Action experience in infancy predicts visual-motor functional connectivity during action anticipation.

Despite substantial evidence indicating a close link between action production and perception in early child development, less is known about how action experience shapes the processes of perceiving and anticipating others' actions. Here, we developed a novel approach to capture functional connectivity specific to certain brain areas to investigate how action experience changes the networks involved in action perception and anticipation. Nine- and-12-month-old infants observed familiar (grasping) and novel (tool-use) actions while their brain activity was measured using EEG. Infants' motor competence of both actions was assessed. A link between action experience and connectivity patterns was found, particularly during the anticipation period. During action anticipation, greater motor competence in grasping predicted greater functional connectivity between visual (occipital alpha) and motor (central alpha) regions relative to global levels of whole-brain EEG connectivity. Furthermore, visual and motor regions tended to be more coordinated in response to familiar versus novel actions and for older than younger participants. Critically, these effects were not found in the control networks (frontal-central; frontal-occipital; parietal-central; parietal-occipital), suggesting a unique role of visual-motor networks on the link between motor skills and action encoding. HIGHLIGHTS: Infants' motor development predicted functional connectivity patterns during action anticipation. Faster graspers, and older infants, showed a stronger ratio of visual-motor neural coherence. Overall whole-brain connectivity was modulated by age and familiarity with the actions. Measuring inter-site relative to whole-brain connectivity can capture specific brain-behavior links. Measures of phase-based connectivity over time are sensitive to anticipatory action.

Revisiting bilateral bony orbital volumes comparison using 3D reconstruction in Korean adults: a reference study for orbital wall reconstruction, 3D printing, and navigation by mirroring.

BACKGROUND: Orbital wall fractures can result in changes to the bony orbital volume and soft tissue. Restoring the bony orbital and intraconal fat volumes is crucial to prevent posttraumatic enophthalmos and hypoglobus. We aimed to establish an evidence-based medical reference point for "mirroring" in orbital wall reconstruction, which incorporates three-dimensional (3D)-printing and navigation-assisted surgery, by comparing bilateral bony orbital volumes. METHODS: We retrospectively analyzed the data obtained from 100 Korean adults who did not have orbital wall fractures, categorized by age groups. The AVIEW Research software (Coreline Soft Inc., Seoul, South Korea) was used to generate 3D reformations of the bony orbital cavity, and bony orbital volumes were automatically calculated after selecting the region of interest on consecutive computed tomography slices. RESULTS: The mean left and right orbital volume of males in their 20 s was 24.67 ± 2.58 mL and 24.70 ± 2.59 mL, respectively, with no significant difference in size (p = 0.98) and Pearson's correlation coefficient of 0.977 (p < 0.001). No significant differences were found in orbital volumes in other age groups without fractures or in patients with nasal bone fractures (p = 0.84, Pearson's correlation coefficient 0.970, p < 0.001). The interclass correlation coefficients (2,1) for inter- and intrarater reliability were 0.97 (p < 0.001) and 0.99 (p < 0.001), respectively. CONCLUSIONS: No significant differences were found in the bilateral bony orbital volumes among males of any age. Thus, the uninjured orbit can be used as a volumetric reference point for the contralateral injured orbit during orbital wall reconstruction.

Intricacies of Relational Intimacy: Approaching the Invasive Edge with a Schizoid Patient.

In hopes of contributing to the developing self-critique of relational analysis, I offer a case that illustrates a modified approach, one informed by current dialogue. The patient described had considerable unmet selfobject needs and a schizoid sensitivity to intrusion, engendering the question explored: How do two minds meet if one is largely relationally dissociated and acutely vulnerable when integrated? A premature emphasis on intersubjectivity would have obscured the patient's narcissistic needs and reinforced her tendency to retreat. Suspending the goal of intersubjectivity allowed for a regressive process to occur, and for contact to become safe before analyst and patient paved the way for future mutual relatedness.

Social context shapes neural processing of others' actions in 9-month-old infants.

