A distributed theta network of error generation and processing in aging.

Based on previous concepts that a distributed theta network with a central "hub" in the medial frontal cortex is critically involved in movement regulation, monitoring, and control, the present study explored the involvement of this network in error processing with advancing age in humans. For that aim, the oscillatory neurodynamics of motor theta oscillations was analyzed at multiple cortical regions during correct and error responses in a sample of older adults. Response-related potentials (RRPs) of correct and incorrect reactions were recorded in a four-choice reaction task. RRPs were decomposed in the time-frequency domain to extract oscillatory theta activity. Motor theta oscillations at extended motor regions were analyzed with respect to power, temporal synchronization, and functional connectivity. Major results demonstrated that errors had pronounced effects on motor theta oscillations at cortical regions beyond the medial frontal cortex by being associated with (1) theta power increase in the hemisphere contra-lateral to the movement, (2) suppressed spatial and temporal synchronization at pre-motor areas contra-lateral to the responding hand, (2) inhibited connections between the medial frontal cortex and sensorimotor areas, and (3) suppressed connectivity and temporal phase-synchronization of motor theta networks in the posterior left hemisphere, irrespective of the hand, left, or right, with which the error was made. The distributed effects of errors on motor theta oscillations demonstrate that theta networks support performance monitoring. The reorganization of these networks with aging implies that in older individuals, performance monitoring is associated with a disengagement of the medial frontal region and difficulties in controlling the focus of motor attention and response selection. Supplementary Information: The online version contains supplementary material available at 10.1007/s11571-023-10018-4.

Motor oscillations reveal new correlates of error processing in the human brain.

It has been demonstrated that during motor responses, the activation of the motor cortical regions emerges in close association with the activation of the medial frontal cortex implicated with performance monitoring and cognitive control. The present study explored the oscillatory neurodynamics of response-related potentials during correct and error responses to test the hypothesis that such continuous communication would modify the characteristics of motor potentials during performance errors. Electroencephalogram (EEG) was recorded at 64 electrodes in a four-choice reaction task and response-related potentials (RRPs) of correct and error responses were analysed. Oscillatory RRP components at extended motor areas were analysed in the theta (3.5-7 Hz) and delta (1-3 Hz) frequency bands with respect to power, temporal synchronization (phase-locking factor, PLF), and spatial synchronization (phase-locking value, PLV). Major results demonstrated that motor oscillations differed between correct and error responses. Error-related changes (1) were frequency-specific, engaging delta and theta frequency bands, (2) emerged already before response production, and (3) had specific regional topographies at posterior sensorimotor and anterior (premotor and medial frontal) areas. Specifically, the connectedness of motor and sensorimotor areas contra-lateral to the response supported by delta networks was substantially reduced during errors. Also, there was an error-related suppression of the phase stability of delta and theta oscillations at these areas. This synchronization reduction was accompanied by increased temporal synchronization of motor theta oscillations at bi-lateral premotor regions and by two distinctive error-related effects at medial frontal regions: (1) a focused fronto-central enhancement of theta power and (2) a separable enhancement of the temporal synchronization of delta oscillations with a localized medial frontal focus. Together, these observations indicate that the electrophysiological signatures of performance errors are not limited to the medial frontal signals, but they also involve the dynamics of oscillatory motor networks at extended cortical regions generating the movement. Also, they provide a more detailed picture of the medial frontal processes activated in relation to error processing.

Nightmare frequency is a risk factor for suicidal ideation during the COVID-19 pandemic.

