Impairment of oculomotor functions in patients with early to advanced amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) can result into an incomplete locked in state (iLIS), in which communication depends on eye tracking computer devices. Oculomotor function impairments in ALS have been reported, but there is little research, particularly with respect to patients in iLIS. In the present study, we compared reflexive and executive oculomotor function by means of an eye tracking test battery between three groups: advanced ALS patients in iLIS (n = 22), patients in early to middle ALS stages (n = 44) and healthy subjects (n = 32). Patients with ALS showed significant deteriorations in oculomotor functions, with stronger impairments in iLIS. More specifically, ALS patients produced visually guided prosaccades with longer latencies and more frequent hypometria compared to healthy subjects. Longest latencies were obtained in iLIS patients, with a stronger prolongation for vertical than for horizontal prosaccades. ALS patients made more antisaccade errors and generated antisaccades with longer latencies. Smooth pursuit was also impaired in ALS. In the earlier ALS stages, bulbar onset patients presented stronger antisaccade and smooth pursuit deficits than spinal onset patients. Our findings reveal a relevant deterioration of important oculomotor functions in ALS, which increases in iLIS. It includes impairments of reflexive eye movements to loss of executive inhibitory control, indicating a progressing pathological involvement of prefrontal, midbrain and brainstem areas. The assessment of oculomotor functions may therefore provide clinically relevant bio- and progression marker, particularly in advanced ALS.

Cognitive effort investment: Does disposition become action?

Contrary to the law of less work, individuals with high levels of need for cognition and self-control tend to choose harder tasks more often. While both traits can be integrated into a core construct of dispositional cognitive effort investment, its relation to actual cognitive effort investment remains unclear. As individuals with high levels of cognitive effort investment are characterized by a high intrinsic motivation towards effortful cognition, they would be less likely to increase their effort based on expected payoff, but rather based on increasing demand. In the present study, we measured actual effort investment on multiple dimensions, i.e., subjective load, reaction time, accuracy, early and late frontal midline theta power, N2 and P3 amplitude, and pupil dilation. In a sample of N = 148 participants, we examined the relationship of dispositional cognitive effort investment and effort indices during a flanker and an n-back task with varying demand and payoff. Exploratorily, we examined this relationship for the two subdimensions cognitive motivation and effortful-self-control as well. In both tasks, effort indices were sensitive to demand and partly to payoff. The analyses revealed a main effect of cognitive effort investment for accuracy (n-back task), interaction effects with payoff for reaction time (n-back and flanker task) and P3 amplitude (n-back task) and demand for early frontal midline theta power (flanker task). Taken together, our results partly support the notion that individuals with high levels of cognitive effort investment exert effort more efficiently. Moreover, the notion that these individuals exert effort regardless of payoff is partly supported, too. This may further our understanding of the conditions under which person-situation interactions occur, i.e. the conditions under which situations determine effort investment in goal-directed behavior more than personality, and vice versa.

Eye movement patterns in complex tasks: Characteristics of ambient and focal processing.

Analyzing the time course of eye movements during scene viewing often indicates that people progress through two distinct modes of visual processing: an ambient mode, which is associated with overall spatial orientation in a scene, followed by a focal mode, which requires central vision of an object. However, the shifts between ambient and focal processing modes have mainly been identified relative to changes in the environment, such as relative to the onset of various visual stimuli but also following scene cuts or subjective event boundaries in dynamic stimuli. The results so far do not allow conclusions about the nature of the two processing mechanisms beyond the influence of externally triggered events. It remains unclear whether people shift back and forth from ambient to focal processing also based on internal triggers, such as switching between different tasks while no external event is given. The present study therefore investigated ambient to focal processing shifts in an active task solving paradigm. The Rubik's Cube task introduced here is a multi-step task, which can be broken down into smaller sub-tasks that are performed serially. The time course of eye movements was analyzed at multiple levels of this Rubik's Cube task, including when there were no external changes to the stimuli but when internal representations of the task were hypothesized to change (i.e., switching between different sub-tasks). Results suggest that initial ambient exploration is followed by a switch to more focal viewing across various levels of task processing with and without external changes to the stimuli. More importantly, the present findings suggest that ambient and focal eye movement characteristics might serve as a probe for the attentional state in task processing, which does not seem to be influenced by changes in task performance.