From infancy, neural processes for perceiving others' actions and producing one's own actions overlap (neural mirroring). Adults and children show enhanced mirroring in social interactions. Yet, whether social context affects mirroring in infancy, a time when processing others' actions is crucial for action learning, remains unclear. We examined whether turn-taking, an early form of social interaction, enhanced 9-month-olds' neural mirroring. We recorded electroencephalography while 9-month-olds were grasping (execution) and observing live grasps (observation). In this design, half of the infants observed and acted in alternation (turn-taking condition), whereas the other half observed several times in a row before acting (blocked condition). Replicating previous findings, infants showed significant 6- to 9-Hz mu suppression (indicating motor activation) during execution and observation (n = 24). In addition, a condition (turn-taking or blocked) by time (action start or end) interaction indicated that infants engaged in turn-taking (n = 9), but not in the blocked context (n = 15), showed more mirroring when observing the action start compared with the action end. Exploratory analyses further suggest that (a) there is higher visual-motor functional connectivity in turn-taking toward the action's end, (b) mirroring relates to later visual-motor connectivity, and (c) visual attention as indexed by occipital alpha is enhanced in turn-taking compared with the blocked context. Together, this suggests that the neural processing of others' actions is modulated by the social context in infancy and that turn-taking may be particularly effective in engaging infants' action perception system.

Reduction of giant parietooccipital fibrous dysplasia using dynamic mirror image guidance: a case report and review of the literature.

BACKGROUND: Craniofacial fibrous dysplasia (CFD) typically occurs in the facial bones and anterior cranial vault and can produce both disfigurement and functional limitations for patients disfigurement. Treatment consists of reducing the abnormal bone. Bone contouring can become challenging when the exposure does not extend to the corresponding normal contralateral structures for comparison or when normal landmarks are not available, which may compromise the overall aesthetic outcome. We describe a technique using dynamic mirroring to accurately contour the involved part of the cranium in a case of giant CFD. OBSERVATIONS: A 49-year-old male presented with a giant deforming fibrous dysplasia of the right mastoid and parieto-temporo-occiput that was causing functional limitations due to the size of the bony mass. This was managed with multidisciplinary bony reduction. Several neurovascular structures were in proximity to the areas of planned drilling of the expansile lesion, and dynamic mirroring of the uninvolved left skull was utilized to maximize safety and symmetry of reduction. High-speed drilling of the right occipital bone was performed until the navigation system alerted the surgeon that symmetric depth had been achieved. There were no complications from the procedure and this technique maximized the limits of symmetric reduction without significantly increasing surgical complexity or duration. LESSONS: Dynamic mirroring of bony structures in the posterior cranium is not commonly employed in neurosurgical practice. This technique may help improve the aesthetic outcomes of bony reduction in craniofacial dysplasia and a variety of similarly managed bony lesions, contour cranioplasties, and in unilateral craniosynostosis surgery.

Research on Discrete Semantics in Continuous Hand Joint Movement Based on Perception and Expression.

Continuous movements of the hand contain discrete expressions of meaning, forming a variety of semantic gestures. For example, it is generally considered that the bending of the finger includes three semantic states of bending, half bending, and straightening. However, there is still no research on the number of semantic states that can be conveyed by each movement primitive of the hand, especially the interval of each semantic state and the representative movement angle. To clarify these issues, we conducted experiments of perception and expression. Experiments 1 and 2 focused on perceivable semantic levels and boundaries of different motion primitive units from the perspective of visual semantic perception. Experiment 3 verified and optimized the segmentation results obtained above and further determined the typical motion values of each semantic state. Furthermore, in Experiment 4, the empirical application of the above semantic state segmentation was illustrated by using Leap Motion as an example. We ended up with the discrete gesture semantic expression space both in the real world and Leap Motion Digital World, containing the clearly defined number of semantic states of each hand motion primitive unit and boundaries and typical motion angle values of each state. Construction of this quantitative semantic expression will play a role in guiding and advancing research in the fields of gesture coding, gesture recognition, and gesture design.

Consensus Paper: Cerebellum and Social Cognition.

