Fear memory in humans is consolidated over time independently of sleep.

Fear memories can be altered after acquisition by processes, such as fear memory consolidation or fear extinction, even without further exposure to the fear-eliciting stimuli, but factors contributing to these processes are not well understood. Sleep is known to consolidate, strengthen, and change newly acquired declarative and procedural memories. However, evidence on the role of time and sleep in the consolidation of fear memories is inconclusive. We used highly sensitive electrophysiological measures to examine the development of fear-conditioned responses over time and sleep in humans. We assessed event-related brain potentials (ERP) in 18 healthy, young individuals during fear conditioning before and after a 2-hour afternoon nap or a corresponding wake interval in a counterbalanced within-subject design. The procedure involved pairing a neutral tone (CS+) with a highly unpleasant sound. As a control, another neutral tone (CS-) was paired with a neutral sound. Fear responses were examined before the interval during a habituation phase and an acquisition phase as well as after the interval during an extinction phase and a reacquisition phase. Differential fear conditioning during acquisition was evidenced by a more negative slow ERP component (stimulus-preceding negativity) developing before the unconditioned stimulus (loud noise). This differential fear response was even stronger after the interval during reacquisition compared with initial acquisition, but this effect was similarly pronounced after sleep and wakefulness. These findings suggest that fear memories are consolidated over time, with this effect being independent of intervening sleep.

Meta-criteria to formulate criteria of consciousness.

Any neurobiological model claiming explanation of a complex human phenomenon should start with an explicit definition of the explanandum. If a classical intensional definition is impossible, we can use a descriptive definition by listing necessary criteria (e.g., of consciousness). This commentary suggests four meta-criteria that different proposed criteria of consciousness should fulfill: phenomenological consensus, empirical evidence, domain specificity, and non-circularity.

Temporally distinct oscillatory codes of retention and manipulation of verbal working memory.

Most psychophysiological studies of working memory (WM) target only the short-term memory construct, whereas short-term memory is only a part of the WM responsible for the storage of sensory information. Here, we aimed to further investigate oscillatory brain mechanisms supporting the executive components of WM-the part responsible for the manipulation of information. We conducted an exploratory reanalysis of a previously published EEG dataset where 156 participants (82 females) performed tasks requiring either simple retention or retention and manipulation of verbal information in WM. A relatively long delay period (>6 s) was employed to investigate the temporal trajectory of the oscillatory brain activity. Compared with baseline, theta activity was significantly enhanced during encoding and the delay period. Alpha-band power decreased during encoding and switched to an increase in the first part of the delay before returning to the baseline in the second part; beta-band power remained below baseline during encoding and the delay. The difference between the manipulation and retention tasks in spectral power had diverse temporal trajectories in different frequency bands. The difference maintained over encoding and the first part of the delay in theta, during the first part of the delay in beta, and during the whole delay period in alpha. Our results suggest that task-related modulations in theta power co-vary with the demands on the executive control network; beta suppression during mental manipulation can be related to the activation of motor networks; and alpha is likely to reflect the activation of language areas simultaneously with sensory input blockade.

Life satisfaction in families with a child in an Unresponsive Wakefulness Syndrome.

BACKGROUND: The article examines life conditions in families living together with a child in an Unresponsive Wakefulness Syndrome (UWS). Such families experience severe stress at financial, logistical, and existential level. METHODS: We investigated a large sample of families living with a UWS child (comprising 13% of the total population) and compared these families with families without a chronically ill child. A set of four questionnaires aimed to evaluate life conditions entails a total of 204 items. One of the questionnaires was developed by the corresponding author specifically for this study. The questionnaires were positively accepted by the persons concerned and permitted us to test six specific hypotheses. RESULTS: Life satisfaction (LS) in families with a UWS child was significantly lower than in control families. LS was significantly affected by external situational factors (everyday support, home visits, support by a doctor, nursing service, health insurance, etc.). Self-management skills were on average lower in families with a UWS child than in controls. These skills strongly and directly correlated with LS. Further, LS was not significantly related to the acceptance of feelings and negatively correlated with the floods of emotions. The relationship with the own child was equally satisfactory in families with and without a UWS child indicating that the families regard their UWS child as a full family member. CONCLUSIONS: The data show that happy life is possible in families living together with a UWS child. They further specify conditions for satisfactory life under multiple highly severe challenges. Personal self-management skills, coping strategies, and resilience, as well as outside social support, appear to be critical factors.

Sleep in disorders of consciousness: behavioral and polysomnographic recording.

