Temporal Dynamics of Brain Activity Predicting Sense of Agency over Muscle Movements.

Our muscles are the primary means through which we affect the external world, and the sense of agency (SoA) over the action through those muscles is fundamental to our self-awareness. However, SoA research to date has focused almost exclusively on agency over action outcomes rather than over the musculature itself, as it was believed that SoA over the musculature could not be manipulated directly. Drawing on methods from human-computer interaction and adaptive experimentation, we use human-in-the-loop Bayesian optimization to tune the timing of electrical muscle stimulation so as to robustly elicit a SoA over electrically actuated muscle movements in male and female human subjects. We use time-resolved decoding of subjects' EEG to estimate the time course of neural activity which predicts reported agency on a trial-by-trial basis. Like paradigms which assess SoA over action consequences, we found that the late (post-conscious) neural activity predicts SoA. Unlike typical paradigms, however, we also find patterns of early (sensorimotor) activity with distinct temporal dynamics predicts agency over muscle movements, suggesting that the "neural correlates of agency" may depend on the level of abstraction (i.e., direct sensorimotor feedback versus downstream consequences) most relevant to a given agency judgment. Moreover, fractal analysis of the EEG suggests that SoA-contingent dynamics of neural activity may modulate the sensitivity of the motor system to external input.SIGNIFICANCE STATEMENT The sense of agency, the feeling of "I did that," when directing one's own musculature is a core feature of human experience. We show that we can robustly manipulate the sense of agency over electrically actuated muscle movements, and we investigate the time course of neural activity that predicts the sense of agency over these actuated movements. We find evidence of two distinct neural processes: a transient sequence of patterns that begins in the early sensorineural response to muscle stimulation and a later, sustained signature of agency. These results shed light on the neural mechanisms by which we experience our movements as volitional.

Exploring the internal forward model: action-effect prediction and attention in sensorimotor processing.

Action-effect predictions are believed to facilitate movement based on its association with sensory objectives and suppress the neurophysiological response to self- versus externally generated stimuli (i.e. sensory attenuation). However, research is needed to explore theorized differences in the use of action-effect prediction based on whether movement is uncued (i.e. volitional) or in response to external cues (i.e. stimulus-driven). While much of the sensory attenuation literature has examined effects involving the auditory N1, evidence is also conflicted regarding this component's sensitivity to action-effect prediction. In this study (n = 64), we explored the influence of action-effect contingency on event-related potentials associated with visually cued and uncued movement, as well as resultant stimuli. Our findings replicate recent evidence demonstrating reduced N1 amplitude for tones produced by stimulus-driven movement. Despite influencing motor preparation, action-effect contingency was not found to affect N1 amplitudes. Instead, we explore electrophysiological markers suggesting that attentional mechanisms may suppress the neurophysiological response to sound produced by stimulus-driven movement. Our findings demonstrate lateralized parieto-occipital activity that coincides with the auditory N1, corresponds to a reduction in its amplitude, and is topographically consistent with documented effects of attentional suppression. These results provide new insights into sensorimotor coordination and potential mechanisms underlying sensory attenuation.

The place of Free Will: the freedom of the prisoner.

Debates about the concept of Free Will date back to ancient times. About 40 years ago, Benjamin Libet designed an experiment showing that the conscious intention to move is preceded by a specific pattern of brain activation. His finding suggested that unconscious processes determine our decisions. Libet-style experiments have continued to dominate the debate about Free Will, pushing some authors to argue that the existence of Free Will is a mere illusion. We believe that this dispute is because we often measure Free Will using arbitrary human decisions rather than deliberate actions. After reviewing the definition of Free Will and the related literature, we conclude that the scientific evidence does not disprove the existence of Free Will. However, our will encounters several constraints and limitations that should be considered when evaluating our deeds' personal responsibility.

Determinants of physical activity in newly diagnosed obstructive sleep apnea patients: testing the health action process approach.

