Optimal deep brain stimulation sites and networks for cervical vs. generalized dystonia.

Dystonia is a debilitating disease with few treatment options. One effective option is deep brain stimulation (DBS) to the internal pallidum. While cervical and generalized forms of isolated dystonia have been targeted with a common approach to the posterior third of the nucleus, large-scale investigations regarding optimal stimulation sites and potential network effects have not been carried out. Here, we retrospectively studied clinical results following DBS for cervical and generalized dystonia in a multicenter cohort of 80 patients. We model DBS electrode placement based on pre- and postoperative imaging and introduce an approach to map optimal stimulation sites to anatomical space. Second, we investigate which tracts account for optimal clinical improvements, when modulated. Third, we investigate distributed stimulation effects on a whole-brain functional connectome level. Our results show marked differences of optimal stimulation sites that map to the somatotopic structure of the internal pallidum. While modulation of the striatopallidofugal axis of the basal ganglia accounted for optimal treatment of cervical dystonia, modulation of pallidothalamic bundles did so in generalized dystonia. Finally, we show a common multisynaptic network substrate for both phenotypes in the form of connectivity to the cerebellum and somatomotor cortex. Our results suggest a brief divergence of optimal stimulation networks for cervical vs. generalized dystonia within the pallidothalamic loop that merge again on a thalamo-cortical level and share a common whole-brain network.

Watching (natural) beauty boosts task performance: testing the nature-as-reward hypothesis.

In two online studies, we tested the "nature-as-reward hypothesis", which suggests that superior cognitive task performance following nature exposure reflects a general performance improvement, driven by the reward value of beautiful things. In both between-subjects experiments, participants viewed either beautiful or less beautiful images for 10 s, comprising beautiful mountain photos (vs. less beautiful mountain drawings) in Study 1 and beautiful fractals (vs. less beautiful pixelated images) in Study 2. Following image exposure, participants engaged in a ticking task requiring them to freely tick up to 200 boxes. Participants had to complete four (Study 1) or five (Study 2) of such ticking tasks, with each task being preceded by either a beautiful or less beautiful image. In Study 1, for a subset of participants the ticking task was framed as a game. We found that in Study 1, ticking declined over the ticking rounds when participants had viewed less beautiful line drawings of mountains, while ticking performance remained unchanged over the rounds after seeing beautiful mountain images. However, when the ticking task was framed as a game, there was no significant difference in ticking performance between the two beauty conditions over the four ticking rounds. In Study 2, participants ticked more boxes over all ticking rounds after viewing images of beautiful fractals compared to less beautiful pixelated images. In line with the nature-as-reward hypothesis, these findings show that brief exposures to beautiful (nature) images can motivate to work and that framing tasks as a game can attenuate this beauty advantage.

The effects of virtual nature exposure on pro-environmental behaviour.

Exposure to (virtual) natural environments may encourage people to care about environmental protection and to engage in pro-environmental behaviour. Previous research on this effect produced inconsistent results, suggesting that it may depend on the type of nature and behaviour under study. In the present study (N = 266), we investigated nature exposure effects on effortful pro-environmental behaviour in an online experiment. After watching pictures of either intact or destroyed natural environments, participants could exert voluntary extra efforts to generate real donations to an environmental organisation. In comparison to the intact nature condition, participants exerted significantly more effort for environmental protection after being exposed to pictures of destroyed nature. No clear differences were observed between the nature exposure conditions and a no-picture control condition. These findings illustrate the complexity of nature exposure effects and suggest that different types of nature exposure may differentially affect people's pro-environmental behaviour.

The laboratory journey to become a decision engine: a roadmap for diagnostic transformation.

Laboratories and diagnostic departments are presiding over a massive amount of data they are failing to fully leverage it. Data is the new black gold of healthcare organizations and by extracting insights from it, laboratories could become true decision engines, able to drive action across healthcare. This opinion paper responds three fundamental questions: (1) Where are we (diagnostic parties)? Taking a look at the most significant trends and challenges in healthcare and shedding some light upon the status of diagnostics. (2) Where do we want to be? Reviewing the opportunities for digital health, its role in the healthcare of the future and providing inspiration about what success looks like. (3) What do we need to do? Explaining what Digital Health Solutions (DHS) from Abbott is doing in this regard. This will include information about how DHS can impact the Diagnosis Cycle and how to set a roadmap for laboratories and diagnostic organizations. Diagnosis Cycle means the different steps in the diagnosis process, from the beginning when a patient is seen by a clinician and some tests are ordered, until the results are reviewed by the clinician and the treatment, follow up or discharge is decided.

