Association of Neighborhood Opportunity with Infant Brain Activity and Cognitive Development.

BACKGROUND AND OBJECTIVES: Neighborhood socioeconomic disadvantage is associated with lower neurocognitive scores and differences in brain structure among school-age children. Associations between positive neighborhood characteristics, infant brain activity, and cognitive development are underexplored. We examined direct and indirect associations between neighborhood opportunity, brain activity, and cognitive development. METHODS: This longitudinal cohort study included infants from 2 primary care clinics in Boston and Los Angeles. Using a sample of 65 infants, we estimated path models to examine associations between neighborhood opportunity (measured by the Child Opportunity Index), infant electroencephalography (EEG) at 6 months, and infant cognitive development (measured using the Mullen Scales of Early Learning) at 12 months. A mediation model tested whether EEG power explained associations between neighborhood opportunity and infant cognition. RESULTS: Neighborhood opportunity positively predicted infant absolute EEG power across multiple frequency bands: low (b = 0.12, 95% CI 0.01-0.24, p = 0.04, = 0.21); high (b = 0.11, 95% CI 0.01-0.21, p = 0.03, = 0.23); (b = 0.10, 95% CI 0.00-0.19, p = 0.04, = 0.20); and (b = 0.12, 95% CI 0.02-0.22, p = 0.02, = 0.24). The results remained statistically significant after applying a Benjamini-Hochberg false discovery rate of 0.10 to adjust for multiple comparisons. No significant associations emerged between neighborhood opportunity, relative EEG power, and infant cognition. Mediation was not significant. CONCLUSION: Neighborhood opportunity is positively associated with some forms of infant brain activity, suggesting that positive neighborhood characteristics may play a salient role in early development.

A Qualitative Study of Maternal Perceptions of Stress and Parenting During Early Childhood.

OBJECTIVE: Exposure to maternal stress in early childhood can increase risk for learning and behavior challenges. We sought to gain in-depth understanding of how mothers perceive stressors to impact child wellbeing and identify mothers' strategies for navigating stressors with their young children. METHODS: We recruited English- and Spanish-speaking mothers from a primary care clinic serving predominantly publicly insured children. Twenty-one mothers (aged >18 years) of children (aged 6-29 months) participated in in-depth, semi-structured interviews to discuss their experiences and beliefs regarding stress and parenting. Interviews were recorded, transcribed verbatim, and analyzed using the constant comparative method associated with a grounded theory approach. RESULTS: We developed the following hypothesized explanatory model based on our key thematic findings: Mothers described a dyadic model of stress, whereby both their children's and their own experiences of and responses to stressors are interdependent. Mothers use preventive and responsive buffering to mitigate the impact of stress on their children; however, their access to resources, including social and financial support, shapes their capacity for implementing such strategies. Affection and other forms of relational support may function to protect against the negative impacts of stress. CONCLUSION: In the setting of poverty-related chronic stressors, mothers play an active role in mitigating the impact of stress on their children's wellbeing through responsive caregiving. Policies aimed at reducing poverty-related stress exposures and experiences among low-income families may be key interventions for promoting responsive caregiving during a critical time in child development.

Exploratory study evaluating the relationships between perinatal adversity, oxidative stress, and infant neurodevelopment across the first year of life.

Early childhood adversity increases risk for negative lifelong impacts on health and wellbeing. Identifying the risk factors and the associated biological adaptations early in life is critical to develop scalable early screening tools and interventions. Currently, there are limited, reliable early childhood adversity measures that can be deployed prospectively, at scale, to assess risk in pediatric settings. The goal of this two-site longitudinal study was to determine if the gold standard measure of oxidative stress, F2-Isoprostanes, is potentially a reliable measure of a physiological response to adversity of the infant and mother. The study evaluated the independent relationships between F2-Isoprostanes, perinatal adversity and infant neurocognitive development. The study included mother-infant dyads born >36 weeks' gestation. Maternal demographic information and mental health assessments were utilized to generate a perinatal cumulative risk score. Infants' development was assessed at 6 and 12 months and both mothers and infants were assayed for F2-isoprostane levels in blood and urine, respectively. Statistical analysis revealed that cumulative risk scores correlated with higher maternal (p = 0.01) and infant (p = 0.05) F2-isoprostane levels at 6 months. Infant F2-isoprostane measures at 2 months were negatively associated with Mullen Scales of Early Learning Composite scores at 12 months (p = 0.04). Lastly, higher cumulative risk scores predicted higher average maternal F2-isoprostane levels across the 1-year study time period (p = 0.04). The relationship between perinatal cumulative risk scores and higher maternal and infant F2-isoprostanes at 6 months may reflect an oxidative stress status that informs a sensitive period in which a biomarker can be utilized prospectively to reveal the physiological impact of early adversity.

