The effect of cognitive load on preference and intensity processing of sweet taste in the brain.

Distracted eating can cause overconsumption. Whereas previous work has shown that cognitive load suppresses perceived taste intensity and increases subsequent consumption, the mechanism behind distraction-induced overconsumption remains unclear. To elucidate this, we performed two event-related fMRI experiments that examined how cognitive load affects neural responses and perceived intensity and preferred intensity, respectively, to solutions varying in sweetness. In Experiment 1 (N = 24), participants tasted weak sweet and strong sweet glucose solutions and rated their intensity while we concurrently varied cognitive load using a digit-span task. In Experiment 2 (N = 22), participants tasted five different glucose concentrations under varying cognitive load and then indicated whether they wanted to keep, decrease or increase its sweetness. Participants in Experiment 1 rated strong sweet solutions as less sweet under high compared to low cognitive load, which was accompanied by attenuated activation the right middle insula and bilateral DLPFC. Psychophysiological interaction analyses showed that cognitive load moreover altered connectivity between the middle insula and nucleus accumbens and DLPFC and middle insula while tasting strong sweet solutions. In Experiment 2, cognitive load did not affect participants' preferred sweetness intensity. fMRI results revealed that cognitive load attenuated DLPFC activation for the strongest sweet solutions in the study. In conclusion, our behavioral and neuroimaging results suggest that cognitive load dampens the sensory processing of strong sweet solutions in particular, which may indicate higher competition for attentional resources for strong sweet than weak sweet solutions under high cognitive load. Implications for future research are discussed.

Influencing the Insulin System by Placebo Effects in Patients With Diabetes Type 2 and Healthy Controls: A Randomized Controlled Trial.

OBJECTIVE: The objective of this study was to investigate whether placebo effect induced by pharmacological conditioning with intranasal insulin can affect glucose, insulin, C-peptide, hunger, and memory in patients with diabetes type 2 and healthy controls. METHODS: Placebo effect was induced by pharmacological conditioning. Thirty-two older patients (mean age = 68.3 years) with diabetes type 2 and age- and sex-matched thirty-two healthy older adults (mean age = 67.8 years) were randomly assigned to a conditioned or a control group. On day 1, conditioned group received six administrations of intranasal insulin with a conditioned stimulus (CS; smell of rosewood oil), whereas the control group received a placebo with the CS. On day 2, both groups received a placebo spray with the CS. Glucose, insulin, and C-peptide were repeatedly measured in blood. Hunger and memory were assessed with validated measures. RESULTS: Intranasal insulin stabilized dropping glucose levels in patients ( B = 0.03, SE = 0.02, p = .027) and healthy men ( B = 0.046, SE = 0.02, p = .021), and decreased C-peptide levels in healthy controls ( B = 0.01, SE = 0.001, p = .008). Conditioning also prevented the drop of glucose levels but only in men (both healthy and patients; B = 0.001, SE = 0.0003, p = .024). Conditioning significantly decreased hunger in healthy participants ( B = 0.31, SE = 0.09, p < .001). No effects were found on other measures. CONCLUSIONS: Placebo effect induced by conditioning with intranasal insulin modifies blood glucose levels and decreases hunger in older adults, but its effects depend on health status and sex. Insulin conditioning might be beneficial for groups suffering from intensive hunger but seems not be particularly suitable for blood glucose reduction. TRIAL REGISTRATION: Netherlands Trial Register, NL7783 ( https://www.trialregister.nl/trial/7783 ).

Food approach dynamics in daily life: Speed and force of food approach movements fluctuate with hunger, but less so for people with high BMI.

