Neurological soft signs as trait markers of a subset of patients with obsessive-compulsive disorder with low insight and altered cognitive abilities.

Neurological soft signs (NSS) are subtle motor control impairments that include involuntary movements and abnormalities of motor coordination, sensory integration and lateralization. They engage different brain networks, including the prefrontal networks that support the higher cognitive functions that are dysfunctional in obsessive-compulsive disorder (OCD). This study investigated the relationships between the presence of NSS and patients' severity of OCD symptoms, insight, and treatment resistance in a sample of 63 patients. Treatment-resistance was assessed considering all the treatments the patients received during the course of their disease. The four dimensions of OCD defined in the dimensional obsessive-compulsive scale were considered. Links between the patients' cognitive abilities and NSS were assessed using tests targeting specifically the core components of executive functions. As expected, OCD patients displayed more NSS than individually matched control participants. In OCD patients, high NSS scores were associated with poor insight and lower cognitive abilities. Multiple regression analysis identified worse visuospatial working memory, attentional control, and verbal fluency as predictive factors of high NSS scores among cognitive functions. Unexpectedly, the patients displaying symptoms in the contamination/washing dimension displayed less NSS than the other patients. In contrast, neither the severity of OCD symptoms nor long-range treatment resistance was significantly related to patients' NSS scores. Altogether, our findings suggest that high NSS scores may be a trait marker of a subset of OCD patients with low insight and particularly altered cognitive abilities who would not express the contamination/washing dimension of the pathology.

The ANTI-Vea-UGR Platform: A Free Online Resource to Measure Attentional Networks (Alertness, Orienting, and Executive Control) Functioning and Executive/Arousal Vigilance.

The Attentional Networks Test for Interactions and Vigilance-executive and arousal components (ANTI-Vea) is a computerized task of 32 min duration in the standard format. The task simultaneously assesses the main effects and interactions of the three attentional networks (i.e., phasic alertness, orienting, and executive control) and two dissociated components of vigilance with reasonable reliability (executive and arousal vigilance). We present this free and publicly accessible resource (ANTI-Vea-UGR; https://anti-vea.ugr.es/) developed to easily run, collect, and analyze data with the ANTI-Vea (or its subtasks measuring some attentional and/or vigilance components embedded in the ANTI-Vea). Available in six different languages, the platform allows for the adaptation of stimulus timing and procedure to facilitate data collection from different populations (e.g., clinical patients, children). Collected data can be freely downloaded and easily analyzed with the provided scripts and tools, including a Shiny app. We discuss previous evidence supporting that attention and vigilance components can be assessed in typical lab conditions as well as online and outside the laboratory. We hope this tutorial will help researchers interested in measuring attention and vigilance with a tool useful to collect data from large sample sizes and easy to use in applied contexts.

High treatment resistance is associated with lower performance in the Stroop test in patients with obsessive-compulsive disorder.

Around 50% of the patients with obsessive-compulsive disorder (OCD) are resistant to treatment, and patients with OCD show alterations in a broad range of cognitive abilities. The present study investigated the links between treatment-resistance, executive and working memory abilities, and the severity of OCD symptoms among 66 patients with OCD. The patients performed seven tests gauging their executive functions and working memory and filled in questionnaires for OCD severity and insight into their pathology. In addition, the executive and working memory abilities of a subset of these patients were compared with those of individually matched control participants. In contrast with previous studies, patients' treatment resistance was evaluated by considering the clinical outcomes of all the treatments that they received during the course of their disease. Higher treatment resistance was associated with lower performance in one particular executive test, the Stroop test, which assessed patients' ability to inhibit prepotent/automatic responses. Older age and more severe OCD symptoms were also associated with higher treatment resistance. Regardless of OCD severity, the patients displayed small to moderate deficits across most components of executive functions compared to control participants. Interestingly, patients with OCD took more time than control participants to perform speeded neuropsychological tests but never made more errors. Altogether, this study shows that the treatment-resistance of patients with OCD may be reliably quantified over the course of years and treatments using Pallanti and Quercioli's (2006) treatment resistance-related scales. The data suggest that the Stroop test could be used clinically to anticipate treatment outcomes in to-be-treated patients.

Attentional distraction affects maintenance of information in visual sensory memory.

Classical theoretical models suggest that visual short-term memory can be divided in two main memory systems: sensory memory, a short-lasting but high-capacity memory storage and working memory, a long-lasting but low-capacity memory store. Whilst, previous research has systematically shown a strong interplay between attentional mechanisms and working memory, less clear is the role of attention in sensory memory. In the present study we approach this issue by asking whether withdrawing attentional resources by a dual task (Experiment 1) or by presenting task irrelevant information during memory maintenance (Experiment 2 and 3) similarly or differently affect sensory and working memory. Overall, results showed that sensory memory content was undermined not only by a simultaneous high-demanding cognitive task but even when purely task-irrelevant and non-masking visual distractors were presented during maintenance. Our data provide support against theories that consider sensory memories as a case of visual awareness free of attention.

