Could Nature Contribute to the Management of ADHD in Children? A Systematic Review.

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that is typically managed with pharmacological and psychotherapeutic interventions. In the general population, exposure to nature has been found to have robust beneficial effects on cognitive performance, including attention. With inattention being a factor of the symptomatology of individuals with ADHD, this provides a rationale to investigate the potential benefits of exposure to nature for this population. Four electronic databases (PubMED, PsycINFO, Embase, and Web of Science) were searched for empirical studies investigating the effects of nature on ADHD prevalence and/or symptom severity in populations of school-aged children. Key characteristics, methodologies, and outcomes of included studies were extracted and evaluated. Out of the 458 studies identified, 7 met the inclusion criteria. Despite the large heterogeneity in methodological approaches, the included articles consistently reported that exposure to nature is associated with reduced ADHD diagnoses and symptom severity. Furthermore, when several covariates, such as age, gender, annual household income, parental income, and education level, as well as several pre-natal factors, were controlled for, the relationship between nature and ADHD remained significant. The reviewed literature provides strong support for the benefits of exposure to nature on ADHD in school-aged children.

The Effectiveness of Adolescent-Focused Therapy and Family-Based Therapy for Anorexia Nervosa.

Anorexia Nervosa is the most deadly mental illness due to the high mortality and relapse rates after reaching remission. The systematic review investigated the effectiveness of two empirically validated interventions (Family-Based Therapy [FBT] and Adolescent-Focused Therapy [AFT]) for an adolescent or young adult living with Anorexia Nervosa to reach partial or full remission and expected weight ratios. Twelve studies published between 1994 and 2015 were evaluated and indicated that FBT resulted in significant weight gain and higher partial and full remission rates than AFT, demonstrating its superiority in treating AN in adolescents and young adult samples, in one instance, at least up to 4 years. Despite FBT and AFT delivery, a significant proportion of participants did not achieve their target weight or full remission, indicating that both treatments may not be effective in all circumstances.

Medication-invariant resting aperiodic and periodic neural activity in Parkinson's disease.

Parkinson's disease (PD) has been associated with greater total power in canonical frequency bands (i.e., alpha, beta) of the resting electroencephalogram (EEG). However, PD has also been associated with a reduction in the proportion of total power across all frequency bands. This discrepancy may be explained by aperiodic activity (exponent and offset) present across all frequency bands. Here, we examined differences in the eyes-open (EO) and eyes-closed (EC) resting EEG of PD participants (N = 26) on and off medication, and age-matched healthy controls (CTL; N = 26). We extracted power from canonical frequency bands using traditional methods (total alpha and beta power) and extracted separate parameters for periodic (parameterized alpha and beta power) and aperiodic activity (exponent and offset). Cluster-based permutation tests over spatial and frequency dimensions indicated that total alpha and beta power, and aperiodic exponent and offset were greater in PD participants, independent of medication status. After removing the exponent and offset, greater alpha power in PD (vs. CTL) was only present in EO recordings and no reliable differences in beta power were observed. Differences between PD and CTL in the resting EEG are likely driven by aperiodic activity, suggestive of greater relative inhibitory neural activity and greater neuronal spiking. Our findings suggest that resting EEG activity in PD is characterized by medication-invariant differences in aperiodic activity which is independent of the increase in alpha power with EO. This highlights the importance of considering aperiodic activity contributions to the neural correlates of brain disorders.

Test-retest reliability of spectral parameterization by 1/f characterization using SpecParam.

SpecParam (formally known as FOOOF) allows for the refined measurements of electroencephalography periodic and aperiodic activity, and potentially provides a non-invasive measurement of excitation: inhibition balance. However, little is known about the psychometric properties of this technique. This is integral for understanding the usefulness of SpecParam as a tool to determine differences in measurements of cognitive function, and electroencephalography activity. We used intraclass correlation coefficients to examine the test-retest reliability of parameterized activity across three sessions (90 minutes apart and 30 days later) in 49 healthy young adults at rest with eyes open, eyes closed, and during three eyes closed cognitive tasks including subtraction (Math), music recall (Music), and episodic memory (Memory). Intraclass correlation coefficients were good for the aperiodic exponent and offset (intraclass correlation coefficients > 0.70) and parameterized periodic activity (intraclass correlation coefficients > 0.66 for alpha and beta power, central frequency, and bandwidth) across conditions. Across all three sessions, SpecParam performed poorly in eyes open (40% of participants had poor fits over non-central sites) and had poor test-retest reliability for parameterized periodic activity. SpecParam mostly provides reliable metrics of individual differences in parameterized neural activity. More work is needed to understand the suitability of eyes open resting data for parameterization using SpecParam.