The traditional view on the cerebellum is that it controls motor behavior. Although recent work has revealed that the cerebellum supports also nonmotor functions such as cognition and affect, only during the last 5 years it has become evident that the cerebellum also plays an important social role. This role is evident in social cognition based on interpreting goal-directed actions through the movements of individuals (social "mirroring") which is very close to its original role in motor learning, as well as in social understanding of other individuals' mental state, such as their intentions, beliefs, past behaviors, future aspirations, and personality traits (social "mentalizing"). Most of this mentalizing role is supported by the posterior cerebellum (e.g., Crus I and II). The most dominant hypothesis is that the cerebellum assists in learning and understanding social action sequences, and so facilitates social cognition by supporting optimal predictions about imminent or future social interaction and cooperation. This consensus paper brings together experts from different fields to discuss recent efforts in understanding the role of the cerebellum in social cognition, and the understanding of social behaviors and mental states by others, its effect on clinical impairments such as cerebellar ataxia and autism spectrum disorder, and how the cerebellum can become a potential target for noninvasive brain stimulation as a therapeutic intervention. We report on the most recent empirical findings and techniques for understanding and manipulating cerebellar circuits in humans. Cerebellar circuitry appears now as a key structure to elucidate social interactions.

Development of electronic medical records for clinical and research purposes: the breast cancer module using an implementation framework in a middle income country- Malaysia.

BACKGROUND: Advances in medical domain has led to an increase of clinical data production which offers enhancement opportunities for clinical research sector. In this paper, we propose to expand the scope of Electronic Medical Records in the University Malaya Medical Center (UMMC) using different techniques in establishing interoperability functions between multiple clinical departments involving diagnosis, screening and treatment of breast cancer and building automatic systems for clinical audits as well as for potential data mining to enhance clinical breast cancer research in the future. RESULTS: Quality Implementation Framework (QIF) was adopted to develop the breast cancer module as part of the in-house EMR system used at UMMC, called i-Pesakit©. The completion of the i-Pesakit© Breast Cancer Module requires management of clinical data electronically, integration of clinical data from multiple internal clinical departments towards setting up of a research focused patient data governance model. The 14 QIF steps were performed in four main phases involved in this study which are (i) initial considerations regarding host setting, (ii) creating structure for implementation, (iii) ongoing structure once implementation begins, and (iv) improving future applications. The architectural framework of the module incorporates both clinical and research needs that comply to the Personal Data Protection Act. CONCLUSION: The completion of the UMMC i-Pesakit© Breast Cancer Module required populating EMR including management of clinical data access, establishing information technology and research focused governance model and integrating clinical data from multiple internal clinical departments. This multidisciplinary collaboration has enhanced the quality of data capture in clinical service, benefited hospital data monitoring, quality assurance, audit reporting and research data management, as well as a framework for implementing a responsive EMR for a clinical and research organization in a typical middle-income country setting. Future applications include establishing integration with external organization such as the National Registration Department for mortality data, reporting of institutional data for national cancer registry as well as data mining for clinical research. We believe that integration of multiple clinical visit data sources provides a more comprehensive, accurate and real-time update of clinical data to be used for epidemiological studies and audits.

Mu rhythm desynchronization is specific to action execution and observation: Evidence from time-frequency and connectivity analysis.

Mu desynchronization is the attenuation of EEG power in the alpha frequency range recorded over central scalp locations thought to reflect motor cortex activation. Mu desynchronization during observation of an action is believed to reflect mirroring system activation in humans. However, this notion has recently been questioned because, among other reasons, the potential contamination of mu rhythm and occipital alpha activity induced by attention processes following presentation of visual stimuli in observation conditions. This study examined the validity of mu desynchronization as a measure of mirroring system activation in infants and further investigated the pattern of functional connectivity between the central and occipital regions during execution and observation of movement. EEG was recorded while 46 9-month-old infants executed grasping actions and observed an experimenter grasping. Current source density (CSD) was applied to EEG data and, time-frequency and connectivity analyses were performed in CSD transformed data. Mu desynchronization was evident over central regions during both execution and observation of movements. Independent alpha desynchronization over occipital region was also present in both conditions. The connectivity analyses revealed that central-occipital areas were functionally more connected compared to other areas of the brain during observation of movements. Collectively, the results demonstrate the validity of mu desynchronization as an index of infant mirroring system activity and support the proposal of a functional connection between distinct mirroring and attention processes during observation of action.

The role of the motor system in action understanding and communication: Evidence from human infants and non-human primates.