This study aims to identify the determinants associated with physical activity (PA) behavior in newly diagnosed obstructive sleep apnea (OSA) patients by applying the Health Action Process Approach (HAPA) with a longitudinal design. Anthropometric and clinical (OSA severity, subjective somnolence, use of continuous positive airway pressure (CPAP)) variables, the determinants of physical activity specified in the HAPA (motivational self-efficacy, outcome expectancies, risk perception, intention, maintenance self-efficacy, action planning, coping planning, social support), as well as physical activity behavior were assessed using a longitudinal (T1 and T2) design in a sample of 57 OSA patients in routine care. Applying regression analyses, regarding the motivation phase, the amount of explained variance in intention was 77% and 39% of the variance in physical activity. In the motivational phase, motivational self-efficacy, risk perception and outcome expectancies were associated with intention. In the volitional phase, physical activity at T1 and social support (family) were related with physical activity at T2. In conclusion, the assumptions of HAPA were partially found in the context of newly diagnosed OSA patients. This study provided additional evidence regarding the role of motivational self-efficacy, outcome expectancies and risk perception during motivational phase, and highlighted the important role of social support from the family in the PA in this population.

Occupational adaptation for adults living with advanced cancer: A phenomenological longitudinal study.

INTRODUCTION: People living with advanced cancer want to continue participating in their valued occupations amid cancer progression. However, increasing dependence and bodily deterioration challenge a person's ability to do so, thus requiring adaptation to how they engage in their occupations. Theoretical frameworks on the process of occupational adaptation often do not address the implications of progressive functional decline. METHODS: A longitudinal phenomenological design was used to understand the lived experience of occupational engagement for working-aged adults living with advanced cancer. A semi-structured interview series explored participants' experience of occupational engagement and how this changed over time. Data were analysed thematically and mapped against the Model of Human Occupation (MOHO). FINDINGS: Eight adults (40-64 years old) participated in 33 interviews over 19 months. Three themes were constructed from the data: ongoing adaptation through doing, the significance of volition in adaptation, and everyday life is contingent on my environment. Study findings demonstrate that the process of adaptation occurs through occupational engagement, is motivated by volition, and is affected by the environment. Volition and the environment play a more central role in occupational adaptation than occupational competency for the advanced cancer cohort. CONCLUSION: Study findings further MOHO's theoretical conceptualisation of occupational adaptation by identifying the centrality of volition and the environment in the process of adaptation. For people living with advanced cancer, disease progression results in unremitting functional decline, thus rendering competency an unstable and untenable construct. Rather, this paper argues that occupational adaptation is facilitated by volition (i.e., the motivation behind the doing) and the environment, thus fostering a sense of identity and meaning at the end of life. Occupational therapists' awareness of the significance of volition and the environment can thus foster continued occupational engagement and meaning at the end of life for people living with advanced cancer.

Consciousness: a neurosurgical perspective.

Neurosurgeons are in a unique position to shed light on the neural basis for consciousness, not only by their clinical care of patients with compromised states of consciousness, but also by employing neurostimulation and neuronal recordings through intracranial electrodes in awake surgical patients, as well as during stages of sleep and anethesia. In this review, we discuss several aspects of consciousness, i.e., perception, memory, and willed actions, studied by electrical stimulation and single neuron recordings in the human brain. We demonstrate how specific neuronal activity underlie the emergence of concepts, memories, and intentions in human consciousness. We discuss the representation of specific conscious content by temporal lobe neurons and present the discovery of "concept cells" and the encoding and retrieval of memories by neurons in the medial temporal lobe. We review prefrontal and parietal neuronal activation that precedes conscious intentions to act. Taken together with other studies in the field, these findings suggest that specific conscious experience may arise from stochastic fluctuations of neuronal activity, reaching a dynamic threshold. Advances in brain recording and stimulation technology coupled with the rapid rise in artificial intelligence are likely to increase the amount and analysis capabilities of data obtained from the human brain, thereby improving the decoding of conscious and preconscious states and open new horizons for modulation of human cognitive functions such as memory and volition.

Autonomy-relatedness Patterns and their Association with Academic and Psychological Adjustment among Chinese Adolescents.