Researchers have suggested that the overconsumption of food, alcohol, and drugs could be explained by chronically elevated approach tendencies to rewarding but unhealthy stimuli. Here, we use the example of food to show that dysregulated rather than chronically elevated approach tendencies are associated with adverse health outcomes. To this end, we developed a new smartphone-based paradigm to measure dynamic changes in food approach tendencies outside the laboratory (piloted with n = 48). We demonstrated in three preregistered experiments (total N = 367) that food approach tendencies decrease from before to after people have eaten. We further show that in overweight and obese participants, these dynamics are disrupted as their food approach tendencies increase rather than decrease after meals. In addition to showing these effects based on traditional reaction time-based food approach tendencies, we also demonstrate these patterns in a novel measure of response force-a measure that has long been used to study motivation in animals but has received little attention in humans. Together, our findings suggest that both reaction time-based and force-based approach tendencies change dynamically in accordance with people's need states and that disruptions in these dynamics are associated with adverse health outcomes, such as overweight and obesity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Test-retest reliability of a smartphone-based approach-avoidance task: Effects of retest period, stimulus type, and demographics.

The approach-avoidance task (AAT) is an implicit task that measures people's behavioral tendencies to approach or avoid stimuli in the environment. In recent years, it has been used successfully to help explain a variety of health problems (e.g., addictions and phobias). Unfortunately, more recent AAT studies have failed to replicate earlier promising findings. One explanation for these replication failures could be that the AAT does not reliably measure approach-avoidance tendencies. Here, we first review existing literature on the reliability of various versions of the AAT. Next, we examine the AAT's reliability in a large and diverse sample (N = 1077; 248 of whom completed all sessions). Using a smartphone-based, mobile AAT, we measured participants' approach-avoidance tendencies eight times over a period of seven months (one measurement per month) in two distinct stimulus sets (happy/sad expressions and disgusting/neutral stimuli). The mobile AAT's split-half reliability was adequate for face stimuli (r = .85), but low for disgust stimuli (r = .72). Its test-retest reliability based on a single measurement was poor for either stimulus set (all ICC1s < .3). Its test-retest reliability based on the average of all eight measurements was moderately good for face stimuli (ICCk = .73), but low for disgust stimuli (ICCk = .5). Results suggest that single-measurement AATs could be influenced by unexplained temporal fluctuations of approach-avoidance tendencies. These fluctuations could be examined in future studies. Until then, this work suggests that future research using the AAT should rely on multiple rather than single measurements.

Daily distracted consumption patterns and their relationship with BMI.

The rapidly increasing prevalence of overweight and obesity has heightened the need for a better understanding of obesity-related eating patterns and dietary behaviours. Recent work suggests that distracted eating is causally related to increased immediate and later food, pushing the need for a better understanding of the prevalence of distracted consumption and how this relates to body weight. To extract insights in the relationship between demographics, daily consumption settings, and BMI, we performed secondary data analyses on data from 1011 individuals representative of the Dutch population (adults, 507F, BMI 17-50 kg/m2). The most commonly reported distractions were talking to others (32.7%) and watching television (21.7%). Only 18.4% of respondents reported no distractions during meals. To examine how different distractions related to BMI, we performed OLS regression which showed, among other things, that watching tv while eating lunch (η2 = 0.37) and working during dinner were associated with a higher BMI (η2 = 1.63). To examine the robustness of these findings, machine learning techniques were used. A random forest analysis (RMSE = 4.09) showed that next to age and education level, distraction during lunch and snack was amongst the largest predictors of BMI. Multiple linear regression with lasso penalty (RMSE = 4.13) showed that specifically watching tv while eating lunch or snacks was associated with a higher BMI. In conclusion, our analyses confirmed the assumption that people are regularly distracted during their daily meals, with distinct distractors relating to BMI. These findings provide a starting point for evidence-based recommendations on which consumption settings are associated with healthier eating patterns and body weight.

Mapping the complex everyday challenges and needs of people with rheumatic disease and their surroundings using a multi-actor approach.