Quality of life and mental health in the locked-in-state-differences between patients with amyotrophic lateral sclerosis and their next of kin.

For both patients with amyotrophic lateral sclerosis (ALS) and their next of kin (NOK), the maintenance of quality of life (QoL) and mental health is particularly important. First studies suggest significant discrepancies between QoL reports by patients and NOK, but little is known for advanced ALS stages. To address this issue, we screened 52 ALS patients in incomplete locked-in state (iLIS). Final results were obtained for 15 couples of iLIS patients and NOK. We assessed patients' and NOK's subjective QoL, depression and anxiety and NOK's caregiver burden. Gaze controlled questionnaires allowed direct assessment of patients. Patients and NOK self-reported comparable, mostly moderate to high levels of QoL. Of note, NOK indicated stronger anxiety symptoms. Higher anxiety levels in NOK were associated with stronger caregiver burden and reduced QoL. No significant misjudgment of patient's QoL by the NOK was evident, while patients overestimated NOK's global QoL. However, NOK with severe caregiver burden and depression symptoms gave poorer estimations of patients' QoL. This relationship is relevant, considering NOK's impact on life critical treatment decisions. While the daily time NOK and patient spend together was positively correlated with NOK's QoL and mental health, this was not reversely found for the patients. Our results suggest that NOK adapt less successfully to the disease and concomitant experience of loss and point to an urgent need for specialized psychosocial support. The findings emphasize the importance of direct psychological wellbeing assessment of both patients and NOK in clinical practice, enabled by eye-tracking technology for patients in iLIS.

Effort beats effectiveness in emotion regulation choice: Differences between suppression and distancing in subjective and physiological measures.

Emotion regulation (ER) can be implemented by different strategies which differ in their capacity to alter emotional responding. What all strategies have in common is that cognitive control must be exercised in order to implement them. The aim of the present preregistered study was to investigate whether the two ER strategies, expressive suppression and distancing, require different amounts of cognitive effort and whether effort is associated with personality traits. Effort was assessed subjectively via ratings and objectively via pupillometry and heart period. In two studies, N = 110 and N = 52 healthy adults conducted an ER paradigm. Participants used suppression and distancing during inspection of positive and negative pictures. They also had the choice to reapply either of the strategies at the end of the paradigm. Although distancing was more effective in downregulation of subjective arousal (Study 1: p < .001, ηp2  = .20; Study 2: p < .001, ηp2  = .207), about two thirds reapplied suppression, because it was perceived as less effortful. Effort was rated significantly lower for suppression compared to distancing (Study 1: p = .042, ηp2  = .04; Study 2: p = .002, ηp2  = .13). However, differences in effort were not reflected in pupillary data or heart period. Broad and narrow personality traits were neither associated with the preferred strategy nor with subjective or physiological effort measures. Findings suggest that people tend to use the ER strategy that is perceived as less effortful, even though it might not be the most effective strategy.

Social communication with virtual agents: The effects of body and gaze direction on attention and emotional responding in human observers.

In social communication, the gaze direction of other persons provides important information to perceive and interpret their emotional response. Previous research investigated the influence of gaze by manipulating mutual eye contact. Therefore, gaze and body direction have been changed as a whole, resulting in only congruent gaze and body directions (averted or directed) of another person. Here, we aimed to disentangle these effects by using short animated sequences of virtual agents posing with either direct or averted body or gaze. Attention allocation by means of eye movements, facial muscle response, and emotional experience to agents of different gender and facial expressions were investigated. Eye movement data revealed longer fixation durations, i.e., a stronger allocation of attention, when gaze and body direction were not congruent with each other or when both were directed towards the observer. This suggests that direct interaction as well as incongruous signals increase the demands of attentional resources in the observer. For the facial muscle response, only the reaction of muscle zygomaticus major revealed an effect of body direction, expressed by stronger activity in response to happy expressions for direct compared to averted gaze when the virtual character's body was directed towards the observer. Finally, body direction also influenced the emotional experience ratings towards happy expressions. While earlier findings suggested that mutual eye contact is the main source for increased emotional responding and attentional allocation, the present results indicate that direction of the virtual agent's body and head also plays a minor but significant role.

Attentional dynamics during free picture viewing: Evidence from oculomotor behavior and electrocortical activity.

