Self-Alert Training: volitional modulation of autonomic arousal improves sustained attention

Attention Training Improves Executive Functions and Ameliorates Behavioral Symptoms in Children with Attention-Deficit Hyperactivity Disorder: Implication of Tele-Cognitive-Rehabilitation in the Era of Coronavirus Disease

Background: Children with attention-deficit hyperactivity disorder (ADHD) struggle with impaired attention, leading to impaired executive function and behavioral symptoms. In this study, we aimed to evaluate the effect of attention training on executive functions and behavioral symptoms in children with ADHD, in a tele-cognitive-rehabilitation setting. Methods: Thirty children (mean age: 9.93 ± 1.68 years, 21 boys) with ADHD were randomly assigned to 2 equal groups of attention training and active control group. Attentive Rehabilitation and Improvement of Attention (ARIA) and a class of storytelling were used for intervention in two groups, in an online platform. Continuous performance test, one-back test, Wisconsin card sorting test (WCST), Conner's parent rating scale, and behavioral rating inventory of executive function (BRIEF) were used for assessment in three-baseline, postintervention, and follow-up sessions. Repeated measures analysis of variances were used for analysis. Results: ARIA leads to significant improvement in omission error (P < 0.001), commission error (P = 0.006), and response time (P = 0.005) of continuous performance test, cluster (P = 0.001), but not preservation error (P = 0.110) of WCST, accuracy of NBT (P = 0.004) and the score of Conner's parent rating scale (P < 0.001) and BRIEF (P < 0.001). These results indicate improved attention and executive functions, amelioration of ADHD symptoms, and improved behavioral performance. Conclusion: This study suggests that attention can be trained through tele-cognitive rehabilitation using a remediation program in children with ADHD. The effectiveness of this training can be confirmed by examining the transfer of training effects to other untrained cognitive domains, executive functions, symptoms of ADHD, and behavioral performance.

A systematic review and activation likelihood estimation meta-analysis of fMRI studies on arousing or wake-promoting effects in Buddhist meditation

Conventional Buddhist texts illustrate meditation as a condition of relaxed alertness that must fend against extreme hypoarousal (sleep, drowsiness) and extreme hyperarousal (restlessness). Theoretical, neurophysiological, and neuroimaging investigations of meditation have highlighted the relaxing effects and hypoarousing without emphasizing the alertness-promoting effects. Here we performed a systematic review supported by an activation-likelihood estimate (ALE) meta-analysis in an effort to counterbalance the surfeit of scholarship emphasizing the hypoarousing and relaxing effects of different forms of Buddhist meditation. Specifically, the current systematic review-cum-meta-analytical review seeks to highlight more support for meditation's wake-promoting effects by drawing from neuroimaging research during wakefulness and meditation. In this systematic review and meta-analysis of 22 fMRI studies, we aim to highlight support for Buddhist meditation's wake-promoting or arousing effects by identifying brain regions associated with alertness during meditation. The most significant peaks were localized medial frontal gyrus (MFG) and precuneus. We failed to determine areas ostensibly common to alertness-related meditation such as the medial prefrontal cortex (mPFC), superior parietal lobule, basal ganglia, thalamus, most likely due to the relatively fewer fMRI investigations that used wakefulness-promoting meditation techniques. Also, we argue that forthcoming research on meditation, related to alertness or wakefulness, continues to adopt a multi-modal method to investigate the correlation between actual behaviors and neural networks connected to Buddhist meditation. Moreover, we recommend the implementation of fMRI paradigms on Buddhist meditation with clinically diagnosed participants to complement recent trends in psychotherapy such as mindfulness-based cognitive therapy (MBCT).

Dysregulation of the autonomic nervous system in adult attention deficit hyperactivity disorder. A systematic review

Background: Adult Attention Deficit Hyperactivity Disorder (aADHD) is characterised by inattention, hyperactivity, impulsivity, and emotional instability, all of which were linked to altered modulation of the autonomic nervous system. This and the clinical effectiveness of sympathomimetic medication raised the question if autonomic modulation is altered in aADHD patients.Methods: We systematically searched PubMed, Cochrane Library, and Web Of Science for publications investigating autonomic modulation in aADHD and controls during resting-state and/or under task conditions.Results: We reviewed 15 studies involving 846 participants (424 aADHD and 422 controls), including 4 studies on sympathetic tone at rest, 13 studies on sympathetic modulation during tasks, 3 studies on resting state parasympathetic modulation and 3 papers on task-related parasympathetic modulation. Studies comprised measurements of electrodermal activity, heart rate variability, blood pressure variability, blood volume pulse, pre-ejection period, and baroreflex sensitivity. 2 studies reported reduced sympathetic tone in aADHD; 7 papers described lower sympathetic reactivity to task demands in this cohort. One study linked aADHD to impaired vagal tone, while no indications of altered tasks-related parasympathetic reactivity in aADHD patients were reported.Conclusion: The reviewed data revealed impaired cardiovascular autonomic modulation in aADHD patients, predominantly in sympathetic modulation and during stress exposure.

