Have you been there before? Decoding recognition of spatial scenes from fMRI signals in precuneus.

One potential application of forensic "brain reading" is to test whether a suspect has previously experienced a crime scene. Here, we investigated whether it is possible to decode real life autobiographic exposure to spatial locations using fMRI. In the first session, participants visited four out of eight possible rooms on a university campus. During a subsequent scanning session, subjects passively viewed pictures and videos from these eight possible rooms (four old, four novel) without giving any responses. A multivariate searchlight analysis was employed that trained a classifier to distinguish between "seen" versus "unseen" stimuli from a subset of six rooms. We found that bilateral precuneus encoded information that can be used to distinguish between previously seen and unseen rooms and that also generalized to the two stimuli left out from training. We conclude that activity in bilateral precuneus is associated with the memory of previously visited rooms, irrespective of the identity of the room, thus supporting a parietal contribution to episodic memory for spatial locations. Importantly, we could decode whether a room was visited in real life without the need of explicit judgments about the rooms. This suggests that recognition is an automatic response that can be decoded from fMRI data, thus potentially supporting forensic applications of concealed information tests for crime scene recognition.

Posttraumatic stress disorder (PTSD) prevalence: an umbrella review.

Posttraumatic stress disorder (PTSD) is one of the most serious and incapacitating mental diseases that can result from trauma exposure. The exact prevalence of this disorder is not known as the literature provides very different results, ranging from 2.5% to 74%. The aim of this umbrella review is to provide an estimation of PTSD prevalence and to clarify whether the prevalence depends on the assessment methods applied (structured interview v. self-report questionnaire) and on the nature of the traumatic event (interpersonal v. not-interpersonal). A systematic search of major databases and additional sources (Google Scholar, EBSCO, Web of Science, PubMed, Galileo Discovery) was conducted. Fifty-nine reviews met the criteria of this umbrella review. Overall PTSD prevalence was 23.95% (95% confidence interval 95% CI 20.74-27.15), with no publication bias or significant small-study effects, but a high level of heterogeneity between meta-analyses. Sensitivities analyses revealed that these results do not change after removing meta-analysis also including data from underage participants (23.03%, 95% CI 18.58-27.48), nor after excluding meta-analysis of low quality (24.26%, 95% CI 20.46-28.06). Regarding the impact of diagnostic instruments on PTSD prevalence, the results revealed a lack of significant differences in PTSD prevalence when structured v. self-report instruments were applied (p = 0.0835). Finally, PTSD prevalence did not differ following event of intentional (25.42%, 95% CI 19.76-31.09) or not intentional (22.48%, 95% CI 17.22-27.73) nature (p = 0.4598). The present umbrella review establishes a robust foundation for future research and provides valuable insights on PTSD prevalence.

Does cognitive decline influence signing?

OBJECTIVE: The study explored the change in handwritten signature in neurodegenerative diseases by using of a rater-based approach. METHODS: Four independent observers were required to compare a pair of signatures (on average, 5 years elapsed between the two signatures) made by 103 patients (mean age 72 years) with Alzheimer's disease (AD) or frontotemporal dementia (FTD) and by 31 healthy participants (HC; mean age 73 years), judging their change according to a 0-1 rating scale (0 = similar or 1 = different). If a signature change was detected, the rater had also to report which signature features (spatial layout, omitted/added/switched letters or names, shape of letter, pen-flow) changed on the same 0-1 scale. For the AD and FTD groups, one signature was collected prior to the diagnosis of dementia, the other subsequent. RESULTS: A signature change was reported by raters in 36% of AD patients, 44% of FTD, and 17% of HC, with significant differences between both clinical groups and HC (vs. AD, p = .01; vs. FTD, p = .001). There was not a distinctive marker of the signature change (i.e., feature change) in patients with dementia. Moreover, the signature changes in neurological patients were unrelated to their clinical and demographic characteristics (age, sex, education, time elapsed between the two signatures, Mini-mental State Examination score). CONCLUSION: The findings suggest a resistance of handwritten signature in neurodegenerative diseases and in physiological aging, also suggesting that the signature may be an unreliable indicator of the cognitive status in AD and FTD, at least if subjectively evaluated.

Disentangling interoceptive abilities in alexithymia.