INTRODUCTION: This study aimed to gain insight into the real-world complexity of the challenges experienced by patients, their significant others, care professionals and the work and education environment concerning rheumatic diseases as well as the interrelation between these challenges; it also aimed to prioritise the identified challenges. METHOD: Using the Dialog Model, 21 people with various rheumatic diseases, 24 care professionals, 9 significant others, and 3 education and work representatives were asked about rheumatic disease-related challenges and needs in a series of focus groups and interviews. Data were inductively coded and analysed, resulting in a mind map thematically displaying the challenges. The mind map was translated into a survey, and respondents (N = 1802) prioritised themes and challenges. RESULTS: Of the six identified themes, 'physical complaints' was prioritised the most, followed by 'collaboration in healthcare', 'social and mental wellbeing', 'self-management', 'information and options in healthcare' and 'work and education'. Challenges of people with rheumatic diseases appeared to be complexly interrelated. For instance, fatigue and pain affect everyday functioning, but can also heavily impact social and mental wellbeing. To facilitate support for these challenges, which many patients desire, patients and care professionals said that better collaboration between primary and secondary care professionals is needed. Additionally, patients felt that their experiential expertise deserves more acknowledgement from care professionals. Results were similar across different rheumatic diseases. CONCLUSION: Many patients desire more support to manage life with their disease. To facilitate this, collaboration and communication between healthcare professionals, and between healthcare professionals and individual patients, should be improved.

Ire and punishment: Incidental anger and costly punishment in children, adolescents, and adults.

Why do children, adolescents, and adults engage in costly punishment to sanction fairness violations? Two studies investigated the differential impact of incidental anger on the costly punishment of 8-year-olds, 13-year-olds, and adults. Focusing on experimentally manipulated incidental anger allows for a causal investigation as to whether and how anger affects costly punishment in these age groups in addition to other motives such as inequity aversion. Study 1 (N = 210) assessed the effect of incidental anger (vs. a neutral emotion) on second-party punishment, where punishers were direct victims of fairness violations. Study 2 (N = 208) examined third-party punishment, where the punisher was an observer unaffected by the violation. Across ages, incidental anger increased the second-party punishment of unequal offers but not equal offers. Thus, anger seems to play a causal role in the punishment of unfairness when fairness violations are self-relevant. As predicted, adults' third-party punishment of unequal offers was higher in the incidental anger condition than in the neutral emotion condition. Children's third-party punishment of unfairness was not affected by the emotion condition, but incidental anger increased adolescents' third-party punishment across offers. Overall, our data suggest that the association between anger and costly punishment is based on the self-relevance of the violation. In third-party situations, where unfairness does not affect the self, social-cognitive processes that develop well into adulthood, such as emotional appraisals, might be necessary for third parties to engage in costly punishment.

The role of financial stress in mental health changes during COVID-19.

Using longitudinal data before and during the first six months of the COVID-19 pandemic for a representative sample of Dutch households, we examined the role of financial stress, defined as the subjective experience of lacking financial resources to cope with demands, in mental health changes. Also, we examined financial stress and mental health relations with households' income, savings, and debts. The data revealed that average mental health did not change during the first six months of the pandemic but showed considerable underlying heterogeneity. Results showed that financial stress changes significantly explained this heterogeneity. Increases in financial stress predicted decreases in mental health, whereas decreases in financial stress predicted increases in mental health. While income did not explain financial stress changes, fewer savings and more debts were related to increased financial stress, which was, in turn, negatively related to mental health. We discuss the implications of our findings for mental health care and financial security policy and provide suggestions for future research.

The minimal access cranial suspension (MACS) lift: A systematic review of literature 18 years after its introduction.

BACKGROUND: One of the most popular short-scar rhytidectomy techniques used nowadays is the minimal access cranial suspension (MACS) lift developed by Tonnard and Vaerpele. The technique uses purse-string sutures in combination with limited skin undermining to obtain a clear vertical tissue repositioning. Since its introduction, the technique has extensively been described and used around the world by facial plastic surgeons. Now, 18 years after its introduction, a systematic review concerning the results and complications of the MACS lift is presented to establish its current position in facial rejuvenation. METHODS: The MEDLINE, Embase, Cochrane Central, and Google Scholar databases were searched for studies evaluating the MACS lift (June 10, 2020). Outcomes of interest were long-term effect, satisfaction, and complications of the MACS lifting as determined by the patient and/or surgeon. RESULTS: Six studies were included, with 739 patients treated with the MACS lift in total. No major complications were reported, four studies did report on the occurrence of minor complications. All of the six studies reported relatively high levels of satisfaction. Three studies reported a shorter procedural duration for the MACS lift compared with the conventional facelift. In three of the six included studies, the level of evidence was low. The effect on neck rejuvenation is limited. CONCLUSION: The MACS lift can be considered a minimally invasive facelift procedure with a relatively low complication rate. The procedure, often combined with additional procedures, results in evident patient and/or surgeon satisfaction. To obtain a better desired result on an aged neck area, additional procedures are warranted.

