The neural correlates of mental fatigue and reward processing: A task-based fMRI study.

Increasing time spent on the task (i.e., the time-on-task (ToT) effect) often results in mental fatigue. Typical effects of ToT are decreasing levels of task-related motivation and the deterioration of cognitive performance. However, a massive body of research indicates that the detrimental effects can be reversed by extrinsic motivators, for example, providing rewards to fatigued participants. Although several attempts have been made to identify brain areas involved in mental fatigue and related reward processing, the neural correlates are still less understood. In this study, we used the psychomotor vigilance task to induce mental fatigue and blood oxygen-level-dependent functional magnetic resonance imaging to investigate the neural correlates of the ToT effect and the reward effect (i.e., providing extra monetary reward after fatigue induction) in a healthy young sample. Our results were interpreted in a recently proposed neurocognitive framework. The activation of the right middle frontal gyrus, right insula and right anterior cingulate gyrus decreased as fatigue emerged and the cognitive performance dropped. However, after providing an extra reward, the cognitive performance, as well as activation of these areas, increased. Moreover, the activation levels of all of the mentioned areas were negatively associated with reaction times. Our results confirm that the middle frontal gyrus, insula and anterior cingulate cortex play crucial roles in cost-benefit evaluations, a potential background mechanism underlying fatigue, as suggested by the neurocognitive framework.

Gray Matter Changes Following Mild COVID-19: An MR Morphometric Study in Healthy Young People.

BACKGROUND: Although COVID-19 is primarily an acute respiratory infection, 5%-40% of patients develop late and prolonged symptoms with frequent neurological complaints, known as long COVID syndrome. The presentation of the disease suggests that COVID infection may cause functional and/or morphological central nervous system alterations, but studies published in the literature report contradictory findings. PURPOSE: To investigate the chronic effects of COVID-19 on cerebral grey matter in a group of young patients without comorbidities, with mild course of COVID infection and no medical complaints at the time of examination. STUDY TYPE: Prospective. POPULATION: Thirty-eight young (age = 26.6 ± 5.0 years; male/female = 14/24), adult participants who recovered from mild COVID infection without a history of clinical long COVID and 37 healthy control subjects (age = 25.9 ± 2.8 years; male/female = 14/23). FIELD STRENGTH/SEQUENCE: Three Tesla, 3D T1-weighted magnetization-prepared rapid gradient-echo, 2D T2-weighted turbo spin-echo. ASSESSMENT: MRI-based morphometry and volumetry along with neuropsychological testing and self-assessed questionnaire. STATISTICAL TESTS: Fisher's exact test, Mann-Whitney U-test, and multiple linear regression analyses were used to assess differences between COVID and healthy control groups. P < 0.05 was used as cutoff for significance. RESULTS: In the COVID group, significantly lower bilateral mean cortical thickness (left/right-hemisphere: 2.51 ± 0.06 mm vs. 2.56 ± 0.07 mm, η2 p = 0.102/2.50 ± 0.06 mm vs. 2.54 ± 0.07 mm, η2 p = 0.101), lower subcortical gray matter (57881 ± 3998 mm3 vs. 60470 ± 5211 mm3 , η2 p = 0.100) and lower right olfactory bulb volume (52.28 ± 13.55 mm3 vs. 60.98 ± 15.8 mm3 , η2 p = 0.078) were found. In patients with moderate to severe anosmia, cortical thickness was significantly lower bilaterally, as compared to patients without olfactory function loss (left/right-hemisphere: 2.50 ± 0.06 mm vs. 2.56 ± 0.05 mm, η2 = 0.173/2.49 ± 0.06 mm vs. 2.55 ± 0.05 mm, η2 = 0.189). Using further exploratory analysis, significantly reduced cortical thickness was detected locally in the right lateral orbitofrontal cortex in the COVID group (2.53 ± 0.10 mm vs. 2.60 ± 0.09 mm, η2 p = 0.112). DATA CONCLUSION: Even without any subjective or objective neurological complaints at the time of the MR scan, subjects in the COVID group showed gray matter alterations in cortical thickness and subcortical gray matter volume. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 3.