There is growing evidence that activation of the motor system during observation of actions, a phenomenon first observed in non-human primates, underlies action understanding and even communication. This review (a) examines the evidence on motor system activity as an underlying neural correlate of action understanding; (b) reviews the theoretical and empirical work linking action understanding and the development of communication, with a specific focus on the role that gestures play as an intermediary; and (c) discusses the research on and existing opportunities for understanding the link between the motor system and communication in both humans and non-human primates, through the lens of action perception. Bringing together findings and perspectives from developmental social cognition in both humans and non-human primates and applying recent neuroscientific perspectives will help to elucidate the processes underlying the ability to understand and communicate with others.

Overlapping and distinct neural correlates of imitating and opposing facial movements.

Previous studies have demonstrated that imitating a face can be relatively automatic and reflexive. In contrast, opposing facial expressions may require engaging flexible, cognitive control. However, few studies have examined the degree to which imitation and opposition of facial movements recruit overlapping and distinct neural regions. Furthermore, little work has examined whether opposition and imitation of facial movements differ between emotional and averted eye gaze facial expressions. This study utilized a novel task with 40 participants to compare passive viewing, imitation and opposition of emotional faces looking forward and neutral faces with averted eye gaze [(3: Look, Imitate, Oppose) x (2: Emotion, Averted Eye)]. Imitation and opposition of both types of facial movements elicited overlapping activation in frontal, premotor, superior temporal and anterior intraparietal regions. These regions are recruited during cognitive control, face processing and mirroring tasks. For both emotional and averted eye gaze photos, opposition engaged the superior frontal gyrus, superior temporal sulcus and the anterior intraparietal sulcus to a greater extent compared to imitation. Finally, stimulus type and instruction interacted, such that for the eye gaze condition only, greater activation was observed in the dorsal anterior cingulate (dACC) during opposition compared to imitation, while no significant dACC differences were observed for the emotional expression conditions, which instead showed significantly greater activation in the middle and frontal pole. Overall these results showed significant overlap between imitation and opposition, as well as increased activation of these regions to generate an opposing facial movement relative to imitating.

Brain correlates of recognition of communicative interactions from biological motion in schizophrenia.

BACKGROUND: Recognition of communicative interactions is a complex social cognitive ability which is associated with a specific neural activity in healthy individuals. However, neural correlates of communicative interaction processing from whole-body motion have not been known in patients with schizophrenia (SCZ). Therefore, the current study aims to examine the neural activity associated with recognition of communicative interactions in SCZ by using displays of the dyadic interactions downgraded to minimalistic point-light presentations. METHODS: Twenty-six healthy controls (HC) and 25 SCZ were asked to judge whether two agents presented only by point-light displays were communicating or acting independently. Task-related activity and functional connectivity of brain structures were examined with General Linear Model and Generalized Psychophysiological Interaction approach, respectively. RESULTS: HC were significantly more efficient in recognizing each type of action than SCZ. At the neural level, the activity of the right posterior superior temporal sulcus (pSTS) was observed to be higher in HC compared with SCZ for communicative v. individual action processing. Importantly, increased connectivity of the right pSTS with structures associated with mentalizing (left pSTS) and mirroring networks (left frontal areas) was observed in HC, but not in SCZ, during the presentation of social interactions. CONCLUSION: Under-recruitment of the right pSTS, a structure known to have a pivotal role in social processing, may also be of importance for higher-order social cognitive deficits in SCZ. Furthermore, decreased task-related connectivity of the right pSTS may result in reduced use of additional sources of information (for instance motor resonance signals) during social cognitive processing in schizophrenia.

Neural mechanisms of social decision-making in the primate amygdala.

Social decisions require evaluation of costs and benefits to oneself and others. Long associated with emotion and vigilance, the amygdala has recently been implicated in both decision-making and social behavior. The amygdala signals reward and punishment, as well as facial expressions and the gaze of others. Amygdala damage impairs social interactions, and the social neuropeptide oxytocin (OT) influences human social decisions, in part, by altering amygdala function. Here we show in monkeys playing a modified dictator game, in which one individual can donate or withhold rewards from another, that basolateral amygdala (BLA) neurons signaled social preferences both across trials and across days. BLA neurons mirrored the value of rewards delivered to self and others when monkeys were free to choose but not when the computer made choices for them. We also found that focal infusion of OT unilaterally into BLA weakly but significantly increased both the frequency of prosocial decisions and attention to recipients for context-specific prosocial decisions, endorsing the hypothesis that OT regulates social behavior, in part, via amygdala neuromodulation. Our findings demonstrate both neurophysiological and neuroendocrinological connections between primate amygdala and social decisions.

