Visually guided associative learning in pediatric and adult migraine without aura.

INTRODUCTION: The Rutgers Acquired Equivalence Test is a visually guided equivalence learning paradigm that involves rule acquisition and generalization. Earlier we found impaired performance in this paradigm among adult migraine patients without aura. The aim of the study was to investigate if similar impairments can be found already in the pediatric form of the disease and to compare the performance of the pediatric study population with that of an adult study population. We hypothesized that the deficits observed in adults would be observable already in the pediatric population. METHODS: Twenty-seven children and adolescents newly diagnosed with migraine without aura and 27 age- and sex-matched healthy controls were tested with the Rutgers Acquired Equivalence Test. Their performance data were compared to each other and those of an earlier adult study population involving 22 patients and 22 age- and sex-matched healthy controls. Four parameters characterizing performance in the two main phases of the paradigm were calculated for each of the four groups. Performance parameters were compared with Mann-Whitney U test. RESULTS: In contrast to the decreased performance of the adult patients in the Rutgers Acquired Equivalence Test, no significant difference was found between pediatric patients and controls in any phase of the paradigm. CONCLUSION: Children living with migraine without aura do not exhibit the same cognitive deficits in the Rutgers Acquired Equivalence Test as their adult counterparts. It can be hypothesized that the deficit of equivalence learning is not an inherent feature of the migrainous cognitive profile, rather the result of the interference of the disease with normal development.

Impairment of visually guided associative learning in children with Tourette syndrome.

The major symptoms of Tourette syndrome are motor and vocal tics, but Tourette syndrome is occasionally associated with cognitive alterations as well. Although Tourette syndrome does not affect the majority of cognitive functions, some of them improve. There is scarce evidence on the impairment of learning functions in patients with Tourette syndrome. The core symptoms of Tourette syndrome are related to dysfunction of the basal ganglia and the frontostriatal loops. Acquired equivalence learning is a kind of associative learning that is related to the basal ganglia and the hippocampi. The modified Rutgers Acquired Equivalence Test was used in the present study to observe the associative learning function of patients with Tourette syndrome. The cognitive learning task can be divided into two main phases: the acquisition and test phases. The latter is further divided into two parts: retrieval and generalization. The acquisition phase of the associative learning test, which mainly depends on the function of the basal ganglia, was affected in the entire patient group, which included patients with Tourette syndrome with attention deficit hyperactivity disorder, obsessive compulsive disorder, autism spectrum disorder, or no comorbidities. Patients with Tourette syndrome performed worse in building associations. However, the retrieval and generalization parts of the test phase, which primarily depend on the function of the hippocampus, were not worsened by Tourette syndrome.

Multisensory guided associative learning in healthy humans.

Associative learning is a basic cognitive function by which discrete and often different percepts are linked together. The Rutgers Acquired Equivalence Test investigates a specific kind of associative learning, visually guided equivalence learning. The test consists of an acquisition (pair learning) and a test (rule transfer) phase, which are associated primarily with the function of the basal ganglia and the hippocampi, respectively. Earlier studies described that both fundamentally-involved brain structures in the visual associative learning, the basal ganglia and the hippocampi, receive not only visual but also multisensory information. However, no study has investigated whether there is a priority for multisensory guided equivalence learning compared to unimodal ones. Thus we had no data about the modality-dependence or independence of the equivalence learning. In the present study, we have therefore introduced the auditory- and multisensory (audiovisual)-guided equivalence learning paradigms and investigated the performance of 151 healthy volunteers in the visual as well as in the auditory and multisensory paradigms. Our results indicated that visual, auditory and multisensory guided associative learning is similarly effective in healthy humans, which suggest that the acquisition phase is fairly independent from the modality of the stimuli. On the other hand, in the test phase, where participants were presented with acquisitions that were learned earlier and associations that were until then not seen or heard but predictable, the multisensory stimuli elicited the best performance. The test phase, especially its generalization part, seems to be a harder cognitive task, where the multisensory information processing could improve the performance of the participants.

The development of acquired equivalence from childhood to adulthood-A cross-sectional study of 265 subjects.

Acquired equivalence (AE) is a form of feedback-based associative learning where the subject learns that two or more stimuli are equivalent in terms of being mapped onto the same outcomes or responses. While several studies dealt with how various neurological and psychiatric conditions affect performance on AE tasks (typically with small populations), studies dealing with AE in healthy subjects are rare, and no study has ever made an attempt to plot the development of this form of learning from the childhood through adulthood. In a cross-sectional study, we assessed the AE performance of 265 healthy subjects aged 3 to 52 years with the computer-based Rutgers Equivalence Test (Fish-Face Test, FFT). The test assesses three main aspects of AE: the efficiency of pair learning, the efficiency of the retrieval of acquired pairs, and the ability to generalise previous knowledge to a new stimulus that partially overlaps with the previous ones. It has been demonstrated in imaging studies that the initial, pair learning phase of this specific test is dependent on the basal ganglia, while its generalization phase requires the hippocampi. We found that both pair learning and retrieval exhibited development well into adulthood, but generalisation did not, after having reached its adult-like level by the age of 6. We propose that these findings might be explained by the integrative encoding theory that focuses on the parallel dopaminergic midbrain-striatum/midbrain-hippocampus connections.

Acquired equivalence and related memory processes in migraine without aura.

Introduction Interictal deficits of elementary visuo-cognitive functions are well documented in patients with migraine and are mostly explained in terms of neocortical hyperexcitability. It has been suggested that the basal ganglia and the hippocampi might also be affected in migraine. If so, a deterioration of learning and memory processes related to these structures is expected. Methods A visual learning paradigm thought to be capable of dissociating learning/memory processes mediated by the basal ganglia from processes mediated by the hippocampus (the Rutgers Acquired Equivalence Test) was applied to a group of patients with migraine without aura and to age- and sex-matched controls. Results Patients with migraine showed a significantly poorer performance in both main phases of the test and the deficit in the phase considered to be dependent on the hippocampi was especially marked. Conclusions These results can be interpreted as behavioural support for findings that have suggested the involvement of the basal ganglia and the hippocampi in migraine, but further research is needed to clarify these findings.

The effect of simultaneous flickering light stimulation on global form and motion perception thresholds.

The question regarding the exact function of the primary visual cortex (V1) in vision has been around ever since the description of residual vision after damage to this cortical area by Riddoch in 1917. In 2002, Schoenfeld and colleagues proposed that V1 can be saturated by flashes of light, by which the function of V1-bypassing visual pathways can be "unmasked". The Schoenfeld group found that light flashes applied on stimulus onset led to the elevation of brightness increment detection thresholds, but left motion detection thresholds unaltered. Although the proposed method (i.e. the use of light flashes to induce refractoriness in V1) could be a simple, cheap and elegant way of exploring V1 functions, no study has followed up on this. Therefore it is not known if it works at all with other types of stimuli. For that reason, we decided to revisit the idea in a modified form. Global form and motion perception thresholds were assessed with static Glass pattern stimuli and random dot kinematograms, with and without 12Hz flickering light stimulation. Global motion thresholds were almost unaltered by flickering stimulation, while a significant threshold elevation was caused in the global form perception task. The strongest conclusion allowed by our data is that simultaneous flickering photostimulation elevates global form perception thresholds but not global motion perception thresholds. This is in some way related to the refractoriness generated in an unsatisfactorily defined part of V1. We suggest that this does not necessarily reflect the activity of V1-bypassing pathways, and propose that the application of light flashes is a method that deserves more attention in the exploration of the V1-dependent and independent elements of visual consciousness in human subjects.