Reducing the Number of Hospitalization Days for COPD: Setting up a Transmural-Care Pathway.

Background: Many patients with chronic obstructive pulmonary disease (COPD) experience exacerbations of symptoms, leading to a large burden on patients and the health system and costs to society. To address this burden, a 25% reduction in number of hospitalization days for COPD exacerbations was recently declared a national goal in the Netherlands, to be achieved in 5 years. Methods: A national care pathway was designed following an established managed clinical pathway setup, which involved prior national surveys and the identification of ten key elements. The concept was discussed, made locally applicable, and finally tested in eight regions containing eleven hospitals and surrounding primary-care groups in a prospective cohort study. All patients were followed for 1 year, starting at hospitalization. Results: In total, 752 patients gave informed consent and participated (mean age 70 years, 58% female). Of these, 120 (16%) died within a year. The median length of index hospitalization was 5 days, and 43% had at least one rehospitalization within 1 year (range 0-8). There was a 19.4% reduction in number of total hospitalization days, without a decrease in health-related quality of life or perceived quality of care. Elements that contributed significantly to the reduction were contact in the first week after hospitalization, and during the year of follow-up pharmacological and nonpharmacological smoking-cessation guidance, checks on inhalation technique, and discussion of lung-attack plan. Discussion: With concerted action between patients and health workers in the hospital and in the community, a large reduction in number of hospitalization days can be achieved. The program was quite demanding for both patients and health workers. In our subsequent national implementation plan after this pilot study, we have named the major contributors to success and advocate the stepwise introduction of the elements in light of feasibility.

Usefulness of current candidate genetic markers to identify childhood cancer patients at risk for platinum-induced ototoxicity: Results of the European PanCareLIFE cohort study.

BACKGROUND: Irreversible sensorineural hearing loss is a common side effect of platinum treatment with the potential to significantly impair the neurocognitive, social and educational development of childhood cancer survivors. Genetic association studies suggest a genetic predisposition for cisplatin-induced ototoxicity. Among other candidate genes, thiopurine methyltransferase (TPMT) is considered a critical gene for susceptibility to cisplatin-induced hearing loss in a pharmacogenetic guideline. The aim of this cross-sectional cohort study was to confirm the genetic associations in a large pan-European population and to evaluate the diagnostic accuracy of the genetic markers. METHODS: Eligibility criteria required patients to be aged less than 19 years at the start of chemotherapy, which had to include cisplatin and/or carboplatin. Patients were assigned to three phenotype categories: no, minor and clinically relevant hearing loss. Fourteen variants in eleven candidate genes (ABCC3, OTOS, TPMT, SLC22A2, NFE2L2, SLC16A5, LRP2, GSTP1, SOD2, WFS1 and ACYP2) were investigated. Multinomial logistic regression was performed to model the relationship between genetic predictors and platinum ototoxicity, adjusting for clinical risk factors. Additionally, measures of the diagnostic accuracy of the genetic markers were determined. RESULTS: 900 patients were included in this study. In the multinomial logistic regression, significant unique contributions were found from SLC22A2 rs316019, the age at the start of platinum treatment, cranial radiation and the interaction term [platinum compound]∗[cumulative dose of cisplatin]. The predictive performance of the genetic markers was poor compared with the clinical risk factors. CONCLUSIONS: PanCareLIFE is the largest study of cisplatin-induced ototoxicity to date and confirmed a role for the polyspecific organic cation transporter SLC22A2. However, the predictive value of the current genetic candidate markers for clinical use is negligible, which puts the value of clinical factors for risk assessment of cisplatin-induced ototoxicity back into the foreground.