In recent years, research on interoceptive abilities (i.e., sensibility, accuracy, and awareness) and their associations with emotional experience has flourished. Yet interoceptive abilities in alexithymia-a personality trait characterized by a difficulty in the cognitive interpretation of emotional arousal, which impacts emotional experience-remain under-investigated, thereby limiting a full understanding of subjective emotional experience processing. Research has proposed two contrasting explanations thus far: in one model, the dimensions of interoceptive sensibility and accuracy in alexithymia would increase; in the other model, they would decrease. Surprisingly, the contribution of interoceptive awareness has been minimally researched. In this study (N = 182), the relationship between participants' level of alexithymia and the three interoceptive dimensions was tested. Our results show that the higher the level of alexithymia is, the higher interoceptive accuracy and sensibility (R2 = 0.29 and R2 = 0.14); conversely, the higher the level of alexithymia is, the lower interoceptive awareness (R2 = 0.36). Moreover, an ROC analysis reveals that interoceptive awareness is the most accurate predictor of alexithymia, yielding over 92% accuracy. Collectively, these results support a coherent understanding of interoceptive abilities in alexithymia, whereby the dissociation of interoceptive accuracy and awareness may explain the underlying psycho-physiological mechanisms of alexithymia. A possible neurocognitive mechanism is discussed which suggests insurgence of psychosomatic disorders in alexithymia and related psychotherapeutic approaches.

The detection of malingering in whiplash-related injuries: a targeted literature review of the available strategies.

OBJECTIVE: The present review is intended to provide an up-to-date overview of the strategies available to detect malingered symptoms following whiplash. Whiplash-associated disorders (WADs) represent the most common traffic injuries, having a major impact on economic and healthcare systems worldwide. Heterogeneous symptoms that may arise following whiplash injuries are difficult to objectify and are normally determined based on self-reported complaints. These elements, together with the litigation context, make fraudulent claims particularly likely. Crucially, at present, there is no clear evidence of the instruments available to detect malingered WADs. METHODS: We conducted a targeted literature review of the methodologies adopted to detect malingered WADs. Relevant studies were identified via Medline (PubMed) and Scopus databases published up to September 2020. RESULTS: Twenty-two methodologies are included in the review, grouped into biomechanical techniques, clinical tools applied to forensic settings, and cognitive-based lie detection techniques. Strengths and weaknesses of each methodology are presented, and future directions are discussed. CONCLUSIONS: Despite the variety of techniques that have been developed to identify malingering in forensic contexts, the present work highlights the current lack of rigorous methodologies for the assessment of WADs that take into account both the heterogeneous nature of the syndrome and the possibility of malingering. We conclude that it is pivotal to promote awareness about the presence of malingering in whiplash cases and highlight the need for novel, high-quality research in this field, with the potential to contribute to the development of standardised procedures for the evaluation of WADs and the detection of malingering.

A model to differentiate WAD patients and people with abnormal pain behaviour based on biomechanical and self-reported tests.

The prevalence of malingering among individuals presenting whiplash-related symptoms is significant and leads to a huge economic loss due to fraudulent injury claims. Various strategies have been proposed to detect malingering and symptoms exaggeration. However, most of them have been not consistently validated and tested to determine their accuracy in detecting feigned whiplash. This study merges two different approaches to detect whiplash malingering (the mechanical approach and the qualitative analysis of the symptomatology) to obtain a malingering detection model based on a wider range of indices, both biomechanical and self-reported. A sample of 46 malingerers and 59 genuine clinical patients was tested using a kinematic test and a self-report questionnaire asking about the presence of rare and impossible symptoms. The collected measures were used to train and validate a linear discriminant analysis (LDA) classification model. Results showed that malingerers were discriminated from genuine clinical patients based on a greater proportion of rare symptoms vs. possible self-reported symptoms and slower but more repeatable neck motions in the biomechanical test. The fivefold cross-validation of the LDA model yielded an area under the curve (AUC) of 0.84, with a sensitivity of 77.8% and a specificity of 84.7%.

Machine learning in liver transplantation: a tool for some unsolved questions?

Machine learning has recently been proposed as a useful tool in many fields of Medicine, with the aim of increasing diagnostic and prognostic accuracy. Models based on machine learning have been introduced in the setting of solid organ transplantation too, where prognosis depends on a complex, multidimensional and nonlinear relationship between variables pertaining to the donor, the recipient and the surgical procedure. In the setting of liver transplantation, machine learning models have been developed to predict pretransplant survival in patients with cirrhosis, to assess the best donor-to-recipient match during allocation processes, and to foresee postoperative complications and outcomes. This is a narrative review on the role of machine learning in the field of liver transplantation, highlighting strengths and pitfalls, and future perspectives.

Numerical Activities of Daily Living - Financial: a short version.