Establishing autonomy and maintaining relatedness with parents are two of the most crucial goals for adolescents and meeting these goals can be critical for academic and psychological adjustment. A two-dimensional framework was proposed for exploring the integrative synthesis of autonomy and relatedness, but its cultural applicability was limited. To better account for the situations associated with non-Western cultural context, this study extended the prior framework to three dimensions (volition, functional independence, and relatedness) and utilized latent profile analysis to explore the configurations and their concurrent and longitudinal (one year later) associations with adjustment (academic engagement, academic buoyancy, depressive symptoms, and externalizing problems). The study collected data from 3992 Chinese adolescents (51.33% girls, Mage = 15.41, SD = 0.55). Latent profile analyses identified five profiles: High, High Functional Independence, Moderate, Low Functional Independence, and Extremely Low Functional Independence. The High profile was the robust optimal pattern for academic and psychological adjustment, while the Low Functional Independence and Extremely Low Functional Independence were risk patterns over time. The High Functional Independence profile was only conducive to academic areas but not to psychological areas. Findings demonstrated the necessity of the three-dimensional framework in this field.

Conceptualizing college-going volition in rural Appalachian high school students.

Understanding the gap between students' aspirations for postsecondary education and their actual postsecondary attainment is key to understanding and reducing educational and vocational inequities. Just as work volition has emerged as a key factor in understanding access to decent work, students' sense of control over or volition in the college-going process may be a key factor in understanding their access to postsecondary education. In the current study, we adapted a common measure of work volition to create a measure of college-going volition (CGV). In a large sample of rural Appalachian high school students, the measure showed good psychometric properties and strong measurement invariance across gender and prospective college-generation groups. There were no gender differences in CGV, but prospective first-generation college students demonstrated significantly lower CGV than their continuing-generation peers. CGV also accounted for significant unique variance in college-going self-efficacy beyond educational barriers.

Potential for Behavioural Pressure Modulation at the Upper Oesophageal Sphincter in Healthy Swallowing.

Supratentorial structures are known to be involved in the neural control of swallowing, thus the potential for volitional manipulation of pharyngeal swallowing is of rehabilitative interest. The extent of volitional control of the upper oesophageal sphincter (UOS) during swallowing remains unclear. Prior research has shown that the UOS opening duration can be volitionally prolonged during execution of the Mendelsohn manoeuvre, which does not change the UOS opening time in isolation but the swallowing response in its entirety. This study explored the capacity of healthy adults to increase the period of pressure drop in the region of the UOS (UOS-Pdrop) during swallowing, through volitional UOS pressure modulation in the absence of altered pharyngeal pressure. The period of UOS-Pdrop was used as a proxy of UOS opening duration that is associated with a pressure decrease at the region of the UOS. Six healthy adults were seen 45 min daily for 2 weeks and for one follow-up session. During training, high-resolution manometry contour plots were provided for visual biofeedback. Participants were asked to maximally prolong the blue period on the monitor (period of UOS-Pdrop) without altering swallowing biomechanics. Performance was assessed prior to training start and following training. There was evidence within the first session for task-specific volitional prolongation of the period of UOS-Pdrop during swallowing with biofeedback; however, performance was not enhanced with further training. This may suggest that the amount to which the period of UOS-Pdrop may be prolonged is restricted in healthy individuals. The findings of this study indicate a potential of healthy adults to volitionally prolong UOS opening duration as measured by the period of pressure drop at the region of the UOS. Further research is indicated to evaluate purposeful pressure modulation intra-swallow in patient populations with UOS dysfunction to clarify if the specificity of behavioural treatment may be increased.

Persistence and disengagement in failing goals: commentary on Boddez, Van Dessel, & De Houwer.

Boddez, Van Dessel, and De Houwer in their paper "Learned helplessness and its relevance for psychological suffering: A new perspective illustrated with attachment problems, burn-out, and fatigue complaints" advance the idea that failing to reach a goal of personal importance unleashes detrimental processes (i.e. learned helplessness) which spill over to other (similar) goals, in the long run resulting in passivity and psychological suffering. As the authors conceptualise learned helplessness in motivational terms (lack of reinforcement, dysregulation of goal-directed response) and attach great weight to the concept of goal failure, I will comment on three issues inherent in their line of argument from a motivational perspective, that is, from the perspective of persistence and disengagement in personal goals. More specifically, first, I will address the distinction between motivational and functional helplessness, then elaborate on goal-related failure and its consequences, and finally cover the issue of generalising failure experience due to the similarity of goals.

