Preventing intrusive memories after trauma via a brief intervention involving Tetris computer game play in the emergency department: a proof-of-concept randomized controlled trial.

After psychological trauma, recurrent intrusive visual memories may be distressing and disruptive. Preventive interventions post trauma are lacking. Here we test a behavioural intervention after real-life trauma derived from cognitive neuroscience. We hypothesized that intrusive memories would be significantly reduced in number by an intervention involving a computer game with high visuospatial demands (Tetris), via disrupting consolidation of sensory elements of trauma memory. The Tetris-based intervention (trauma memory reminder cue plus c. 20 min game play) vs attention-placebo control (written activity log for same duration) were both delivered in an emergency department within 6 h of a motor vehicle accident. The randomized controlled trial compared the impact on the number of intrusive trauma memories in the subsequent week (primary outcome). Results vindicated the efficacy of the Tetris-based intervention compared with the control condition: there were fewer intrusive memories overall, and time-series analyses showed that intrusion incidence declined more quickly. There were convergent findings on a measure of clinical post-trauma intrusion symptoms at 1 week, but not on other symptom clusters or at 1 month. Results of this proof-of-concept study suggest that a larger trial, powered to detect differences at 1 month, is warranted. Participants found the intervention easy, helpful and minimally distressing. By translating emerging neuroscientific insights and experimental research into the real world, we offer a promising new low-intensity psychiatric intervention that could prevent debilitating intrusive memories following trauma.

Preparatory α-band oscillations reflect spatial gating independently of predictions regarding target identity.

Preparatory modulations of cortical α-band oscillations are a reliable index of the voluntary allocation of covert spatial attention. It is currently unclear whether attentional cues containing information about a target's identity (such as its visual orientation), in addition to its location, might additionally shape preparatory α modulations. Here, we explore this question by directly comparing spatial and feature-based attention in the same visual detection task while recording brain activity using magnetoencephalography (MEG). At the behavioral level, preparatory feature-based and spatial attention cues both improved performance and did so independently of each other. Using MEG, we replicated robust α lateralization following spatial cues: in preparation for a visual target, α power decreased contralaterally and increased ipsilaterally to the attended location. Critically, however, preparatory α lateralization was not significantly modulated by predictions regarding target identity, as carried via the behaviorally effective feature-based attention cues. Furthermore, nonlateralized α power during the cue-target interval did not differentiate between uninformative cues and cues carrying feature-based predictions either. Based on these results we propose that preparatory α modulations play a role in the gating of information between spatially segregated cortical regions and are therefore particularly well suited for spatial gating of information.NEW & NOTEWORTHY The present work clarifies if and how human brain oscillations in the α-band support multiple types of anticipatory attention. Using magnetoencephalography, we show that posterior α-band oscillations are modulated by predictions regarding the spatial location of an upcoming visual target, but not by feature-based predictions regarding its identity, despite robust behavioral benefits. This provides novel insights into the functional role of preparatory α mechanisms and suggests a limited specificity with which they may operate.

Differences between endogenous attention to spatial locations and sensory modalities.

Vibell et al. (J Cogn Neurosci 19:109-120, 2007) reported that endogenously attending to a sensory modality (vision or touch) modulated perceptual processing, in part, by the relative speeding-up of neural activation (i.e., as a result of prior entry). However, it was unclear whether it was the fine temporal discrimination required by the temporal-order judgment task that was used, or rather, the type of attentional modulation (spatial locations or sensory modalities) that was responsible for the shift in latencies that they observed. The present study used a similar experimental design to evaluate whether spatial attention would also yield similar latency effects suggestive of prior entry in the early visual P1 potentials. Intriguingly, while the results demonstrate similar neural latency shifts attributable to spatial attention, they started at a somewhat later stage than seen in Vibell et al.'s study. These differences are consistent with different neural mechanisms underlying attention to a specific sensory modality versus to a spatial location.

Inferring task-related networks using independent component analysis in magnetoencephalography.