The association between nightmare frequency (NMF) and suicidal ideation (SI) is well known, yet the impact of the COVID-19 pandemic on this relation is inconsistent. This study aimed to investigate changes in NMF, SI, and their association during the COVID-19 pandemic. Data were collected in 16 countries using a harmonised questionnaire. The sample included 9328 individuals (4848 women; age M[SD] = 46.85 [17.75] years), and 17.60% reported previous COVID-19. Overall, SI was significantly 2% lower during the pandemic vs. before, and this was consistent across genders and ages. Most countries/regions demonstrated decreases in SI during this pandemic, with Austria (-9.57%), Sweden (-6.18%), and Bulgaria (-5.14%) exhibiting significant declines in SI, but Italy (1.45%) and Portugal (2.45%) demonstrated non-significant increases. Suicidal ideation was more common in participants with long-COVID (21.10%) vs. short-COVID (12.40%), though SI did not vary by COVID-19 history. Nightmare frequency increased by 4.50% during the pandemic and was significantly higher in those with previous COVID-19 (14.50% vs. 10.70%), during infection (23.00% vs. 8.10%), and in those with long-COVID (18.00% vs. 8.50%). The relation between NMF and SI was not significantly stronger during the pandemic than prior (rs = 0.18 vs. 0.14; z = 2.80). Frequent nightmares during the pandemic increased the likelihood of reporting SI (OR = 1.57, 95% CI 1.20-2.05), while frequent dream recall during the pandemic served a protective effect (OR = 0.74, 95% CI 0.59-0.94). These findings have important implications for identifying those at risk of suicide and may offer a potential pathway for suicide prevention.

Estimation bias and agreement limits between two common self-report methods of habitual sleep duration in epidemiological surveys.

Accurate measurement of habitual sleep duration (HSD) is crucial for understanding the relationship between sleep and health. This study aimed to assess the bias and agreement limits between two commonly used short HSD self-report methods, considering sleep quality (SQ) and social jetlag (SJL) as potential predictors of bias. Data from 10,268 participants in the International COVID Sleep Study-II (ICOSS-II) were used. Method-Self and Method-MCTQ were compared. Method-Self involved a single question about average nightly sleep duration (HSDself), while Method-MCTQ estimated HSD from reported sleep times on workdays (HSDMCTQwork) and free days (HSDMCTQfree). Sleep quality was evaluated using a Likert scale and the Insomnia Severity Index (ISI) to explore its influence on estimation bias. HSDself was on average 42.41 ± 67.42 min lower than HSDMCTQweek, with an agreement range within ± 133 min. The bias and agreement range between methods increased with poorer SQ. HSDMCTQwork showed less bias and better agreement with HSDself compared to HSDMCTQfree. Sleep duration irregularity was - 43.35 ± 78.26 min on average. Subjective sleep quality predicted a significant proportion of variance in HSDself and estimation bias. The two methods showed very poor agreement and a significant systematic bias, both worsening with poorer SQ. Method-MCTQ considered sleep intervals without adjusting for SQ issues such as wakefulness after sleep onset but accounted for sleep irregularity and sleeping in on free days, while Method-Self reflected respondents' interpretation of their sleep, focusing on their sleep on workdays. Including an SQ-related question in surveys may help bidirectionally adjust the possible bias and enhance the accuracy of sleep-health studies.

Aging alters functional connectivity of motor theta networks during sensorimotor reactions.

OBJECTIVE: Both cognitive and primary motor networks alter with advancing age in humans. The networks activated in response to external environmental stimuli supported by theta oscillations remain less well explored. The present study aimed to characterize the effects of aging on the functional connectivity of response-related theta networks during sensorimotor tasks. METHODS: Electroencephalographic signals were recorded in young and middle-to-older age adults during three tasks performed in two modalities, auditory and visual: a simple reaction task, a Go-NoGo task, and a choice-reaction task. Response-related theta oscillations were computed. The phase-locking value (PLV) was used to analyze the spatial synchronization of primary motor and motor control theta networks. RESULTS: Performance was overall preserved in older adults. Independently of the task, aging was associated with reorganized connectivity of the contra-lateral primary motor cortex. In younger adults, it was synchronized with motor control regions (intra-hemispheric premotor/frontal and medial frontal). In older adults, it was only synchronized with intra-hemispheric sensorimotor regions. CONCLUSIONS: Motor theta networks of older adults manifest a functional decoupling between the response-generating motor cortex and motor control regions, which was not modulated by task variables. The overall preserved performance in older adults suggests that the increased connectivity within the sensorimotor network is associated with an excessive reliance on sensorimotor feedback during movement execution compensating for a deficient cognitive regulation of motor regions during sensorimotor reactions. SIGNIFICANCE: New evidence is provided for the reorganization of motor networks during sensorimotor reactions already at the transition from middle to old age.