Physical activity automaticity, intention, and trait self-control as predictors of physical activity behavior - a dual-process perspective.

Dual-process theories assume that physical activity (PA) behavior is regulated by two different processes: impulsive (i.e., automatic, fast) and reflective (i.e., effortful, slow) processes. In this study we examined main effects as well as the interaction of reflective (intention and trait self-control)and impulsive (automaticity)processes on PA behavior. A prospective study with two points of measurement (N = 118 university students) was conducted. At t1, age, sex, past PA behavior (control variables), PA intention, automaticity and trait self-control (predictors) were assessed with standardized questionnaires. At t2 (4 weeks later), PA behavior (dependent variable) was measured with a standardized questionnaire. Hierarchical multiple linear regression analysis revealed that automaticity was associated with PA behavior. The expected interaction effects Intention x Trait Self-control and Automaticity x Intention x Trait self-control on PA were significant. Moderation analyses revealed that PA intention has a significant positive association with PA behavior when trait self-control was higher compared to lower. Furthermore, automaticity has the strongest association with behavior when both intention and trait self-control where lower compared to higher. Our results underline the additive and interactive effects of impulsive and reflective processes in regulating PA behavior.

Contemporary occupational priorities at the end of life mapped against Model of Human Occupation constructs: A scoping review.

INTRODUCTION: People with end-of-life care needs are seen in an increasingly diverse range of health and community settings. Opportunity for continued occupational participation is highly valued by people at the end of life. This scoping review sought to identify the priorities and preferences for participation at the end of life and to map findings using the model of human occupation. METHODS: A search strategy informed by the research question was developed in collaboration with a research librarian. Data sources used were Ovid Medline(R), CINAHL, Ovid Emcare, Scopus, Web of Science and PsychInfo. Studies that focused on clinician perspectives, clinical care, grief and loss, did not clearly identify end-stage diseases, <18 years and written in languages other than English were excluded. FINDINGS: Forty-four studies were included with a total of 1,070 study participants. Inductively developed themes were mapped against the model of human occupation constructs of volition (personal causation, values, interests), habituation (habits of occupational performance and routine), performance capacity and the lived body within the physical, social and occupational environment. The majority of findings sat within the construct of volition, particularly around sense of personal capacity, self-efficacy and values. At the end of life, people prioritise ongoing engagement in valued occupations even if participation is effortful. As disease progresses, opportunity to exert influence and control over this participation and engagement increases in importance. Personal causation plays an important role in the experience of occupational participation at this time. CONCLUSION: This review provides important insights into the occupational priorities of people at the end of life and the importance of supporting agency and volition at this time. The model of human occupation and its client-centred focus offer a framework for a more robust examination of ways to enhance volitional capacity and enable occupational participation for people at the end of life.

Anatomical bases of fast parietal grasp control in humans: A diffusion-MRI tractography study.