A vigilance decrement comes along with an executive control decrement: Testing the resource-control theory.

A decrease in vigilance over time is often observed when performing prolonged tasks, a phenomenon known as "vigilance decrement." The present study aimed at testing some of the critical predictions of the resource-control theory about the vigilance decrement. Specifically, the theory predicts that the vigilance decrement is mainly due to a drop in executive control, which fails to keep attentional resources on the external task, thus devoting a larger number of resources to mind-wandering across time-on-task. Datasets gathered from a large sample size (N = 617) who completed the Attentional Networks Test for Interactions and Vigilance-executive and arousal components in Luna, Roca, Martín-Arévalo, and Lupiáñez (2021b, Behavior Research Methods, 53[3], 1124-1147) were reanalyzed to test whether executive control decreases across time in a vigilance task and whether the vigilance decrement comes along with the decrement in executive control. Vigilance was examined as two dissociated components: executive vigilance, as the ability to detect infrequent critical signals, and arousal vigilance, as the maintenance of a fast reaction to stimuli. The executive control decrement was evidenced by a linear increase in the interference effect for mean reaction time, errors, and the inverse efficiency score. Critically, interindividual differences showed that the decrease in the executive-but not in the arousal-component of vigilance was modulated by the change in executive control across time-on-task, thus supporting the predictions of the resource-control theory. Nevertheless, given the small effect sizes observed in our large sample size, the present outcomes suggest further consideration of the role of executive control in resource-control theory.

Attentional Capture From Inside vs. Outside the Attentional Focus.

In this study, we jointly reported in an empirical and a theoretical way, for the first time, two main theories: Lavie's perceptual load theory and Gaspelin et al.'s attentional dwelling hypothesis. These theories explain in different ways the modulation of the perceptual load/task difficulty over attentional capture by irrelevant distractors and lead to the observation of the opposite results with similar manipulations. We hypothesized that these opposite results may critically depend on the distractor type used by the two experimental procedures (i.e., distractors inside vs. outside the attentional focus, which could be, respectively, considered as potentially relevant vs. completely irrelevant to the main task). Across a series of experiments, we compared both theories within the same paradigm by manipulating both the perceptual load/task difficulty and the distractor type. The results were strongly consistent, suggesting that the influence of task demands on attentional capture varies as a function of the distractor type: while the interference from (relevant) distractors presented inside the attentional focus was consistently higher for high vs. low load conditions, there was no modulation by (irrelevant) distractors presented outside the attentional focus. Moreover, we critically analyzed the theoretical conceptualization of interference using both theories, disentangling important outcomes for the dwelling hypothesis. Our results provide specific insights into new aspects of attentional capture, which can critically redefine these two predominant theories.

Crossmodal Semantic Congruence Interacts with Object Contextual Consistency in Complex Visual Scenes to Enhance Short-Term Memory Performance.

Object sounds can enhance the attentional selection and perceptual processing of semantically-related visual stimuli. However, it is currently unknown whether crossmodal semantic congruence also affects the post-perceptual stages of information processing, such as short-term memory (STM), and whether this effect is modulated by the object consistency with the background visual scene. In two experiments, participants viewed everyday visual scenes for 500 ms while listening to an object sound, which could either be semantically related to the object that served as the STM target at retrieval or not. This defined crossmodal semantically cued vs. uncued targets. The target was either in- or out-of-context with respect to the background visual scene. After a maintenance period of 2000 ms, the target was presented in isolation against a neutral background, in either the same or different spatial position as in the original scene. The participants judged the same vs. different position of the object and then provided a confidence judgment concerning the certainty of their response. The results revealed greater accuracy when judging the spatial position of targets paired with a semantically congruent object sound at encoding. This crossmodal facilitatory effect was modulated by whether the target object was in- or out-of-context with respect to the background scene, with out-of-context targets reducing the facilitatory effect of object sounds. Overall, these findings suggest that the presence of the object sound at encoding facilitated the selection and processing of the semantically related visual stimuli, but this effect depends on the semantic configuration of the visual scene.

Transcranial Magnetic Stimulation of the Right Superior Parietal Lobule Modulates the Retro-Cue Benefit in Visual Short-Term Memory.