Behavioral paradigms for studying pro-environmental behavior: A systematic review.

In view of global environmental deterioration and climate change, researchers from multiple fields of the behavioral sciences examine the determinants of pro-environmental behavior. Research on pro-environmental behavior is dominated by the use of self-report measures, which relates to critical validity problems. Some of these problems can be addressed by studying consequential behavior in behavioral paradigms (i.e., systematically arranged situations of actual environmental relevance). However, pro-environmental behavior paradigms have been scattered across disciplines, and many researchers may not be aware of the wealth of available paradigms. The present review aims to acquaint researchers across disciplinary borders with the behavioral paradigms developed to study pro-environmental behavior in different domains. A systematic literature search revealed 99 ad hoc paradigms and five validated paradigms of pro-environmental behavior. I review how different authors have succeeded in implementing the consequences of pro-environmental behavior in standardized field, laboratory, or online situations, point to caveats in the use of behavioral paradigms, and illustrate how researchers can select a paradigm for their own research.

The Work for Environmental Protection Task: A consequential web-based procedure for studying pro-environmental behavior.

Some human behaviors have serious societal consequences, but these consequences tend to be neglected in online research on societally relevant behaviors. For example, human activities contribute to climate change and biodiversity loss, but pro-environmental behavior is often studied using inconsequential self-reports and hypothetical scenarios. Such measures can easily be administered online, but suffer from severe validity problems. To address these problems, we developed a multi-trial web-based procedure for the study of consequential pro-environmental behavior. On the Work for Environmental Protection Task (WEPT), participants can choose to exert voluntary extra efforts screening numerical stimuli in exchange for donations to an environmental organization. They thus have the opportunity to produce actual environmental benefits at actual behavioral costs (i.e., to show actual pro-environmental behavior). In a preregistered validation study (N = 209), we found WEPT performance to systematically vary with these consequences, that is, the implemented costs and benefits were large enough for participants to effectively take them into account. In addition, aggregated WEPT performance was found to be highly reliable and to be correlated to self-reports and objective observations of other pro-environmental behaviors and conceptually related measures. These findings support the validity of the WEPT as an online procedure for the study of actual pro-environmental behavior. We discuss how the WEPT can advance the experimental analysis of pro-environmental behavior, help to address problems of common-method variance in individual difference research, and be adapted for the consequential study of other societally relevant behaviors.

Generation of Current Vortex by Spin Current in Rashba Systems.

Employing unbiased large-scale time-dependent density-matrix renormalization-group simulations, we demonstrate the generation of a charge-current vortex via spin injection in the Rashba system. The spin current is polarized perpendicular to the system plane and injected from an attached antiferromagnetic spin chain. We discuss the conversion between spin and orbital angular momentum in the current vortex that occurs because of the conservation of the total angular momentum and the spin-orbit interaction. This is in contrast to the spin Hall effect, in which the angular-momentum conservation is violated. Finally, we predict the electromagnetic field that accompanies the vortex with regard to possible future experiments.

Working for the future: parentally deprived Nigerian Children have enhanced working memory ability.

BACKGROUND: The dominant view based on the deficit model of developmental psychopathology is that early adverse rearing impairs cognition. In contrast, an emerging evolutionary-developmental model argues that individuals exposed to early-life stress may have improved cognitive abilities that are adapted to harsh environments. We set out to test this hypothesis by examining cognitive functions in parentally deprived children in Nigeria. METHODS: Cognitive performance was compared between 53 deprived children who currently live in institutional homes and foster families and 51 nondeprived control participants. We used a multifaceted neurocognitive test battery for the assessment of inhibition, set-shifting and working memory. RESULTS: Results showed that the deprived and nondeprived group did not significantly differ in their performance on set-shifting and inhibition tasks. Conversely, the deprived group performed significantly better than the nondeprived group in the working memory task. DISCUSSION: We interpret the enhanced working memory ability of the deprived group as a correlate of its ecological relevance. In Nigeria, underprivileged children may need to rely to a larger extent on working memory abilities to attain success through academic work. This study provides further evidence that exposure to early adversity does not necessarily impair cognitive functions but can even enhance it under some conditions and in some domains.