Sudden gamer death: non-violent death cases linked to playing video games.

BACKGROUND AND AIMS: Internet gaming disorder (IGD) is an emerging problem. Rarely, media reports about people, who have died during playing video games, but thus far no systematic, scientific study is available about the topic. We investigated such cases, looking for common characteristics, connection between gaming and death, and the possible reasons leading to death. METHODS: Cases were collected through internet search with general keywords, with ones specific to identified cases, and by working along cross references. RESULTS: 24 cases were found: one from 1982, the others between 2002 and 2021. Twenty-three of the victims were male, age ranged from 11 to 40 years. More than half of the cases originated from Southeast Asia, and 12 deaths happened in internet cafes. Gamers played action-rich multiplayer games. In 18 cases the gaming session before death was extremely long (around a day or even several days) with minimal rest. The cause of death was pulmonary embolism in 5 cases, cerebral hemorrhage in 2 cases, most of the rest was presumably due to fatal cardiac arrhythmia. DISCUSSION: Long sedentary position and dehydration may precipitate thromboembolism, acute blood pressure elevation during gaming may promote cerebral hemorrhage, and several factors (including acute and chronic sleep deprivation, exhaustion, stress) can lead to acute autonomic dysfunction and fatal arrhythmia. CONCLUSION: Incidence of non-violent death cases linked to playing video games is presumably very low. It mostly occurs in young males and it is often characterized by extremely long gaming time.

[Examination of shortened version of spider phobia and snake phobia questionnaire on Hungarian sample].

INTRODUCTION: One of the most common mental disorders is the specific phobia. Within this, the prevalence of animal phobia, such as the fear from spiders and snakes, is very high. In case of irrational fears, beyond the change in behavior (for example avoidance of the situation), a specific brain activation pattern can also be observed. However, if animal phobia is detected, it can be treated through several different therapeutic methods. There is a great need for reliable questionnaires to examine the subtypes of animal phobia. The SNAQ-12 and SPQ-12 can be used for this purpose, furthermore these questionnaires have good psychometric properties and clinical cut-off scores. The aim of the present study is therefore to examine the psychometric properties of the two questionnaires' Hungarian version. METHOD AND RESULTS: The SNAQ-12 (12 item long Snake Questionnaire, SNAQ) and the SPQ-12 (12 item long Spider Phobia Questionnaire), according to the measured sample (1071 Hungarian subject) have excellent psychometric properties (Snake Questionnaire: Cronbach alpha=0.912. Spider Questionnaire: Cronbach alpha=0.909), and are suitable for reliable testing of fear from snake and spider. CONCLUSION: The questionnaires are useful in phobia related researches and studies and can promote the clinical work, to recognize phobias and to monitor the effectiveness of therapy.

Multisensory integration and age-dependent sensitivity to body representation modification induced by the rubber hand illusion.

The aim of the present study was to compare junior and senior healthy participants for their multimodal integration capability. The instrument used for the investigation was the rubber hand illusion (RHI) where synchronous and asynchronous multimodal stimulation were applied. The study focused on assessing the rate of integration for visuo-tactile and visuo-proprioceptive stimuli. METHODS: From a large sample of right-handed volunteers, 50 senior employees (containing younger and middle age adults) and 51 senior retired (senior adults) participants were recruited. RESULTS: The between-subject analyses revealed that individuals both the junior and the senior participants responded to induction of RHI with vivid ownership and disownership experiences and a higher mislocalization error in the synchronous condition. However, the between-group analysis showed that participants in the senior group reported less vivid ownership and less vivid total RHI experiences scores compared to members of the junior group, but no mislocalization error differences were found between the groups. CONCLUSION: The results indicated that when visuo-tactile stimuli synchronously presented, the gain in multisensory integration decreased in seniors group. In contrast, in the case of visuo-proprioceptive synchronous presentation, the efficiency of multisensory integration remained unchanged across the lifespan.

Concussive convulsions: A YouTube video analysis.