Several studies have shown enhanced performance in change detection tasks when spatial cues indicating the probe's location are presented after the memory array has disappeared (i.e., retro-cues) compared with spatial cues that are presented simultaneously with the test array (i.e., post-cues). This retro-cue benefit led some authors to propose the existence of two different stores of visual short-term memory: a weak but high-capacity store (fragile memory (FM)) linked to the effect of retro-cues and a robust but low-capacity store (working memory (WM)) linked to the effect of post-cues. The former is thought to be an attention-free system, whereas the latter would strictly depend on selective attention. Nonetheless, this dissociation is under debate, and several authors do not consider retro-cues as a proxy to measure the existence of an independent memory system (e.g., FM). We approached this controversial issue by altering the attention-related functions in the right superior parietal lobule (SPL) by transcranial magnetic stimulation (TMS), whose effects were mediated by the integrity of the right superior longitudinal fasciculus (SLF). Specifically, we asked whether TMS on the SPL affected the performance of retro cues vs. post-cues to a similar extent. The results showed that TMS on the SPL, mediated by right SLF-III integrity, produced a modulation of the retro-cue benefit, namely a memory capacity decrease in the post-cues but not in the retro-cues. These findings have strong implications for the debate on the existence of independent stages of visual short-term memory and for the growing literature showing a key role of the SLF for explaining the variability of TMS effects across participants.

On the putative role of intervening events in exogenous attention.

In exogenous attention, two main behavioural effects are usually observed across time: facilitation at short cue-target onset asynchronies (CTOAs), and Inhibition of Return (IOR) at longer CTOAs. The presentation of an intervening event (IE)-i.e., a cue presented at fixation between the peripheral cue and target period-favours the appearance of IOR. However, although there is a general consensus on this empirical modulation, there is no agreement about the putative role of IEs and/or the mechanism/s underlying their effect. While some authors consider IEs as a "cue-back", automatically reorienting attention to fixation, thus allowing IOR to occur, others have considered IEs as events modulating cue-target integration processes, consequently affecting exogenous cueing. Even in this later case, it is not clear whether IEs modulate cueing by inducing an attentional set (top-down) modulation or by inducing a trial-by-trial (bottom-up) online modulation. To disentangle this issue, in two experiments, we manipulated the proportion of trials in which the IE was presented, thus being able to measure the effect of the presence/absence and proportion of IEs. We observed a gradual influence of the % of IEs over cueing effects, which becomes less positive or more negative as the % of IEs increases. This pattern of findings fits well with the idea that facilitation and IOR depend on cue-target integration processes, and presents critical implications for the open debate about the mechanism/s underlying exogenous spatial cueing effects.

Does spatial attention modulate sensory memory?

According to some theoretical models, information contained in visual short-term memory (VSTM) consists of two main memory stages/storages: sensory memory, a system wherein information is stored for a brief time with high detail and low resistance to visual interference, and visual working memory, a low-capacity system wherein information is protected from visual interference and maintained for longer delays. Previous studies have consistently shown a strong relationship between attention and visual working memory. However, evidence is contradictory on whether or not attention modulates the construction and maintenance of visual representations in sensory memory. Here, we examined whether and how spatial attention differentially affects sensory and working memory contents, by separately analysing attentional costs and attentional benefits. Results showed that both sensory memory and visual working memory were reliably affected by the distribution of spatial attention, suggesting that spatial attention modulates the VSTM content starting from very early stages of memory storage. Moreover, endogenously attending a specific location led to similar performance in sensory and working memory, and therefore to larger attentional benefits in working memory (where there was more room for improvement than in sensory memory, because of worse performance in unattended locations). On the other hand, exogenous attentional capture by peripheral unpredictive cues produced invariant attentional costs and invariant attentional benefits regardless of the memory type, with performance being higher in sensory memory than in working memory even at the attended location.

Visual search for verbal material in patients with obsessive-compulsive disorder.

This study aimed at investigating attentional mechanisms in obsessive-compulsive disorder (OCD) by analysing how visual search processes are modulated by normal and obsession-related distracting information in OCD patients and whether these modulations differ from those observed in healthy people. OCD patients were asked to search for a target word within distractor words that could be orthographically similar to the target, semantically related to the target, semantically related to the most typical obsessions/compulsions observed in OCD patients, or unrelated to the target. Patients' performance and eye movements were compared with those of individually matched healthy controls. In controls, the distractors that were visually similar to the target mostly captured attention. Conversely, patients' attention was captured equally by all kinds of distractor words, whatever their similarity with the target, except obsession-related distractors that attracted patients' attention less than the other distractors. OCD had a major impact on the mostly subliminal mechanisms that guide attention within the search display, but had much less impact on the distractor rejection processes that take place when a distractor is fixated. Hence, visual search in OCD is characterized by abnormal subliminal, but not supraliminal, processing of obsession-related information and by an impaired ability to inhibit task-irrelevant inputs.