Motivation moderates gender differences in navigation performance.

Gender differences in navigation performance are a recurrent and controversial topic. Previous research suggests that men outperform women in navigation tasks and that men and women exhibit different navigation strategies. Here, we investigate whether motivation to complete the task moderates the relationship between navigation performance and gender. Participants learned the locations of landmarks in a novel virtual city. During learning, participants could trigger a top-down map that depicted their current position and the locations of the landmarks. During testing, participants were divided into control and treatment groups and were not allowed to consult the map. All participants were given 16 minutes to navigate to the landmarks, but those in the treatment group were monetarily penalized for every second they spent completing the task. Results revealed a negative relationship between physiological arousal and the time required to locate the landmarks. In addition, gender differences in strategy were found during learning, with women spending more time with the map and taking 40% longer than men to locate the landmarks. Interestingly, an interaction between gender and treatment group revealed that women in the control group required more time than men and women in the treatment group to retrieve the landmarks. During testing, women in the control group also took more circuitous routes compared to men in the control group and women in the treatment group. These results suggest that a concurrent and relevant stressor can motivate women to perform similarly to men, helping to diminish pervasive gender differences found in the navigation literature.

Extended Reality Use in Paediatric Intensive Care: A Scoping Review.

Background: Extended reality (XR) technology such as virtual and augmented reality is increasingly being utilised in paediatric medicine due to its role in medical education and reported positive impacts on outcomes including pain, anxiety, and sleep. To the author's knowledge, no previous reviews investigating the use of XR in paediatric intensive care have been undertaken. Objectives: To scope the use of XR in paediatric intensive care, and assess its barriers to adoption, including safety considerations, cleaning and infection control. Eligibility criteria: All articles of any methodological design discussing the use of XR within paediatric intensive and critical care were included. Sources of evidence: Four databases (EMBASE, CINAHL, PsychInfo, PubMed) and Google Scholar were searched without any limitations on publication year. Charting methods: Data was extracted into Microsoft Excel by two authors independently (AG & SF) and cross-checked for completeness. Results: One hundred and eighty-eight articles were originally identified. Following the application of eligibility criteria 16 articles utilising XR in clinical interventions (n = 7) and medical education (n = 9) were included. Articles utilised VR and AR for highly variable purposes within both medical education (eg disaster preparedness, intubation) and clinical interventions (eg decrease pain, nausea, anxiety and improve Glasgow Coma Scale). Conclusions: While research into the use of XR in paediatric intensive care is still in its infancy it has increased dramatically over the past 5 years within two key areas. Firstly, in healthcare education, to assist in the acquisition of PICU-specific knowledge and practice of skills such as intubation of difficult airways. Secondly, studies have evaluated and demonstrated that with appropriate use, VR appears to be a safe and feasible intervention to decrease pain and anxiety in PICU patients.

Use of extended reality in sleep health, medicine, and research: a scoping review.

STUDY OBJECTIVES: This scoping review explores the use of extended reality (virtual, augmented, and mixed reality) within sleep health, sleep medicine, and sleep research. It aims to provide insight into current uses and implementation considerations whilst highlighting directions for future research. METHODS: A systematic scoping review was undertaken informed by the preferred reporting items for systematic reviews and meta-analyses for scoping reviews and Johanna Briggs Institute. RESULTS: The use of virtual reality (VR) as a research tool in the investigation of areas such as dreaming and memory reactivation is growing. Thirty-one articles were identified in total with 20 utilizing VR to improve sleep as a clinical intervention. CONCLUSIONS: Research exploring the utility of VR as a clinical intervention in various patient populations and clinical settings is therefore warranted. Researchers and clinicians should ensure that extended reality interventions are developed based on clinical reasoning and informed by evidence of both sleep medicine and the effects of virtual and augmented reality. Where possible future research should utilize up-to-date technology and reporting frameworks to assist in the translation of research into clinical practice.

Psychological mechanisms and interventions directed at vaccination attitudes.

Attitudes about vaccination impact not only the individual but also society. Therefore, understanding the underlying psychological processes of those who disagree with vaccination is critical for creating compassion through understanding and change through promoting autonomy. The current review aimed to fill a gap in the literature, outlining the state of the recent research on vaccination attitudes, specifically on the underlying mechanisms driving anti-vaccination movements and individuals' thoughts and behaviors. In addition, we aimed to evaluate current research on the effectiveness of interventions targeting these mechanisms. Overall, results indicated that those declining vaccines had beliefs related to distrust in the scientific community and pharmaceutical companies and moral preferences for purity and liberty. In addition, our review identified the potential for utilizing motivational interviewing techniques as an intervention. This literature review provides a platform for further research and enhances the current understanding of vaccination attitudes.