OBJECTIVE: To analyze seizure-like motor phenomena immediately occurring after concussion (concussive convulsions). METHODS: Twenty-five videos of concussive convulsions were obtained from YouTube as a result of numerous sports-related search terms. The videos were analyzed by four independent observers, documenting observations of the casualty, the head injury, motor symptoms of the concussive convulsions, the postictal period, and the outcome. RESULTS: Immediate responses included the fencing response, bear hug position, and bilateral leg extension. Fencing response was the most common. The side of the hit (p = 0.039) and the head turning (p = 0.0002) was ipsilateral to the extended arm. There was a tendency that if the blow had only a vertical component, the bear hug position appeared more frequently (p = 0.12). The motor symptom that appeared with latency of 6 ± 3 s was clonus, sometimes superimposed with tonic motor phenomena. Clonus was focal, focally evolving bilateral or bilateral, with a duration of 27 ± 19 s (5-72 s). Where lateralization of clonus could be determined, the side of clonus and the side of hit were contralateral (p = 0.039). SIGNIFICANCE: Concussive convulsions consist of two phases. The short-latency first phase encompasses motor phenomena resembling neonatal reflexes and may be of brainstem origin. The long-latency second phase consists of clonus. We hypothesize that the motor symptoms of the long-latency phase are attributed to cortical structures; however, they are probably not epileptic in origin but rather a result of a transient cortical neuronal disturbance induced by mechanical forces.

THE RELATIONSHIP BETWEEN SERUM CHOLESTEROL AND VERBAL MEMORY MAY BE INFLUENCED BY BODY MASS INDEX (BMI) IN YOUNG HEALTHY WOMEN.

The objective of this study was to examine the relationship between verbal memory and total cholesterol (TC) levels related to body mass index (BMI) in healthy young women. Verbal memory was assessed using the Rey Auditory-Verbal Learning Test (RAVLT) while total serum cholesterol was measured by enzymatic colorimetric test. In order to analyze the potential significance of BMI subjects were divided into three groups according to their calculated BMI percentile values. No significant correlation was found when assessing the group as a whole. However a remarkable pattern of correlation emerged when assessing the BMI groups separately: a close-to-significant positive correlation was found for total learning score and TC in the low BMI group, no correlation emerged in the medium BMI group while a strong inverse correlation was found in the high BMI group. These findings indicate that the relationship between verbal memory and serum TC level is also influenced by BMI.

Intracranial volume inversely correlates with serum 25(OH)D level in healthy young women.

OBJECTIVES: Vitamin D is important in normal brain development. In animals low vitamin D level is associated with brain morphological alterations including enlargement of the brain. Whether a similar association exists in humans is unknown. Here we investigated the relationship between vitamin D and total intracranial volume as well as total volume of the cortical grey and cerebral white matter and that of the ventricles in young healthy women. METHODS: To assess volumes we applied semi-automatic user-independent MR volumetry. For the vitamin D measurements automated electrochemiluminescence immunoassay was used. RESULTS: We found a significant negative correlation between vitamin D and total intracranial volume as well as total cortical grey and cerebral white matter volumes. DISCUSSION: This association may reflect a trait-like relationship between vitamin D and brain size possibly determined in early development.

Milk and dairy consumption correlates with cerebral cortical as well as cerebral white matter volume in healthy young adults.

The objective of this study was to investigate the relation between habitual milk and dairy consumption and brain morphology as assessed by magnetic resonance imaging (MRI) investigations in 119 young healthy university students. MRI measurements were performed on a Siemens Magnetom Trio Tim (3T) system while FreeSurfer software suite was used for volumetric segmentation. Dietary habits related to milk and dairy consumption were assessed by a structured questionnaire. Total cerebral cortex, total cerebral white matter, and total cerebral parenchyma were significantly related with cottage cheese and total protein intake from milk and dairy also when controlled for age and gender in the multivariate model. Our results indicate that dietary habits related with milk and dairy are proportionally associated with volumes of both cerebral cortex and cerebral white matter.

Alexithymia is associated with low level of vitamin D in young healthy adults.