Effects and feasibility of psychological interventions to reduce inattention symptoms in adults with ADHD: a systematic review

BACKGROUND

Adult ADHD is common, highly comorbid, and restricts daily functioning. However, only a minority of patients receive appropriate treatment.

AIMS

Primary objective: To identify psychological interventions that diminish inattention symptoms in adults with ADHD. Secondary objective: To evaluate feasibility aspects.

METHODS

A search in PubMed, Cochrane Library, PsycInfo, PSYNDEX, and Eric was conducted. Interventions were grouped in: ADHD coaching, neuro feedback, cognitive training, psychoeducation, and behavioral therapy. Inattention symptoms were evaluated using standardized mean differences. Study quality was rated with the Cochrane Risk of Bias tool. Feasibility was assessed by number and time of sessions, setting, and qualification of the provider.

RESULTS

A total of N = 2229 results were identified, 19 randomized controlled studies were included in the analysis. Behavioral therapy showed effects on inattention symptoms [SMD: 0.44-1.71] when compared to inactive controls. In terms of feasibility, longer interventions did not outperform shorter ones and individual sessions were not superior to group sessions. No effects were given for neuro feedback, cognitive training, and psychoeducation in comparison to controls.

CONCLUSION

For adults with ADHD behavioral therapy seems an effective intervention to reduce inattention symptoms. In terms of feasibility, brief interventions may be valuable for a primary care setting.

Investigating the effect of synchronized movement on toddlers' word learning

The effect of interpersonal behavioral synchrony on children's behavior is an emerging field rich with research potential. While studies demonstrate its effect on affiliative and prosocial outcomes, the role of synchronized movement on children's specific learning outcomes has not yet been investigated experimentally. One possibility is that synchrony, as a coordinated social activity, encourages perceived social bonds, leading to heightened attention, and better information retention. Equally likely is that physiological, rather than social learning, mechanisms mediate the effect, given the previously demonstrated role of autonomic arousal in attentional fluctuations, cognitive engagement, problem solving, exploration, and curiosity. The present study investigated the behavioral and physiological effects of synchrony conceptualized as induced, interpersonal, behavioral, movement-based interaction, on word learning in 2.5-year-old children. In a laboratory experiment, toddlers engaged in either a synchronous or an asynchronous movement-based interaction with an adult experimenter while listening to an upbeat children's song. After the (a)synchronous movement episode, the same experimenter engaged children in a word learning task. During the (a)synchrony and learning phases, children's physiological arousal was continuously recorded, resulting in heart rate and skin conductance response measures. Following a caregiver-child free play break, children were tested on their novel word retention. The results indicated that children learned novel labels at equal rates during the learning phase in both conditions, and their retention at test did not differ between conditions: although above chance retention of novel labels was found only following the synchronous, but not the asynchronous episode, the cross-episode comparisons did not reach statistical significance. Physiological arousal indices following the (a)synchrony episode did not differ between conditions and did not predict better word learning, although skin conductance response was higher during the learning than the movement episode. This study contributes to our understanding of the underlying cognitive and physiological mechanisms of interpersonal behavioral synchrony in the knowledge acquisition domain and paves the way to future investigations.

Effects of overnight military training and acute battle stress on the cognitive performance of soldiers in simulated urban combat

Understanding the effect of stress, fatigue, and sleep deprivation on the ability to maintain an alert and attentive state in an ecologically valid setting is of importance as lapsing attention can, in many safety-critical professions, have devastating consequences. Here we studied the effect of close-quarters battle (CQ battle) exercise combined with overnight military training with sleep deprivation on cognitive performance, namely sustained attention and response inhibition. In addition, the effect of the CQ battle and overnight training on cardiac activity [heart rate and root mean square of the successive differences (RMSSD)] during the cognitive testing and the relationship between cardiac activity and cognitive performance were examined. Cognitive performance was measured with the psychomotor vigilance task (PVT) and the sustained attention to response task (SART). Altogether 45 conscripts participated in the study. The conscripts were divided into control (CON) and experimental (EXP) groups. The CON completed the training day after a night of sleep and the EXP after the overnight military training with no sleep. Results showed that the effect of the overnight training on cognitive performance and the between-group difference in heart rate (HR) and heart rate variability (HRV) depended on the cognitive test. Surprisingly, the cognitive performance was not largely affected by the CQ battle. However, as expected, the CQ battle resulted in a significant decrease in RMSSD and an increase in HR measured during the cognitive testing. Similarly, the HR parameters were related to cognitive performance, but the relationship was found only with the PVT. In conclusion, fatigue due to the overnight training impaired the ability to maintain sufficient alertness level. However, this impairment in arousal upregulation was counteracted by the arousing nature of the SART. Hence, the conscripts' cognitive performance was mainly preserved when performing a stimulating task, despite the fatigue from the sleep loss of the preceding night and physical activity.