Longitudinal Assessment of Rotation Angles after Implantation of Directional Deep Brain Stimulation Leads.

PURPOSE: The risk/benefit-ratio of deep brain stimulation (DBS) depends on focusing the electrical field onto the target volume, excluding side-effect eliciting structures. Directional leads limiting radial current diffusion can target stimulation but add a spatial degree of freedom that requires control to align multimodal imaging datasets and for anatomical interpretation of stimulation. Unpredictable postoperative lead rotations have been reported. The extent and timing of rotation from the surgically intended alignment remain uncertain, as does the time point at which directional stimulation can be safely initiated without risking unexpected shifts in stimulation volume. We present a retrospective analysis of clinically indicated, repeated neuroimaging controls postimplantation in patients with directional DBS systems, which allow estimation of the amount and timing of postoperative lead rotation. METHODS: Data from 67 patients with directional leads and multiple cranial computer tomographies (CCT) and/or rotation fluoroscopies at different postoperative time points were included. Rotation angles were detected based on CCT artifacts (n = 56) or direct visualization of lead segments on rotation fluoroscopies (n = 52). Cross-validation of both methods was conducted in patients who received both imaging modalities (n = 51). RESULTS: Rotation angles deviated significantly (∼30°) from their intended 0° anterior/posterior orientation. Rotation was firmly established within the first postoperative day, with no additional torque in subsequent scans. The two methods highly correlated (right hemisphere: R2 = 0.94, left hemisphere: R2 = 0.91). CONCLUSION: Both methods for measuring rotation angles led to comparable results and can be used interchangeably. Directional stimulation settings can safely be initiated after the first postoperative day, without risking subsequent lead rotation-related anatomical shifts.

Probabilistic mapping of the antidystonic effect of pallidal neurostimulation: a multicentre imaging study.

Deep brain stimulation of the internal globus pallidus is a highly effective and established therapy for primary generalized and cervical dystonia, but therapeutic success is compromised by a non-responder rate of up to 25%, even in carefully-selected groups. Variability in electrode placement and inappropriate stimulation settings may account for a large proportion of this outcome variability. Here, we present probabilistic mapping data on a large cohort of patients collected from several European centres to resolve the optimal stimulation volume within the pallidal region. A total of 105 dystonia patients with pallidal deep brain stimulation were enrolled and 87 datasets (43 with cervical dystonia and 44 with generalized dystonia) were included into the subsequent 'normative brain' analysis. The average improvement of dystonia motor score was 50.5 ± 30.9% in cervical and 58.2 ± 48.8% in generalized dystonia, while 19.5% of patients did not respond to treatment (<25% benefit). We defined probabilistic maps of anti-dystonic effects by aggregating individual electrode locations and volumes of tissue activated (VTA) in normative atlas space and ranking voxel-wise for outcome distribution. We found a significant relation between motor outcome and the stimulation volume, but not the electrode location per se. The highest probability of stimulation induced motor benefit was found in a small volume covering the ventroposterior globus pallidus internus and adjacent subpallidal white matter. We then used the aggregated VTA-based outcome maps to rate patient individual VTAs and trained a linear regression model to predict individual outcomes. The prediction model showed robustness between the predicted and observed clinical improvement, with an r2 of 0.294 (P < 0.0001). The predictions deviated on average by 16.9 ± 11.6 % from observed dystonia improvements. For example, if a patient improved by 65%, the model would predict an improvement between 49% and 81%. Results were validated in an independent cohort of 10 dystonia patients, where prediction and observed benefit had a correlation of r2 = 0.52 (P = 0.02) and a mean prediction error of 10.3% (±8.9). These results emphasize the potential of probabilistic outcome brain mapping in refining the optimal therapeutic volume for pallidal neurostimulation and advancing computer-assisted planning and programming of deep brain stimulation.

