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1.
Dev Sci ; 26(3): e13337, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36305770

RESUMO

Individual differences in cognitive abilities emerge early during development, and children with poorer cognition are at increased risk for adverse outcomes as they enter adolescence. Caregiving plays an important role in supporting cognitive development, yet it remains unclear how specific types of caregiving behaviors may shape cognition, highlighting the need for large-scale studies. In the present study, we characterized replicable yet specific associations between caregiving behaviors and cognition in two large sub-samples of children ages 9-10 years old from the Adolescent Brain Cognitive Development Study® (ABCD). Across both discovery and replication sub-samples, we found that child reports of caregiver monitoring (supervision or regular knowledge of the child's whereabouts) were positively associated with general cognition abilities, after covarying for age, sex, household income, neighborhood deprivation, and parental education. This association was specific to the type of caregiving behavior (caregiver monitoring, but not caregiver warmth), and was most strongly associated with a broad domain of general cognition (but not executive function or learning/memory). Additionally, we found that caregiver monitoring partially mediated the association between household income and cognition, furthering our understanding of how socioeconomic disparities may contribute to disadvantages in cognitive development. Together, these findings underscore the influence of differences in caregiving behavior in shaping youth cognition. RESEARCH HIGHLIGHTS: Caregiver monitoring, but not caregiver warmth, is associated with cognitive performance in youth Caregiver monitoring partially mediates the association between household income and cognition Results replicated across two large matched samples from the Adolescent Brain Cognitive Development Study® (ABCD).


Assuntos
Cognição , Pais , Criança , Humanos , Adolescente , Escolaridade
2.
Neuroimage ; 249: 118900, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35021039

RESUMO

How does attention enhance neural representations of goal-relevant stimuli while suppressing representations of ignored stimuli across regions of the brain? While prior studies have shown that attention enhances visual responses, we lack a cohesive understanding of how selective attention modulates visual representations across the brain. Here, we used functional magnetic resonance imaging (fMRI) while participants performed a selective attention task on superimposed stimuli from multiple categories and used a data-driven approach to test how attention affects both decodability of category information and residual correlations (after regressing out stimulus-driven variance) with category-selective regions of ventral temporal cortex (VTC). Our data reveal three main findings. First, when two objects are simultaneously viewed, the category of the attended object can be decoded more readily than the category of the ignored object, with the greatest attentional enhancements observed in occipital and temporal lobes. Second, after accounting for the response to the stimulus, the correlation in the residual brain activity between a cortical region and a category-selective region of VTC was elevated when that region's preferred category was attended vs. ignored, and more so in the right occipital, parietal, and frontal cortices. Third, we found that the stronger the residual correlations between a given region of cortex and VTC, the better visual category information could be decoded from that region. These findings suggest that heightened residual correlations by selective attention may reflect the sharing of information between sensory regions and higher-order cortical regions to provide attentional enhancement of goal-relevant information.


Assuntos
Atenção/fisiologia , Formação de Conceito/fisiologia , Reconhecimento Visual de Modelos/fisiologia , Lobo Temporal/fisiologia , Adolescente , Adulto , Reconhecimento Facial/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Lobo Temporal/diagnóstico por imagem , Adulto Jovem
3.
Cogn Affect Behav Neurosci ; 22(2): 414-428, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34850363

RESUMO

Although impaired attention is a diagnostic feature of anxiety disorders, we lack an understanding of which aspects of attention are impaired, the neurobiological basis of these impairments, and the contribution of stressors. To address these gaps in knowledge, we developed and tested behavioral tasks designed to parse the subdomains of attention impairments associated with anxiety symptoms and used electro-encephalographic (EEG) recordings to probe the neural basis of attentional performance. Participants were n = 55 individuals aged 18-35 with mild-to-moderate mood and anxiety symptoms. We also assessed stressful life events that may impact mental health and attention abilities, including stressors that occurred in early life before age 18 years. Severity of anxiety was found to be specifically associated with impairments in spatial attention but not feature-based attention. These impairments in spatial attention also partially mediated the association between early-life stressors and anxiety symptoms. Impairments in spatial selective attention were associated with decreased posterior alpha oscillations in EEG recordings in a subsample of participants, whereas spatial divided attention impairments were associated with decreased frontocentral theta oscillations. Our results provide a thorough characterization of attention impairments associated with anxiety, their EEG correlates, and the impact of stressors both in early life and adulthood.