Habitual short sleepers with pre-existing medical conditions are at higher risk of Long COVID.

STUDY OBJECTIVES: Preliminary evidence suggests that the risk of Long COVID is higher among people with pre-existing medical conditions. Based on its proven adjuvant role in immunity, habitual sleep duration may alter the risk of developing Long COVID. The objective of this study was to determine whether the odds of Long COVID are higher among those with pre-existing medical conditions, and whether the strength of this association varies by habitual sleep duration. METHODS: Using data from 13,461 respondents from 16 countries who participated in the 2021 survey-based International COVID Sleep Study II (ICOSS II), we studied the associations between habitual sleep duration, pre-existing medical conditions, and Long COVID. RESULTS: Of 2,508 individuals who had COVID-19, 61% reported at least 1 Long COVID symptom. Multivariable logistic regression analysis showed that the risk of having Long COVID was 1.8-fold higher for average-length sleepers (6-9 h/night) with pre-existing medical conditions compared with those without pre-existing medical conditions (adjusted odds ratio [aOR] 1.84 [1.18-2.90]; P = .008). The risk of Long COVID was 3-fold higher for short sleepers with pre-existing medical conditions (aOR 2.95 [1.04-8.4]; P = .043) and not significantly higher for long sleepers with pre-existing conditions (aOR 2.11 [0.93-4.77]; P = .073) compared with average-length sleepers without pre-existing conditions. CONCLUSIONS: Habitual short nighttime sleep duration exacerbated the risk of Long COVID in individuals with pre-existing conditions. Restoring nighttime sleep to average duration represents a potentially modifiable behavioral factor to lower the odds of Long COVID for at-risk patients. CITATION: Berezin L, Waseem R, Merikanto I, et al. Habitual short sleepers with pre-existing medical conditions are at higher risk of long COVID. J Clin Sleep Med. 2024;20(1):111-119.

The association of insomnia with long COVID: An international collaborative study (ICOSS-II).

OBJECTIVE: There is evidence of a strong association between insomnia and COVID-19, yet few studies have examined the relationship between insomnia and long COVID. This study aimed to investigate whether COVID-19 patients with pre-pandemic insomnia have a greater risk of developing long COVID and whether long COVID is in turn associated with higher incident rates of insomnia symptoms after infection. METHODS: Data were collected cross-sectionally (May-Dec 2021) as part of an international collaborative study involving participants from 16 countries. A total of 2311 participants (18-99 years old) with COVID-19 provided valid responses to a web-based survey about sleep, insomnia, and health-related variables. Log-binomial regression was used to assess bidirectional associations between insomnia and long COVID. Analyses were adjusted for age, sex, and health conditions, including sleep apnea, attention and memory problems, chronic fatigue, depression, and anxiety. RESULTS: COVID-19 patients with pre-pandemic insomnia showed a higher risk of developing long COVID than those without pre-pandemic insomnia (70.8% vs 51.4%; adjusted relative risk [RR]: 1.33, 95% confidence interval [CI]: 1.07-1.65). Among COVID-19 cases without pre-pandemic insomnia, the rates of incident insomnia symptoms after infection were 24.1% for short COVID cases and 60.6% for long COVID cases (p < .001). Compared with short COVID cases, long COVID cases were associated with an increased risk of developing insomnia symptoms (adjusted RR: 2.00; 95% CI: 1.50-2.66). CONCLUSIONS: The findings support a bidirectional relationship between insomnia and long COVID. These findings highlight the importance of addressing sleep and insomnia in the prevention and management of long COVID.