Most empirical evidence on attentional control is based on brief presentations of rather abstract stimuli. Results revealed indications for a dynamic interplay between bottom-up and top-down attentional mechanisms. Here we used a more naturalistic task to examine temporal signatures of attentional mechanisms on fine and coarse time scales. Subjects had to inspect digitized copies of 60 paintings, each shown for 40 s. We simultaneously measured oculomotor behavior and electrophysiological correlates of brain activity to compare early and late intervals (1) of inspection time of each picture (picture viewing) and (2) of the full experiment (time on task). For picture viewing, we found an increase in fixation duration and a decrease of saccadic amplitude while these parameters did not change with time on task. Furthermore, early in picture viewing we observed higher spatial and temporal similarity of gaze behavior. Analyzing electrical brain activity revealed changes in three components (C1, N1 and P2) of the eye fixation-related potential (EFRP); during picture viewing; no variation was obtained for the power in the frontal beta- and in the theta activity. Time on task analyses demonstrated no effects on the EFRP amplitudes but an increase of power in the frontal theta and beta band activity. Thus, behavioral and electrophysiological measures similarly show characteristic changes during picture viewing, indicating a shifting balance of its underlying (bottom-up and top-down) attentional mechanisms. Time on task also modulated top-down attention but probably represents a different attentional mechanism.

Saccadic context indicates information processing within visual fixations: evidence from event-related potentials and eye-movements analysis of the distractor effect.

Attention, visual information processing, and oculomotor control are integrated functions of closely related brain mechanisms. Recently, it was shown that the processing of visual distractors appearing during a fixation is modulated by the amplitude of its preceding saccade (Pannasch & Velichkovsky, 2009). So far, this was demonstrated only at the behavioral level in terms of saccadic inhibition. The present study investigated distractor-related brain activity with cortical eye fixation-related potentials (EFRPs). Moreover, the following saccade was included as an additional classification criterion. Eye movements and EFRPs were recorded during free visual exploration of paintings. During some of the fixations, a visual distractor was shown as an annulus around the fixation position, 100 ms after the fixation onset. The saccadic context of a fixation was classified by its preceding and following saccade amplitudes with the cut-off criterion set to 4° of visual angle. The prolongation of fixation duration induced by distractors was largest for fixations preceded and followed by short saccades. EFRP data revealed a difference in distractor-related P2 amplitude between the saccadic context conditions, following the same trend as in eye movements. Furthermore, influences of the following saccade amplitude on the latency of the saccadic inhibition and on the N1 amplitude were found. The EFRP results cannot be explained by the influence of saccades per se since this bias was removed by subtracting the baseline from the distractor EFRP. Rather, the data suggest that saccadic context indicates differences in how information is processed within single visual fixations.

Virtual friend or threat? The effects of facial expression and gaze interaction on psychophysiological responses and emotional experience.

The present study aimed to investigate the impact of facial expression, gaze interaction, and gender on attention allocation, physiological arousal, facial muscle responses, and emotional experience in simulated social interactions. Participants viewed animated virtual characters varying in terms of gender, gaze interaction, and facial expression. We recorded facial EMG, fixation duration, pupil size, and subjective experience. Subject's rapid facial reactions (RFRs) differentiated more clearly between the character's happy and angry expression in the condition of mutual eye-to-eye contact. This finding provides evidence for the idea that RFRs are not simply motor responses, but part of an emotional reaction. Eye movement data showed that fixations were longer in response to both angry and neutral faces than to happy faces, thereby suggesting that attention is preferentially allocated to cues indicating potential threat during social interaction.

Surprise, surprise: two distinct components in the visually evoked distractor effect.

The distractor effect is an inhibition of saccades shortly after a sudden visual event. It has been explained both as an oculomotor reflex and as a manifestation of the orienting response. To clarify which explanation is more appropriate, we investigated a possible habituation of this effect. Visual and auditory distractors were presented at gaze-contingent intervals during the perception of meaningful pictures. Both reflexlike and modifiable components were present in the visual distractor effect, with latencies of about 110 and 180 ms, respectively. The influence of visual and auditory distractors on saccades preceded the earliest changes in cortical ERPs. Only for long-term habituation in the visual modality was a correlation with ERPs (N1) found.