Assuntos
Experiências Adversas da Infância , Adolescente , Adulto , Ansiedade , Transtornos de Ansiedade , Atenção , Eletroencefalografia , Humanos , Adulto Jovem
4.
Psychol Med ; 50(13): 2203-2212, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-31477195

RESUMO

BACKGROUND: Attention impairment is an under-investigated feature and diagnostic criterion of Major Depressive Disorder (MDD) that is associated with poorer outcomes. Despite increasing knowledge regarding mechanisms of attention in healthy adults, we lack a detailed characterization of attention impairments and their neural signatures in MDD. METHODS: Here, we focus on selective attention and advance a deep multi-modal characterization of these impairments in MDD, using data acquired from n = 1008 patients and n = 336 age- and sex-matched healthy controls. Selective attention impairments were operationalized and anchored in a behavioral performance measure, assessed within a battery of cognitive tests. We sought to establish the accompanying neural signature using independent measures of functional magnetic resonance imaging (15% of the sample) and electroencephalographic recordings of oscillatory neural activity. RESULTS: Greater impairment on the behavioral measure of selective attention was associated with intrinsic hypo-connectivity of the fronto-parietal attention network. Not only was this relationship specific to the fronto-parietal network unlike other large-scale networks; this hypo-connectivity was also specific to selective attention performance unlike other measures of cognition. Selective attention impairment was also associated with lower posterior alpha (8-13 Hz) power at rest and was related to more severe negative bias (frequent misidentifications of neutral faces as sad and lingering attention on sad faces), relevant to clinical features of negative attributions and brooding. Selective attention impairments were independent of overall depression severity and of worrying or sleep problems. CONCLUSIONS: These results provide a foundation for the clinical translational development of objective markers and targeted therapeutics for attention impairment in MDD.


Assuntos
Disfunção Cognitiva/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Lobo Frontal/fisiopatologia , Vias Neurais/fisiopatologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Modelos Lineares , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Adulto Jovem
7.
J Vis ; 15(15): 7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26575193

RESUMO

We examined short-term memory for sequences of visual stimuli embedded in varying multisensory contexts. In two experiments, subjects judged the structure of the visual sequences while disregarding concurrent, but task-irrelevant auditory sequences. Stimuli were eight-item sequences in which varying luminances and frequencies were presented concurrently and rapidly (at 8 Hz). Subjects judged whether the final four items in a visual sequence identically replicated the first four items. Luminances and frequencies in each sequence were either perceptually correlated (Congruent) or were unrelated to one another (Incongruent). Experiment 1 showed that, despite encouragement to ignore the auditory stream, subjects' categorization of visual sequences was strongly influenced by the accompanying auditory sequences. Moreover, this influence tracked the similarity between a stimulus's separate audio and visual sequences, demonstrating that task-irrelevant auditory sequences underwent a considerable degree of processing. Using a variant of Hebb's repetition design, Experiment 2 compared musically trained subjects and subjects who had little or no musical training on the same task as used in Experiment 1. Test sequences included some that intermittently and randomly recurred, which produced better performance than sequences that were generated anew for each trial. The auditory component of a recurring audiovisual sequence influenced musically trained subjects more than it did other subjects. This result demonstrates that stimulus-selective, task-irrelevant learning of sequences can occur even when such learning is an incidental by-product of the task being performed.