Financial capacity is the ability to manage money and finances according to a person's values and self-interests. In Italy, the first instrument specifically designed to assess financial capacity has recently been developed: the Numerical Activities of Daily Living - Financial (NADL-F). The aims of this study are (1) to prepare a shorter version of NADL-F and (2) to examine the relationship between the new short version and a measure of general cognitive functioning of comparable length, the MMSE. After an item analysis performed on NADL-F, the items presenting a higher internal consistency were selected. The resulting NADL-F Short is a reliable, easy to use, and quick to administer tool for assessing financial capacity both in clinical and legal practice. Correlation analysis showed a low positive correlation between four NADL-F Short tasks and the MMSE, for the healthy participants group. For the patient group, instead, a low-moderate correlation was found for all the NADL-F Short tasks, except one. Many participants scoring high in the MMSE (both healthy controls and neurological patients) showed low NADL-F Short scores. These findings suggest that it is not correct to use generic tools like the MMSE to make inferences on a person's financial capacity.

The detection of faked identity using unexpected questions and choice reaction times.

The identification of faked identities, especially within the Internet environment, still remains a challenging issue both for companies and researchers. Recently, however, latency-based lie detection techniques have been developed to evaluate whether the respondent is the real owner of a certain identity. Among the paradigms applied to this purpose, the technique of asking unexpected questions has proved to be useful to differentiate liars from truth-tellers. The aim of the present study was to assess whether a choice reaction times (RT) paradigm, combined with the unexpected question technique, could efficiently detect identity liars. Results demonstrate that the most informative feature in distinguishing liars from truth-tellers is the Inverse Efficiency Score (IES, an index that combines speed and accuracy) to unexpected questions. Moreover, to focus on the predictive power of the technique, machine-learning models were trained and tested, obtaining an out-of-sample classification accuracy of 90%. Overall, these findings indicate that it is possible to detect liars declaring faked identities by asking unexpected questions and measuring RTs and errors, with an accuracy comparable to that of well-established latency-based techniques, such as mouse and keystroke dynamics recording.

Detecting faking-good response style in personality questionnaires with four choice alternatives.

Deliberate attempts to portray oneself in an unrealistic manner are commonly encountered in the administration of personality questionnaires. The main aim of the present study was to explore whether mouse tracking temporal indicators and machine learning models could improve the detection of subjects implementing a faking-good response style when answering personality inventories with four choice alternatives, with and without time pressure. A total of 120 volunteers were randomly assigned to one of four experimental groups and asked to respond to the Virtuous Responding (VR) validity scale of the PPI-R and the Positive Impression Management (PIM) validity scale of the PAI via a computer mouse. A mixed design was implemented, and predictive models were calculated. The results showed that, on the PIM scale, faking-good participants were significantly slower in responding than honest respondents. Relative to VR items, PIM items are shorter in length and feature no negations. Accordingly, the PIM scale was found to be more sensitive in distinguishing between honest and faking-good respondents, demonstrating high classification accuracy (80-83%).

Past Life Experiences and Neurological Recovery: The Role of Cognitive Reserve in the Rehabilitation of Severe Post-Anoxic Encephalopathy and Traumatic Brain Injury.

OBJECTIVE: Patients with an equivalent clinical background may show unexpected interindividual differences in their outcome. The cognitive reserve (CR) model has been proposed to account for such discrepancies, but its role after acquired severe injuries is still being debated. We hypothesize that inappropriate investigative methods might have been used when dealing with severe patients, which have very likely reduced the possibility of observing meaningful influences in recovery from severe traumas. METHODS: To overcome this issue, the potential neuroprotective role of CR was investigated, considering a wider spectrum of clinical symptoms ranging from low-level brain stem functions necessary for life to more complex motor and cognitive skills. In the present study, data from 50 severe patients, 20 suffering from post-anoxic encephalopathy (PAE) and 30 with traumatic brain injury (TBI), were collected and retrospectively analyzed. RESULTS: We found that CR, diagnosis, time of hospitalization, and their interaction had an effect on the clinical indexes. When the predictive power of CR was investigated by means of two machine learning classifier algorithms, CR, together with age, emerged as the strongest factor in discriminating between patients who reached or did not reach successful recovery. CONCLUSIONS: Overall, the present study highlights a possible role of CR in shaping the recovery of severe patients suffering from either PAE or TBI. The practical implications underlying the need to routinely considered CR in the clinical practice are discussed.

Memory performance predicts interrogative suggestibility better than global cognition in older adults with subjective cognitive complaints.