Associations between changes in habitual sleep duration and lower self-rated health among COVID-19 survivors: findings from a survey across 16 countries/regions.

BACKGROUND: Self-rated health (SRH) is widely recognized as a clinically significant predictor of subsequent mortality risk. Although COVID-19 may impair SRH, this relationship has not been extensively examined. The present study aimed to examine the correlation between habitual sleep duration, changes in sleep duration after infection, and SRH in subjects who have experienced SARS-CoV-2 infection. METHODS: Participants from 16 countries participated in the International COVID Sleep Study-II (ICOSS-II) online survey in 2021. A total of 10,794 of these participants were included in the analysis, including 1,509 COVID-19 individuals (who reported that they had tested positive for COVID-19). SRH was evaluated using a 0-100 linear visual analog scale. Habitual sleep durations of < 6 h and > 9 h were defined as short and long habitual sleep duration, respectively. Changes in habitual sleep duration after infection of ≤ -2 h and ≥ 1 h were defined as decreased or increased, respectively. RESULTS: Participants with COVID-19 had lower SRH scores than non-infected participants, and those with more severe COVID-19 had a tendency towards even lower SRH scores. In a multivariate regression analysis of participants who had experienced COVID-19, both decreased and increased habitual sleep duration after infection were significantly associated with lower SRH after controlling for sleep quality (ß = -0.056 and -0.058, respectively, both p < 0.05); however, associations between current short or long habitual sleep duration and SRH were negligible. Multinomial logistic regression analysis showed that decreased habitual sleep duration was significantly related to increased fatigue (odds ratio [OR] = 1.824, p < 0.01), shortness of breath (OR = 1.725, p < 0.05), diarrhea/nausea/vomiting (OR = 2.636, p < 0.01), and hallucinations (OR = 5.091, p < 0.05), while increased habitual sleep duration was significantly related to increased fatigue (OR = 1.900, p < 0.01). CONCLUSIONS: Changes in habitual sleep duration following SARS-CoV-2 infection were associated with lower SRH. Decreased or increased habitual sleep duration might have a bidirectional relation with post-COVID-19 symptoms. Further research is needed to better understand the mechanisms underlying these relationships for in order to improve SRH in individuals with COVID-19.

Persistent short nighttime sleep duration is associated with a greater post-COVID risk in fully mRNA-vaccinated individuals.

Short nighttime sleep duration impairs the immune response to virus vaccination, and long nighttime sleep duration is associated with poor health status. Thus, we hypothesized that short (<6 h) and long (>9 h) nighttime sleepers have a higher post-COVID risk than normal nighttime sleepers, despite two doses of mRNA vaccine (which has previously been linked to lower odds of long-lasting COVID-19 symptoms). Post-COVID was defined as experiencing at least one core COVID-19 symptom for at least three months (e.g., shortness of breath). Multivariate logistic regression adjusting for age, sex, BMI, and other factors showed in 9717 respondents (age span 18-99) that two mRNA vaccinations lowered the risk of suffering from post-COVID by about 21% (p < 0.001). When restricting the analysis to double-vaccinated respondents (n = 5918), short and long sleepers exhibited a greater post-COVID risk than normal sleepers (adjusted OR [95%-CI], 1.56 [1.29, 1.88] and 1.87 [1.32, 2.66], respectively). Among respondents with persistent sleep duration patterns during the pandemic compared to before the pandemic, short but not long sleep duration was significantly associated with the post-COVID risk (adjusted OR [95%-CI], 1.59 [1.24, 2.03] and 1.18 [0.70, 1.97], respectively). No significant association between sleep duration and post-COVID symptoms was observed in those reporting positive SARS-CoV-2 test results (n = 538). Our findings suggest that two mRNA vaccinations against SARS-CoV-2 are associated with a lower post-COVID risk. However, this protection may be less pronounced among those sleeping less than 6 h per night. Our findings warrant replication in cohorts with individuals with confirmed SARS-CoV-2 infection.