Assuntos
Percepção Auditiva/fisiologia , Aprendizagem/fisiologia , Memória de Curto Prazo/fisiologia , Percepção Visual/fisiologia , Adolescente , Feminino , Humanos , Masculino , Rememoração Mental , Estimulação Luminosa , Visão Ocular , Adulto Jovem
8.
Biol Psychiatry ; 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38460580

RESUMO

BACKGROUND: Symptoms of borderline personality disorder (BPD) often manifest during adolescence, but the underlying relationship between these debilitating symptoms and the development of functional brain networks is not well understood. Here, we aimed to investigate how multivariate patterns of functional connectivity are associated with borderline personality traits in large samples of young adults and adolescents. METHODS: We used functional magnetic resonance imaging data from young adults and adolescents from the HCP-YA (Human Connectome Project Young Adult) (n = 870, ages 22-37 years, 457 female) and the HCP-D (Human Connectome Project Development) (n = 223, ages 16-21 years, 121 female). A previously validated BPD proxy score was derived from the NEO Five-Factor Inventory. A ridge regression model with cross-validation and nested hyperparameter tuning was trained and tested in HCP-YA to predict BPD scores in unseen data from regional functional connectivity. The trained model was further tested on data from HCP-D without further tuning. Finally, we tested how the connectivity patterns associated with BPD aligned with age-related changes in connectivity. RESULTS: Multivariate functional connectivity patterns significantly predicted out-of-sample BPD scores in unseen data in young adults (HCP-YA ppermuted = .001) and older adolescents (HCP-D ppermuted = .001). Regional predictive capacity was heterogeneous; the most predictive regions were found in functional systems relevant for emotion regulation and executive function, including the ventral attention network. Finally, regional functional connectivity patterns that predicted BPD scores aligned with those associated with development in youth. CONCLUSIONS: Individual differences in functional connectivity in developmentally sensitive regions are associated with borderline personality traits.

9.
Dev Cogn Neurosci ; 66: 101370, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38583301

RESUMO

Childhood environments are critical in shaping cognitive neurodevelopment. With the increasing availability of large-scale neuroimaging datasets with deep phenotyping of childhood environments, we can now build upon prior studies that have considered relationships between one or a handful of environmental and neuroimaging features at a time. Here, we characterize the combined effects of hundreds of inter-connected and co-occurring features of a child's environment ("exposome") and investigate associations with each child's unique, multidimensional pattern of functional brain network organization ("functional topography") and cognition. We apply data-driven computational models to measure the exposome and define personalized functional brain networks in pre-registered analyses. Across matched discovery (n=5139, 48.5% female) and replication (n=5137, 47.1% female) samples from the Adolescent Brain Cognitive Development study, the exposome was associated with current (ages 9-10) and future (ages 11-12) cognition. Changes in the exposome were also associated with changes in cognition after accounting for baseline scores. Cross-validated ridge regressions revealed that the exposome is reflected in functional topography and can predict performance across cognitive domains. Importantly, a single measure capturing a child's exposome could more accurately and parsimoniously predict cognition than a wealth of personalized neuroimaging data, highlighting the importance of children's complex, multidimensional environments in cognitive neurodevelopment.

10.
Nat Commun ; 15(1): 3511, 2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38664387

RESUMO

Human cortical maturation has been posited to be organized along the sensorimotor-association axis, a hierarchical axis of brain organization that spans from unimodal sensorimotor cortices to transmodal association cortices. Here, we investigate the hypothesis that the development of functional connectivity during childhood through adolescence conforms to the cortical hierarchy defined by the sensorimotor-association axis. We tested this pre-registered hypothesis in four large-scale, independent datasets (total n = 3355; ages 5-23 years): the Philadelphia Neurodevelopmental Cohort (n = 1207), Nathan Kline Institute-Rockland Sample (n = 397), Human Connectome Project: Development (n = 625), and Healthy Brain Network (n = 1126). Across datasets, the development of functional connectivity systematically varied along the sensorimotor-association axis. Connectivity in sensorimotor regions increased, whereas connectivity in association cortices declined, refining and reinforcing the cortical hierarchy. These consistent and generalizable results establish that the sensorimotor-association axis of cortical organization encodes the dominant pattern of functional connectivity development.