Stimulus- and response-based interference contributes to the costs of switching between cognitive tasks.

Little is known about how stimulus- and response-based interference might interact to contribute to the costs of switching between cognitive tasks. We analyzed switch costs in a novel cued task-switching/card-matching paradigm in a large study (N = 95). We reasoned that interference from previously active task sets may be contingent upon the retrieval of these task sets via stimulus processing, or alternatively, via response processing. We examined the efficacy of these two factors through eligibility manipulations. That is, stimulus/response features that were capable of retrieving task sets from the previous trial remained eligible (or not) on the current trial. We report three main findings: first, no switch costs were found when neither stimulus features, nor response features, were adequate for the retrieval of the previously executed task sets. Second, we found substantial switch costs when, on switch trials, stimulus features kept the previously executed task eligible, and we found roughly equivalent switch costs when the previously executed response remained eligible. Third, evidence for stimulus-induced switch costs was exclusively observed when previously executed responses remained ineligible. These data indicate that stimulus-based interference, and of importance, response-based interference, contribute comparably to switch costs. Possible interpretations of non-additive switch costs are discussed.

Perseverative Responding in Nigerian Chronic Alcohol and Marijuana Users.

Background: Chronic consumption of alcohol and marijuana, especially when initiated at an early age, has been implicated in cognitive alterations in the domain of executive functioning. Despite the robustness of this finding in Western populations, its generalizability to other cultural contexts is largely unknown. In this study, we examined whether the regular use of alcohol or marijuana use relates to impaired executive functioning in male students of a Nigerian university. Methods: Chronic alcohol users (n = 39), chronic marijuana users (n = 35) and drug-abstinent control participants (n = 40) recruited through snow-ball sampling technique completed a computerized version of the Wisconsin Card Sorting Test (cWCST). As an established measure of executive functioning, the cWCST allows for the simultaneous assessment of three distinct executive processes: set shifting, rule inference, and set maintenance. Results revealed a selective set-shifting deficit in both alcohol and marijuana users. Results: Both groups committed significantly more perseverative errors than the control group, and group differences were significantly stronger on this indicator of set shifting than on indicators of rule inference or set maintenance. Conclusions: Our findings support the generalizability of drug-related deficits in executive functioning and contribute to the characterization of executive dysfunction in non-Western populations. Future longitudinal studies are required to clarify whether executive dysfunction is an antecedent or consequence of alcohol and marijuana use in young Nigerians.

Risky decision making and cognitive flexibility among online sports bettors in Nigeria.

Online sports betting is a popular recreational activity in Nigeria. Like other forms of gambling, risk of pathological progression exists for gamblers who continue betting despite severe financial and psychosocial consequences. In the present study, we examined whether this population of gamblers shows deficits in decision making and cognitive flexibility that have been documented in Western gambling populations. Thirty-six online sports bettors and 42 non-gambling participants completed a version of the Iowa gambling task (IGT) and an established set-shifting task for the assessment of cognitive flexibility. The two groups did not differ significantly in the selection of disadvantageous decks on the IGT. In contrast, sports bettors committed significantly more errors on the set-shifting task than non-gambling control participants. As this performance deficit was not specific to trials requiring a set shift, it most likely resulted from gambling-related changes in general cognitive or motivational abilities that are required to successfully complete challenging mental tasks. While our results illustrate that findings from Western populations cannot automatically be generalised to other contexts, it should be noted that we focused on only one particular type of gambling and included mostly participants with mild gambling-related problems.

Cortical network fingerprints predict deep brain stimulation outcome in dystonia.