A novel framework for analysing task-positive data in magnetoencephalography (MEG) is presented that can identify task-related networks. Techniques that combine beamforming, the Hilbert transform and temporal independent component analysis (ICA) have recently been applied to resting-state MEG data and have been shown to extract resting-state networks similar to those found in fMRI. Here we extend this approach in two ways. First, we systematically investigate optimisation of time-frequency windows for connectivity measurement. This is achieved by estimating the distribution of functional connectivity scores between nodes of known resting-state networks and contrasting it with a distribution of artefactual scores that are entirely due to spatial leakage caused by the inverse problem. We find that functional connectivity, both in the resting-state and during a cognitive task, is best estimated via correlations in the oscillatory envelope in the 8-20 Hz frequency range, temporally down-sampled with windows of 1-4s. Second, we combine ICA with the general linear model (GLM) to incorporate knowledge of task structure into our connectivity analysis. The combination of ICA with the GLM helps overcome problems of these techniques when used independently: namely, the interpretation and separation of interesting independent components from those that represent noise in ICA and the correction for multiple comparisons when applying the GLM. We demonstrate the approach on a 2-back working memory task and show that this novel analysis framework is able to elucidate the functional networks involved in the task beyond that which is achieved using the GLM alone. We find evidence of localised task-related activity in the area of the hippocampus, which is difficult to detect reliably using standard methods. Task-positive ICA, coupled with the GLM, has the potential to be a powerful tool in the analysis of MEG data.

Whole-brain white matter organization, intelligence, and educational attainment.

General cognitive ability, sometimes referred to as intelligence, is associated with educational attainment throughout childhood. Most studies that have explored the neural correlates of intelligence in childhood focus on individual brain regions. This analytical approach is designed to identify restricted sets of voxels that overlap across participants. By contrast, we explored the relationship between white matter connectome organization, intelligence, and education. In both a sample of typically-developing children (N = 63) and a sample of struggling learners (N = 139), the white matter connectome efficiency was strongly associated with intelligence and educational attainment. Further, intelligence partially mediated the relationship between connectome efficiency and educational attainment. In contrast, a canonical voxel-wise analysis failed to identify any significant relationships. The results emphasize the importance of distributed brain network properties for cognitive or educational ability in childhood. Our findings are interpreted in the context of a developmental theory, which emphasizes the interaction between different subsystems over developmental time.

The neural system of language: structure and development.

Recent neuroimaging and neuropsychological research in adults and infants suggests that the neural system for language is widely distributed and shares organizational principles with other cognitive systems in the brain. Connectionist modelling has clarified that networks operating with associative mechanisms can display properties typically associated with genetically predetermined and dedicated symbolic functions.

Modulation of brain activity by selective task sets observed using event-related potentials.

We investigated the ability of subjects to shift dynamically between selective task sets, using informative trial-by-trial cues. Two tasks were used which involved non-overlapping neural systems and different hemispheric specialization. In a verbal task, subjects decided whether a letter string was a real word or a non-word. In a spatial task, subjects decided whether an angle was acute or obtuse. A behavioural experiment showed that performance improved when cues predicted the upcoming task (80% validity), compared to when neutral cues did not afford selective task sets. Event-related potentials (ERPs) revealed brain activity related to forming selective task expectations, to switching tasks, and to the modulation of target processing as a function of such expectations and switches. Activity predicting the probable task started over parietal electrodes 160 ms after cue presentation, while activity related to task switching started at frontal electrodes around 280 ms. Both types of activities developed before target onset. Target processing was significantly influenced by the validity of the cue prediction, including strong modulation of language-related potentials. These results show that it is possible to switch dynamically between task sets involving distinct neural systems, even before the appearance of an imperative target stimulus, and that the nature of the task sets can influence neural activity related to task-set reconfiguration. Selective task sets can in turn modulate the processing of target stimuli. The effects also apply to the case of foveally presented words, whose processing has often been hypothesized to be automatic and outside the influence of selective attention.

Components of attentional set-switching.