Sleep symptoms are essential features of long-COVID - Comparing healthy controls with COVID-19 cases of different severity in the international COVID sleep study (ICOSS-II).

Many people report suffering from post-acute sequelae of COVID-19 or "long-COVID", but there are still open questions on what actually constitutes long-COVID and how prevalent it is. The current definition of post-acute sequelae of COVID-19 is based on voting using the Delphi-method by the WHO post-COVID-19 working group. It emphasizes long-lasting fatigue, shortness of breath and cognitive dysfunction as the core symptoms of post-acute sequelae of COVID-19. In this international survey study consisting of 13,628 subjects aged 18-99 years from 16 countries of Asia, Europe, North America and South America (May-Dec 2021), we show that post-acute sequelae of COVID-19 symptoms were more prevalent amongst the more severe COVID-19 cases, i.e. those requiring hospitalisation for COVID-19. We also found that long-lasting sleep symptoms are at the core of post-acute sequelae of COVID-19 and associate with the COVID-19 severity when COVID-19 cases are compared with COVID-negative cases. Specifically, fatigue (61.3%), insomnia symptoms (49.6%) and excessive daytime sleepiness (35.8%) were highly prevalent amongst respondents reporting long-lasting symptoms after hospitalisation for COVID-19. Understanding the importance of sleep-related symptoms in post-acute sequelae of COVID-19 has a clinical relevance when diagnosing and treating long-COVID.

The Primacy of Beauty in Music, Visual Arts and Literature: Not Just a Replication Study in the Greek Language Exploring the Effects of Verbal Fluency, Age and Gender.

Research on aesthetic descriptors of art in different languages is scarce. The aim of the present study was to elucidate the conceptual structure of aesthetic experiences of three forms of art (music, visual arts and literature) in the Greek language, which has not been explored so far. It was further aimed to study if biological and cognitive factors such as age and gender might produce differences in art appreciation. A total of 467 younger and older individuals from Greece were asked to generate verbal descriptors (adjectives) in free word-listing conditions in order to collect terms reflecting the aesthetics-related semantic field of art. The capacity of verbal memory was controlled by using a battery of neuropsychological tests. Analysis of generated adjectives' frequency and salience revealed that 'beautiful' was the most prominent descriptor that was selected with a distinctive primacy for all three forms of arts. The primacy of 'beautiful' was significantly more pronounced for visual arts relative to music and literature. Although the aging-related decline of verbal capacity was similar for males and females, the primacy of 'beautiful' depended on age and gender by being more emphasized for young females than males, and for old males than females. Analysis of secondary descriptors and pairs of adjectives revealed that affective and hedonic experiences are essentially fixed in the semantic field of art reflection. It is concluded that although the concept of the aesthetics seems to be diversified and rich, a clear primacy of beauty is found for the Greek cultural environment and across different forms of art. The results also highlight the presence of complex influences of biological and cognitive factors on aesthetic art experiences.

Neural Correlates of Aging-Related Differences in Pro-active Control in a Dual Task.