BACKGROUND: Deep brain stimulation (DBS) is an effective evidence-based therapy for dystonia. However, no unequivocal predictors of therapy responses exist. We investigated whether patients optimally responding to DBS present distinct brain network organization and structural patterns. METHODS: From a German multicenter cohort of 82 dystonia patients with segmental and generalized dystonia who received DBS implantation in the globus pallidus internus, we classified patients based on the clinical response 3 years after DBS. Patients were assigned to the superior-outcome group or moderate-outcome group, depending on whether they had above or below 70% motor improvement, respectively. Fifty-one patients met MRI-quality and treatment response requirements (mean age, 51.3 ± 13.2 years; 25 female) and were included in further analysis. From preoperative MRI we assessed cortical thickness and structural covariance, which were then fed into network analysis using graph theory. We designed a support vector machine to classify subjects for the clinical response based on individual gray-matter fingerprints. RESULTS: The moderate-outcome group showed cortical atrophy mainly in the sensorimotor and visuomotor areas and disturbed network topology in these regions. The structural integrity of the cortical mantle explained about 45% of the DBS stimulation amplitude for optimal response in individual subjects. Classification analyses achieved up to 88% of accuracy using individual gray-matter atrophy patterns to predict DBS outcomes. CONCLUSIONS: The analysis of cortical integrity, informed by group-level network properties, could be developed into independent predictors to identify dystonia patients who benefit from DBS. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Anyonic Haldane Insulator in One Dimension.

We demonstrate numerically the existence of a nontrivial topological Haldane phase for the one-dimensional extended (U-V) Hubbard model with a mean density of one particle per site, not only for bosons but also for anyons, despite a broken reflection parity symmetry. The Haldane insulator, surrounded by superfluid, Mott insulator, and density-wave phases in the V-U parameter plane, is protected by combined (modified) spatial-inversion and time-reversal symmetries, which is verified within our matrix-product-state based infinite density-matrix renormalization group scheme by analyzing generalized transfer matrices. With regard to an experimental verification of the anyonic Haldane insulator state the calculated asymmetry of the dynamical density structure factor should be of particular importance.

Subscales of the Barratt Impulsiveness Scale differentially relate to the Big Five factors of personality.

The place of impulsiveness in multidimensional personality frameworks is still unclear. In particular, no consensus has yet been reached with regard to the relation of impulsiveness to Neuroticism and Extraversion. We aim to contribute to a clearer understanding of these relationships by accounting for the multidimensional structure of impulsiveness. In three independent studies, we related the subscales of the Barratt Impulsiveness Scale (BIS) to the Big Five factors of personality. Study 1 investigated the associations between the BIS subscales and the Big Five factors as measured by the NEO Five-Factor Inventory (NEO-FFI) in a student sample (N = 113). Selective positive correlations emerged between motor impulsiveness and Extraversion and between attentional impulsiveness and Neuroticism. This pattern of results was replicated in Study 2 (N = 132) using a 10-item short version of the Big Five Inventory. In Study 3, we analyzed BIS and NEO-FFI data obtained from a sample of patients with pathological buying (N = 68). In these patients, the relationship between motor impulsiveness and Extraversion was significantly weakened when compared to the non-clinical samples. At the same time, the relationship between attentional impulsiveness and Neuroticism was substantially stronger in the clinical sample. Our studies highlight the utility of the BIS subscales for clarifying the relationship between impulsiveness and the Big Five personality factors. We conclude that impulsiveness might occupy multiple places in multidimensional personality frameworks, which need to be specified to improve the interpretability of impulsiveness scales.

P300 amplitude variations, prior probabilities, and likelihoods: A Bayesian ERP study.

The capability of the human brain for Bayesian inference was assessed by manipulating probabilistic contingencies in an urn-ball task. Event-related potentials (ERPs) were recorded in response to stimuli that differed in their relative frequency of occurrence (.18 to .82). A veraged ERPs with sufficient signal-to-noise ratio (relative frequency of occurrence > .5) were used for further analysis. Research hypotheses about relationships between probabilistic contingencies and ERP amplitude variations were formalized as (in-)equality constrained hypotheses. Conducting Bayesian model comparisons, we found that manipulations of prior probabilities and likelihoods were associated with separately modifiable and distinct ERP responses. P3a amplitudes were sensitive to the degree of prior certainty such that higher prior probabilities were related to larger frontally distributed P3a waves. P3b amplitudes were sensitive to the degree of likelihood certainty such that lower likelihoods were associated with larger parietally distributed P3b waves. These ERP data suggest that these antecedents of Bayesian inference (prior probabilities and likelihoods) are coded by the human brain.

Cognitive Flexibility in Primary Dystonia.