OBJECTIVE: Vitamin D plays an important role in brain development and functioning. Low levels of vitamin D have been described in several psychiatric and neurologic conditions including autism spectrum disorder. Alexithymia that shows high comorbidity with autism is also present in the general population as well as hypovitaminosis D. METHODS: Here we assessed the relation between alexithymia as measured by the Toronto Alexithymia Scale-20 and vitamin D level in healthy young adults. Results We found an inverse correlation between the levels of alexithymia and vitamin D. DISCUSSION: These data suggest the association between disturbed emotional processing and low levels of vitamin D to be present in young healthy subjects.

Prevalence of celebrity worship: Development and application of the short version of the Celebrity Attitude Scale (CAS-7) on a large-scale representative sample.

Background and aims: Celebrity worship, defined as an excessive admiration towards celebrities, has generated considerable research and public interest. A widely used assessment instrument to measure celebrity worship is the 23-item Celebrity Attitude Scale. However, concerns have been raised regarding the measurement, including the inconsistent factor structure and lack of a cut-off point to identify "celebrity worshipers". The present study aims to address these concerns by testing the psychometric appropriateness of a short, 7-item version of the CAS (i.e., CAS-7) and estimating the prevalence of individuals with high-level celebrity admiration using a representative sample of Hungarian adults (between 18 and 64 years of age) according to gender, age, geographic location, and size of residence. Methods: The total sample comprised 2028 respondents, of which 769 valid responses were administered from participants who reported having a favorite celebrity (51.11% men, Mage = 36.38 years, SD = 13.36). Results: Results indicated an excellent model fit for the two-factor and bifactor model of the CAS-7. Based on the suggested cut-off score of 26, the prevalence of high-level celebrity admiration is 4.53% in the Hungarian adult population (18-64 years of age) and 8.51% among young adults (18-34 years of age). Individuals with this high level of admiration towards a favorite celebrity reported more symptoms of problematic Internet use, depression, anxiety, and stress than individuals with general celebrity admiration levels. Discussion and conclusions: The CAS-7 demonstrated sound psychometric properties, confirming its applicability in research and practice.

Structural neural correlates of mental fatigue and reward-induced improvement in performance.

Neuroimaging studies investigating the association between mental fatigue (henceforth fatigue) and brain physiology have identified many brain regions that may underly the cognitive changes induced by fatigue. These studies focused on the functional changes and functional connectivity of the brain relating to fatigue. The structural correlates of fatigue, however, have received little attention. To fill this gap, this study explored the associations of fatigue with cortical thickness of frontal and parietal regions. In addition, we aimed to explore the associations between reward-induced improvement in performance and neuroanatomical markers in fatigued individuals. Thirty-nine healthy volunteers performed the psychomotor vigilance task for 15 min (i.e., 3 time-on-task blocks of 5 min) out of scanner; followed by an additional rewarded block of the task lasting 5 min. Baseline high-resolution T1-weigthed MR images were obtained. Reaction time increased with time-on-task but got faster again in the rewarded block. Participants' subjective fatigue increased during task performance. In addition, we found that higher increase in subjective mental fatigue was associated with the cortical thickness of the following areas: bilateral precuneus, right precentral gyrus; right pars triangularis and left superior frontal gyrus. Our results suggest that individual differences in subjective mental fatigue may be explained by differences in the degree of cortical thickness of areas that are associated with motor processes, executive functions, intrinsic alertness and are parts of the default mode network.

The interference of negative emotional stimuli on semantic vigilance performance in a dual-task setting.