A Behavioral and Biological Analysis of Aesthetics: Implications for Research and Applications.

Seeking to identify the common and distinguishing attributes of effects one might call "aesthetic," I examined hundreds of examples in music, visual arts, poetry, literature, humor, performance arts, architecture, science, mathematics, games, and other disciplines. I observed that all involve quasi-emotional reactions to stimuli that are composites of multiple elements that ordinarily do not occur together and whose interaction, when appropriately potentiated, is transformative-different in kind from the effects of the separate constituent elements. Such effects, termed synergetic, can evoke surprise-tinged emotional responses. Aesthetic reactions, unlike many other kinds of emotional reactions, are never evoked by biologically urgent action-demanding events, such as threats or opportunities. The examined effects were created by various concept manipulation devices: class expansion, identification of new relations, repetition, symmetry, parsimony, and emotional displays for the audience to mirror (I identified a total of 16 such devices). The effects would occur only for individuals with the necessary priming, in circumstances that include effective potentiating factors. Synergetic stimuli that evoke aesthetic responses tend to be reinforcing, via mechanisms related to their biological utility during our evolution. I offer a theory as to how aesthetics may have evolved from its primordial pre-aesthetic roots, with examples of how consideration of those roots often explains aesthetic and related effects. The article suggests that aesthetic phenomena are a special case of a more pervasive aspect of behavior and proposes research approaches involving laboratory models and fMRI technology.

Revisiting The Depleted Self.

This article revisits Donald Capps's book The Depleted Self (The depleted self: sin in a narcissistic age. Fortress Press, Minneapolis, 1993), which grew out of his 1990 Schaff Lectures at Pittsburgh Theological Seminary. In these lectures Capps proposed that the theology of guilt had dominated much of post-Reformation discourse. But with the growing prevalence of the narcissistic personality in the late twentieth century, the theology of guilt no longer adequately expressed humanity's sense of "wrongness" before God. Late twentieth-century persons sense this disjunction between God and self through shame dynamics. Narcissists are not "full" of themselves, as popular perspectives might indicate. Instead, they are empty, depleted selves. Psychologists suggest this stems from lack of emotional stimulation and the absence of mirroring in the early stages of life. The narcissist's search for attention and affirmation takes craving, paranoid, manipulative, or phallic forms and is essentially a desperate attempt to fill the internal emptiness. Capps suggests that two narratives from the Gospels are helpful here: the story of the woman with the alabaster jar and the story of Jesus's dialogue with Mary and John at Calvary. These stories provide us with clues as to how depleted selves experienced mirroring and the potential for internal peace in community with Jesus.

Observing painful events in others leads to a temporally extended general response facilitation in the self.

Excitability in the motor cortex is modulated when we observe other people receiving a painful stimulus (Avenanti et al., Nat Neurosci 8(7):955-960, 2005). However, the task dependency of this modulation is not well understood, as different paradigms have yielded seemingly different results. Previous neurophysiological work employing transcranial magnetic stimulation (TMS) suggests that watching another person's hand being pierced by a needle leads to a muscle specific inhibition, assessed via motor evoked potentials. Results from previous behavioural studies suggest that overt behavioural responses are facilitated due to pain observation (Morrison et al., Cereb Cortex 17:2214-2222, 2007b; Morrison et al., Cognition 104:407-416, 2007a). There are several paradigmatic differences both between typical TMS studies and behavioural studies, and within behavioural studies themselves, that limit our overall understanding of how pain observation affects the motor system. In the current study, we combine elements of typical TMS experimental designs in a behavioural assessment of how pain observation affects overt behavioural responding. Specifically, we examined the muscle specificity, timing, and direction of modulation of motor responses due to pain observation. To assess muscle specificity, we employed pain and non-pain videos from previous TMS studies in a Go/No-Go task in which participants responded by either pressing a key with their index finger or with their foot. To assess timing, we examined response times for Go signals presented at 0 or 500 ms after the video. Results indicate that observation of another individual receiving a painful stimulus leads to a non-effector specific, temporally extended response facilitation (e.g., finger and foot facilitation present at 0 and 500 ms delays), compared to observation of non-pain videos. This behavioural facilitation effect differs from the typical motor inhibition seen in TMS studies, and we argue that the effects of pain observation on the motor system are state-dependent, with different states induced via task instructions. We discuss our results in light of previous work on motor responses to pain observation.