Research on Emotion Recognition for Online Learning in a Novel Computing Model

The recognition of human emotions is expected to completely change the mode of human-computer interaction. In emotion recognition research, we need to focus on accuracy and real-time performance in order to apply emotional recognition based on physiological signals to solve practical problems. Considering the timeliness dimension of emotion recognition, we propose a terminal-edge-cloud system architecture. Compared to traditional sentiment computing architectures, the proposed architecture in this paper reduces the average time consumption by 15% when running the same affective computing process. Proposed Joint Mutual Information (JMI) based feature extraction affective computing model, and we conducted extensive experiments on the AMIGOS dataset. Through experimental comparison, this feature extraction network has obvious advantages over the commonly used methods. The model performs sentiment classification, and the average accuracy of valence and arousal is 71% and 81.8%, compared with recent similar sentiment classifier research, the average accuracy is improved by 0.85%. In addition, we set up an experiment with 30 people in an online learning scenario to validate the computing system and algorithm model. The result proved that the accuracy and real-time recognition were satisfactory, and improved the online learning real-time emotional interaction experience.

Lost in Time: Temporal Monitoring Elicits Clinical Decrements in Sustained Attention Post-Stroke

OBJECTIVES

Mental fatigue, 'brain fog', and difficulties maintaining engagement are commonly reported issues in a range of neurological and psychiatric conditions. Traditional sustained attention tasks commonly measure this capacity as the ability to detect target stimuli based on sensory features in the auditory or visual domains. However, with this approach, discrete target stimuli may exogenously capture attention to aid detection, thereby masking deficits in the ability to endogenously sustain attention over time.

METHODS

To address this, we developed the Continuous Temporal Expectancy Task (CTET) where individuals continuously monitor a stream of patterned stimuli alternating at a fixed temporal interval (690 ms) and detect an infrequently occurring target stimulus defined by a prolonged temporal duration (1020 ms or longer). As such, sensory properties of target and non-target stimuli are perceptually identical and differ only in temporal duration. Using the CTET, we assessed stroke survivors with unilateral right hemisphere damage (N = 14), a cohort in which sustained attention deficits have been extensively reported.

RESULTS

Stroke survivors had overall lower target detection accuracy compared with neurologically healthy age-matched older controls (N = 18). Critically, stroke survivors performance was characterised by significantly steeper within-block performance decrements, which occurred within short temporal windows (˜3 ½ min), and were restored by the break periods between blocks.

CONCLUSIONS

These findings suggest that continuous temporal monitoring taxes sustained attention processes to capture clinical deficits in this capacity over time, and outline a precise measure of the endogenous processes hypothesised to underpin sustained attention deficits following right hemisphere stroke.

EEG Correlates of Sustained Attention Variability during Discrete Multi-finger Force Control Tasks

The neurophysiological characteristics of sustained attention states are unclear in discrete multi-finger force control tasks. In this article, we developed an immersive visuo-haptic task for conducting stimulus-response measurements. Visual cues were randomly provided to signify the required amplitude and tolerance of fingertip force. Participants were required to respond to the visual cues by pressing force transducers using their fingertips. Response time variation was taken as a behavioral measure of sustained attention states during the task. 50% low-variability trials were classified as the optimal state and the other high-variability trials were classified as the suboptimal state using z-scoring over time. A 64-channel electroencephalogram (EEG) acquisition system was used to collect brain activities during the tasks. The haptics-elicited potential amplitude at 20 ∼ 40 ms in latency and over the frontal-central region significantly decreased in the optimal state. Furthermore, the alpha-band power in the spectra of 8 ∼ 13 Hz was significantly suppressed in the frontal-central, right temporal, and parietal regions in the optimal state. Taken together, we have identified neuroelectrophysiological features that were associated with sustained attention during multi-finger force control tasks, which would be potentially used in the development of closed-loop attention detection and training systems exploiting haptic interaction.