The present study aims to investigate to which extent global cognition and verbal memory can estimate interrogative suggestibility (IS) in elderly people with subjective cognitive complaints (SCCs). We used the Gudjonsson Suggestibility Scale (GSS 2) subscales (i.e., Yield 1, Yield 2 and Shift) as measures of IS. Data from a sample of consecutive patients (N = 94) who referred to neuropsychology units for the first time were collected. Our results showed that verbal memory is a better predictor of IS than global cognition. Moreover, memory impairment led to significantly higher IS independently of global cognitive status. These findings suggest that the assessment of verbal memory allows to estimate individual levels of IS better than global cognition, even in elders with objective cognitive deficits. Implications for forensic assessment of senior witnesses are discussed.

Lessons for the courtroom from the study of Flashbulb memory: an integrative review.

In legal proceedings, when no corroboration is possible with external sources of evidence, judges and jurors derive from their own experience the criteria to ascertain if a memory report is accurate and a witness credible. These legal criteria closely resemble the aspects traditionally investigated by literature on Flashbulb memory (i.e., consistency, confidence, quantity), but have failed to obtain a generalised consensus within the scientific community. Drawing up a set of univocal rules upon which to base a conclusion regarding witnesses' credibility is a difficult task, from both legal and scientific points of view. Respectful cooperation between cognitive science and criminal law will encompass both technical support by expert witnesses, and updating guidelines for fact-finders. This cooperation would prevent the risk of common sense fallacies in the legal process, preserving the legal autonomy to evaluate witness credibility.

Measuring the flashbulb-like nature of memories for private events: the flashbulb memory checklist.

What do we remember following an emotionally charged event? The assessment of memory characteristics for an emotional event represents one of the most challenging issues in the domain of autobiographical memory. Literature of flashbulb memories (FBMs) provides a crucial contribution on this issue: Following an emotional and unexpected public event, people remember not only central details of the episode, but also irrelevant, peripheral and idiosyncratic details of the reception context in which they learned of the news. The present study was set up to assess the factorial structure (samples 1 and 2) and convergent validity (sample 2) of an FBM checklist, an instrument designed to measure Flashbulb-like features of memories for emotional private events. Factorial analyses account for an oblique two-factor solution - FBM Specificity and Confidence - while correlational analyses support the convergent validity of this instrument. Practical implications are discussed, especially for the credibility assessment of witnesses of emotional events in forensic settings.

A novel methodology for the objective ascertainment of psychic and existential damage.

Personal injury is a legal term for a physical or psychic injury suffered by the plaintiff under civil and/or tort law. With reference to non-pecuniary damages, the evidence itself of physical and/or psychic injury is not sufficient for damage compensation. The process of ascertaining impairments and/or disabilities which pertain to the "personal sphere" of the individual, such as pain and suffering, loss of amenity, and/or psycho-existential damage, poses particular difficulties in relation to the obtainment of scientific evidence. The "immateriality" and the subjective connotation of the personal sphere are, in themselves, critical issues. The clinical data obtained from the neuropsychological ascertainment find their essential prerequisite in the active participation of the examinee who, in legally relevant contexts (criminal law, civil law, insurance), may be "affected" by personal interests. The present manuscript presents a novel interdisciplinary methodology, experimented on a series of judicial and extra-judicial cases, aimed at the attainment of objectivity and accuracy eligible in relation to the judicial settlement of cases and other matters involving the ascertainment of peculiar aspects of non-pecuniary damage.

Flashbulb memories of the Pope's resignation: explicit and implicit measures across differing religious groups.

In the present paper, we aimed to provide evidence in support of the idea tested in a recent study by Lanciano and colleagues that flashbulb memories (FBMs) are a special class of autobiographical memories that can be assessed through the autobiographical implicit association test (aIAT). FBMs and event memories (EMs) for the news of the resignation of Pope Benedict XVI were evaluated in three samples of churchgoer Catholic, non-churchgoer Catholic and Evangelical Italian participants through the traditional self-report measures (specificity/accuracy, confidence, consistency) and aIAT indices. Results confirmed the strength of the association between FBM and true information. The aIAT effect was stronger for FBMs than for EM details, and for Catholic respondents who were the group most concerned by the original event. Furthermore, the use of implicit measures for memory assessment concurs with the traditional self-report indices of FBMs. The present evidence supports the idea that FBMs are special autobiographical memories which remain detailed, certain and consistent over time.

Transcranial direct current stimulation and cognitive training in the rehabilitation of Alzheimer disease: A case study.