The dorso-posterior parietal cortex (DPPC) is a major node of the grasp/manipulation control network. It is assumed to act as an optimal forward estimator that continuously integrates efferent outflows and afferent inflows to modulate the ongoing motor command. In agreement with this view, a recent per-operative study, in humans, identified functional sites within DPPC that: (i) instantly disrupt hand movements when electrically stimulated; (ii) receive short-latency somatosensory afferences from intrinsic hand muscles. Based on these results, it was speculated that DPPC is part of a rapid grasp control loop that receives direct inputs from the hand-territory of the primary somatosensory cortex (S1) and sends direct projections to the hand-territory of the primary motor cortex (M1). However, evidence supporting this hypothesis is weak and partial. To date, projections from DPPC to M1 grasp zone have been identified in monkeys and have been postulated to exist in humans based on clinical and transcranial magnetic studies. This work uses diffusion-MRI tractography in two samples of right- (n = 50) and left-handed (n = 25) subjects randomly selected from the Human Connectome Project. It aims to determine whether direct connections exist between DPPC and the hand control sectors of the primary sensorimotor regions. The parietal region of interest, related to hand control (hereafter designated DPPChand), was defined permissively as the 95% confidence area of the parietal sites that were found to disrupt hand movements in the previously evoked per-operative study. In both hemispheres, irrespective of handedness, we found dense ipsilateral connections between a restricted part of DPPChand and focal sectors within the pre and postcentral gyrus. These sectors, corresponding to the hand territories of M1 and S1, targeted the same parietal zone (spatial overlap > 92%). As a sensitivity control, we searched for potential connections between the angular gyrus (AG) and the pre and postcentral regions. No robust pathways were found. Streamline densities identified using AG as the starting seed represented less than 5 % of the streamline densities identified from DPPChand. Together, these results support the existence of a direct sensory-parietal-motor loop suited for fast manual control and more generally, for any task requiring rapid integration of distal sensorimotor signals.

Culture and Sexual Medicine: A Road Map for Clinical Inquiry and Practice.

As the field of sexual medicine continues to grow, there has been increasing attention to the importance of the sociocultural components of the biopsychosocial model. Although important in all medical practice, culture and sexual health are particularly entwined, so engaging with sociocultural aspects of the patient experience as part of evaluation and treatment is necessary to optimize patient outcomes in this field. We invite clinicians to consider the importance of sexual health literacy, cultural humility, and support for patient volition as key aspects of moving care towards a model that embraces all aspects of the biopsychosocial model. The aim of the current paper is to provide readers with concrete steps and illustrative examples to help guide this process. Bober SL, Chevalier L. Culture and Sexual Medicine: A Road Map for Clinical Inquiry and Practice. J Sex Med 2021;18:1475-1478.

Decoding Changes of Mind in Voluntary Action-Dynamics of Intentional Choice Representations.

Voluntary actions rely on appropriate flexibility of intentions. Usually, we should pursue our goals, but sometimes we should change goals if they become too costly to achieve. Using functional magnetic resonance imaging, we investigated the neural dynamics underlying the capacity to change one's mind based on new information after action onset. Multivariate pattern analyses revealed that in visual areas, neural representations of intentional choice between 2 visual stimuli were unchanged by additional decision-relevant information. However, in fronto-parietal cortex, representations changed dynamically as decisions evolved. Precuneus, angular gyrus, and dorsolateral prefrontal cortex encoded new externally cued rewards/costs that guided subsequent changes of mind. Activity in medial frontal cortex predicted changes of mind when participants detached from externally cued evidence, suggesting a role in endogenous decision updates. Finally, trials with changes of mind were associated with an increase in functional connectivity between fronto-parietal areas, allowing for integration of various endogenous and exogenous decision components to generate a distributed consensus about whether to pursue or abandon an initial intention. In conclusion, local and global dynamics of choice representations in fronto-parietal cortex allow agents to maintain the balance between adapting to changing environments versus pursuing internal goals.

Volition in prospective Memory: Evidence against differences between free and fixed target events.

Volition is the extent to which actions are generated as a result of internal states in contrast to responses to external conditions or dictated by external events. Delayed intentions about future action are stored in prospective memory until the intended action has to be formed at a later point in time. It is unknown how voluntary choice affects prospective memory. We compared the difference between freely chosen and fixed targets on the reaction times and task performance in the ongoing task and for the target stimuli in a prospective memory task. The task performance and the reaction time was modelled using a Bayesian hierarchical drift-diffusion model. The analysis showed no differences between self-chosen and fixed prospective memory cues on task responses. The result suggests that volition in choosing the cue to act upon or given a fixed cue does not make a difference for prospective memory task performance.

Sensory attenuation of action outcomes of varying amplitude and valence.