Target bottom-up strength determines the extent of attentional modulations on conscious perception.

A sufficient level of alerting, bottom-up stimulus strength, and attention have been proposed as important pre-requisites for conscious perception (Dehaene et al. in Trends Cogn Sci 10:204-211, 2006). The combination of different levels of each of these processes might differentially bias the access to consciousness, so that the impact of a specific factor on conscious access would depend on the levels of the other factors. To explore this possibility, we measured how the interaction between different levels of (phasic and tonic) alerting, stimulus bottom-up activation, and endogenous spatial attention, influences conscious perception. We observed that endogenous spatial attention affected conscious perception mainly when target bottom-up strength was low, by improving perceptual sensitivity and making the response criterion stricter. Attention-driven increases of perceptual sensitivity (without variations in response criterion) were also observed for higher levels of bottom-up strength, but only when tonic alerting decreased. Phasic alerting boosted perceptual sensitivity independently of target bottom-up strength, even though it differently affected response bias, yielding a more liberal response criterion when target bottom-up strength increases. These results suggest that a more exhaustive approach to the study of conscious perception should consider the interaction of the multiple factors that are susceptible to modulate perceptual consciousness, rather than studying their effects in isolation.

A cow on the prairie vs. a cow on the street: long-term consequences of semantic conflict on episodic encoding.

Long-term effects of cognitive conflict on performance are not as well understood as immediate effects. We used a change detection task to explore long-term consequences of cognitive conflict by manipulating the congruity between a changing object and a background scene. According to conflict-based accounts of memory formation, incongruent trials (e.g., a cow on the street), in spite of hindering immediate performance, should promote stronger encoding than congruent trials (e.g., a cow on a prairie). Surprisingly, across three experiments we show that semantic incongruity actually impairs remembering of the information presented during scene processing. This set of results is incompatible with the frequently accepted hypothesis of conflict-triggered learning. Rather, we discuss the present data and other studies previously reported in the literature in the light of two much older hypotheses of memory formation: the desirable difficulty and the levels of processing principles.

Interactions between phasic alerting and consciousness in the fronto-striatal network.

Only a small fraction of all the information reaching our senses can be the object of conscious report or voluntary action. Although some models propose that different attentional states (top-down amplification and vigilance) are necessary for conscious perception, few studies have explored how the brain activations associated with different attentional systems (such as top-down orienting and phasic alerting) lead to conscious perception of subsequent visual stimulation. The aim of the present study was to investigate the neural mechanisms associated with endogenous spatial attention and phasic alertness, and their interaction with the conscious perception of near-threshold stimuli. The only region demonstrating a neural interaction between endogenous attention and conscious perception was the thalamus, while a larger network of cortical and subcortical brain activations, typically associated with phasic alerting, was highly correlated with participants' conscious reports. Activation of the anterior cingulate cortex, supplementary motor area, frontal eye fields, thalamus, and caudate nucleus was related to perceptual consciousness. These data suggest that not all attentional systems are equally effective in enhancing conscious perception, highlighting the importance of thalamo-cortical circuits on the interactions between alerting and consciousness.

Endogenous attention modulates attentional and motor interference from distractors: evidence from behavioral and electrophysiological results.

Selective visual attention enhances the processing of relevant stimuli and filters out irrelevant stimuli and/or distractors. However, irrelevant information is sometimes processed, as demonstrated by the Simon effect (Simon and Rudell, 1967). We examined whether fully irrelevant distractors (task and target-irrelevant) produce interference (measured as the Simon effect), and whether endogenous orienting modulated this interference. Despite being fully irrelevant, distractors were attentionally coded (as reflected by the distractor-related N2pc component), and interfered with the processing of the target response (as reflected by the target-related lateralized readiness potential component). Distractors' attentional capture depended on endogenous attention, and their interference with target responses was modulated by both endogenous attention and distractor location repetition. These results demonstrate both endogenous attentional and motor modulations over the Simon effect produced by fully irrelevant distractors.

Spatial distribution of attentional bias in visuo-spatial working memory following multiple cues.