Assuntos
Conectoma , Imageamento por Ressonância Magnética , Córtex Sensório-Motor , Humanos , Adolescente , Feminino , Masculino , Adulto Jovem , Criança , Córtex Sensório-Motor/fisiologia , Córtex Sensório-Motor/diagnóstico por imagem , Pré-Escolar , Rede Nervosa/fisiologia , Rede Nervosa/diagnóstico por imagem , Vias Neurais/fisiologia , Adulto , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/fisiologia , Córtex Cerebral/crescimento & desenvolvimento
12.
Trends Neurosci ; 46(10): 847-862, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37643932

RESUMO

To understand human brain development it is necessary to describe not only the spatiotemporal patterns of neurodevelopment but also the neurobiological mechanisms that underlie them. Human neuroimaging studies have provided evidence for a hierarchical sensorimotor-to-association (S-A) axis of cortical neurodevelopment. Understanding the biological mechanisms that underlie this program of development using traditional neuroimaging approaches has been challenging. Animal models have been used to identify periods of enhanced experience-dependent plasticity - 'critical periods' - that progress along cortical hierarchies and are governed by a conserved set of neurobiological mechanisms that promote and then restrict plasticity. In this review we hypothesize that the S-A axis of cortical development in humans is partly driven by the cascading maturation of critical period plasticity mechanisms. We then describe how recent advances in in vivo neuroimaging approaches provide a promising path toward testing this hypothesis by linking signals derived from non-invasive imaging to critical period mechanisms.


Assuntos
Período Crítico Psicológico , Neurobiologia , Animais , Humanos , Modelos Animais , Neuroimagem
13.
Trends Cogn Sci ; 27(2): 160-174, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36437189

RESUMO

In this perspective, we describe how developmental improvements in youth executive function (EF) are supported by hierarchically organized maturational changes in functional brain systems. We first highlight evidence that functional brain systems are embedded within a hierarchical sensorimotor-association axis of cortical organization. We then review data showing that functional system developmental profiles vary along this axis: systems near the associative end become more functionally segregated, while those in the middle become more integrative. Developmental changes that strengthen the hierarchical organization of the cortex may support EF by facilitating top-down information flow and balancing within- and between-system communication. We propose a central role for attention and frontoparietal control systems in the maturation of healthy EF and suggest that reduced functional system differentiation across the sensorimotor-association axis contributes to transdiagnostic EF deficits.


Assuntos
Encéfalo , Função Executiva , Adolescente , Humanos , Imageamento por Ressonância Magnética
14.
bioRxiv ; 2023 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-37662311

RESUMO

Background |: Symptoms of borderline personality disorder (BPD) often manifest in adolescence, yet the underlying relationship between these debilitating symptoms and the development of functional brain networks is not well understood. Here we aimed to investigate how multivariate patterns of functional connectivity are associated with symptoms of BPD in a large sample of young adults and adolescents. Methods |: We used high-quality functional Magnetic Resonance Imaging (fMRI) data from young adults from the Human Connectome Project: Young Adults (HCP-YA; N = 870, ages 22-37 years, 457 female) and youth from the Human Connectome Project: Development (HCP-D; N = 223, age range 16-21 years, 121 female). A previously validated BPD proxy score was derived from the NEO Five Factor Inventory (NEO-FFI). A ridge regression model with 10-fold cross-validation and nested hyperparameter tuning was trained and tested in HCP-YA to predict BPD scores in unseen data from regional functional connectivity, while controlling for in-scanner motion, age, and sex. The trained model was further tested on data from HCP-D without further tuning. Finally, we tested how the connectivity patterns associated with BPD aligned with age-related changes in connectivity. Results |: Multivariate functional connectivity patterns significantly predicted out-of-sample BPD proxy scores in unseen data in both young adults (HCP-YA; pperm = 0.001) and older adolescents (HCP-D; pperm = 0.001). Predictive capacity of regions was heterogeneous; the most predictive regions were found in functional systems relevant for emotion regulation and executive function, including the ventral attention network. Finally, regional functional connectivity patterns that predicted BPD proxy scores aligned with those associated with development in youth. Conclusion |: Individual differences in functional connectivity in developmentally-sensitive regions are associated with the symptoms of BPD.