Association of cerebral metabolic rate following therapeutic hypothermia with 18-month neurodevelopmental outcomes after neonatal hypoxic ischemic encephalopathy.

BACKGROUND: Therapeutic hypothermia (TH) is standard of care for moderate to severe neonatal hypoxic ischemic encephalopathy (HIE) but many survivors still suffer lifelong disabilities and benefits of TH for mild HIE are under active debate. Development of objective diagnostics, with sensitivity to mild HIE, are needed to select, guide, and assess response to treatment. The objective of this study was to determine if cerebral oxygen metabolism (CMRO2) in the days after TH is associated with 18-month neurodevelopmental outcomes as the first step in evaluating CMRO2's potential as a diagnostic for HIE. Secondary objectives were to compare associations with clinical exams and characterise the relationship between CMRO2 and temperature during TH. METHODS: This was a prospective, multicentre, observational, cohort study of neonates clinically diagnosed with HIE and treated with TH recruited from the tertiary neonatal intensive care units (NICUs) of Boston Children's Hospital, Brigham and Women's Hospital, and Beth Israel Deaconess Medical Center between December 2015 and October 2019 with follow-up to 18 months. In total, 329 neonates ≥34 weeks gestational age admitted with perinatal asphyxia and suspected HIE were identified. 179 were approached, 103 enrolled, 73 received TH, and 64 were included. CMRO2 was measured at the NICU bedside by frequency-domain near-infrared and diffuse correlation spectroscopies (FDNIRS-DCS) during the late phases of hypothermia (C), rewarming (RW) and after return to normothermia (NT). Additional variables were body temperature and clinical neonatal encephalopathy (NE) scores, as well as findings from magnetic resonance imaging (MRI) and spectroscopy (MRS). Primary outcome was the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) at 18 months, normed (SD) to 100 (15). FINDINGS: Data quality for 58 neonates was sufficient for analysis. CMRO2 changed by 14.4% per °C (95% CI, 14.2-14.6) relative to its baseline at NT while cerebral tissue oxygen extraction fraction (cFTOE) changed by only 2.2% per °C (95% CI, 2.1-2.4) for net changes from C to NT of 91% and 8%, respectively. Follow-up data for 2 were incomplete, 33 declined and 1 died, leaving 22 participants (mean [SD] postnatal age, 19.1 [1.2] month; 11 female) with mild to moderate HIE (median [IQR] NE score, 4 [3-6]) and 21 (95%) with BSID-III scores >85 at 18 months. CMRO2 at NT was positively associated with cognitive and motor composite scores (ß (SE) = 4.49 (1.55) and 2.77 (1.00) BSID-III points per 10-10 moL/dl × mm2/s, P = 0.009 and P = 0.01 respectively; linear regression); none of the other measures were associated with the neurodevelopmental outcomes. INTERPRETATION: Point of care measures of CMRO2 in the NICU during C and RW showed dramatic changes and potential to assess individual response to TH. CMRO2 following TH outperformed conventional clinical evaluations (NE score, cFTOE, and MRI/MRS) at predicting cognitive and motor outcomes at 18 months for mild to moderate HIE, providing a promising objective, physiologically-based diagnostic for HIE. FUNDING: This clinical study was funded by an NIH grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, United States (R01HD076258).

Associations between EEG trajectories, family income, and cognitive abilities over the first two years of life.