Objectives Although primary dystonia is typically characterized as a movement disorder, it is also associated with cognitive alterations in the domain of executive functioning which may arise from changes in cortico-basal ganglia circuits. Specifically, in comparison to healthy controls, patients with dystonia show deficits in neuropsychological tests of cognitive flexibility. However, it is unclear whether cognitive inflexibility is caused by the pathomechanisms underlying primary dystonia or by confounding factors such as depression or symptom-related distraction.Methods The present study aimed to eliminate these confounds by examining cognitive flexibility in dystonia patients and in patients with similar motor symptoms but without a comparable central pathophysiology. Eighteen patients with primary blepharospasm, a common form of dystonia affecting the muscles around the eyes, and 19 patients with hemifacial spasm, a facial nerve disorder causing similar eyelid spasms, completed a computerized version of the Wisconsin Card Sorting Test (cWCST). The two groups were further compared on tests of global cognitive functioning, psychiatric symptoms, health status, and impulsiveness. Results Blepharospasm patients committed significantly more errors on the cWCST than patients with hemifacial spasm. Group differences were most pronounced with regard to integration errors, a measure of rule-inference processes on the cWCST. Integration errors were also associated with impulsiveness in patients with blepharospasm. Conclusions Primary blepharospasm is related to deficits in cognitive flexibility, even when blepharospasm patients are compared with patients who suffer from motor symptoms of non-dystonic origin. Our results support the possibility that cognitive inflexibility results from the specific pathophysiological processes underlying primary dystonia. (JINS, 2016, 22, 662-670).

Prior probabilities modulate cortical surprise responses: A study of event-related potentials.

The human brain predicts events in its environment based on expectations, and unexpected events are surprising. When probabilistic contingencies in the environment are precisely instructed, the individual can form expectations based on quantitative probabilistic information ('inference-based learning'). In contrast, when probabilistic contingencies are imprecisely instructed, expectations are formed based on the individual's cumulative experience ('experience-based learning'). Here, we used the urn-ball paradigm to investigate how variations in prior probabilities and in the precision of information about these priors modulate choice behavior and event-related potential (ERP) correlates of surprise. In the urn-ball paradigm, participants are repeatedly forced to infer hidden states responsible for generating observable events, given small samples of factual observations. We manipulated prior probabilities of the states, and we rendered the priors calculable or incalculable, respectively. The analysis of choice behavior revealed that the tendency to consider prior probabilities when making decisions about hidden states was stronger when prior probabilities were calculable, at least in some of our participants. Surprise-related P3b amplitudes were observed in both the calculable and the incalculable prior probability condition. In contrast, calculability of prior probabilities modulated anteriorly distributed ERP amplitudes: when prior probabilities were calculable, surprising events elicited enhanced P3a amplitudes. However, when prior probabilities were incalculable, surprise was associated with enhanced N2 amplitudes. Furthermore, interindividual variability in reliance on prior probabilities was associated with attenuated P3b surprise responses under calculable in comparison to incalculable prior probabilities. Our results suggest two distinct neural systems for probabilistic learning that are recruited depending on contextual cues such as the precision of probabilistic information. Individuals with stronger tendencies to rely on calculable prior probabilities seem to have better adapted expectations at their disposal, as indicated by an attenuation of their P3b surprise responses when prior probabilities are calculable.

If ego depletion cannot be studied using identical tasks, it is not ego depletion.

The hypothesis that human self-control capacities are fueled by glucose has been challenged on multiple grounds. A recent study by Lange and Eggert adds to this criticism by presenting two powerful but unsuccessful attempts to replicate the effect of sugar drinks on ego depletion. The dual-task paradigms employed in these experiments have been criticized for involving identical self-control tasks, a methodology that has been argued to reduce participants' willingness to exert self-control. The present article addresses this criticism by demonstrating that there is no indication to believe that the study of glucose effects on ego depletion should be restricted to paradigms using dissimilar acts of self-control. Failures to observe such effects in paradigms involving identical tasks pose a serious problem to the proposal that self-control exhaustion might be reversed by rinsing or ingesting glucose. In combination with analyses of statistical credibility, the experiments by Lange and Eggert suggest that the influence of sugar on ego depletion has been systematically overestimated.