BACKGROUND: Sleep-wakefulness cycles are an essential diagnostic criterion for disorders of consciousness (DOC), differentiating prolonged DOC from coma. Specific sleep features, like the presence of sleep spindles, are an important marker for the prognosis of recovery from DOC. Based on increasing evidence for a link between sleep and neuronal plasticity, understanding sleep in DOC might facilitate the development of novel methods for rehabilitation. Yet, well-controlled studies of sleep in DOC are lacking. Here, we aimed to quantify, on a reliable evaluation basis, the distribution of behavioral and neurophysiological sleep patterns in DOC over a 24-h period while controlling for environmental factors (by recruiting a group of conscious tetraplegic patients who resided in the same hospital). METHODS: We evaluated the distribution of sleep and wakefulness by means of polysomnography (EEG, EOG, EMG) and video recordings in 32 DOC patients (16 unresponsive wakefulness syndrome [UWS], 16 minimally conscious state [MCS]), and 10 clinical control patients with severe tetraplegia. Three independent raters scored the patients' polysomnographic recordings. RESULTS: All but one patient (UWS) showed behavioral and electrophysiological signs of sleep. Control and MCS patients spent significantly more time in sleep during the night than during daytime, a pattern that was not evident in UWS. DOC patients (particularly UWS) exhibited less REM sleep than control patients. Forty-four percent of UWS patients and 12% of MCS patients did not have any REM sleep, while all control patients (100%) showed signs of all sleep stages and sleep spindles. Furthermore, no sleep spindles were found in 62% of UWS patients and 21% of MCS patients. In the remaining DOC patients who had spindles, their number and amplitude were significantly lower than in controls. CONCLUSIONS: The distribution of sleep signs in DOC over 24 h differs significantly from the normal sleep-wakefulness pattern. These abnormalities of sleep in DOC are independent of external factors such as severe immobility and hospital environment.

Spatial characteristics of spontaneous and stimulus-induced individual functional connectivity networks in severe disorders of consciousness.

BACKGROUND: Functional connectivity (fcMRI) analyses of resting state functional magnetic resonance imaging (fMRI) data revealed substantial differences between states of consciousness. The underlying cause-effect linkage, however, remains unknown to the present day. The aim of this study was to examine the relationship between fcMRI measures and Disorders of Consciousness (DOC) in resting state and under adequate stimulation. METHODS AND FINDINGS: fMRI data from thirteen patients with unresponsive wakefulness syndrome, eight patients in minimally conscious state, and eleven healthy controls were acquired in rest and during the application of nociceptive and emotional acoustic stimuli. We compared spatial characteristics and anatomical topography of seed-based fcMRI networks on group and individual levels. The anatomical topography of fcMRI networks of patients was altered in all three conditions as compared with healthy controls. Spread and distribution of individual fcMRI networks, however, differed significantly between patients and healthy controls in stimulation conditions only. The exploration of individual metric values identified two patients whose spatial metrics did not deviate from metric distributions of healthy controls in a statistically meaningful manner. CONCLUSIONS: These findings suggest that the disturbance of consciousness in DOC is related to deficits in global topographical network organization rather than a principal inability to establish long-distance connections. In addition, the results question the claim that task-free measurements are particularly valuable as a tool for individual diagnostics in severe neurological disorders. Further studies comparing connectivity indices with outcome of DOC patients are needed to determine the clinical relevance of spatial metrics and stimulation paradigms for individual diagnosis, prognosis and treatment in DOC.

Interrelationships of factors of social development are more complex than Life History Theory predicts.

Life History Theory (LHT) predicts a monotonous relationship between affluence and the rate of innovations and strong correlations within a cluster of behavioral features. Although both predictions can be true in specific cases, they are incorrect in general. Therefore, the author's explanations may be right, but they do not prove LHT and cannot be generalized to other apparently similar processes.

EEG correlates of working memory performance in females.