We sought to characterize developmental trajectories of EEG spectral power over the first 2 years after birth and examine whether family income or maternal education alter those trajectories. We analyzed EEGs (n = 161 infants, 534 EEGs) collected longitudinally between 2 and 24 months of age, and calculated frontal absolute power across 7 canonical frequency bands. For each frequency band, a piecewise growth curve model was fit, resulting in an estimated intercept and two slope parameters from 2 to 9 months and 9-24 months of age. Across 6/7 frequency bands, absolute power significantly increased over age, with steeper slopes in the 2-9 month period compared to 9-24 months. Increased family income, but not maternal education, was associated with higher intercept (2-3 month power) across delta-gamma bands (p range = 0.002-0.04), and reduced change in power between 2 and 9 months of age in lower frequency bands (delta-alpha, p range = 0.01-0.02). There was no significant effect of income on slope between 9 and 24 months. EEG intercept and slope measures did not mediate relationships between income and 24-month verbal and nonverbal development. These results add to growing literature concerning the role of socioeconomic factors in shaping brain trajectories.

Maternal stress and development of infant attention to threat-related facial expressions.

Attentional biases to threat-related stimuli, such as fearful and angry facial expressions, are important to survival and emerge early in development. Infants demonstrate an attentional bias to fearful facial expressions by 5-7 months of age and an attentional bias toward anger by 3 years of age that are modulated by experiential factors. In a longitudinal study of 87 mother-infant dyads from families predominantly experiencing low income, we examined whether maternal stress and depressive symptoms were associated with trajectories of attentional biases to threat, assessed during an attention disengagement eye-tracking task when infants were 6-, 9-, and 12-month old. By 9 months, infants demonstrated a generalized bias toward threat (both fearful and angry facial expressions). Maternal perceived stress was associated with the trajectory of the bias toward angry facial expressions between 6 and 12 months. Specifically, infants of mothers with higher perceived stress exhibited a greater bias toward angry facial expressions at 6 months that decreased across the next 6 months, compared to infants of mothers with lower perceived stress who displayed an increased bias to angry facial expressions over this age range. Maternal depressive symptoms and stressful life events were not associated with trajectories of infant attentional bias to anger or fear. These findings highlight the role of maternal perceptions of stress in shaping developmental trajectories of threat-alerting systems.

Perinatal and early childhood biomarkers of psychosocial stress and adverse experiences.

The human brain develops through a complex interplay of genetic and environmental influences. During critical periods of development, experiences shape brain architecture, often with long-lasting effects. If experiences are adverse, the effects may include the risk of mental and physical disease, whereas positive environments may increase the likelihood of healthy outcomes. Understanding how psychosocial stress and adverse experiences are embedded in biological systems and how we can identify markers of risk may lead to discovering new approaches to improve patient care and outcomes. Biomarkers can be used to identify specific intervention targets and at-risk children early when physiological system malleability increases the likelihood of intervention success. However, identifying reliable biomarkers has been challenging, particularly in the perinatal period and the first years of life, including in preterm infants. This review explores the landscape of psychosocial stress and adverse experience biomarkers. We highlight potential benefits and challenges of identifying risk clinically and different sub-signatures of stress, and in their ability to inform targeted interventions. Finally, we propose that the combination of preterm birth and adversity amplifies the risk for abnormal development and calls for a focus on this group of infants within the field of psychosocial stress and adverse experience biomarkers. IMPACT: Reviews the landscape of biomarkers of psychosocial stress and adverse experiences in the perinatal period and early childhood and highlights the potential benefits and challenges of their clinical utility in identifying risk status in children, and in developing targeted interventions. Explores associations between psychosocial stress and adverse experiences in childhood with prematurity and identifies potential areas of assessment and intervention to improve outcomes in this at-risk group.

Maternal Stress and Early Neurodevelopment: Exploring the Protective Role of Maternal Growth Mindset.

OBJECTIVE: The purpose of this study was to test associations between maternal stress, maternal mindset, and infant neurodevelopment at 12 months of age. Specifically, we sought to examine the extent to which maternal growth mindsets may serve to attenuate the negative associations between maternal stress and infants' neurodevelopment. METHODS: The current exploratory study leverages data from a longitudinal cohort study following mother-infant dyads. Maternal-perceived stress, maternal mindset, and infant electroencephalography (EEG) recordings were collected when infants were 12 months of age. The final analytic sample included 33 dyads. RESULTS: Results revealed no statistically significant main effects of maternal stress or maternal mindset for any of the infant EEG frequency band outcomes. After including interactions between maternal stress and mindset, statistically significant positive interactions were detected for all EEG frequency bands. Simple slope tests revealed significant negative associations between maternal stress and each of the 6 EEG frequency bands for mothers with more fixed-oriented mindsets. Associations between maternal stress and infant EEG outcomes for mothers with more growth-oriented mindsets did not differ from 0. CONCLUSION: These findings suggest that infants raised by mothers with growth mindsets may be protected against the neurodevelopmental consequences of higher maternal stress.