Association of candidate pharmacogenetic markers with platinum-induced ototoxicity: PanCareLIFE dataset.

Genetic association studies suggest a genetic predisposition for cisplatin-induced ototoxicity. Among other candidate genes, thiopurine methyltransferase (TPMT) is considered a critical gene for susceptibility to cisplatin-induced hearing loss in a pharmacogenetic guideline. The PanCareLIFE cross-sectional cohort study evaluated the genetic associations in a large pan-European population and assessed the diagnostic accuracy of the genetic markers. 1,112 pediatric cancer survivors who had provided biomaterial for genotyping were screened for participation in the pharmacogenetic association study. 900 participants qualified for inclusion. Based on the assessment of original audiograms, patients were assigned to three phenotype categories: no, minor, and clinically relevant hearing loss. Fourteen variants in eleven candidate genes (ABCC3, OTOS, TPMT, SLC22A2, NFE2L2, SLC16A5, LRP2, GSTP1, SOD2, WFS1, and ACYP2) were genotyped. The genotype and phenotype data represent a resource for conducting meta-analyses to derive a more precise pooled estimate of the effects of genes on the risk of hearing loss due to platinum treatment.

Long-acting dual bronchodilator therapy (indacaterol/glycopyrronium) versus nebulized short-acting dual bronchodilator (salbutamol/ipratropium) in chronic obstructive pulmonary disease: A double-blind, randomized, placebo-controlled trial.

INTRODUCTION: Most guidelines recommend long-acting bronchodilators over short-acting bronchodilators for patients with chronic obstructive pulmonary disease (COPD). The available evidence for the guidelines was based on dry powder or pressurized metered dose inhalers, but not nebulizations. Nevertheless, there is considerable, poorly evidenced based, use of short acting nebulized bronchodilators. METHODS: This was an investigator initiated, randomized, active controlled, cross-over, double-blind and double-dummy single centre study in patients with stable COPD. The active comparators were indacaterol/glycopyrronium 110/50 µg as Ultibro® via Breezhaler® (IND/GLY) and salbutamol/ipratropium 2,5/0,5 mg via air driven nebulization (SAL/IPR), both given as a single dose on separate days. The primary end point was the area under the FEV1 curve from baseline till 6 h. Secondary end points included change in Borg dyspnoea score, adverse events and change in hyperinflation measured by the inspiratory capacity. RESULTS: A total of 33 COPD patients completed the trial and were evaluable, most of them were ex-smokers. The difference between the tested regimens for the primary endpoint, FEV1 AUC 0-6 h, 2965 ± 1544 mL (mean ± SD) for IND/GLY versus 3513 ± 1762 mL for SAL/IPR, was not significant (P = 0.08). The peak in FEV1 was higher and was reached faster with SAL/IPR compared to IND/GLY. No other significant differences were detected for the secondary endpoints including the Borg score, or adverse events. CONCLUSION: Among patients with stable COPD, dry powder long-acting single inhalation of a LABA and a LAMA (IND/GLY) was not superior compared to nebulized short-acting salbutamol plus ipratropium (SAL/IPR) in its bronchodilating effects over 6 h.The effects of the nebulization kicked in faster and peaked higher. The observed differences may be caused by the difference in dosing between the two regimens. The improvement in Borg dyspnoea score did not favour the nebulization. Long-term outcomes were not assessed in this study.

Choice architecture meets motivation science: How stimulus availability interacts with internal factors in shaping the desire for food.

