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It was with the promise of rendering an experimental approach to consciousness that psychology started its trajectory as an independent science more than 150 years ago. Here, we will posit that the neurosciences were instrumental in leading psychology to resume the study of consciousness by projecting an empirical agenda for the future. First, we will start by showing how scientists were able to venture into the consciousness of supposedly unconscious patients, opening the door for the identification of important neural correlates of distinct consciousness states. Then, we will describe how different technological advances and elegant experimental paradigms helped in establishing important neuronal correlates of global consciousness (i.e., being conscious at all), perceptual consciousness (i.e., being conscious of something), and self-consciousness (i.e., being conscious of itself). Finally, we will illustrate how the study of complex consciousness experiences may contribute to the clarification of the mechanisms associated with global consciousness, the relationship between perceptual and self-consciousness, and the interface among distinct self-consciousness domains. In closing, we will elaborate on the road ahead of us for re-establishing psychology as a science of consciousness.
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Standardized Emotion Elicitation Databases (SEEDs) allow studying emotions in laboratory settings by replicating real-life emotions in a controlled environment. The International Affective Pictures System (IAPS), containing 1182 coloured images as stimuli, is arguably the most popular SEED. Since its introduction, multiple countries and cultures have validated this SEED, making its adoption on the study of emotion a worldwide success. For this review, 69 studies were included. Results focus on the discussion of validation processes by combining self-report and physiological data (Skin Conductance Level, Heart Rate Variability and Electroencephalography) and self-report only. Cross-age, cross-cultural and sex differences are discussed. Overall, IAPS is a robust instrument for emotion elicitation around the world.
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Nivel de Alerta , Emociones , Humanos , Masculino , Femenino , Nivel de Alerta/fisiología , Estimulación Luminosa/métodos , Emociones/fisiología , Frecuencia Cardíaca/fisiología , Caracteres SexualesRESUMEN
Background: Major depressive disorder (MDD) is a serious mood disorder and leading cause of disability. Despite treatment advances, approximately 30% of individuals with MDD do not achieve adequate clinical response. Better understanding the biological mechanism(s) underlying clinical response to specific psychopharmacological interventions may help fine tune treatments in order to further modulate their underlying mechanisms of action. However, little is known regarding the effect of non-pharmacological treatments (NPTs) on candidate molecular biomarker levels in MDD. This review aims to identify molecular biomarkers that may elucidate NPT response for MDD. Methods: We performed a systematic review and a multilevel linear mixed-effects meta-analyses, and a meta-regression. Searches were performed in PubMed, Scopus, and PsycINFO in October 2020 and July 2021. Results: From 1387 retrieved articles, 17 and six studies were included in the systematic review and meta-analyses, respectively. Although there was little consensus associating molecular biomarker levels with symptomology and/or treatment response, brain metabolites accessed via molecular biomarker-focused neuroimaging techniques may provide promising information on whether an individual with MDD would respond positively to NPTs. Furthermore, non-invasive brain stimulation interventions significantly increased the expression of neurotrophic factors (NTFs) compared to sham/placebo, regardless of add-on pharmacological treatment. Conclusions: NTFs are candidate biomarkers to fine-tune NIBS for MDD treatment.
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The ability to empathize with another person's inner experience is believed to be a central element of our social interactions. Previous research has focused on cognitive (e.g., theory of mind) and emotional (e.g., emotional contagion) empathy, and less on behavioral factors (i.e., the ability to respond empathically). Recent studies suggest that the Default Mode Network (DMN) mediates individual variability in distinct empathy-related behaviors. However, little is known about DMN activity during actual empathic responses, understood in this study as the ability to communicate our understanding of the others' experience back to them. This study used an empathy response paradigm with 28 participants (22-37 years old) to analyze the relationship between the quality of empathic responses to 14 empathy-eliciting vignettes and patterns of attenuation in the DMN. Overall, the results suggest that high levels of empathic response, are associated with sustained activation of the DMN when compared with lower levels of empathy. Our results demonstrate that the DMN becomes increasingly involved in empathy-related behavior, as our level of commitment to the other's experience increases. This study represents a first attempt to understand the relation between the capacity for responding in a supportive way to others' needs and the intra-individual variability of the pattern of the DMN attenuation. Here we underline the critical role that the DMN plays in high-level social cognitive processes and corroborate the DMN role in different psychiatric disorders associated with a lack of empathy.