Program for attention rehabilitation and strengthening (PARS) improves executive functions in children with attention deficit- hyperactivity disorder (ADHD)

Attention is improved through cognitive rehabilitation. The purpose of the present study was the evaluation of the effect of a paper and pencil program for attention rehabilitation and strengthening (PARS) in children with ADHD. Thirty children with ADHD were randomly divided into two equal intervention and control groups. The intervention group received 12-15 sessions of intervention through PARS. Sustained, selective, and shifting attention, inhibitory control, and working memory were assessed by Persian attention registration, Stroop, color trail making, Go/No-Go, and 1- back tests. Analyses indicated that the experimental group, in comparison with the control group, showed improved selective and sustained attention and the training effects transfers to executive functions, inhibitory control and working memory. The result is discussed in the light of transferability of training effects from attention to executive functions.

Effect of Age in Auditory Go/No-Go Tasks: A Magnetoencephalographic Study

Response inhibition is frequently examined using visual go/no-go tasks. Recently, the auditory go/no-go paradigm has been also applied to several clinical and aging populations. However, age-related changes in the neural underpinnings of auditory go/no-go tasks are yet to be elucidated. We used magnetoencephalography combined with distributed source imaging methods to examine age-associated changes in neural responses to auditory no-go stimuli. Additionally, we compared the performance of high- and low-performing older adults to explore differences in cortical activation. Behavioral performance in terms of response inhibition was similar in younger and older adult groups. Relative to the younger adults, the older adults exhibited reduced cortical activation in the superior and middle temporal gyrus. However, we did not find any significant differences in cortical activation between the high- and low-performing older adults. Our results therefore support the hypothesis that inhibition is reduced during aging. The variation in cognitive performance among older adults confirms the need for further study on the underlying mechanisms of inhibition.

Can biofeedback-based training alleviate fatigue and vigilance performance in fatigued MS patients?

MS related fatigue might be related to autonomous nervous system (ANS) dysfunctions or to inflammation related vagal (hyper-) activation. Consequently, influencing ANS status may lead to relieve of fatigue. We used two opposite biofeedback interventions to either increase sympathetic ("self-alert training", SAT) or parasympathetic activation ("progressive muscle relaxation", PMR). We recorded fatigue status of patients before and after a challenging vigilance task, their behavioural performance on this task, their skin conductance response (SCR), and parameters indicating parasympathetic activity concerning heart rate variability (HRV). We repeated these recordings after the biofeedback training sessions. Patients of the SAT group were able to learn to increase their SCR voluntarily. Patients of the PMR group showed increasing parameters indicating parasympathetic modulation of the HRV. The vigilance task increased their feeling of fatigue. However, there was no effect of biofeedback training on either fatigue status or performance on the vigilance task. Our results show that MS patients can learn to change voluntarily their ANS activity using biofeedback instructions based on SCR and this can be used in future studies to test the postulated link between ANS and fatigue. However, in this experimental intervention we were unable to document a relation between ANS activity and fatigue.Trial registration: ClinicalTrials.gov identifier: NCT03268187.

Neuropsychological Deficits in Adult ADHD: Evidence for Differential Attentional Impairments, Deficient Executive Functions, and High Self-Reported Functional Impairments

Objective: This study is aimed to investigate neuropsychological deficits in adult ADHD. Method: Neuropsychological deficits in terms of executive functions, divided, selective, and sustained attention, were investigated in a group of adults with ADHD using a series of neuropsychological tests as well as electroencephalography (EEG). Subjective ratings of everyday life attention and memory problems were also collected. Results: Adults with ADHD showed impairments in executive functions, divided attention and sustained attention, compared with adult controls. Performance on selective attention tasks in adults with ADHD was instead no different from control participants' performance. EEG results confirmed neuropsychological findings by showing a selective impairment on P3 event-related potential (ERP) amplitude indicative of sustained attention deficits. Higher subjective ratings of everyday attentional and memory problems were also found in the ADHD group compared with the control group. Conclusion: This pattern of results suggests differential impairments of attentional skills. Impaired executive functions and higher subjective functional impairments were also found.

Normative data of neuropsychological tests of attention and executive functions in Ecuadorian adult population

OBJECTIVE

The purpose of this study was to generate normative data for five tests of attention and executive functions (M-WCST, Stroop test, TMT, BTA, and SDMT), in a group of 322 Ecuadorian adults from Quito between the ages of 18 and 85.

METHOD

Multiple regression analyzes taking into account age, education, and gender were used to generate the normative data.

RESULTS

Age and education were significantly related to test performance such that scores decreased with age and improved as a function of education. An online calculator is provided to generate normative test scores.