In the present study we tested the cognitive effects of transcranial direct current stimulation (tDCS) in a case of probable Alzheimer disease (AD). The patient (male, 60 years, mild AD) underwent two cycles of treatments, separated by 2 months. In the first cycle, active stimulation (10 sessions, 2 mA for 20 min; anode over the left dorsolateral prefrontal cortex) was followed by computerised tasks (CTs) specifically chosen to engage the most impaired cognitive processes in the patient (tDCS+CT condition). In the second cycle, which was structured as the first, CTs were administered after placebo stimulation (sham+CT condition). Effects on cognitive performance were evaluated not only by the CTs, but also by neuropsychological tests assessing global cognitive functioning. Statistical analyses revealed that whereas the tDCS+CT condition had few effects on the CTs, it induced a stability of the patient's global cognitive functioning lasting approximately 3 months, which was not achieved when the patient underwent sham+CT condition. Therefore, the synergetic use of tDCS and CTs appeared to slow down the cognitive decline of our patient. This preliminary result, although in need of further confirmation, suggests the potentiality of tDCS as an adjuvant tool for cognitive rehabilitation in AD.

Detecting lies in investigative interviews through the analysis of response latencies and error rates to unexpected questions.

In this study, we propose an approach to detect deception during investigative interviews by integrating response latency and error analysis with the unexpected question technique. Sixty participants were assigned to an honest (n = 30) or deceptive group (n = 30). The deceptive group was instructed to memorize the false biographical details of a fictitious identity. Throughout the interviews, participants were presented with a randomized sequence of control, expected, and unexpected open-ended questions about identity. Responses were audio recorded for detailed examination. Our findings indicate that deceptive participants showed markedly longer latencies and higher error rates when answering expected (requiring deception) and unexpected questions (for which premeditated deception was not possible). Longer response latencies were also observed in participants attempting deception when answering control questions (which necessitated truthful answers). Moreover, a within-subject analysis highlighted that responding to unexpected questions significantly impaired individuals' performance compared to answering control and expected questions. Leveraging machine-learning algorithms, our approach attained a classification accuracy of 98% in distinguishing deceptive and honest participants. Additionally, a classification analysis on single response levels was conducted. Our findings underscore the effectiveness of merging response latency metrics and error rates with unexpected questioning as a robust method for identity deception detection in investigative interviews. We also discuss significant implications for enhancing interview strategies.

Autobiographical Implicit Association Test and eye movements: fixations topography enables detection of autobiographical memories.

Introduction: Autobiographical memory is the capacity to recollect memories of personally experienced events. The detection of such memories plays a key role in criminal trials. Among behavioral memory-detection methods, the autobiographical Implicit Association Test (aIAT) has gained popularity for its flexibility and suitability for forensic applications. The aIAT is a reaction time-based methodology aiming to assess whether information about an event is encoded in the respondent's mind. Here, we introduced the eye-D index, a measure based on the topography of fixations while performing the aIAT, as an additional measure to detect autobiographical memories covertly. Methods: In this study, participants were involved in a mock-crime experiment in which they could act as Guilty or Innocent. One week later all participants underwent the aIAT combined with eye-tracking to investigate the presence of the crime-related memory. Results: Guilty participants showed a higher number of fixations towards the category labels in the block in which true sentences shared the same response key with crime-related sentences, as compared to the block in which true sentences were paired with sentences describing an alternative version. Innocent participants showed the opposite pattern. This unbalanced allocation of attention to the category labels was quantified by the eye-D index and was found to be highly correlated to the standard aIAT-D index. Discussion: This suggests that more fixations to the category labels could indicate increased cognitive load and monitoring of response conflicts. These preliminary results highlight eye-tracking as a tool to detect autobiographical memories covertly while performing the aIAT.

Top-down modulation of brain activity underlying intentional action and its relationship with awareness of intention: an ERP/Laplacian analysis.

Intentional actions are executed with the peculiar experience of "I decide to do that." It has been proposed that intentional actions involve a specific brain network involving the supplementary motor areas (SMAs). Here, we manipulated the internal representation participants attended to (intention vs. movement) in order to (1) examine the activity of SMAs and of the primary motor cortex (M1) during intentional action preparation and execution, and (2) investigate the temporal relationship between activity in these structures and intention awareness. Participants performed self-paced key presses. After each key press, participants were asked to report either the time they had the first intention to press the key (W-condition) or the time they actually started the movement (M-condition). We then estimated surface Laplacians from brain electrical potentials recorded while participants were performing the task. Activity in SMAs was greater in the W-condition than in the M-condition more than 1 s before electromyographic (EMG) activation, suggesting that this region is indeed associated to the formation of conscious intention. Conversely, activity in primary motor cortex (M1) contralateral to the responding hand was larger in the M-condition than in the W-condition, revealing that this region is also modulated by top-down processes. In addition, waveforms time-locked to the W-judgement revealed that M1 as well as EMG activation preceded the time at which participants become aware of their intention by about 0.3 s. This observation argues against the possibility that the temporal delay between motor-related activation and intention awareness results from smearing artifacts.