Neuroimaging Correlates of Cognitive Behavioral Therapy for Insomnia (CBT-I): A Systematic Literature Review.

Cognitive behavioral therapy for insomnia (CBT-I) is the gold-standard non-pharmacological treatment for insomnia, a complex disorder that comprises psychological, behavioral, and physiological components. This systematic literature review aimed to evaluate a growing body of exploratory studies that have examined CBT-I treatment effects using neuroimaging assessment. Nine studies met current review selection criteria, of which six studies compared insomnia groups with good sleepers, waitlist, and/or control groups. CBT-I administration varied in treatment length and duration across the studies, as did neuroimaging assessment, which included task-based and resting-state functional magnetic resonance imaging (fMRI), and structural magnetic resonance imaging (MRI). Functional connectivity abnormalities were observed in participants, including reduced engagement in task-related brain regions and apparent difficulties in regulating default mode brain areas that appeared to reverse following CBT-I treatment. Taken together, the neuroimaging results complement behavioral measures of treatment efficacy, indicating support for the effectiveness of CBT-I treatment in the recovery of brain function and structure.

Predictors of concussion reporting intentions in adolescent hockey players.

Young athletes who do not report a concussion injury are at greater risk for a prolonged recovery time and further neurocognitive impairments. Despite the seriousness of the issue and the scale of the problem, not enough is known about the behavioural underpinnings of concussion underreporting in minor athletes. This paper aims to apply the Knowledge, Attitude, and Behaviour (KAB) framework to the issue of injury reporting in adolescents, with the specific purpose of exploring to which degree concussion knowledge, concussion attitudes, and gender affect concussion reporting intentions of both male and female athletes. We recruited 97 young athletes between the ages of 14 and 19 (M = 16.22, SD = 11.06) from the Okanagan Hockey Academy (Canada) and employed a self-administered supervised survey approach to measuring the target variables. A hierarchical multiple regression was conducted, and consistent with the prior literature, females were more likely to report a sport-related concussion than males. It was further found that attitudes around concussions (i.e., taking concussions seriously) were significant predictors of concussion reporting intention. At the same time, there was no significant relationship between concussion knowledge and concussion reporting intention. These results highlight that knowledge about concussion symptoms is insufficient to warrant proper injury reporting. It will therefore be essential to work on changing the attitudes of young athletes regarding the significance of concussions to achieve meaningful behavioural change.

Does path integration contribute to human navigation in large-scale space?

Path integration is a process in which navigators estimate their position and orientation relative to a known location by using body-based internal sensory cues that arise from navigation-related bodily motion (e.g., vestibular and proprioceptive signals). Although humans are capable of navigating via path integration in small-scale space, a question has been raised as to whether path integration plays any role in human navigation in large-scale space because it is inherently prone to accumulating error. In this review, we examined whether there is evidence that path integration contributes to large-scale human navigation. It was found that navigation with path integration (e.g., walking in a large-scale environment) can enhance learning of the layout of the environment as compared with mere exposure to the environment without path integration (e.g., viewing a walk-through video while sitting), suggesting that the body-based cues are reliably processed and encoded through path integration when they are present during navigation. This facilitatory effect is clearer when proprioceptive cues are available than when the navigators receive vestibular cues only (e.g., driving or being pushed in a wheelchair). More specifically, path integration with proprioceptive cues may help build survey knowledge of the environment in which metric distance and direction between landmarks are represented. Overall, the existing data are indicative of path integration's contributions to large-scale navigation. This suggests that instead of dismissing it as too error-prone, path integration should be characterised as a fundamental mechanism of human navigation irrespective of the scale of a space in which it is carried out.

EcoMeditation Modifies Brain Resting State Network Activity.

Background: The tendency of the mind to wander, a characteristic of the brain's default mode network (DMN), correlates with increased unhappiness and self-referential processing and is a deterrent to establishing a consistent meditation practice. The objective of this study was to test the impact of a secular physiological method of meditation. We hypothesized that EcoMeditation would produce increases in neural communication in brain regions associated with compassion and prosociality and decreases in self-referencing networks, such as the DMN, and that these changes would be found in the experimental group, but not the control group. Methods: Participants (n=38) were randomized into two groups, and the final sample consisted of 25 participants. One group listened daily to a 22-minute EcoMeditation audio track, while the other used an active control. Functional magnetic resonance imaging (fMRI) was used to assess brain function before and after four weeks of practice. Mystical experiences, as well as psychological conditions, such as anxiety and depression, were measured. Results: Participants in the EcoMeditation group showed significantly increased connectivity between the bilateral hippocampus and the bilateral insula, compared to pre-intervention. In addition, significant decreases of connectivity between the bilateral hippocampus and the midprefrontal and left dorsolateral prefrontal cortices occurred. EcoMeditation participants also scored significantly higher for mystical experiences than the control group. The results for emotional states were mixed, with one assessment finding increased positive mood, but another finding increased negative affect. Conclusion: After only four weeks, participants using EcoMeditation demonstrated brain states similar to meditation adepts with thousands of hours of traditional practice.