A large body of previous research has shown that emotional stimuli have an advantage in a wide variety of cognitive processes. This was mainly observed in visual search and working memory tasks. Emotionally charged objects draw and hold attention, are remembered better, and interfere more with the completion of the primary task than neutral ones. Therefore, it seems reasonable to assume that emotional stimuli also greatly affect sustained attention and vigilance decrement. In the present research, we investigated whether emotional stimuli demand more attentional resources than neutral ones in a dual-task paradigm. We adopted the abbreviated semantic discrimination vigilance task and measured participants' (N = 49) performance in a single-task and two dual-task settings. In the dual-task conditions, the visual semantic vigilance paradigm was combined with an auditory word recall task (with neutral or emotional stimuli). We found reduced vigilance and improved word recall performance in the emotional dual-task condition compared to the neutral dual-task and single-task conditions. The reduced performance was apparent throughout the task, while in the neutral conditions, participants' performance first increased and then dropped as time progressed. To conclude, our results indicate that emotional stimuli not only have an advantage in cognitive processing but also demand more attentional resources continuously while it is present compared to neutral stimuli. These results are consistent with the emotionality effect theory and evolutionary accounts of the neural circuits underlying motivated behaviors associated with critical survival needs.

Altered functional brain networks in problematic smartphone and social media use: resting-state fMRI study.

Nowadays, the limitless availability to the World Wide Web can lead to general Internet misuse and dependence. Currently, smartphone and social media use belong to the most prevalent Internet-related behavioral addiction forms. However, the neurobiological background of these Internet-related behavioral addictions is not sufficiently explored. In this study, these addiction forms were assessed with self-reported questionnaires. Resting-state functional magnetic resonance imaging was acquired for all participants (n = 59, 29 males) to examine functional brain networks. The resting-state networks that were discovered using independent component analysis were analyzed to estimate within network differences. Significant negative associations with social media addiction and smartphone addiction were found in the language network, the lateral visual networks, the auditory network, the sensorimotor network, the executive network and the frontoparietal network. These results suggest that problematic smartphone and social media use are associated with sensory processing and higher cognitive functioning.

Emotional face expression recognition in problematic Internet use and excessive smartphone use: task-based fMRI study.

Growing literature indicates that problematic Internet use (PIU) and excessive smartphone use (ESU) are associated with breakdown of functional brain networks. The effects of PIU&ESU on emotional face expression (EFE) recognition are not well understood, however behavioural investigations and fMRI studies of different addiction forms indicated the impairment of this function. The Facial Emotion Recognition Paradigm was used to probe cortico-limbic responses during EFE recognition. Combined fMRI and psychophysiological analysis were implemented to measure EFE-related functional brain changes in PIU&ESU. Self-reported questionnaires were used to assess PIU&ESU. Positive associations were found between the extent of PIU&ESU and functional connections related to emotional cognitive control and social brain networks. Our findings highlight the involvement of social functioning, especially EFE recognition in PIU&ESU. Therefore, we emphasize that besides the brain's executive and reward systems, the social brain network might be the next candidate to be involved in the pathogenesis of PIU&ESU.

Generalisable machine learning models trained on heart rate variability data to predict mental fatigue.

A prolonged period of cognitive performance often leads to mental fatigue, a psychobiological state that increases the risk of injury and accidents. Previous studies have trained machine learning algorithms on Heart Rate Variability (HRV) data to detect fatigue in order to prevent its consequences. However, the results of these studies cannot be generalised because of various methodological issues including the use of only one type of cognitive task to induce fatigue which makes any predictions task-specific. In this study, we combined the datasets of three experiments each of which applied different cognitive tasks for fatigue induction and trained algorithms that detect fatigue and predict its severity. We also tested different time window lengths and compared algorithms trained on resting and task related data. We found that classification performance was best when the support vector classifier was trained on task related HRV calculated for a 5-min time window (AUC = 0.843, accuracy = 0.761). For the prediction of fatigue severity, CatBoost regression showed the best performance when trained on 3-min HRV data and self-reported measures (R2 = 0.248, RMSE = 17.058). These results indicate that both the detection and prediction of fatigue based on HRV are effective when machine learning models are trained on heterogeneous, multi-task datasets.

Language processing in Internet use disorder: Task-based fMRI study.