A series of distinct event-related potentials (ERPs) have been recorded from the scalp of human subjects as they switch from one task to another. It is possible that task switching may depend on different mechanisms depending on whether the switch requires a change in attentional set, in other words the redirecting of attention to different aspects of a sensory stimulus, or whether it requires a change in intentional set, in others words a change in the way that responses are selected. To address this issue, the current study recorded ERPs while subjects switched between attentional sets and the results were compared with those of a previous investigation in which subjects switched between intentional sets. Subjects selected stimuli according to two conflicting attentional sets, each emphasizing one visual stimulus dimension (colour, shape). Pairs of stimuli, only one of which was to be attended, were presented for between eight and seventeen trials then either a switch or a stay cue was shown. The switch cue instructed subjects to switch from the current attentional set to the other set, while the stay cue instructed subjects to maintain the current set. Comparing ERPs time-locked to the switch and stay cues revealed neural correlates of the initiation of a task switch. Comparing the ERPs time locked to the first stimuli after either stay or switch cues identified neural correlates of the implementation of a task switch. A similar modulation over parietal electrodes was seen when subjects were switching between either attentional or intentional sets. While an intentional set switch began with a medial frontal modulation, attentional set switching began with a lateral frontal modulation. Implementing a new attentional set was associated with modulation of relatively early visual potentials, while implementing a new intentional set was associated with modulation of later response-related potentials. The results confirm that task switching consists of a number of constituent processes which may be taxed to different degrees depending on whether a task-switch paradigm requires subjects to change the way in which they select stimuli or responses.

The attentive homunculus: now you see it, now you don't.

The nature of the neural system that directs our attention toward selective items in the extrapersonal world is a longstanding and interesting puzzle. The ability to image the human brain at work non-invasively using positron-emission tomography or functional magnetic resonance has provided the means to investigate this issue. In this article, I review the contributions of brain imaging toward the characterization of attentional control in the human brain. The majority of experiments to date have investigated visual spatial orienting. A consistent pattern of brain areas has been revealed, comprising most notably the posterior parietal cortex around the intraparietal sulcus and frontal regions including the frontal eye fields. The brain areas implicated in the control of visual spatial attention were noted to resemble those involved in the control of eye movements, and direct experimental comparisons supported a tight link between the two systems. The findings suggested a sensible view of the attentional 'homunculus' as a distributed neural system related to the control of eye movements. Eye movements form perhaps the most basic orienting response, and can be shifted rapidly and efficiently based on multiple frames of reference. Some attention experiments using objects and features instead of spatial locations as the target of selection also obtained similar patterns of parietal-frontal activations, rendering further support to this view of the attentional control system. Some recent experiments, however, have cautioned against a premature conclusion regarding the ubiquity of the attentional control system revealed by studies of visual spatial attention. Different parietal and frontal regions become engaged when attention is shifted along non-spatial dimensions, such as when attention is directed toward a particular motor act or toward a specific point in time. In these cases, the neural system resembles those involved in the control of limb movements. The attentional homunculus thus begins to dissolve. The alternative view suggested is that attentional control may be a property of specialized parietal-frontal systems that transform perception into action. Future studies will be needed to validate this view of attention, or to provide a more mature understanding of its true nature.

Orienting attention to instants in time.

My colleagues and I have investigated whether the temporal framework can be used to guide selective attention, and have applied non-invasive methodology to reveal the brain systems and mechanisms involved. Our findings show that we are able to orient attention selectively to different points in time, enhancing behavioral performance. These effects are mediated by a left-hemisphere dominant parietal-frontal system, which partially overlaps with the networks involved in spatial orienting. The neural system for temporal orienting also includes brain areas associated with motor preparation and anticipation, suggesting that sensorimotor areas with different specializations can contribute to attentional orienting depending on the stimulus attributes guiding selection. The optimization of behavior by temporal orienting involves enhancement of the latency and amplitude of event-related potentials that are associated with motor responses and decisions. The effects are distinct from those during visual spatial attention, indicating that behavioral advantages can be conferred by multiple types of neural mechanisms. Taken together, the findings illustrate the flexibility of attentional functions in the human brain.