Background: Multi-tasking is usually impaired in older people. In multi-tasking, a fixed order of sub-tasks can improve performance by promoting a time-structured preparation of sub-tasks. How proactive control prioritizes the pre-activation or inhibition of complex tasks in older people has received no sufficient clarification so far. Objective: To explore the effects of aging on neural proactive control mechanisms in a dual task. Methodology: To address this question, the psychological refractory period (PRP) paradigm was used. Two 2-alternative-forced-choice reaction tasks with a predefined order (T1 and T2) signaled by a cue had to be executed simultaneously or consecutively by young (mean age 25.1 years, n = 36) and old subjects (mean age 70.4 years, n = 118). Performance indices of dual-task preparation were used to assess the focused preparation of T1 and T2. To compare preparatory mechanisms at the neurophysiologic level, multi-channel electroencephalogram (EEG) was recorded and negative slow cortical potentials (SCPs) were analyzed as objective markers of the amount and localization of cortical pre-activation before sub-task presentation. Results: Dual-task performance was significantly slower in old adults. T1 performance was facilitated in both age groups, but T2 processing in old adults was not optimized by the temporal structure as efficiently as in young adults. Also, only young adults manifested a stable pattern of focused of negative slow-wave activity increase at medial frontal and right-hemisphere posterior regions, which was associated with a coordinated preparatory T1 pre-activation and T2 deferment, while old adults manifested a broad topographic distribution of negative SCPs associated with a pre-activation of sensory and motor processes. Conclusions: These observations demonstrate that the proactive preparation for dual tasking is altered with aging. It is suggested that in young adults, attention-based pre-activation of working memory and inhibitory networks in the right hemisphere synchronizes the simultaneous preparation of the two sub-tasks, whereas in old adults, sensory and motor networks appear to be non-specifically pre-activated for subsequent deferred mode of processing.

Attentional and cognitive monitoring brain networks in long-term meditators depend on meditation states and expertise.

Meditation practice is suggested to engage training of cognitive control systems in the brain. To evaluate the functional involvement of attentional and cognitive monitoring processes during meditation, the present study analysed the electroencephalographic synchronization of fronto-parietal (FP) and medial-frontal (MF) brain networks in highly experienced meditators during different meditation states (focused attention, open monitoring and loving kindness meditation). The aim was to assess whether and how the connectivity patterns of FP and MF networks are modulated by meditation style and expertise. Compared to novice meditators, (1) highly experienced meditators exhibited a strong theta synchronization of both FP and MF networks in left parietal regions in all mediation styles, and (2) only the connectivity of lateralized beta MF networks differentiated meditation styles. The connectivity of intra-hemispheric theta FP networks depended non-linearly on meditation expertise, with opposite expertise-dependent patterns found in the left and the right hemisphere. In contrast, inter-hemispheric FP connectivity in faster frequency bands (fast alpha and beta) increased linearly as a function of expertise. The results confirm that executive control systems play a major role in maintaining states of meditation. The distinctive lateralized involvement of FP and MF networks appears to represent a major functional mechanism that supports both generic and style-specific meditation states. The observed expertise-dependent effects suggest that functional plasticity within executive control networks may underpin the emergence of unique meditation states in expert meditators.

Common and distinct lateralised patterns of neural coupling during focused attention, open monitoring and loving kindness meditation.

Meditation has been integrated into different therapeutic interventions. To inform the evidence-based selection of specific meditation types it is crucial to understand the neural processes associated with different meditation practices. Here we explore commonalities and differences in electroencephalographic oscillatory spatial synchronisation patterns across three important meditation types. Highly experienced meditators engaged in focused attention, open monitoring, and loving kindness meditation. Improving on previous research, our approach avoids comparisons between groups that limited previous findings, while ensuring that the meditation states are reliably established. Employing a novel measure of neural coupling - the imaginary part of EEG coherence - the study revealed that all meditation conditions displayed a common connectivity pattern that is characterised by increased connectivity of (a) broadly distributed delta networks, (b) left-hemispheric theta networks with a local integrating posterior focus, and (c) right-hemispheric alpha networks, with a local integrating parieto-occipital focus. Furthermore, each meditation state also expressed specific synchronisation patterns differentially recruiting left- or right-lateralised beta networks. These observations provide evidence that in addition to global patterns, frequency-specific inter-hemispheric asymmetry is one major feature of meditation, and that mental processes specific to each meditation type are also supported by lateralised networks from fast-frequency bands.

Aging-related changes in motor response-related theta activity.