When attention is focused on one location, its spatial distribution depends on many factors, such as the distance between the attended location and the target location, the presence of visual meridians in between them, and the way, endogenous or exogenous, by which attention is oriented. However, it is not well known how attention distributes when more than one location is endogenously or exogenously cued, which was the focus of the current study. Furthermore, the distribution of attention has been manly investigated in perception. In the present study we faced this issue from a different perspective, by examining the spatial distribution of the attentional bias in visuo-spatial working memory (VSWM), when attention is oriented either exogenously or endogenously, i.e., after two peripheral vs. central symbolic cues (also manipulating cue-target predictability). Results indicated a systematic difference between endogenous and exogenous attention regarding the distribution of the attentional bias over VSWM. In fact, attentional bias following endogenous cues was affected by the presence of visual meridians and by the split of the attentional focus, converging in a unipolar attentional distribution, independently of cue-target predictability. On the other hand, when pulled by exogenous cues, attention distributed uni-modally or multi-modally depending on the distance between the cued locations, with larger effects for highly predictive cues. Results are discussed in terms of space-based, object-based and perceptual grouping mechanisms.

The Spatial Orienting paradigm: how to design and interpret spatial attention experiments.

This paper is conceived as a guide that will describe the very well known Spatial Orienting paradigm, used to explore attentional processes in healthy individuals as well as in people suffering from psychiatric disorders and brain-damaged patients. The paradigm was developed in the late 1970s, and since then, it has been used in thousands of attentional studies. In this review, we attempt to describe, the paradigm for the naïf reader, and explain in detail when is it used, which variables are usually manipulated, how to interpret its results, and how can it be adapted to different populations and methodologies. The main goal of this review is to provide a practical guide to researchers who have never used the paradigm that will help them design their experiments, as a function of their theoretical and experimental needs. We also focus on how to adapt the paradigm to different technologies (such as event-related potentials, functional resonance imaging, or transcranial magnetic stimulation), and to different populations by presenting an example of its use in brain-damaged patients.

When endogenous spatial attention improves conscious perception: effects of alerting and bottom-up activation.

Recent studies have consistently demonstrated that conscious perception interacts with exogenous attentional orienting, but it can be dissociated from endogenous attentional orienting (Chica Lasaponara, et al., 2011; Wyart & Tallon-Baudry, 2008). It has been hypothesized that enhanced conscious processing at exogenously attended locations results from a synergistic action of spatial orienting, bottom-up activation, and phasic alerting induced by the abrupt onset of the exogenous cue (Chica, Lasaponara, et al., 2011). Instead, as endogenous cues need more time to be interpreted, the phasic alerting they produce may have dissipated when the target appears. Furthermore, endogenous cues presumably elicit a weak bottom-up activation at the cued location. Consistent with these hypotheses, we observed that endogenous attention modulated conscious perception, but only when phasic alerting or bottom-up activation was increased. Results are discussed in the context of recent theoretical models of consciousness (Dehaene, Changeux, Naccache, Sackur, & Sergent, 2006).

Visual unimodal grouping mediates auditory attentional bias in visuo-spatial working memory.

Audiovisual links in spatial attention have been reported in many previous studies. However, the effectiveness of auditory spatial cues in biasing the information encoding into visuo-spatial working memory (VSWM) is still relatively unknown. In this study, we addressed this issue by combining a cuing paradigm with a change detection task in VSWM. Moreover, we manipulated the perceptual organization of the to-be-remembered visual stimuli. We hypothesized that the auditory effect on VSWM would depend on the perceptual association between the auditory cue and the visual probe. Results showed, for the first time, a significant auditory attentional bias in VSWM. However, the effect was observed only when the to-be-remembered visual stimuli were organized in two distinctive visual objects. We propose that these results shed new light on audio-visual crossmodal links in spatial attention suggesting that, apart from the spatio-temporal contingency, the likelihood of perceptual association between the auditory cue and the visual target can have a large impact on crossmodal attentional biases.

Spatial attention and conscious perception: interactions and dissociations between and within endogenous and exogenous processes.

A current controversy exists about the relationship between spatial attention and conscious perception. While some authors propose that these phenomena are intimately related (Bartolomeo, 2008; Chun & Marois, 2002; O'Regan & Noë, 2001; Posner, 1994), others report dissociations between them (Kentridge et al., 1999; Koch & Tsuchiya, 2007; Wyart & Tallon-Baudry, 2008). However, spatial attention is not a unitary mechanism, and it is possible that not all forms of attention dissociate from conscious perception. In the present study we used a paradigm in which endogenous and exogenous forms of attention are orthogonally manipulated in order to investigate their relation with conscious perception within the same design. By analyzing two different cue-related components, our results demonstrated that while endogenous attention was electrophysiologically dissociated from conscious perception, exogenous attention was not, consistent with the hypothesis that exogenous attention is an important antecedent of our conscious experience. Our results support previous claims of dissociations between some forms of spatial attention and conscious perception, but also highlight the importance of exogenous orienting on the selection of information for conscious access.