Internet use disorder (IUD) is generally conceptualized as a fast-growing behavioral addiction. Several structural and functional brain alterations have been revealed in this condition, but previous behavioral studies indicated that language systems may also be impaired. We used a silent word generation task to induce brain activation in Broca's area and other parts of the language system. Blood-oxygen-level-dependent activation analysis and psychophysiological interaction analysis were applied to assess functional brain changes. IUD was measured by the Problematic Internet Use Questionnaire and two additional questions concerning usage time and subjective rating of addiction. According to our key findings, areas strongly related to the default mode network were altered in IUD during the task. Moreover, Broca's area showed altered functional connectivity with other language network and occipital areas in IUD. These findings may address the neural background of decreased verbal fluency performance previously reported in the literature, and we emphasize that beside the brain's reward and inhibitory control systems, the language system is the next candidate to be involved in the pathogenesis of IUD.

Epilepsy is overrepresented among young people who died from COVID-19: Analysis of nationwide mortality data in Hungary.

BACKGROUND: Studies examining epilepsy as a COVID-related death risk have come to conflicting conclusions. Our aim was to assess the prevalence of epilepsy among COVID-related deaths in Hungary. METHODS: Each COVID-19 infection case is required to be reported on a daily basis to the National Public Health Center of Hungary. This online report includes the beginning and end of the infection, as well as information on comorbidities. Death during infection is regarded as COVID-related. The anonymized data of each deceased patient are published on an information website (www.koronavirus.gov.hu) and provides up-to-date information on each patient with the date of death, the patient's sex, age, and chronic illness. RESULTS: There were 11,968 patients who died of COVID-19 in Hungary between 13 March 2020 and 23 January 2021. Among 11,686 patients with no missing values for comorbidities, 255 patients had epilepsy (2.2%). Epilepsy was much more common among those who died at a young age: 9.3% of those who died under the age of 50 had epilepsy, compared with only 1.3% in those over the age of 80. The younger an age group was, the higher was the prevalence of epilepsy. CONCLUSION: Patients who died of COVID-19 under the age of 50 were 10 to 20 times more likely to have epilepsy than what would have been expected from epidemiological data. Our results highlight the need for increased protection of young people with epilepsy from COVID-19 infection and the development of a vaccination strategy accordingly.

Individual differences in the experience of body ownership are related to cortical thickness.

The widely used rubber hand illusion (RHI) paradigm provides insight into how the brain manages conflicting multisensory information regarding bodily self-consciousness. Previous functional neuroimaging studies have revealed that the feeling of body ownership is linked to activity in the premotor cortex, the intraparietal areas, the occipitotemporal cortex, and the insula. The current study investigated whether the individual differences in the sensation of body ownership over a rubber hand, as measured by subjective report and the proprioceptive drift, are associated with structural brain differences in terms of cortical thickness in 67 healthy young adults. We found that individual differences measured by the subjective report of body ownership are associated with the cortical thickness in the somatosensory regions, the temporo-parietal junction, the intraparietal areas, and the occipitotemporal cortex, while the proprioceptive drift is linked to the premotor area and the anterior cingulate cortex. These results are in line with functional neuroimaging studies indicating that these areas are indeed involved in processes such as cognitive-affective perspective taking, visual processing of the body, and the experience of body ownership and bodily awareness. Consequently, these individual differences in the sensation of body ownership are pronounced in both functional and structural differences.

Disentangling the facilitating and hindering effects of threat-related stimuli - A visual search study.

Although large body of research has demonstrated the attention-grabbing nature of threat-related stimuli, threat could also facilitate attentional processes. Previous studies suggest a linear relationship between the facilitating effect of the arousal level conveyed by threat and performance on visual search tasks. Due to the temporal competition bias favouring stimuli with higher arousal level, this could be more pronounced for shorter onset times. Here, through two experiments we aimed to disentangle the two effects by using a visual search paradigm that allowed us to separate the emotional stimuli and the cognitive task. We manipulated stimulus onset time and threat intensity. Participants saw neutral and threatening pictures as priming stimuli, and then, they had to find numbers in ascending order in a matrix array. We measured the reaction time for finding the first number, and search time for finding all the numbers. Our results showed that when the priming stimulus is presented, longer threatening pictures produced longer reaction times compared to neutral ones, which was reversed with increase in arousal. We did not find any significant effects for the shorter onset time. Further theoretical and methodological implications are discussed.