CONCLUSIONS

This is the first study that presents normative data for tests of executive functions and attention in an Ecuadorian adult population. This data will improve the clinical practice of neuropsychology and help to develop the field in the country.

Volitional Control of Piloerection: Objective Evidence and Its Potential Utility in Neuroscience Research

The volitional control of piloerection has been previously reported in a small subset of individuals. Although this ability may be useful to study the mechanism underlying piloerection, there is little existing research on this ability, neither objective evidence at a group-level, nor information about its stability under experimental constraints. The present study aimed to validate existing findings of voluntarily generated piloerection (VGP) and to examine its potential contribution to neuroscientific research based on objective evidence of this ability. In Study 1, to confirm the characteristics of VGP reported in previous studies and identify individuals with VGP capability, an online survey of VGP candidates was conducted. In Study 2, 18 VGP holders participated in a mail-based piloerection measurement experiment, and the nature of VGP was examined based on the objective data obtained by image-based analysis (GooseLab). Study 1 largely confirmed the characteristics of VGP reported in previous studies, and Study 2 demonstrated VGP at a group-level and provided information about the temporal characteristics of this ability, which supports the utility of VGP in neuroscientific research. For some participants, VGP appeared to be emotionally promoted, which suggests that VGP has some relationship with the emotional nature of involuntary piloerection. Although the studies did not tightly control the environment in which VGP was elicited, the findings nonetheless demonstrate the possible contribution of VGP to elucidating the mechanism of involuntary emotional piloerection and the neural basis of piloerection itself.

Looking through blue glasses: bioelectrical measures to assess the awakening after a calm situation

Colors can elicit cognitive and emotional states. In particular, blue colour is associated to "refresh" and "restart" effects and is suggested to enhance a wake-up after a calm situation. In this exploratory study, these claims are investigated using Electroencephalographic (EEG), Skin Conductance (SC) and pupil diameter data. The results confirmed the "wake-up effect" for subjects wearing the lenses, as measured by Global Field Power (GFP) in Theta Band, Skin Conductance Response (SCR) and pupil diameter data.

Does the Mind Wander When the Brain Takes a Break? Local Sleep in Wakefulness, Attentional Lapses and Mind-Wandering

Sleep has been classically described as an all-or-nothing global phenomenon. However, recent research strongly suggests that this view requires tempering. Invasive and non-invasive recordings in animals and humans show that neural activity typically associated with sleep can locally occur during wakefulness. Although local sleep is defined neuronally, it has been associated with impaired performance during cognitive tasks. Comparatively, the phenomenology of local sleep (i.e., what it feels like when your brain is partially asleep) has been less explored. Taking into account the literature on the neuronal and behavioral profile of local sleep intrusions in wakefulness, we propose that occurrences of local sleep could represent the neural mechanism underlying many attentional lapses. In particular, we argue that a unique physiological event such as local sleep could account for a diversity of behavioral outcomes from sluggish to impulsive responses. We further propose that local sleep intrusions could impact individuals' subjective experience. Specifically, we propose that the timing and anatomical sources of local sleep intrusions could be responsible for both the behavioral consequences and subjective content of attentional lapses and may underlie the difference between subjective experiences such as mind wandering and mind blanking. Our framework aims to build a parallel between spontaneous experiences in sleep and wakefulness by integrating evidence across neuronal, behavioral and experiential levels. We use the example of attention deficit hyperactivity disorder (ADHD) to illustrate how local sleep could explain complex cognitive profiles which include inattention, impulsivity, mind-wandering and mind-blanking.

Suboptimal Engagement of High-Level Cortical Regions Predicts Random-Noise-Related Gains in Sustained Attention

Interindividual variability in outcomes across individuals poses great challenges for the application of noninvasive brain stimulation in psychological research. Here, we examined how the effects of high-frequency transcranial random-noise stimulation (tRNS) on sustained attention varied as a function of a well-studied electrocortical marker: spontaneous theta:beta ratio. Seventy-two participants received sham, 1-mA, and 2-mA tRNS in a double-blind, crossover manner while they performed a sustained-attention task. Receiving 1-mA tRNS was associated with improved sustained attention, whereas the effect of 2-mA tRNS was similar to the effect of sham tRNS. Furthermore, individuals’ baseline theta:beta ratio moderated the effects of 1-mA tRNS and provided explanatory power beyond baseline behavioral performance. The tRNS-related effects on sustained attention were also accompanied by reductions in theta:beta ratio. These findings impart novel insights into mechanisms underlying tRNS effects and emphasize how designing studies that link variability in cognitive outcomes to variability in neurophysiology can improve inferential power in neurocognitive research.