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Background/Objective: Anxiety disorders are highly prevalent and negatively impact daily functioning and quality of life. Transcranial direct current stimulation (tDCS) targeting the dorsolateral prefrontal cortex (dlPFC), especially in the right hemisphere impacts extinction learning; however, the underlying neural mechanisms are elusive. Therefore, we aimed to investigate the effects of cathodal tDCS stimulation to the right dlPFC on neural activity and connectivity patterns during delayed fear extinction in healthy participants. Methods: We conducted a two-day fear conditioning and extinction procedure. On the first day, we collected fear-related self-reports, clinical questionnaires, and skin conductance responses during fear acquisition. On the second day, participants in the tDCS group (n = 16) received 20-min offline tDCS before fMRI and then completed the fear extinction session during fMRI. Participants in the control group (n = 18) skipped tDCS and directly underwent fMRI to complete the fear extinction procedure. Whole-brain searchlight classification and resting-state functional connectivity analyses were performed. Results: Whole-brain searchlight classification during fear extinction showed higher classification accuracy of threat and safe cues in the left anterior dorsal and ventral insulae and hippocampus in the tDCS group than in the control group. Functional connectivity derived from the insula with the dlPFC, ventromedial prefrontal cortex, and inferior parietal lobule was increased after tDCS. Conclusion: tDCS over the right dlPFC may function as a primer for information exchange among distally connected areas, thereby increasing stimulus discrimination. The current study did not include a sham group, and one participant of the control group was not randomized. Therefore, to address potential allocation bias, findings should be confirmed in the future with a fully randomized and sham controlled study.
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Neurofeedback and transcranial Direct Current Stimulation (tDCS) are promising techniques for neuroenhancement of attentional performance. As far as we know no study compared both techniques on attentional performance in healthy participants. We compared tDCS and neurofeedback in a randomized, single-blind, controlled experiment assessing both behavioral (accuracy and time reaction) and electrophysiological (N1, P1, and P3 components) data of participants responding to the Attention Network Task (ANT). Eighty volunteers volunteered for this study. We adopted standard protocols for both techniques, i.e., a Sensorimotor Rhythm (SMR) protocol for neurofeedback and the right DLPFC anodal stimulation for tDCS, applied over nine sessions (two weeks). We did not find significant differences between treatment groups on ANT, neither at the behavioral nor at the electrophysiological levels. However, we found that participants from both neuromodulation groups, irrespective of if active or sham, reported attentional improvements in response to the treatment on a subjective scale. Our study adds another null result to the neuromodulation literature, showing that neurofeedback and tDCS effects are more complex than previously suggested and associated with placebo effect. More studies in neuroenhancement literature are necessary to fully comprehend neuromodulation mechanisms.
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Neurorretroalimentación , Estimulación Transcraneal de Corriente Directa , Humanos , Estimulación Transcraneal de Corriente Directa/métodos , Neurorretroalimentación/métodos , Método Simple Ciego , Tiempo de Reacción/fisiología , Voluntarios SanosRESUMEN
Several cognitive training programs, alone or in combination with non-invasive brain stimulation have been tested in order to ameliorate age-related cognitive impairments, such as the ones found in Mild Cognitive Impairment (MCI). However, the effects of Cognitive Training (CT)-combined or not-with several forms of non-invasive brain stimulation have been modest at most. We aim to assess if Speed of Processing (SoP) training combined with alpha transcranial alternating current stimulation (α-tACS) is able to increase speed of processing as assessed by the Useful Field of View (UFOV), when comparing to SoP training or active α-tACS alone. Moreover, we want to assess if those changes in speed of processing transfer to other cognitive domains, such as memory, language and executive functioning by using the NIH EXAMINER. We also want to test the mechanisms underlying these interventions, namely brain connectivity and coherence as assessed by electroencephalography (EEG). To that purpose, our proposal is to enroll 327 elders diagnosed with MCI in a double-blinded, parallel randomized clinical trial assessing the effects of combining SoP with alpha endogenous tACS (either active or sham) in people with MCI. Participants will perform an intervention that will last for 15 sessions. For the first 3 weeks, participants will receive nine sessions of the intervention, and then will receive two sessions per week (i.e., booster) for the following 3 weeks. They will then be assessed at 1, 3, and 6 months after the intervention has ended. This will allow us to detect the immediate, and long-term effects of the interventions, as well as to probe the mechanisms underlying its effects. Clinical Trial Registration: Clinicaltrials.gov, Identifier: NCT05198726.