BACKGROUND: The study investigates oscillatory brain activity during working memory (WM) tasks. The tasks employed varied in two dimensions. First, they differed in complexity from average to highly demanding. Second, we used two types of tasks, which required either only retention of stimulus set or retention and manipulation of the content. We expected to reveal EEG correlates of temporary storage and central executive components of WM and to assess their contribution to individual differences. RESULTS: Generally, as compared with the retention condition, manipulation of stimuli in WM was associated with distributed suppression of alpha1 activity and with the increase of the midline theta activity. Load and task dependent decrement of beta1 power was found during task performance. Beta2 power increased with the increasing WM load and did not significantly depend on the type of the task. At the level of individual differences, we found that the high performance (HP) group was characterized by higher alpha rhythm power. The HP group demonstrated task-related increment of theta power in the left anterior area and a gradual increase of theta power at midline area. In contrast, the low performance (LP) group exhibited a drop of theta power in the most challenging condition. HP group was also characterized by stronger desynchronization of beta1 rhythm over the left posterior area in the manipulation condition. In this condition, beta2 power increased in the HP group over anterior areas, but in the LP group over posterior areas. CONCLUSIONS: WM performance is accompanied by changes in EEG in a broad frequency range from theta to higher beta bands. The most pronounced differences in oscillatory activity between individuals with high and low WM performance can be observed in the most challenging WM task.

Name conditioning in event-related brain potentials.

Four experiments are reported in which two harmonic tones (CS+ and CS-) were paired with a participant's own name (SON) and different names (DN), respectively. A third tone was not paired with any other stimulus and served as a standard (frequent stimulus) in a three-stimuli oddball paradigm. The larger posterior positivity (P3) to SON than DN, found in previous studies, was replicated in all experiments. Conditioning of the P3 response was albeit observed in two similar experiments (1 and 3), but the obtained effects were weak and not identical in the two experiments. Only Experiment 4, where the number of CS/UCS pairings and the Stimulus-Onset Asynchrony between CS and UCS were increased, showed clear CS+/CS- differences both in time and time-frequency domains. Surprisingly, differential responses to CS+ and CS- were also obtained in Experiment 2, although SON and DN in that experiment were masked and never consciously recognized as meaningful words (recognition rate 0/63 participants). The results are discussed in the context of other ERP conditioning experiments and, particularly, the studies of non-conscious effect on ERP. Several further experiments are suggested to replicate and extend the present findings and to remove the remaining methodological limitations.

Night sleep in patients with vegetative state.

Polysomnographic recording of night sleep was carried out in 15 patients with the diagnosis vegetative state (syn. unresponsive wakefulness syndrome). Sleep scoring was performed by three raters, and confirmed by means of a spectral power analysis of the electroencephalogram, electrooculogram and electromyogram. All patients but one exhibited at least some signs of sleep. In particular, sleep stage N1 was found in 13 patients, N2 in 14 patients, N3 in nine patients, and rapid eye movement sleep in 10 patients. Three patients exhibited all phenomena characteristic for normal sleep, including spindles and rapid eye movements. However, in all but one patient, sleep patterns were severely disturbed as compared with normative data. All patients had frequent and long periods of wakefulness during the night. In some apparent rapid eye movement sleep episodes, no eye movements were recorded. Sleep spindles were detected in five patients only, and their density was very low. We conclude that the majority of vegetative state patients retain some important circadian changes. Further studies are necessary to disentangle multiple factors potentially affecting sleep pattern of vegetative state patients.

Evoked and event-related potentials in disorders of consciousness: A quantitative review.

Sixty-one publications about evoked and event-related potentials (EP and ERP, respectively) in patients with severe Disorders of Consciousness (DoC) were found and analyzed from a quantitative point of view. Most studies are strongly underpowered, resulting in very broad confidence intervals (CI). Results of such studies cannot be correctly interpreted, because, for example, CI>1 (in terms of Cohen's d) indicate that the real effect may be very strong, very weak, or even opposite to the reported effect. Furthermore, strong negative correlations were obtained between sample size and effect size, indicating a possible publication bias. These correlations characterized not only the total data set, but also each thematically selected subset. The minimal criteria of a strong study to EP/ERP in DoC are proposed: at least 25 patients in each patient group; as reliable diagnosis as possible; the complete report of all methodological details and all details of results (including negative results); and the use of appropriate methods of data analysis. Only three of the detected 60 studies (5%) satisfy these criteria. The limitations of the current approach are also discussed.

Effects of Transcranial Magnetic Stimulation on Body Perception: No Evidence for Specificity of the Right Temporo-Parietal Junction.

Previous data suggest that the right temporo-parietal junction (rTPJ) may have a specific role in abnormal body perception (ABP), including out-of-body experience. We tested this hypothesis with inhibitory (1 Hz) and excitatory (15 Hz) repetitive transcranial magnetic stimulation (rTMS) of the rTPJ and a control site (CS, 5 cm posterior to the rTPJ along the lateral sulcus direction in Brodmann area 19R) in 35 healthy adults. ABP frequency was higher with 1 Hz than with 15 Hz rTMS but unaffected by the rTMS site (rTPJ/CS). Response to an own-body transformation task were delayed with 1 Hz compared to 15 Hz rTMS but also unaffected by rTMS site. ABP from rTMS at both sites induced electroencephalographic power decrease in all frequencies at left anterior and central cortical sites. Our data suggest that inhibitory rTMS can lead to ABP. However, the rTPJ may not play a specific role in this process.