Autonomic arousal profiles in adolescents and young adults with ADHD as a function of recording context

A recent study (James et al. 2016) found that attention-deficit/hyperactivity disorder (ADHD) was associated with hypo-arousal, indexed by low electrodermal activity, during a low-demand reaction-time task, which normalized in a fast-incentive condition. We now investigate if (1) autonomic arousal in individuals with ADHD changes over a long testing session and (2) across time, to clarify if arousal profiles are context-dependent. We also examine (3) how autonomic arousal relates to each ADHD symptom domain, and specificity of arousal profiles to ADHD, by controlling for oppositional defiant/conduct disorder (ODD/CD) symptoms. Skin conductance level and non-specific fluctuations were measured during four successive resting-state and cognitive conditions (Resting-state time 1, Continuous Performance Task, Fast Task: Baseline and Fast-Incentive conditions, Resting-state time 2) from 71 adolescents/young adults with ADHD and 140 controls. Lower arousal was observed in individuals with ADHD only during a slow, low-demanding task, and more fluctuating arousal was observed towards the end of assessment. Both inattentive and hyperactive-impulsive symptoms were associated with arousal levels and fluctuations, independently from ODD/CD. Overall, we extend previous findings showing that under-arousal, but also fluctuating arousal, are context-specific rather than stable impairments in ADHD.

Inhibiting the Physiological Stress Effects of a Sustained Attention Task on Shoulder Muscle Activity

Objective: The objective of this study was to investigate if a breathing technique could counteract the effects of hyperventilation due to a sustained attention task on shoulder muscle activity. Background: The trend towards higher levels of automation in industry is increasing. Consequently, manufacturing operators often monitor automated process for long periods of their work shift. Prolonged monitoring work requires sustained attention, which is a cognitive process that humans are typically poor at and find stressful. As sustained attention becomes an increasing requirement of manufacturing operators’ job content, the resulting stress experienced could contribute to the onset of many health problems, including work related musculoskeletal disorders (WRMSDs). Methods: The SART attention test was completed by a group of participants before and after a breathing intervention exercise. The effects of the abdominal breathing intervention on breathing rate, upper trapezius muscle activity and end-tidal CO₂ were evaluated. Results: The breathing intervention reduced the moderation effect of end-tidal CO₂ on upper trapezius muscle activity. Conclusions: Abdominal breathing could be a useful technique in reducing the effects of sustained attention work on muscular activity. Application: This research can be applied to highly-automated manufacturing industries, where prolonged monitoring of work is widespread and could, in its role as a stressor, be a potential contributor to WRMSDs.

Cognitive remediation improves executive functions, self-regulation and quality of life in residents of a substance use disorder therapeutic community

BACKGROUND

Executive dysfunction is common in substance use disorder (SUD) populations and hinders treatment. We previously found that 50% of residents in SUD therapeutic communities had been hospitalized for head injuries; this was a significant determinant of cognitive impairment. The current study aimed to establish whether cognitive remediation improves executive functions (EFs) and self-regulation in an ecologically valid sample of female residents attending SUD therapeutic community treatment, including those with past head injuries and psychiatric comorbidities.

METHODS

Controlled sequential groups design with residents (N=33, all female) receiving treatment as usual (TAU). The intervention group (n=16) completed four weeks of cognitive remediation (CR) and the control, TAU only (n=17). Outcome measures assessed pre- and post-intervention included both performance- and inventory-based measures of EFs, and self-reported self-regulation and quality of life.

RESULTS

CR relative to TAU significantly improved performance-based assessment of inhibition (Color-Word Interference Test; F=4.29, p=0.047), inventory-based assessment of EFs (Behavior Rating Inventory of Executive Function - Adult Version: Global Executive Composite; F=6.38, p=0.017), impulsivity (Barratt Impulsiveness Scale; F=4.61, p=0.040), self-control (Brief Self-Control Scale; F=5.53, p=0.026), and quality of life (Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form; F=7.68, p=0.010).

CONCLUSIONS

Findings suggest that CR improves EFs in a heterogeneous sample of female residents in therapeutic community SUD treatment. Future research may explore the possibility of tailoring CR interventions for various SUD subgroups.

The importance of sustained attention in early Alzheimer's disease

INTRODUCTION

There is conflicting evidence regarding impairment of sustained attention in early Alzheimer's disease (AD). We examine whether sustained attention is impaired and predicts deficits in other cognitive domains in early AD.

METHODS

Fifty-one patients with early AD (MMSE > 18) and 15 healthy elderly controls were recruited. The sustained attention to response task (SART) was used to assess sustained attention. A subset of 25 patients also performed tasks assessing general cognitive function (ADAS-Cog), episodic memory (Logical memory scale, Paired Associates Learning), executive function (verbal fluency, grammatical reasoning) and working memory (digit and spatial span).