It has been suggested that a distributed oscillatory system in the brain operating in the theta (3.5-7 Hz) frequency range plays a major role in coordinating motor actions. The major objective of the present study was to explore the effects of human aging on the neurodynamics of motor-related EEG theta activity during correct motor response generation. Response-related potentials of young and older adults elicited in auditory and visual four-choice sensorimotor tasks were analyzed in the time-frequency domain. The phase-locking factor and total power were computed at motor cortical regions contra- and ipsilateral to the movement and at the midline to reflect phase synchronization and power of motor theta oscillations. Major results demonstrated that in both young and older adults, a pronounced response-locked theta activity (3.5-7 Hz) was generated at premotor, motor and sensorimotor cortical regions contra-lateral to the responding hand. Aging was associated with a decreased lateral asymmetry in the phase synchronization of only the left-hand responses. Also, there was a strong aging-related suppression of theta power at the medial fronto-central region that was specifically enhanced and correlated with response speed only in young adults. These results confirm the involvement of theta oscillations in movement generation in relation to action coordination in humans. Also, they show that aging is associated with a dysfunction of the oscillatory theta system for motor action regulation due to a strong suppression of a medial frontal integrating mechanism and an impaired balance in the functional control of responses with the right and the left hand.

Dynamic coupling between slow waves and sleep spindles during slow wave sleep in humans is modulated by functional pre-sleep activation.

Co-existent sleep spindles and slow waves have been viewed as a mechanism for offline information processing. Here we explored if the temporal synchronization between slow waves and spindle activity during slow wave sleep (SWS) in humans was modulated by preceding functional activations during pre-sleep learning. We activated differentially the left and right hemisphere before sleep by using a lateralized variant of serial response time task (SRTT) and verified these inter-hemispheric differences by analysing alpha and beta electroencephalographic (EEG) activities during learning. The stability and timing of coupling between positive and negative phases of slow waves and sleep spindle activity during SWS were quantified. Spindle activity was temporally synchronized with both positive (up-state) and negative (down-state) slow half waves. Synchronization of only the fast spindle activity was laterally asymmetric after learning, corresponding to hemisphere-specific activations before sleep. However, the down state was associated with decoupling, whereas the up-state was associated with increased coupling of fast spindle activity over the pre-activated hemisphere. These observations provide original evidence that (1) the temporal grouping of fast spindles by slow waves is a dynamic property of human SWS modulated by functional pre-sleep activation patterns, and (2) fast spindles synchronized by slow waves are functionally distinct.

Sleep Spindles in the Right Hemisphere Support Awareness of Regularities and Reflect Pre-Sleep Activations.

Study Objectives: The present study explored the sleep mechanisms which may support awareness of hidden regularities. Methods: Before sleep, 53 participants learned implicitly a lateralized variant of the serial response-time task in order to localize sensorimotor encoding either in the left or right hemisphere and induce implicit regularity representations. Electroencephalographic (EEG) activity was recorded at multiple electrodes during both task performance and sleep, searching for lateralized traces of the preceding activity during learning. Sleep EEG analysis focused on region-specific slow (9-12 Hz) and fast (13-16 Hz) sleep spindles during nonrapid eye movement sleep. Results: Fast spindle activity at those motor regions that were activated during learning increased with the amount of postsleep awareness. Independently of side of learning, spindle activity at right frontal and fronto-central regions was involved: there, fast spindles increased with the transformation of sequence knowledge from implicit before sleep to explicit after sleep, and slow spindles correlated with individual abilities of gaining awareness. These local modulations of sleep spindles corresponded to regions with greater presleep activation in participants with postsleep explicit knowledge. Conclusions: Sleep spindle mechanisms are related to explicit awareness (1) by tracing the activation of motor cortical and right-hemisphere regions which had stronger involvement already during learning and (2) by recruitment of individually consolidated processing modules in the right hemisphere. The integration of different sleep spindle mechanisms with functional states during wake collectively supports the gain of awareness of previously experienced regularities, with a special role for the right hemisphere.

Synchronization of fronto-parietal beta and theta networks as a signature of visual awareness in neglect.