On the relationship between negative affective priming and prefrontal cognitive control mechanisms.

Although several studies have examined inhibition of affective stimuli, valence-dependent cognitive control effects remain poorly understood. Behavioural and functional imaging (functional magnetic resonance imaging) data were collected from 17 healthy participants to examine neural correlates of the Negative Affective Priming (NAP) task. We created relative ratio scores considering the reaction times of prime trials in order to assess the amount of interference after the presentation of negative and positive distracter words. Behavioural results showed an attenuated NAP effect for negative distracters compared to neutral stimuli. Furthermore, priming negative distracters generated more interference by reacting to the probe target than positive distracters. Neuroimaging data revealed a stronger prefrontal activation during negative NAP trials compared to positive NAP and neutral control trials, which was reflected in a heightened activation of superior and middle frontal gyrus as well as parietal cortex. The findings show the impact of negative distracters on prefrontal response, contributing to the understanding of NAP effects in healthy subjects.

Flagrant Misconduct of Reviewers and Editor: A Case Study.

A case of a particularly severe misbehavior in a review process is described. Two reviewers simply copied and pasted their critical comments from their previous reviews without reading the reviewed manuscript. The editor readily accepted the reviewers' opinion and rejected the manuscript. These facts give rise to some general questions about possible factors affecting the ethical behavior of reviewers and editors, as well as possible countermeasures to prevent ethical violations.

Neural correlates of sensory preconditioning: a preliminary fMRI investigation.

Sensory preconditioning (SPC; also known as behaviorally silent learning) consists of a combination of two neutral stimuli, none of which elicits an unconditional response. After one of them is later paired with an unconditional stimulus (US), the other neutral stimulus also yields a conditional response although it has never been paired with the US. In this study, an event-related functional magnetic resonance imaging (fMRI) paradigm was used to specify brain regions involved in SPC. The results demonstrated that SPC was associated with significant changes in activity of several regions, notably, the left amygdala, the left hippocampus, the bilateral thalamus, the bilateral medial globus pallidus, the bilateral cerebellum, the bilateral premotor cortex, and the bilateral middle frontal gyrus. This is a first effort to use fMRI to examine the effects of SPC on brain activation. Our data suggest that there is a distributed network of structures involved in SPC including both cortical and subcortical regions, therefore add to our understanding of the neural mechanisms underlying the ability to associative learning.

Event-related potentials indicate context effect in reading ambiguous words.

The aim of the study was a comparison of lexical and contextual factors in understanding ambiguous words in German. First, a sample of native speakers selected 56 words having maximally strong differences between a dominant and a subordinate meaning. After this, another sample from the same population was visually presented with sentences that activated dominant or subordinate meanings of the words and were accompanied by probes associated with dominant or subordinate meanings. This resulted in a crossed design with two factors: sentence dominant vs. sentence subordinate and probe dominant vs. probe subordinate. An analysis of event-related brain potentials revealed a large, long-lasting and highly-significant N400 wave whenever the meaning of the probe was incongruent with the meaning of the sentence and the lack of this wave whenever the two meanings were congruent. In the typical N400 space and time, the effect was independent of whether the lexical word meaning was dominant or subordinate. At other sites and times, however (e.g., at lateral frontal electrodes F7/F8, and after 700ms), the congruence effect was significant after dominant sentences only. The data indicate that lexical factors have a rather limited influence on the activation of a particular meaning of ambiguous words. A strong context can virtually override even a very strong difference in the preference for different meanings.

What kind of consciousness is minimal?