RESULTS

AD patients were significantly impaired on the SART compared to healthy controls (total error β = 19.75, p = 0.027). SART errors significantly correlated with MMSE score (Spearman's rho = -0.338, p = 0.015) and significantly predicted deficits in ADAS-Cog (β = 0.14, p = 0.004).

DISCUSSIONS

Patients with early AD have significant deficits in sustained attention, as measured using the SART. This may impair performance on general cognitive testing, and therefore should be taken into account during clinical assessment, and everyday management of individuals with early AD. Copyright © 2016 John Wiley & Sons, Ltd.

Synchronized practice helps bearded capuchin monkeys learn to extend attention while learning a tradition

Culture extends biology in that the setting of development shapes the traditions that individuals learn, and over time, traditions evolve as occasional variations are learned by others. In humans, interactions with others impact the development of cognitive processes, such as sustained attention, that shape how individuals learn as well as what they learn. Thus, learning itself is impacted by culture. Here, we explore how social partners might shape the development of psychological processes impacting learning a tradition. We studied bearded capuchin monkeys learning a traditional tool-using skill, cracking nuts using stone hammers. Young monkeys practice components of cracking nuts with stones for years before achieving proficiency. We examined the time course of young monkeys' activity with nuts before, during, and following others' cracking nuts. Results demonstrate that the onset of others' cracking nuts immediately prompts young monkeys to start handling and percussing nuts, and they continue these activities while others are cracking. When others stop cracking nuts, young monkeys sustain the uncommon actions of percussing and striking nuts for shorter periods than the more common actions of handling nuts. We conclude that nut-cracking by adults can promote the development of sustained attention for the critical but less common actions that young monkeys must practice to learn this traditional skill. This work suggests that in nonhuman species, as in humans, socially specified settings of development impact learning processes as well as learning outcomes. Nonhumans, like humans, may be culturally variable learners.

The knowns and unknowns of boredom: a review of the literature

Despite the ubiquitous nature of boredom, the definition, function, and correlates of boredom are still poorly understood. In this review, we summarize the "known" (consistent evidence) and "unknown" (inconsistent evidence) correlates of boredom. We show that boredom is consistently related to negative affect, task-unrelated thought, over-estimation of elapsed time, reduced agency, as well as to over- and under-stimulation. Activation of the default mode network was consistent across the few available fMRI studies, while the recruitment of other brain areas such as the hippocampus and anterior insular cortex, was a notable but less consistent correlate of boredom. Other less consistent correlates of boredom are also reviewed, such as the level of arousal and the mental attributions given to fluctuations of attention. Finally, we identify two critical factors that may contribute to current inconsistencies in the literature and may hamper further progress in the field. First, there is relatively little consistency in the way in which boredom has been operationalized across studies to date, with operationalizations of boredom ranging from negative affect paired with under-stimulation, over-stimulation, to negative affect paired with a lack of goal-directed actions. Second, preliminary evidence suggests the existence of distinct types of boredom (e.g., searching vs. apathetic) that may have different and sometimes even opposing correlates. Adopting a more precise and consistent way of operationalizing boredom, and arriving at an empirically validated taxonomy of different types of boredom, could serve to overcome the current roadblocks to facilitate further progress in our scientific understanding of boredom.

fMRI Neurofeedback Training for Increasing Anterior Cingulate Cortex Activation in Adult Attention Deficit Hyperactivity Disorder. An Exploratory Randomized, Single-Blinded Study

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by poor cognitive control/attention and hypofunctioning of the dorsal anterior cingulate cortex (dACC). In the current study, we investigated for the first time whether real-time fMRI neurofeedback (rt-fMRI) training targeted at increasing activation levels within dACC in adults with ADHD leads to a reduction of clinical symptoms and improved cognitive functioning. An exploratory randomized controlled treatment study with blinding of the participants was conducted. Participants with ADHD (n = 7 in the neurofeedback group, and n = 6 in the control group) attended four weekly MRI training sessions (60-min training time/session), during which they performed a mental calculation task at varying levels of difficulty, in order to learn how to up-regulate dACC activation. Only neurofeedback participants received continuous feedback information on actual brain activation levels within dACC. Before and after the training, ADHD symptoms and relevant cognitive functioning was assessed. Results showed that both groups achieved a significant increase in dACC activation levels over sessions. While there was no significant difference between the neurofeedback and control group in clinical outcome, neurofeedback participants showed stronger improvement on cognitive functioning. The current study demonstrates the general feasibility of the suggested rt-fMRI neurofeedback training approach as a potential novel treatment option for ADHD patients. Due to the study’s small sample size, potential clinical benefits need to be further investigated in future studies.