15.
bioRxiv ; 2023 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-38045258

RESUMO

Functional neuroimaging is an essential tool for neuroscience research. Pre-processing pipelines produce standardized, minimally pre-processed data to support a range of potential analyses. However, post-processing is not similarly standardized. While several options for post-processing exist, they tend not to support output from disparate pre-processing pipelines, may have limited documentation, and may not follow BIDS best practices. Here we present XCP-D, which presents a solution to these issues. XCP-D is a collaborative effort between PennLINC at the University of Pennsylvania and the DCAN lab at the University at Minnesota. XCP-D uses an open development model on GitHub and incorporates continuous integration testing; it is distributed as a Docker container or Singularity image. XCP-D generates denoised BOLD images and functional derivatives from resting-state data in either NifTI or CIFTI files, following pre-processing with fMRIPrep, HCP, and ABCD-BIDS pipelines. Even prior to its official release, XCP-D has been downloaded >3,000 times from DockerHub. Together, XCP-D facilitates robust, scalable, and reproducible post-processing of fMRI data.

16.
Neuron ; 111(8): 1316-1330.e5, 2023 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-36803653

RESUMO

Hierarchical processing requires activity propagating between higher- and lower-order cortical areas. However, functional neuroimaging studies have chiefly quantified fluctuations within regions over time rather than propagations occurring over space. Here, we leverage advances in neuroimaging and computer vision to track cortical activity propagations in a large sample of youth (n = 388). We delineate cortical propagations that systematically ascend and descend a cortical hierarchy in all individuals in our developmental cohort, as well as in an independent dataset of densely sampled adults. Further, we demonstrate that top-down, descending hierarchical propagations become more prevalent with greater demands for cognitive control as well as with development in youth. These findings emphasize that hierarchical processing is reflected in the directionality of propagating cortical activity and suggest top-down propagations as a potential mechanism of neurocognitive maturation in youth.


Assuntos
Desenvolvimento do Adolescente , Córtex Cerebral , Desenvolvimento Infantil , Neuroimagem Funcional , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Adulto Jovem , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/fisiologia , Cognição/fisiologia , Estudos de Coortes , Conjuntos de Dados como Assunto , Neuroimagem Funcional/métodos , Fluxo Óptico
17.
Nat Commun ; 14(1): 8411, 2023 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-38110396

RESUMO

Individual differences in cognition during childhood are associated with important social, physical, and mental health outcomes in adolescence and adulthood. Given that cortical surface arealization during development reflects the brain's functional prioritization, quantifying variation in the topography of functional brain networks across the developing cortex may provide insight regarding individual differences in cognition. We test this idea by defining personalized functional networks (PFNs) that account for interindividual heterogeneity in functional brain network topography in 9-10 year olds from the Adolescent Brain Cognitive Development℠ Study. Across matched discovery (n = 3525) and replication (n = 3447) samples, the total cortical representation of fronto-parietal PFNs positively correlates with general cognition. Cross-validated ridge regressions trained on PFN topography predict cognition in unseen data across domains, with prediction accuracy increasing along the cortex's sensorimotor-association organizational axis. These results establish that functional network topography heterogeneity is associated with individual differences in cognition before the critical transition into adolescence.