Stimuli caused by self-initiated actions are perceived as less intense than those caused externally; this effect is called sensory attenuation (SA). In two experiments, we aimed to assess the impact of the amplitude of outcomes and its affective valence on SA and explicit ratings of sense of agency. This allowed us to test the predictions of the available SA frameworks and better understand the link between SA, affect, and agency. The results indicated that SA can be reversed, and such sensory amplification is driven by low-amplitude and positive-valence outcomes. We also show that intentional action influences the perceived valence of outcomes, and that modulations of explicit sense of agency are divergent from those of SA. Our study shows that valence influences the processing of the amplitude of intentional action outcomes and suggests that none of the currently available frameworks give full justice to SA's variability.

Lesion network localization of free will.

Our perception of free will is composed of a desire to act (volition) and a sense of responsibility for our actions (agency). Brain damage can disrupt these processes, but which regions are most important for free will perception remains unclear. Here, we study focal brain lesions that disrupt volition, causing akinetic mutism (n = 28), or disrupt agency, causing alien limb syndrome (n = 50), to better localize these processes in the human brain. Lesion locations causing either syndrome were highly heterogeneous, occurring in a variety of different brain locations. We next used a recently validated technique termed lesion network mapping to determine whether these heterogeneous lesion locations localized to specific brain networks. Lesion locations causing akinetic mutism all fell within one network, defined by connectivity to the anterior cingulate cortex. Lesion locations causing alien limb fell within a separate network, defined by connectivity to the precuneus. Both findings were specific for these syndromes compared with brain lesions causing similar physical impairments but without disordered free will. Finally, our lesion-based localization matched network localization for brain stimulation locations that disrupt free will and neuroimaging abnormalities in patients with psychiatric disorders of free will without overt brain lesions. Collectively, our results demonstrate that lesions in different locations causing disordered volition and agency localize to unique brain networks, lending insight into the neuroanatomical substrate of free will perception.

Potential for Volitional Control of Resting Pressure at the Upper Oesophageal Sphincter in Healthy Individuals.

Resting pressure at the upper oesophageal sphincter (UOS) has been reported to be susceptible to factors such as emotional stress or respiration. This exploratory study investigated the potential for behavioural modulation of UOS resting pressure in healthy adults to increase our understanding of volitional control of UOS pressure, and the potential development of rehabilitation approaches. Six healthy adults were seen one hour daily for two weeks (10 days) and for one post-training session after a training break of two weeks. Manipulation of UOS resting pressure was practised during a protocol of alternating increased and decreased pressure. A high-resolution manometry contour plot was used as a biofeedback modality. Participants were asked to explore how to achieve warmer and cooler colours (pressure increase and decrease, respectively) at the UOS resting pressure band, without changing head position or manipulating activity of other muscles. Performance was analysed prior to training start and following daily training. Participants were able to increase resting pressure following one week of practice; however, there was no evidence for purposeful pressure decrease. The increased resting pressure achieved by participants indicates a capacity for purposeful pressure modulation given intensive biofeedback training. The lack of volitional reduction in pressure may be explained by sustained pressure generation due to the intrinsic muscular characteristics of the UOS and a flooring effect in healthy subjects, in whom physiology mandates a minimum degree of resting pressure to fulfil the barrier function. Distention caused by the presence of the intraluminal catheter cannot be ruled out.

Preparation and execution of voluntary action both contribute to awareness of intention.

How and when motor intentions form has long been controversial. In particular, the extent to which motor preparation and action-related processes produce a conscious experience of intention remains unknown. Here, we used a brain-computer interface (BCI) while participants performed a self-paced movement task to trigger cues upon the detection of a readiness potential (a well-characterized brain signal that precedes movement) or in its absence. The BCI-triggered cues instructed participants either to move or not to move. Following this instruction, participants reported whether they felt they were about to move at the time the cue was presented. Participants were more likely to report an intention (i) when the cue was triggered by the presence of a readiness potential than when the same cue was triggered by its absence, and (ii) when they had just made an action than when they had not. We further describe a time-dependent integration of these two factors: the probability of reporting an intention was maximal when cues were triggered in the presence of a readiness potential, and when participants also executed an action shortly afterwards. Our results provide a first systematic investigation of how prospective and retrospective components are integrated in forming a conscious intention to move.