Cerebellum and Emotion Processing.

Clinical examinations and neuroimaging investigations have dramatically changed the prevailing view of human cerebellar function and suggest contributions beyond movement control. Of these new views, perhaps the most intriguing proposal is that the cerebellum plays a key role in regulating emotion. According to the dysmetria of thought theory, the cerebellum provides accuracy, consistency and appropriateness to cognitive and affective functions, as it does for movement-related operations. Despite the value of a universal theory on cerebellar function, it is also essential to consider its unique contributions to specific functional domains. This chapter aims to provide an accentuated account of the cerebellar role in emotion processing by separately evaluating its impact for sub-components of emotion processing. These include physiological responses that contribute to the subjective or "feeling" component of emotion, emotional expressions that serve essential social-communicative functions, and the cognitive appraisal process that determines the emotional significance of events and therefore affects the generation and modulation of emotions.

Neural correlates associated with processing food stimuli in anorexia nervosa and bulimia nervosa: an activation likelihood estimation meta-analysis of fMRI studies.

PURPOSE: Various neurobiological models have utilised symptom categories to explore the underlying neural correlates in both anorexia nervosa (AN) and bulimia nervosa (BN). The aim of this research was to investigate the brain activity patterns associated with viewing food stimuli in anorexia nervosa and bulimia nervosa. METHODS: Electronic databases including PsycInfo and PubMed were systematically searched from data base inception until 1st of December 2020, identifying 14 suitable functional magnetic resonance imaging studies (fMRI), involving 470 participants. ALE meta-analysis was used to statistically analyse the overlap of activation foci from different fMRI studies in response to visual food stimuli. RESULTS: Comparing patients with AN with healthy control (HC), we detected hypoactivation in brain areas related to reward processing (i.e., amygdala and lentiform nucleus), and interoceptive processing (i.e., insula). In addition, patients with AN showed hyperactivations in cognitive control areas (i.e., prefrontal and anterior cingulate cortex). In contrast, patients with BN exhibited hyperactivations in brain areas related to reward processing (i.e., lentiform nucleus), and interoceptive processing (i.e., insula). Furthermore, patients with BN showed hypoactivations in brain regions associated with cognitive control (i.e., prefrontal and anterior cingulate cortex). CONCLUSIONS: Our study shows differing neural endotypes of the two types of eating disorders, that underpin their behavioural phenotypes. While exploratory in nature, these findings might be relevant for guiding new emerging therapies, including invasive and non-invasive neuromodulation techniques in treatment of eating disorders. LEVEL OF EVIDENCE: Level I, meta-analysis.

Doorways do not always cause forgetting: a multimodal investigation.

BACKGROUND: The 'doorway effect', or 'location updating effect', claims that we tend to forget items of recent significance immediately after crossing a boundary. Previous research suggests that such a forgetting effect occurs both at physical boundaries (e.g., moving from one room to another via a door) and metaphysical boundaries (e.g., imagining traversing a doorway, or even when moving from one desktop window to another on a computer). Here, we aimed to conceptually replicate this effect using virtual and physical environments. METHODS: Across four experiments, we measured participants' hit and false alarm rates to memory probes for items recently encountered either in the same or previous room. Experiments 1 and 2 used highly immersive virtual reality without and with working memory load (Experiments 1 and 2, respectively). Experiment 3 used passive video watching and Experiment 4 used active real-life movement. Data analysis was conducted using frequentist as well as Bayesian inference statistics. RESULTS: Across this series of experiments, we observed no significant effect of doorways on forgetting. In Experiment 2, however, signal detection was impaired when participants responded to probes after moving through doorways, such that false alarm rates were increased for mismatched recognition probes. Thus, under working memory load, memory was more susceptible to interference after moving through doorways. CONCLUSIONS: This study presents evidence that is inconsistent with the location updating effect as it has previously been reported. Our findings call into question the generalisability and robustness of this effect to slight paradigm alterations and, indeed, what factors contributed to the effect observed in previous studies.

Extrahippocampal contributions to spatial navigation in humans: A review of the neuroimaging evidence.