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BACKGROUND: Machine learning modeling can provide valuable support in different areas of mental health, because it enables to make rapid predictions and therefore support the decision making, based on valuable data. However, few studies have applied this method to predict symptoms' worsening, based on sociodemographic, contextual, and clinical data. Thus, we applied machine learning techniques to identify predictors of symptomatologic changes in a Spanish cohort of OCD patients during the initial phase of the COVID-19 pandemic. METHODS: 127 OCD patients were assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and a structured clinical interview during the COVID-19 pandemic. Machine learning models for classification (LDA and SVM) and regression (linear regression and SVR) were constructed to predict each symptom based on patient's sociodemographic, clinical and contextual information. RESULTS: A Y-BOCS score prediction model was generated with 100% reliability at a score threshold of ± 6. Reliability of 100% was reached for obsessions and/or compulsions related to COVID-19. Symptoms of anxiety and depression were predicted with less reliability (correlation R of 0.58 and 0.68, respectively). The suicidal thoughts are predicted with a sensitivity of 79% and specificity of 88%. The best results are achieved by SVM and SVR. CONCLUSION: Our findings reveal that sociodemographic and clinical data can be used to predict changes in OCD symptomatology. Machine learning may be valuable tool for helping clinicians to rapidly identify patients at higher risk and therefore provide optimized care, especially in future pandemics. However, further validation of these models is required to ensure greater reliability of the algorithms for clinical implementation to specific objectives of interest.
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Transcranial direct current stimulation (tDCS) has been studied to enhance extinction-based treatments for anxiety disorders. However, the field shows conflicting results about its anxiolytic effect and only a few studies have observed the extinction of consolidated memories. We looked to study the effect of offline 1 mA tDCS over the right dorsolateral pre-frontal cortex across the fear pathways, in consolidated fear response during delayed extinction. Participants (N = 34 women) underwent in a two-day fear conditioning procedure. On day 1, participants were assigned to the control group (N = 18) or the tDCS group (N = 16) and went through a fear acquisition procedure. On day 2, the tDCS group received 20 min tDCS before extinction and while inside the MRI scanner. The control group completed the extinction procedure only. The tDCS session (for the tDCS group) and the fMRI scan (for both groups) were completed just on the second day. Univariate fMRI analysis showed stimulation-dependent activity during late extinction with the tDCS group showing decreased neural activity during the processing of threat cues (CS +) and increased activity during the processing of safety cues (CS -), in prefrontal, postcentral and paracentral regions, during late extinction. ROI to whole-brain psychophysiological interaction (PPI) analysis showed the tDCS effect on the connectivity between the left dorsolateral prefrontal cortex three cortical-amygdalo-hippocampal-cerebellar pathway clusters during the processing of the CS + in late extinction (TFCE corrected; p < 0.05). Increased neuronal activity during the processing of safety cues and stronger coupling during the processing of threat cues might be the mechanisms by which tDCS contributes to stimuli discrimination.
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Estimulación Transcraneal de Corriente Directa , Cerebelo , Extinción Psicológica , Miedo , Femenino , Humanos , Imagen por Resonancia Magnética , Corteza PrefrontalRESUMEN
Transcranial direct current stimulation (tDCS) has been widely used to modulate cognition and behavior. However, only a few studies have been probing the brain mechanism underlying the effects of tDCS on cognitive processing, especially throughout electrophysiological markers, such as the P3. This meta-analysis assessed the effects of tDCS in P3 amplitude and latency during an oddball, n-back, and Go/No-Go tasks, as well as during emotional processing. A total of 36 studies were identified, but only 23 were included in the quantitative analysis. The results show that the parietal P3 amplitude increased during oddball and n-back tasks, mostly after anodal stimulation over the left dorsolateral prefrontal cortex (p = 0.018, SMD = 0.4) and right inferior frontal gyrus (p < 0.001, SMD = 0.669) respectively. These findings suggest the potential usefulness of the parietal P3 ERP as a marker of tDCS-induced effects during task performance. Nonetheless, this study had a low number of studies and the presence of considerable risk of bias, highlighting issues to be addressed in the future.