Assuntos
Individualidade , Imageamento por Ressonância Magnética , Humanos , Adolescente , Imageamento por Ressonância Magnética/métodos , Encéfalo , Cognição , Testes Neuropsicológicos , Mapeamento Encefálico
18.
Biol Psychiatry ; 91(6): 561-571, 2022 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-34482948

RESUMO

BACKGROUND: Despite tremendous advances in characterizing human neural circuits that govern emotional and cognitive functions impaired in depression and anxiety, we lack a circuit-based taxonomy for depression and anxiety that captures transdiagnostic heterogeneity and informs clinical decision making. METHODS: We developed and tested a novel system for quantifying 6 brain circuits reproducibly and at the individual patient level. We implemented standardized circuit definitions relative to a healthy reference sample and algorithms to generate circuit clinical scores for the overall circuit and its constituent regions. RESULTS: In new data from primary and generalizability samples of depression and anxiety (N = 250), we demonstrated that overall disconnections within task-free salience and default mode circuits map onto symptoms of anxious avoidance, loss of pleasure, threat dysregulation, and negative emotional biases-core characteristics that transcend diagnoses-and poorer daily function. Regional dysfunctions within task-evoked cognitive control and affective circuits may implicate symptoms of cognitive and valence-congruent emotional functions. Circuit dysfunction scores also distinguished response to antidepressant and behavioral intervention treatments in an independent sample (n = 205). CONCLUSIONS: Our findings articulate circuit dimensions that relate to transdiagnostic symptoms across mood and anxiety disorders. Our novel system offers a foundation for deploying standardized circuit assessments across research groups, trials, and clinics to advance more precise classifications and treatment targets for psychiatry.


Assuntos
Depressão , Psiquiatria , Ansiedade , Transtornos de Ansiedade , Humanos
19.
J Affect Disord ; 295: 366-376, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34492429

RESUMO

BACKGROUND: There is limited research examining the natural trajectories of depression and anxiety, how these trajectories relate to baseline neural circuit function, and how symptom trajectory-circuit relationships are impacted by engagement in lifestyle activities including exercise, hobbies, and social interactions. To address these gaps, we assessed these relations over three months in untreated participants. METHODS: 262 adults (59.5% female, mean age 35) with symptoms of anxiety and depression, untreated with pharmacotherapy or behavioral therapy, completed the DASS-42, WHOQOL, and custom surveys at baseline and follow-up to assess symptoms, psychosocial function, and lifestyle activity engagement. At baseline, participants underwent fMRI under task-free and task-evoked conditions. We quantified six circuits implicated in these symptoms: default mode, salience, negative and positive affect, attention, and cognitive control. RESULTS: From baseline to 3 months, some participants demonstrated a natural improvement in anxiety (24%) and depression (26%) symptoms. Greater baseline salience circuit connectivity (pFDR=0.045), specifically between the left and right insula (pFDR=0.045), and greater negative affect circuit connectivity elicited by sad faces (pFDR=0.030) were associated with anxiety symptom improvement. While engagement in lifestyle activities were not associated with anxiety improvements, engagement in hobbies moderated the association between negative affect circuit connectivity and anxiety symptom improvement (p = 0.048). LIMITATIONS: The observational design limits causal inference. CONCLUSIONS: Our findings highlight the role of the salience and negative affect circuits as potential circuit markers of natural anxiety symptom improvements over time. Future studies that identify biomarkers associated with symptom improvements are critical for the development of personalized treatment targets.


Assuntos
Transtornos de Ansiedade , Ansiedade , Adulto , Ansiedade/terapia , Transtornos de Ansiedade/terapia , Córtex Cerebral/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino
20.
CBE Life Sci Educ ; 19(3): fe5, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32870089

RESUMO

Attention is thought to be the gateway between information and learning, yet there is much we do not understand about how students pay attention in the classroom. Leveraging ideas from cognitive neuroscience and psychology, we explore a framework for understanding attention in the classroom, organized along two key dimensions: internal/external attention and on-topic/off-topic attention. This framework helps us to build new theories for why active-learning strategies are effective teaching tools and how synchronized brain activity across students in a classroom may support learning. These ideas suggest new ways of thinking about how attention functions in the classroom and how different approaches to the same active-learning strategy may vary in how effectively they direct students' attention. We hypothesize that some teaching approaches are more effective than others because they leverage natural fluctuations in students' attention. We conclude by discussing implications for teaching and opportunities for future research.


Assuntos
Atenção , Aprendizagem , Humanos , Estudantes , Inquéritos e Questionários , Ensino
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