Modeling self on others: An import theory of subjectivity and selfhood.

This paper outlines an Import Theory of subjectivity and selfhood. Import theory claims that subjectivity is initially perceived as a key feature of other minds before it then becomes imported from other minds to own minds whereby it lays the ground for mental selfhood. Import theory builds on perception-production matching, which in turn draws on both representational mechanisms and social practices. Representational mechanisms rely on common coding of perception and production. Social practices rely on action mirroring in dyadic interactions. The interplay between mechanisms and practices gives rise to model self on others. Individuals become intentional agents in virtue of perceiving others mirroring themselves. The outline of the theory is preceded by an introductory section that locates import theory in the broader context of competing approaches, and it is followed by a concluding section that assesses import theory in terms of empirical evidence and explanatory power.

Motor System Activation Predicts Goal Imitation in 7-Month-Old Infants.

The current study harnessed the variability in infants' neural and behavioral responses as a novel method for evaluating the potential relations between motor system activation and social behavior. We used electroencephalography (EEG) to record neural activity as 7-month-old infants observed and responded to the actions of an experimenter. To determine whether motor system activation predicted subsequent imitation behavior, we assessed event-related desynchronization (ERD) at central sites during action observation as a function of subsequent behavior. Greater mu desynchronization over central sites was observed when infants subsequently reproduced the experimenter's goal than when they did not reproduce the goal and instead selected the nongoal object. We also found that mu desynchronization during action execution predicted the infants' later propensity to reproduce the experimenter's goal-directed behavior. These results provide the first evidence that motor system activation predicts the imitation of other individuals' goals during infancy.

Mentalizing and the Role of the Posterior Superior Temporal Sulcus in Sharing Others' Embarrassment.

The experience of embarrassment provides a highly salient cue for the human moral apparatus. Interestingly, people also experience embarrassment on behalf of others' inappropriate conditions. The perceiver's embarrassment often lacks an equivalent expression of embarrassment in the social counterpart. The present study examines this phenomenon and distinguishes neural circuits involved in embarrassment with and embarrassment for another person's mishaps. Using functional magnetic resonance imaging, we show that the embarrassment on behalf of others engages the temporal pole and the medial prefrontal cortex, central structures of the mentalizing network, together with the anterior insula and anterior cingulate cortex. In contrast, sharing others' embarrassment additionally stimulated the posterior superior temporal sulcus (STS), which exhibited increased functional integration with inferior parietal and insular cortex areas. These findings characterize common neural circuits involved in the embodied representation of embarrassment and further unravel the unique role of the posterior STS in sharing others' affective state.

Mental action simulation synchronizes action-observation circuits across individuals.

A frontoparietal action-observation network (AON) has been proposed to support understanding others' actions and goals. We show that the AON "ticks together" in human subjects who are sharing a third person's feelings. During functional magnetic resonance imaging, 20 volunteers watched movies depicting boxing matches passively or while simulating a prespecified boxer's feelings. Instantaneous intersubject phase synchronization (ISPS) was computed to derive multisubject voxelwise similarity of hemodynamic activity and inter-area functional connectivity. During passive viewing, subjects' brain activity was synchronized in sensory projection and posterior temporal cortices. Simulation induced widespread increase of ISPS in the AON (premotor, posterior parietal, and superior temporal cortices), primary and secondary somatosensory cortices, and the dorsal attention circuits (frontal eye fields, intraparietal sulcus). Moreover, interconnectivity of these regions strengthened during simulation. We propose that sharing a third person's feelings synchronizes the observer's own brain mechanisms supporting sensations and motor planning, thereby likely promoting mutual understanding.