Maternal stress predicts neural responses during auditory statistical learning in 26-month-old children: An event-related potential study.

Exposure to high levels of early life stress have been associated with long-term difficulties in learning, behavior, and health, with particular impact evident in the language domain. While some have proposed that the increased stress of living in a low-income household mediates observed associations between socioeconomic status (SES) and child outcomes, considerable individual differences have been observed. The extent to which specific variables associated with socioeconomic status - in particular exposure to stressful life events - influence the neurocognitive mechanisms underlying language acquisition are not well understood. Auditory statistical learning, or the ability to segment a continuous auditory stream based on its statistical properties, develops during early infancy and is one mechanism thought to underlie language learning. The present study used an event-related potential (ERP) paradigm to test whether maternal stress, adjusting for socioeconomic variables (e.g., family income, maternal education) was associated with neurocognitive processes underlying statistical learning in a sample of 26-month-old children (n = 23) from predominantly low- to middle-income backgrounds. Event-related potentials were recorded while children listened to a continuous stream of tri-tone "words" in which tone elements varied in transitional probability. "Tone-words" were presented in random order, such that Tone 1 always predicted Tones 2 and 3 (transitional probability for Tone 3 = 1.0), but Tone 1 appeared randomly. A larger P2 amplitude was observed in response to Tone 3 compared to Tone 1, demonstrating that children implicitly tracked differences in transitional probabilities during passive listening. Maternal reports of stress at 26 months, adjusting for SES, were negatively associated with difference in P2 amplitude between Tones 1 and 3. These findings suggest that maternal stress, within a low-SES context, is associated with the manner in which children process statistical properties of auditory input.

Associations Between Maternal Stress, Early Language Behaviors, and Infant Electroencephalography During the First Year of Life.

Associations have been observed between socioeconomic status (SES) and language outcomes from early childhood, but individual variability is high. Exposure to high levels of stress, often associated with low-SES status, might influence how parents and infants interact within the early language environment. Differences in these early language behaviors, and in early neurodevelopment, might underlie SES-based differences in language that emerge later on. Analysis of natural language samples from a predominantly low-/mid-income sample of mother-infant dyads, obtained using the Language Environment Analysis (LENA) system, found that maternal reports of exposure to stressful life events, and perceived stress, were negatively correlated with child vocalizations and conversational turns when infants were 6 and 12 months of age. Greater numbers of vocalizations and conversational turns were also associated with lower relative theta power and higher relative gamma power in 6- and 12-month baseline EEG - a pattern that might support subsequent language development.

An exploratory study of predictors of cognition in two low-income samples of infants across the first year of life.

OBJECTIVE: In this exploratory longitudinal study we assessed cognitive development in a community sample of infants born into predominantly low-income families from two different urban sites, to identify family and community factors that may associate with outcomes by 1 year of age. METHOD: Infant-mother dyads (n = 109) were recruited in Boston and Los Angeles community pediatric practices. Infant cognition was measured using the Mullen Scales of Early Learning when the infant was aged 2, 6, 9, and 12 months. Longitudinal linear mixed effects modeling and linear regression models explored potential predictors of cognitive outcomes. RESULTS: Cognitive scores were lower than the reference population mean at both 6 and 12 months. There were site differences in demographics and cognitive performance. Maternal education predicted expressive language in Boston, and speaking Spanish and lower rates of community poverty were associated with greater increases in overall cognition in Los Angeles. CONCLUSION: This exploratory study identified a number of drivers of child development that are both shared across cohorts and unique to specific community samples. Factors influencing heterogeneity within and across populations both may be important contributors to prevention and intervention in supporting healthy development among children.

Association of Perceived Maternal Stress During the Perinatal Period With Electroencephalography Patterns in 2-Month-Old Infants.