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Estimulación Transcraneal de Corriente Directa , Cognición/fisiología , Potenciales Evocados/fisiología , Humanos , Corteza Prefrontal/fisiología , Estimulación Transcraneal de Corriente Directa/métodosRESUMEN
Attention is a complex cognitive process that selects specific stimuli for further processing. Previous research suggested the existence of three attentional networks: alerting, orienting and executive. However, one important topic is how to enhance the efficiency of attentional networks. In this context, understanding how this system behaves under two different modulatory conditions, namely transcranial direct current stimulation (tDCS) and transcranial Random Noise Stimulation (tRNS), will provide important insights towards the understanding of the attention network system. Twenty-seven healthy students took part on a randomized single-blinded crossover study, testing the effects that involved three modalities of unilateral stimulation (tRNS, anodal tDCS, and sham) over the DLPFC, during the performance of the attention network test (ANT) in three different conditions: standard, speed and accuracy. Results showed that tRNS was able to increase attention during more complex situations, namely by increasing alerting and decreasing conflict effect in the executive network. Under the Speed condition, tRNS increased efficiency of the alerting network, as well as under the more demanding conflict network, tRNS overall increased the performance when comparing to sham. No statistical significant effects of tDCS were observed. These results are compatible with the attention requiring the synchronization of pre-existing networks, rather the reinforcement or creation of new pathways.
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Atención/fisiología , Función Ejecutiva/fisiología , Vías Nerviosas/fisiología , Orientación/fisiología , Corteza Prefrontal/fisiología , Adolescente , Adulto , Estudios Cruzados , Femenino , Humanos , Masculino , Ruido , Estimulación Transcraneal de Corriente Directa/métodosRESUMEN
Callous-unemotional (CU) traits observed during childhood and adolescence are thought to be precursors of psychopathic traits in adulthood. Adults with high levels of psychopathic traits typically present antisocial behavior. Such behavior can be indicative of atypical moral processing. Evidence suggests that moral dysfunction in these individuals may stem from a disruption of affective components of moral processing rather than from an inability to compute moral judgments per se. No study to date has tested if the dissociation between affective and cognitive dimensions of moral processing linked to psychopathic traits in adulthood is also linked to CU traits during development. Here, 47 typically developing adolescents with varying levels of CU traits completed a novel, animated cartoon task depicting everyday moral transgressions and indicated how they would feel in such situations and how morally wrong the situations were. Adolescents with higher CU traits reported reduced anticipated guilt and wrongness appraisals of the transgressions. However, our key finding was a significant interaction between CU traits and anticipated guilt in predicting wrongness judgments. The strength of the association between anticipated guilt and wrongness judgement was significantly weaker for those with higher levels of CU traits. This evidence extends our knowledge on the cognitive-affective processing deficits that may underlie moral dysfunction in youth who are at heightened risk for antisocial behavior and psychopathy in adulthood. Future longitudinal research is required to elucidate whether there is an increased dissociation between different components of moral processing from adolescence to adulthood for those with high psychopathic traits.
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Functional connectivity (FC) is typically altered in individuals with Multiple Sclerosis (MS). However, in relapsing-remitting multiple sclerosis (RRMS) patients, the relationship between brain FC, tissue integrity and cognitive impairment is still unclear as contradictory findings have been documented. In this exploratory study we compared both the whole brain connectome and resting state networks (RSNs) FC of twenty-one RRMS and seventeen healthy controls (HCs), using combined network based statistics and independent component analyses. The total white matter (WM) lesion volume and information processing efficiency were also correlated with FC in the RRMS group. Both whole brain connectome and individual RSNs FC were diminished in patients with RRMS compared to HC. Additionally, the reduction in FC was found to be a function of the total WM lesion volume, with greatest impact in those harboring the largest lesion volume. Finally, a positive correlation between FC and information processing efficiency was observed in RRMS. This complimentary whole brain and RSNs FC approach can contribute to clarify literature inconsistencies regarding FC alterations and provide new insights on the white matter structural damage in explaining functional abnormalities in RRMS.