PRIMARY OBJECTIVE: A comparison between unitary and non-unitary views on minimal consciousness. RESEARCH DESIGN: First, unitary (all-or-none) and non-unitary (gradual or continuous) models of consciousness are defined as they have been developed in both philosophy and neurophysiology. Then, the implications of these ideas to the notion the minimally conscious state (MCS) are discussed. METHODS AND PROCEDURES: Review and analysis of theoretical conceptions and empirical data. MAIN OUTCOME AND RESULTS: Both kinds of models are compatible with the actual definitions of MCS. Although unitary views may seem to contradict the description of the MCS in 'Neurology' 2002, the apparent contradiction can easily be solved. Most recent data, particularly those obtained using fMRI and concerning learning, emotional responsiveness and pain and suffering, speak for non-unitary models. CONCLUSIONS: Most evidence speaks for non-unitary models of minimal consciousness. If these models are correct, patients with MCS may have, in addition to temporal fluctuations, a lower level of consciousness compared with fully conscious individuals. A still lower level could characterize patients diagnosed as unresponsive wakefulness syndrome (UWS). From this point of view, therefore, the difference between UWS and MCS is gradual rather than qualitative. However, due to methodological limitations of the available studies, the evidence for non-unitary models cannot be regarded as definite.

Predicting outcome in disorders of consciousness: A mega-analysis.

OBJECTIVE: Assessing recovery potential in patients with disorders of consciousness (DoC) is pivotal for guiding clinical and ethical decisions. We conducted a mega-analysis of individual patient data to understand (1) if a time threshold exists, beyond which regaining consciousness is almost impossible, and (2) how recovery varies based on factors such as diagnosis, etiology, age, sex, and neuropsychological status. METHODS: A systematic literature search revealed a total of 3290 patients. In this sample, we performed a Cox proportional hazards analysis for interval censored data. RESULTS: We observed a late saturation of probability to regain consciousness in Kaplan-Meier curves, and the annual rate of recovery was remarkably stable, in that approximately 35% of patients regained consciousness per year. Patients in minimally conscious state (MCS) recovered more frequently than patients in unresponsive wakefulness syndrome (UWS). No significant difference was observed between the recovery dynamics of MCS subgroups: MCS+ and MCS-. Patients with hypoxic brain lesions showed worse recovery rate than patients with traumatic brain injury and patients with vascular brain lesions, while the latter two categories did not differ from each other. Male patients had moderately better chance to regain consciousness. While younger UWS patients recovered more frequently than older patients, it was not the case in MCS. INTERPRETATION: Our findings highlight the necessity for neurologists to exercise caution when making negative predictions in individual cases, challenge traditional beliefs regarding recovery timelines, and underscore the importance of conducting detailed and prolonged assessments to better understand recovery prospects in DoC.

Working memory processes and intrinsic motivation: An EEG study.

Processes typically encompassed by working memory (WM) include encoding, retention, and retrieval of information. Previous research has demonstrated that motivation can influence WM performance, although the specific WM processes affected by motivation are not yet fully understood. In this study, we investigated the effects of motivation on different WM processes, examining how task difficulty modulates these effects. We hypothesized that motivation level and personality traits of the participants (N = 48, 32 females; mean age = 21) would modulate the parietal alpha and frontal theta electroencephalography (EEG) correlates of WM encoding, retention, and retrieval phases of the Sternberg task. This effect was expected to be more pronounced under conditions of very high task difficulty. We found that increasing difficulty led to reduced accuracy and increased response time, but no significant relationship was found between motivation and accuracy. However, EEG data revealed that motivation influenced WM processes, as indicated by changes in alpha and theta oscillations. Specifically, higher levels of the Resilience trait-associated with mental toughness, hardiness, self-efficacy, achievement motivation, and low anxiety-were related to increased alpha desynchronization during encoding and retrieval. Increased scores of Subjective Motivation to perform well in the task were related to enhanced frontal midline theta during retention. Additionally, these effects were significantly stronger under conditions of high difficulty. These findings provide insights into the specific WM processes that are influenced by motivation, and underscore the importance of considering both task difficulty and intrinsic motivation in WM research.

Brain-computer interfaces for communication with nonresponsive patients.

A substantial number of patients who survive severe brain injury progress to a nonresponsive state of wakeful unawareness, referred to as a vegetative state (VS). They appear to be awake, but show no signs of awareness of themselves, or of their environment in repeated clinical examinations. However, recent neuroimaging research demonstrates that some VS patients can respond to commands by willfully modulating their brain activity according to instruction. Brain-computer interfaces (BCIs) may allow such patients to circumvent the barriers imposed by their behavioral limitations and communicate with the outside world. However, although such devices would undoubtedly improve the quality of life for some patients and their families, developing BCI systems for behaviorally nonresponsive patients presents substantial technical and clinical challenges. Here we review the state of the art of BCI research across noninvasive neuroimaging technologies, and propose how such systems should be developed further to provide fully fledged communication systems for behaviorally nonresponsive populations.