Recent research on choice architecture has highlighted the role of external aspects such as stimulus proximity or availability on consumption. How such external factors interact with internal, intraindividual factors, however, is very poorly understood. Here we show how the wanting for palatable food emerges from the interplay of one key external factor, availability, and two key internal factors central to motivation science, need state and learning history. Across three experiments in the food domain, we find converging evidence for a main effect of stimulus availability which is qualified in theoretically predicted ways by a three-way interaction such that food desire peaks when the availability of tempting food stimuli is accompanied by high need states and a positive learning experience. A pooled analysis across the three studies supported this general conclusion. We conclude that nudging effects are strongest when external factors of choice architecture synergize with internal factors in critical ways.

Jumping on the 'bad'wagon? How group membership influences responses to the social exclusion of others.

In four studies, we addressed whether group membership influences behavioral and neural responses to the social exclusion of others. Participants played a modified three-player Cyberball game (Studies 1-3) or a team-selection task (Study 4) in the absence or presence of a minimal group setting. In the absence of a minimal group, when one player excluded another player, participants actively included the excluded target. When the excluder was from the in-group and the excluded player from the out-group, participants were less likely to intervene (Studies 1-3) and also more often went along with the exclusion (Study 4). Functional magnetic resonance imaging results (Study 3) showed that greater exclusion in the minimal group setting concurred with increased activation in the dorsolateral pre-frontal cortex, a region associated with overriding cognitive conflict. Self-reports from Study 4 supported these results by showing that participants' responses to the target's exclusion were motivated by group membership as well as participants' general aversion to exclude others. Together, the findings suggest that when people witness social exclusion, group membership triggers a motivational conflict between favoring the in-group and including the out-group target. This underscores the importance of group composition for understanding the dynamics of social exclusion.

A mobile approach-avoidance task.

Approach and avoidance tendencies have helped explain phenomena as diverse as addiction (Mogg, Field, & Bradley, 2005), phobia (Rinck & Becker, 2007), and intergroup discrimination (Bianchi, Carnaghi, & Shamloo, 2018; Degner, Essien, & Reichardt, 2016). When the original approach-avoidance task (AAT; Solarz, 1960) that measures these tendencies was redesigned to run on regular desktop computers, it made the task much more flexible but also sacrificed some important behavioral properties of the original task-most notably its reliance on physical distance change (Chen & Bargh, 1999). Here, we present a new, mobile version of the AAT that runs entirely on smartphones and combines the flexibility of modern tasks with the behavioral properties of the original AAT. In addition, it can easily be deployed in the field and, next to traditional reaction time measurements, includes the novel measurement of response force. In two studies, we demonstrate that the mobile AAT can reliably measure known approach-avoidance tendencies toward happy and angry faces both in the laboratory and in the field.

Genetic variation of cisplatin-induced ototoxicity in non-cranial-irradiated pediatric patients using a candidate gene approach: The International PanCareLIFE Study.

Ototoxicity is a common side effect of platinum treatment and manifests as irreversible, high-frequency sensorineural hearing loss. Genetic association studies have suggested a role for SNPs in genes related to the disposition of cisplatin or deafness. In this study, 429 pediatric patients that were treated with cisplatin were genotyped for 10 candidate SNPs. Logistic regression analyses revealed that younger age at treatment (≤5 years vs >15 years: OR: 9.1; 95% CI: 3.8-21.5; P = 5.6 × 10-7) and higher cumulative dose of cisplatin (>450 vs ≤300 mg/m2: OR: 2.4; 95% CI: 1.3-4.6; P = 0.007) confer a significant risk of ototoxicity. Of the SNPs investigated, none of them were significantly associated with an increase of ototoxicity. In the meta-analysis, ACYP2 rs1872328 (OR: 3.94; 95% CI: 1.04-14.03; P = 0.04) and SLC22A2 rs316019 (OR: 1.46; 95% CI: 1.07-2.00; P = 0.02) were associated with ototoxicity. In order to increase the understanding of the association between SNPs and ototoxicity, we propose a polygenic model, which takes into account multiple interacting genes of the cisplatin pathway that together confer an increased risk of ototoxicity.

[Sharing oncological knowledge via expert panels; are there legal obstacles or practical objections?] / Oncologische kennis delen via expertpanels.