Importance: Variation in child responses to adversity creates a clinical challenge to identify children most resilient or susceptible to later risk for disturbances in cognition and health. Advances in establishing scalable biomarkers can lead to early identification and mechanistic understanding of the association of early adversity with neurodevelopment. Objectives: To examine whether maternal reports of stress are associated with patterns in resting electroencephalography at 2 months of age and whether unique electroencephalographic profiles associated with risk and resiliency factors can be identified. Design, Setting, and Participants: For this cohort study, a population-based sample of 113 mother-infant dyads was recruited from January 1, 2016, to March 1, 2018, during regularly scheduled pediatric visits before infants were 2 months of age from 2 primary care clinics in Boston, Massachusetts, and Los Angeles, California, that predominantly serve families from low-income backgrounds. Data are reported from a single time point, when infants were aged 2 months, of an ongoing cohort study longitudinally following the mother-infant dyads. Exposures: Maternal reported exposure to stressful life events and perceived stress. Main Outcomes and Measures: Spectral power (absolute and relative) in different frequency bands (Δ, θ, low and high α, ß, and γ) from infant resting electroencephalography (EEG) and EEG profiles across frequency bands determined by latent profile analysis. Results: Of 113 enrolled infants, 70 (mean [SD] age, 2.42 [0.37] months; 35 girls [50%]) provided usable EEG data. In multivariable hierarchical linear regressions, maternal perceived stress was significantly and negatively associated with absolute ß (ß = -0.007; 95% CI, -0.01 to -0.001; semipartial r = -0.25) and γ power (ß = -0.008; 95% CI, -0.01 to -0.002; semipartial r = -0.28). Maternal educational level was significantly and positively associated with power in high α, ß, and γ bands after adjusting for covariates (high school: γ: ß = 0.108; 95% CI, 0.014-0.203; semipartial r = -0.236; associate's degree or higher: high α: ß = 0.133; 95% CI, 0.018-0.248; semipartial r = 0.241; ß: ß = 0.167; 95% CI, 0.055-0.279; semipartial r = 0.309; and γ: ß = 0.183; 95% CI, 0.066-0.299; semipartial r = 0.323). Latent profile analysis identified 2 unique profiles for absolute and relative power. Maternal perceived stress (ß = 0.13; 95% CI, 0.01-0.25; adjusted odds ratio [AOR], 1.14; 95% CI, 1.01-1.28) and maternal educational level (high school: ß = 3.00; 95% CI, 0.35-5.65; AOR, 20.09; 95% CI, 1.42-283.16; associate's degree or higher: ß = 4.12; 95% CI, 1.45-6.79; AOR, 61.56; 95% CI, 4.28-885.01) were each associated with unique profile membership. Conclusions and Relevance: These findings suggest that unique contributions of caregiver stress and maternal educational level on infant neurodevelopment are detectable at 2 months; EEG might be a promising tool to identify infants most susceptible to parental stress and to reveal mechanisms by which neurodevelopment is associated with adversity. Additional studies validating subgroups across larger cohorts with different stressors and at different ages are required before use at the individual level in clinical settings.

Past experience shapes ongoing neural patterns for language.

Early experiences may establish a foundation for later learning, however, influences of early language experience on later neural processing are unknown. We investigated whether maintenance of neural templates from early language experience influences subsequent language processing. Using fMRI, we scanned the following three groups performing a French phonological working memory (PWM) task: (1) monolingual French children; (2) children adopted from China before age 3 who discontinued Chinese and spoke only French; (3) Chinese-speaking children who learned French as a second language but maintained Chinese. Although all groups perform this task equally well, brain activation differs. French monolinguals activate typical PWM brain regions, while both Chinese-exposed groups also activate regions implicated in cognitive control, even the adoptees who were monolingual French speakers at testing. Early exposure to a language, and/or delayed exposure to a subsequent language, continues to influence the neural processing of subsequently learned language sounds years later even in highly proficient, early-exposed users.

Mapping the unconscious maintenance of a lost first language.

Optimal periods during early development facilitate the formation of perceptual representations, laying the framework for future learning. A crucial question is whether such early representations are maintained in the brain over time without continued input. Using functional MRI, we show that internationally adopted (IA) children from China, exposed exclusively to French since adoption (mean age of adoption, 12.8 mo), maintained neural representations of their birth language despite functionally losing that language and having no conscious recollection of it. Their neural patterns during a Chinese lexical tone discrimination task matched those observed in Chinese/French bilinguals who have had continual exposure to Chinese since birth and differed from monolingual French speakers who had never been exposed to Chinese. They processed lexical tone as linguistically relevant, despite having no Chinese exposure for 12.6 y, on average, and no conscious recollection of that language. More specifically, IA participants recruited left superior temporal gyrus/planum temporale, matching the pattern observed in Chinese/French bilinguals. In contrast, French speakers who had never been exposed to Chinese did not recruit this region and instead activated right superior temporal gyrus. We show that neural representations are not overwritten and suggest a special status for language input obtained during the first year of development.