In the neglect syndrome, the perceptual deficit for contra-lesional hemi-space is increasingly viewed as a dysfunction of fronto-parietal cortical networks, the disruption of which has been described in neuroanatomical and hemodynamic studies. Here we exploit the superior temporal resolution of electroencephalography (EEG) to study dynamic transient connectivity of fronto-parietal circuits at early stages of visual perception in neglect. As reflected by inter-regional phase synchronization in a full-field attention task, two functionally distinct fronto-parietal networks, in beta (15-25Hz) and theta (4-8Hz) frequency bands, were related to stimulus discrimination within the first 200 ms of visual processing. Neglect pathology was specifically associated with significant suppressions of both beta and theta networks engaging right parietal regions. These connectivity abnormalities occurred in a pattern that was distinctly different from what was observed in right-hemisphere lesion patients without neglect. Also, both beta and theta abnormalities contributed additively to visual awareness decrease, quantified in the Behavioural Inattention Test. These results provide evidence for the impairment of fast dynamic fronto-parietal interactions during early stages of visual processing in neglect pathology. Also, they reveal that different modes of fronto-parietal dysfunction contribute independently to deficits in visual awareness at the behavioural level.

Labile sleep promotes awareness of abstract knowledge in a serial reaction time task.

Sleep has been identified as a critical brain state enhancing the probability of gaining insight into covert task regularities. Both non-rapid eye movement (NREM) and rapid eye movement (REM) sleep have been implicated with offline re-activation and reorganization of memories supporting explicit knowledge generation. According to two-stage models of sleep function, offline processing of information during sleep is sequential requiring multiple cycles of NREM and REM sleep stages. However, the role of overnight dynamic sleep macrostructure for insightfulness has not been studied so far. In the present study, we test the hypothesis that the frequency of interactions between NREM and REM sleep stages might be critical for awareness after sleep. For that aim, the rate of sleep stage transitions was evaluated in 53 participants who learned implicitly a serial reaction time task (SRTT) in which a determined sequence was inserted. The amount of explicit knowledge about the sequence was established by verbal recall after a night of sleep following SRTT learning. Polysomnography was recorded in this night and in a control night before and was analyzed to compare the rate of sleep-stage transitions between participants who did or did not gain awareness of task regularity after sleep. Indeed, individual ability of explicit knowledge generation was strongly associated with increased rate of transitions between NREM and REM sleep stages and between light sleep stages and slow wave sleep. However, the rate of NREM-REM transitions specifically predicted the amount of explicit knowledge after sleep in a trait-dependent way. These results demonstrate that enhanced lability of sleep goes along with individual ability of knowledge awareness. Observations suggest that facilitated dynamic interactions between sleep stages, particularly between NREM and REM sleep stages play a role for offline processing which promotes rule extraction and awareness.

Is insight a godsend? Explicit knowledge in the serial response-time task has precursors in EEG potentials already at task onset.

Whether, and how, explicit knowledge about some regularity arises from implicit sensorimotor learning by practice has been a matter of long-standing debate. Previously, we had found in the number reduction task that participants who will acquire explicit knowledge differ from other participants in their event-related potentials (ERPs) already at task onset. In the present study, we investigated such ERP precursors and correlates both of explicit and of sensorimotor knowledge (response speeding) about the regular sequence in a large sample of participants (n≈100) in the serial response time task. Already when perceiving random sequences at task onset, those participants had largest P3 amplitudes who would later gain explicit knowledge but whose responses were not speeded. Later in the task, sensorimotor knowledge was reflected in increased fronto-central negativity in irregular blocks, overlapping the early part of P3, and participants with later explicit knowledge generally had increased P3 amplitudes. These results support the notion that explicit knowledge about covert regularities is acquired in two ways: on the one hand by a particular subgroup of participants possibly independently of sequence-specific response speeding, and on the other hand by transforming such sensorimotor to explicit knowledge through practice.