Concentration and increasing specialization of oncological care makes it impossible for each hospital to have in-house access to the most up-to-date knowledge on diagnostic and therapeutic options. Therefore, knowledge is increasingly shared through consultation collaboratives. If such consultations do not suffice, then expert panels can be asked to answer specific questions about, for example, primary tumours or metastases. With this new type of consultation it is essential that the rights of both the patients and the professionals are guaranteed. In this article we describe the legal frameworks in which an expert panel can and is allowed to operate. If certain quality requirements regarding the use of medical data, the application procedure for and composition of an expert panel are met, then there should be no legal obstacles or practical objections to introduce expert panels in clinical practice.

EEG neurofeedback research: A fertile ground for psychiatry?

The clinical efficacy of neurofeedback is still a matter of debate. This paper analyzes the factors that should be taken into account in a transdisciplinary approach to evaluate the use of EEG NFB as a therapeutic tool in psychiatry. Neurofeedback is a neurocognitive therapy based on human-computer interaction that enables subjects to train voluntarily and modify functional biomarkers that are related to a defined mental disorder. We investigate three kinds of factors related to this definition of neurofeedback. We focus this article on EEG NFB. The first part of the paper investigates neurophysiological factors underlying the brain mechanisms driving NFB training and learning to modify a functional biomarker voluntarily. Two kinds of neuroplasticity involved in neurofeedback are analyzed: Hebbian neuroplasticity, i.e. long-term modification of neural membrane excitability and/or synaptic potentiation, and homeostatic neuroplasticity, i.e. homeostasis attempts to stabilize network activity. The second part investigates psychophysiological factors related to the targeted biomarker. It is demonstrated that neurofeedback involves clearly defining which kind of relationship between EEG biomarkers and clinical dimensions (symptoms or cognitive processes) is to be targeted. A nomenclature of accurate EEG biomarkers is proposed in the form of a short EEG encyclopedia (EEGcopia). The third part investigates human-computer interaction factors for optimizing NFB training and learning during the closed loop interaction. A model is proposed to summarize the different features that should be controlled to optimize learning. The need for accurate and reliable metrics of training and learning in line with human-computer interaction is also emphasized, including targeted biomarkers and neuroplasticity. All these factors related to neurofeedback show that it can be considered as a fertile ground for innovative research in psychiatry.

A review of classification algorithms for EEG-based brain-computer interfaces: a 10 year update.

OBJECTIVE: Most current electroencephalography (EEG)-based brain-computer interfaces (BCIs) are based on machine learning algorithms. There is a large diversity of classifier types that are used in this field, as described in our 2007 review paper. Now, approximately ten years after this review publication, many new algorithms have been developed and tested to classify EEG signals in BCIs. The time is therefore ripe for an updated review of EEG classification algorithms for BCIs. APPROACH: We surveyed the BCI and machine learning literature from 2007 to 2017 to identify the new classification approaches that have been investigated to design BCIs. We synthesize these studies in order to present such algorithms, to report how they were used for BCIs, what were the outcomes, and to identify their pros and cons. MAIN RESULTS: We found that the recently designed classification algorithms for EEG-based BCIs can be divided into four main categories: adaptive classifiers, matrix and tensor classifiers, transfer learning and deep learning, plus a few other miscellaneous classifiers. Among these, adaptive classifiers were demonstrated to be generally superior to static ones, even with unsupervised adaptation. Transfer learning can also prove useful although the benefits of transfer learning remain unpredictable. Riemannian geometry-based methods have reached state-of-the-art performances on multiple BCI problems and deserve to be explored more thoroughly, along with tensor-based methods. Shrinkage linear discriminant analysis and random forests also appear particularly useful for small training samples settings. On the other hand, deep learning methods have not yet shown convincing improvement over state-of-the-art BCI methods. SIGNIFICANCE: This paper provides a comprehensive overview of the modern classification algorithms used in EEG-based BCIs, presents the principles of these methods and guidelines on when and how to use them. It also identifies a number of challenges to further advance EEG classification in BCI.