Spatial navigation is a crucial everyday skill, which when impaired leads to a significant decrease in quality of life. In humans, functional magnetic resonance imaging (fMRI) has provided extensive insights into the neural underpinnings of navigation skills. Whereas the hippocampus has been recognized as the prime region underpinning navigation abilities, by providing a cognitive map of the environment, imaging studies have also implicated a range of other brain regions. In this review, we provide an overview of the fMRI evidence for extrahippocampal contributions to spatial navigation. We show that the parahippocampal cortex, retrosplenial cortex, dorsal striatum, and the posterior parietal cortex provide important complementary functions, and ultimately form part of a functional network that regulates successful way-finding behavior.

The Role of Frontoparietal Cortex across the Functional Stages of Visual Search.

Areas in frontoparietal cortex have been shown to be active in a range of cognitive tasks and have been proposed to play a key role in goal-driven activities (Dosenbach, N. U. F., Fair, D. A., Miezin, F. M., Cohen, A. L., Wenger, K. K., Dosenbach, R. A. T., et al. Distinct brain networks for adaptive and stable task control in humans. Proceedings of the National Academy of Sciences, U.S.A., 104, 11073-11078, 2007; Duncan, J. The multiple-demand (MD) system of the primate brain: Mental programs for intelligent behavior. Trends in Cognitive Sciences, 14, 172-179, 2010). Here, we examine the role this frontoparietal system plays in visual search. Visual search, like many complex tasks, consists of a sequence of operations: target selection, stimulus-response (SR) mapping, and response execution. We independently manipulated the difficulty of target selection and SR mapping in a novel visual search task that involved identical stimulus displays. Enhanced activity was observed in areas of frontal and parietal cortex during both difficult target selection and SR mapping. In addition, anterior insula and ACC showed preferential representation of SR-stage information, whereas the medial frontal gyrus, precuneus, and inferior parietal sulcus showed preferential representation of target selection-stage information. A connectivity analysis revealed dissociable neural circuits underlying visual search. We hypothesize that these circuits regulate distinct mental operations associated with the allocation of spatial attention, stimulus decisions, shifts of task set from selection to SR mapping, and SR mapping. Taken together, the results show frontoparietal involvement in all stages of visual search and a specialization with respect to cognitive operations.

Behavioral and Neural Effects of Familiarization on Object-Background Associations.

Associative memory is the ability to link together components of stimuli. Previous evidence suggests that prior familiarization with study items affects the nature of the association between stimuli. More specifically, novel stimuli are learned in a more context-dependent fashion than stimuli that have been encountered previously without the current context. In the current study, we first acquired behavioral data from 62 human participants to conceptually replicate this effect. Participants were instructed to memorize multiple object-scene pairs (study phase) and were then tested on their recognition memory for the objects (test phase). Importantly, 1 day prior, participants had been familiarized with half of the object stimuli. During the test phase, the objects were either matched to the same scene as during study (intact pair) or swapped with a different object's scene (rearranged pair). Our results conceptually replicated the context-dependency effect by showing that breaking up a studied object-context pairing is more detrimental to object recognition performance for non-familiarized objects than for familiarized objects. Second, we used functional magnetic resonance imaging (fMRI) to determine whether medial temporal lobe encoding-related activity patterns are reflective of this familiarity-related context effect. Data acquired from 25 human participants indicated a larger effect of familiarization on encoding-related hippocampal activity for objects presented within a scene context compared to objects presented alone. Our results showed that both retrieval-related accuracy patterns and hippocampal activation patterns were in line with a familiarization-mediated context-dependency effect.

Explaining short-term memory phenomena with an integrated episodic/semantic framework of long-term memory.

Current thinking about human memory is dominated by distinctions between episodic and semantic memory and between short-term memory (STM) and long-term memory (LTM). However, many memory phenomena seem to cut across these distinctions. This article attempts to set the groundwork for the issues that need to be resolved in generating an integrated model of long-term memory that incorporates semantic, episodic, and short-term memory. We contrast Nairne's (2002, Annual Review of Psychology) consensus account of short-term memory with a relatively generic theory of an integrated episodic-semantic memory. The later consists primarily of a list of principles which we and others argue are necessary to include in any theory of long-term memory. We then add some more specific assumptions to outline a modern theory of forgetting. We then turn to the issue of much of the phenomena thought to necessitate a dedicated short-term memory can be explained by an integrated theory of episodic and semantic memory. Our conclusion is that an integrated theory of long-term memory must be augmented to explain a small number of outstanding memory phenomena. Finally, we ask whether the augmentation needs to involve a dedicated mnemonic system, or sensory or language-based systems, which also have mnemonic capabilities.