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Esclerosis Múltiple Recurrente-Remitente , Esclerosis Múltiple , Sustancia Blanca , Encéfalo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Esclerosis Múltiple/diagnóstico por imagen , Esclerosis Múltiple Recurrente-Remitente/diagnóstico por imagen , Sustancia Blanca/diagnóstico por imagenRESUMEN
Background: Major Depressive Disorder (MDD) affects more than 264 million people worldwide. Current treatments include the use of psychotherapy and/or drugs, however ~30% of patients either do not respond to these treatments, or do not tolerate the side effects associated to the use of pharmacological interventions. Thus, it is important to study non-pharmacological interventions targeting mechanisms not directly involved with the regulation of neurotransmitters. Several studies demonstrated that transcranial Direct Current Stimulation (tDCS) can be effective for symptoms relief in MDD. However, tDCS seems to have a better effect when used as an add-on treatment to other interventions. Methods/Design: This is a study protocol for a parallel, randomized, triple-blind, sham-controlled clinical trial in which a total of 90 drug-naïve, first-episode MDD patients (45 per arm) will be randomized to one of two groups to receive a 6-weeks of CBT combined with either active or sham tDCS to the dorsolateral prefrontal cortex (DLPFC). The primary outcome will depressive symptoms improvement as assessed by the Montgomery-Asberg Depression Rating Scale (MADRS) at 6-weeks. The secondary aim is to test whether CBT combined with tDCS can engage the proposed mechanistic target of restoring the prefrontal imbalance and connectivity through the bilateral modulation of the DLPFC, as assessed by changes over resting-state and emotional task eliciting EEG. Discussion: This study evaluates the synergetic clinical effects of CBT and tDCS in the first episode, drug-naïve, patients with MDD. First episode MDD patients provide an interesting opportunity, as their brains were not changed by the pharmacological treatments, by the time course, or by the recurrence of MDD episodes (and other comorbidities). Trial Registration: This study is registered with the United States National Library of Medicine Clinical Trials Registry (NCT03548545). Registered June 7, 2018, clinicaltrials.gov/ct2/show/NCT03548545. Protocol Version 1.
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Previous research showed that the ability to make inferences about our own and other's mental states rely on common brain pathways; particularly in the case of close relationships (e.g., romantic relationships). Despite the evidence for shared neural representations of self and others, less is known about the distributed processing within these common neural networks, particularly whether there are specific patterns of internode communication when focusing on other vs. self. This study aimed to characterize context-sensitive coupling among social brain regions involved in self and other understanding. Participants underwent an fMRI while watching emotional video vignettes of their romantic partner and elaborated on their partner's (other-condition) or on their own experience (self-condition). We used dynamic causal modeling (DCM) to quantify the associated changes in effective connectivity (EC) in a network of brain regions involved in social cognition including the temporoparietal junction (TPJ), the posterior cingulate (PCC)/precuneus and middle temporal gyrus (MTG). DCM revealed that: the PCC plays a central coordination role within this network, the bilateral MTG receives driving inputs from other nodes suggesting that social information is first processed in language comprehension regions; the right TPJ evidenced a selective increase in its sensitivity when focusing on the other's experience, relative to focusing on oneself.
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Precedent: Impairments in executive functioning may be associated with compulsive symptoms in Obsessive Compulsive Disorder (OCD). The aim of this study was to conduct a systematic review of cognitive flexibility, inhibitory control and working memory in OCD patients, using emotional and non-emotional paradigms. METHOD: we reviewed research published in PubMed, Web of Science, PsychInfo, Scopus, Scielo, and ProQuest Psychology databases, from January 2008 to April 2019. The review followed a two-stage process. In the first stage, we selected only studies using neutral stimuli paradigms, while in the second we selected executive-emotional paradigms. RESULTS: The first stage of the review provided 16 final results, while the second stage, with emotional stimuli, provided 3 results. CONCLUSIONS: There is some initial evidence for the existence of executive impairments in OCD, as expressed in the performance and/or processing of working memory inhibitory control and cognitive flexibility. There is also initial evidence that these latter two could be modulated by the presentation or mental representation of negative valence stimuli or images, as well as the presence of aversive contingencies.
