test this idea, we conducted two studies to evaluate whether increasing the cognitive accessibility of reappraisal through a brief emotion regulation task would lead to an increase in positive evaluations of ambiguity. Supporting this prediction, we demonstrated that cuing reappraisal, but not in three other forms of emotion regulation (Study 1a-d; n = 120), increased positive evaluations of ambiguous faces. In a sign of robustness, we also found that the effect of reappraisal generalised from ambiguous faces to ambiguous scenes (Study 2; n = 34). Collectively, these findings suggest that reappraisal may play a key role in determining responses to ambiguous stimuli. We discuss these findings in the context of affective flexibility, and suggest that valence bias (i.e. the tendency to evaluate ambiguity more positively or negatively) represents a novel approach to measuring implicit emotion regulation.

Impact of binge drinking during college on resting state functional connectivity.

AIM: The current study examined the longitudinal effects of standard binge drinking (4+/5+ drinks for females/males in 2 hours) and extreme binge drinking (8+/10+ drinks for females/males in 2 hours) on resting-state functional connectivity. METHOD: 119 college students (61 males) were recruited in groups of distinct bingeing patterns at baseline: non-bingeing controls, standard and extreme bingers. Resting-state scans were first obtained when participants were freshmen/sophomores and again approximately two years later. Associations between longitudinal bingeing (reported during this two-year gap) and network connectivity were examined. Network connectivity was calculated by aggregating all edges affiliated with the same network (an edge is a functional connection between two brain regions). The relationship between longitudinal bingeing and connectivity edges was also studied using connectome-based predictive modeling (CPM). RESULTS: Greater standard bingeing was negatively associated with change in connectivity between Default Mode Network and Ventral Attention Network (DMN-VAN; False Discovery Rate corrected), controlling for initial binge groups, longitudinal network changes, motions, scanner, SES, sex, and age. The correlations between change in DMN-VAN connectivity and change in cognitive performance (Stroop, Digit Span, Letter Fluency, and Trail Making) were also tested, but the results were not significant. Lastly, CPM failed to identify a generalizable predictive model of longitudinal bingeing from change in connectivity edges. CONCLUSIONS: Binge drinking is associated with abnormality in networks implicated in attention and self-focused processes, which, in turn, have been implicated in rumination, craving, and relapse. More extensive alterations in functional connectivity might be observed with heavier or longer binge drinking pattern.

Behavioral inhibition and reward processing in college binge drinkers with and without marijuana use.

AIM: Binge drinking is common during college, and studies have shown that many college students drink in quantities that far exceed the standard binge drinking threshold. Previous research has noted personality differences in individuals who engage in binge drinking, but few studies have examined neurobiological differences in both standard bingers (4/5 drinks in two hours for females/males; sBinge) and extreme binge drinkers (8+/10+ drinks in two hours for females/males; eBinge). METHOD: The current study of 221 college students used functional magnetic resonance imaging (fMRI) to study neural activation on a stop signal task (SST) to assess behavioral inhibition and a monetary incentive delay (MID) task to assess activation to rewards and losses. Non-bingeing controls, sBinge, and eBinge freshmen and sophomores were recruited. In addition, because binge/extreme binge drinking is often associated with marijuana (MJ) use, MJ + sBinge and MJ + eBinge groups were also included. RESULTS: All five groups showed strong activation in expected key cortical and striatal regions on both the SST and the MID. However, there were no significant differences between groups either at the whole-brain level or in specific regions of interest. Behavioral performance on the fMRI tasks also did not differ between groups. CONCLUSIONS: These results suggest that our sample of individuals who engage in binge or extreme binge drinking with or without MJ co-use do not differ in brain activity on reward and inhibitory tasks. Neural differences may be present on other cognitive tasks or may emerge later after more sustained use of alcohol, MJ, and other drugs.

Individual differences in valence bias: fMRI evidence of the initial negativity hypothesis.

Facial expressions offer an ecologically valid model for examining individual differences in affective decision-making. They convey an emotional signal from a social agent and provide important predictive information about one's environment (presence of potential rewards or threats). Although some expressions provide clear predictive information (angry, happy), others (surprised) are ambiguous in that they predict both positive and negative outcomes. Thus, surprised faces can delineate an individual's valence bias, or the tendency to interpret ambiguity as positive or negative. Our initial negativity hypothesis suggests that the initial response to ambiguity is negative, and that positivity relies on emotion regulation. We tested this hypothesis by comparing brain activity during explicit emotion regulation (reappraisal) and while freely viewing facial expressions, and measuring the relationship between brain activity and valence bias. Brain regions recruited during reappraisal showed greater activity for surprise in individuals with an increasingly positive valence bias. Additionally, we linked amygdala activity with an initial negativity, revealing a pattern similarity in individuals with negative bias between viewing surprised faces and maintaining negativity. Finally, these individuals failed to show normal habituation to clear negativity. These results support the initial negativity hypothesis, and are consistent with emotion research in both children and adult populations.

All in the first glance: first fixation predicts individual differences in valence bias.

Surprised expressions are interpreted as negative by some people, and as positive by others. When compared to fearful expressions, which are consistently rated as negative, surprise and fear share similar morphological structures (e.g. widened eyes), but these similarities are primarily in the upper part of the face (eyes). We hypothesised, then, that individuals would be more likely to interpret surprise positively when fixating faster to the lower part of the face (mouth). Participants rated surprised and fearful faces as either positive or negative while eye movements were recorded. Positive ratings of surprise were associated with longer fixation on the mouth than negative ratings. There were also individual differences in fixation patterns, with individuals who fixated the mouth earlier exhibiting increased positive ratings. These findings suggest that there are meaningful individual differences in how people process faces.

Don't like what you see? Give it time: Longer reaction times associated with increased positive affect.

Images with an ambiguous valence (e.g., surprised facial expressions) are interpreted by some people as having a negative valence, and by others, as having a more positive valence. Despite these individual differences in valence bias, the more automatic interpretation is negative, and positivity appears to require regulation. Interestingly, extant research has shown that there is an age-related positivity effect such that relative to young adults, older adults attend to and remember positive more than negative information. In this report, the authors show that this positivity effect extends to emotional ambiguity (Experiment 1). Eighty participants (aged 19-71, 42 females) rated the valence of images with a clear or ambiguous valence. They found that age correlated with valence bias, such that older adults showed a more positive bias, and they took longer to rate images, than younger adults. They also found that this increase in reaction times was sufficient to bias positivity (Experiment 2). Thirty-four participants (aged 18-28, 24 females) rated ambiguous and clear images, before and after an instruction to delay their RTs. They also found that although ratings among individuals with a positive bias did not change, those with a negative bias became more positive when encouraged to delay. Indeed, participants with the strongest negativity bias showed the greatest increase in RTs. Taken together, this work demonstrates that the valence bias, which represents a stable, trait-like difference across people, can be moved in the positive direction, at least temporarily, when participants are encouraged to take their time and consider alternatives. (PsycINFO Database Record