Losing face: impaired discrimination of featural and configural information in the mouth region of an inverted face.

Given that all faces share the same set of features-two eyes, a nose, and a mouth-that are arranged in similar configuration, recognition of a specific face must depend on our ability to discern subtle differences in its featural and configural properties. An enduring question in the face-processing literature is whether featural or configural information plays a larger role in the recognition process. To address this question, the face dimensions task was designed, in which the featural and configural properties in the upper (eye) and lower (mouth) regions of a face were parametrically and independently manipulated. In a same-different task, two faces were sequentially presented and tested in their upright or in their inverted orientation. Inversion disrupted the perception of featural size (Exp. 1), featural shape (Exp. 2), and configural changes in the mouth region, but it had relatively little effect on the discrimination of featural size and shape and configural differences in the eye region. Inversion had little effect on the perception of information in the top and bottom halves of houses (Exp. 3), suggesting that the lower-half impairment was specific to faces. Spatial cueing to the mouth region eliminated the inversion effect (Exp. 4), suggesting that participants have a bias to attend to the eye region of an inverted face. The collective findings from these experiments suggest that inversion does not differentially impair featural or configural face perceptions, but rather impairs the perception of information in the mouth region of the face.

Acquisition of English grammatical morphology by internationally adopted children from China.

Acquisition of English grammatical morphology was examined in five internationally adopted (IA) children from China (aged 0;10-1;1 at adoption) during the first three years' exposure to English to determine whether acquisition patterns were characteristic of child second language (L2) learners or monolingual first language (L1) learners. Results from spontaneous and elicited speech showed that IA children acquired grammatical morphemes similarly to L1 learners; namely, (1) non-tense-marking morphemes were acquired earlier than tense-marking morphemes; (2) BE was acquired in synchrony with other tense-marking morphemes; and (3) a high percentage of omission errors and a low percentage of commission errors were observed.

The n250 brain potential to personally familiar and newly learned faces and objects.

Studies employing event-related potentials have shown that when participants are monitoring for a novel target face, the presentation of their own face elicits an enhanced negative brain potential in posterior channels approximately 250 ms after stimulus onset. Here, we investigate whether the own face N250 effect generalizes to other highly familiar objects, specifically, images of the participant's own dog and own car. In our experiments, participants were asked to monitor for a pre-experimentally unfamiliar target face (Joe), a target dog (Experiment 1: Joe's Dog) or a target car (Experiment 2: Joe's Car). The target face and object stimuli were presented with non-target foils that included novel face and object stimuli, the participant's own face, their own dog (Experiment 1), and their own car (Experiment 2). The consistent findings across the two experiments were the following: (1) the N250 potential differentiated the target faces and objects from the non-target face and object foils and (2) despite being non-targets, the own face and own objects produced an N250 response that was equal in magnitude to the target faces and objects by the end of the experiment. Thus, as indicated by its response to personally familiar and recently familiarized faces and objects, the N250 component is a sensitive index of individuated representations in visual memory.

The neural plasticity of other-race face recognition.

Although it is well established that people are better at recognizing own-race faces than at recognizing other-race faces, the neural mechanisms mediating this advantage are not well understood. In this study, Caucasian participants were trained to differentiate African American (or Hispanic) faces at the individual level (e.g., Joe, Bob) and to categorize Hispanic (or African American) faces at the basic level of race (e.g., Hispanic, African American). Behaviorally, subordinate-level individuation training led to improved performance on a posttraining recognition test, relative to basic-level training. As measured by event-related potentials, subordinate- and basic-level training had relatively little effect on the face N170 component. However, as compared with basic-level training, subordinate-level training elicited an increased response in the posterior expert N250 component. These results demonstrate that learning to discriminate other-race faces at the subordinate level of the individual leads to improved recognition and enhanced activation of the expert N250 component.