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Cognición , Emociones , Función Ejecutiva , Inhibición Psicológica , Memoria a Corto Plazo , Trastorno Obsesivo Compulsivo/psicología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Affective touch activates a brain network responsible for processing social-emotional stimuli in infants, children, and adults, with a core node in the superior temporal sulcus (STS). STS is known to be a region highly susceptible to individual variability, including for tactile stimuli processing. However, little is known about how this region is recruited to process affective touch in infancy. The aim of this study was to examine brain activity to affective touch in the temporal region (STS) and understand if it relates to behavioral patterns of sensory-over responsivity (SOR) to touch. Twelve-month-old infants (n = 24) were given affective and discriminative stimuli to the forearm while they were watching a silent movie. Brain activation was recorded in the STS for measures of oxy-hemoglobin (HbO2 ) and deoxy-hemoglobin (Hbb) using functional near infra-red spectroscopy (fNIRS). Aversive responses to tactile stimuli were measured using the Infant-Toddler Sensory Profile. A significant hemodynamic response increase in HbO2 to affective touch was observed in the STS for infants with less aversive behavioral responses to tactile stimuli. The findings suggest that brain activity in the STS for affective touch might be related to individual differences in the affective reaction toward touch.
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Afecto/fisiología , Desarrollo Infantil/fisiología , Neuroimagen Funcional , Percepción Social , Espectroscopía Infrarroja Corta , Percepción del Tacto/fisiología , Femenino , Humanos , Lactante , MasculinoRESUMEN
BACKGROUND: Extinction-based procedures are often used to inhibit maladaptive fear responses. However, because extinction procedures show efficacy limitations, transcranial direct current stimulation (tDCS) has been suggested as a promising add-on enhancer. OBJECTIVE: In this study, we tested how cathodal tDCS over the right dorsolateral prefrontal cortex affects extinction and tried to unveil the processes at play that boost the effectiveness of extinction procedures and its translational potential to the treatment of anxiety disorders. METHODS: We implemented a fear conditioning paradigm whereby 41 healthy women (mean age = 20.51 ± 5.0) were assigned to either cathodal tDCS (n = 27) or sham tDCS (n = 16). Fear responses were measured with self-reports, autonomic responses, and implicit avoidance tendencies. RESULTS: Cathodal tDCS shows no statistically significant effect in extinction, according to self-reports, and seems to even negatively affect fear conditioned skin conductance responses. However, one to three months after the tDCS session and extinction, we found a group difference in the action tendencies towards the neutral stimuli (F (1, 41) = 12.04, p = .001, ηp2 = .227), with the cathodal tDCS group (as opposed to the sham group) showing a safety learning (a positive bias towards the CS-), with a moderate effect size. This suggests that cathodal tDCS may foster stimuli discrimination, leading to a decreased generalization effect. DISCUSSION: Cathodal tDCS may have enhanced long-term distinctiveness between threatening cues and perceptively similar neutral cues through a disambiguation process of the value of the neutral stimuli-a therapeutic target in anxiety disorders. Future studies should confirm these results and extend the study of cathodal tDCS effect on short term avoidance tendencies.
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Extinción Psicológica/fisiología , Miedo/fisiología , Corteza Prefrontal/fisiología , Estimulación Transcraneal de Corriente Directa/métodos , Adolescente , Adulto , Reacción de Prevención , Condicionamiento Clásico/fisiología , Femenino , Humanos , Autoinforme , Adulto JovenRESUMEN
Binge Drinking (BD) is a pattern of excessive alcohol consumption highly prevalent among college students, and has been associated with structural and functional alterations of brain networks. Recent advances in the resting-state connectivity analysis have boosted the research of the network-level connectivity disturbances associated with many psychiatric and neurological disorders, including addiction. Accordingly, atypical functional connectivity patterns in resting-state networks such as the Executive Control Network (ECN) have been found in substance users and alcohol-dependent individuals. In this study, we assessed for the first time the ECN functional and structural connectivity in a group of 34 college students, 20 (10 women) binge drinkers (BDs) in comparison with a group of 14 (8 women) alcohol abstinent controls (AACs). Overall, our findings documented increased resting-state functional connectivity (rsFC) in the BDs left middle frontal cortex of the left ECN in comparison to the AACs, while no structural connectivity differences were observed between groups. Pearson correlations revealed a positive association between the left middle frontal gyrus rsFC and the frequency of BD episodes per month, in the BD group. These findings suggest that maintaining a pattern of acute and intermittent alcohol consumption during important stages of brain development, as the transition from adolescence to adulthood, is associated with impaired ECN rsFC despite no group differences being yet noticed in the ECN structural connectivity.