Trial Registration: ISRCTN12390961

Modifiable Arousal in Attention-Deficit/Hyperactivity Disorder and Its Etiological Association With Fluctuating Reaction Times

Background

Cognitive theories of attention-deficit/hyperactivity disorder (ADHD) propose that high within-subject fluctuations of cognitive performance in ADHD, particularly reaction time (RT) variability (RTV), may reflect arousal dysregulation. However, direct evidence of arousal dysregulation and how it may account for fluctuating RTs in ADHD is limited. We used skin conductance (SC) as a measure of peripheral arousal and aimed to investigate its phenotypic and familial association with RTV in a large sample of ADHD and control sibling pairs.

Methods

Adolescents and young adults (N = 292), consisting of 73 participants with ADHD and their 75 siblings, and 72 controls and their 72 siblings, completed the baseline (slow, unrewarded) and fast-incentive conditions of a RT task, while SC was simultaneously recorded.

Results

A significant group-by-condition interaction emerged for SC level (SCL). Participants with ADHD had decreased SCL, compared with controls, in the baseline condition but not the fast-incentive condition. Baseline SCL was negatively associated with RTV, and multivariate model fitting demonstrated that the covariance of SCL with RTV, and of SCL with ADHD, was mostly explained by shared familial effects.

Conclusions

ADHD is associated with decreased, but modifiable, tonic peripheral arousal. A shared familial cause underlies the relationship between arousal and RTV and between arousal and ADHD. Given the malleability of SCL, if our findings are replicated, it warrants further exploration as a potential treatment target for ADHD.

Does state boredom cause failures of attention? Examining the relations between trait boredom, state boredom, and sustained attention

Boredom is an important personal and social problem, but the phenomena itself remains poorly understood. Recent work has shown that boredom is highly related to attention, and that this relationship may be instrumental in revealing boredom's causes and consequences. In this paper, experimental findings on trait boredom, state boredom, and sustained attention performance are presented. We demonstrate that trait boredom uniquely predicts sustained attention performance, over and above depression and self-report attention problems. We also present exploratory findings consistent with the claim that attention failures may cause boredom and that sustained attention tasks may themselves be boring. Discussion of each of these findings, and potential ramifications for cognitive research as a whole, is included.

Targeting alertness to improve cognition in older adults: A preliminary report of benefits in executive function and skill acquisition

Efficient self-regulation of alertness declines with age exacerbating normal declines in performance across multiple cognitive domains, including learning and skill acquisition. Previous cognitive intervention studies have shown that it is possible to enhance alertness in patients with acquired brain injury and marked attention impairments, and that this benefit generalizes to improvements in more global cognitive functions. In the current preliminary studies, we sought to test whether this approach, that targets both tonic (over a period of minutes) and phasic (moment-to-moment) alertness, can improve key executive functioning declines in older adults, and enhance the rate of skill acquisition. The results of both Experiments 1 and 2 demonstrate that, compared to active control (AC) training, alertness training significantly enhanced performance in several validated executive function measures. In Experiment 2, alertness training significantly improved skill acquisition compared to AC training in a well-characterized speed of processing (SOP) task, with the largest benefits shown in the most challenging SOP blocks. The results of the current study suggest that targeting intrinsic alertness through cognitive training provides a novel approach to improve executive functions in older adults and may be a useful adjunct treatment to enhance benefits gained in other clinically validated treatments.

Emotional modulation of interval timing and time perception

Like other senses, our perception of time is not veridical, but rather, is modulated by changes in environmental context. Anecdotal experiences suggest that emotions can be powerful modulators of time perception; nevertheless, the functional and neural mechanisms underlying emotion-induced temporal distortions remain unclear. Widely accepted pacemaker-accumulator models of time perception suggest that changes in arousal and attention have unique influences on temporal judgments and contribute to emotional distortions of time perception. However, such models conflict with current views of arousal and attention suggesting that current models of time perception do not adequately explain the variability in emotion-induced temporal distortions. Instead, findings provide support for a new perspective of emotion-induced temporal distortions that emphasizes both the unique and interactive influences of arousal and attention on time perception over time. Using this framework, we discuss plausible functional and neural mechanisms of emotion-induced temporal distortions and how these temporal distortions may have important implications for our understanding of how emotions modulate our perceptual experiences in service of adaptive responding to biologically relevant stimuli.

The aetiological association between the dynamics of cortisol productivity and ADHD

Attention-deficit/hyperactivity disorder (ADHD) has been linked to dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, indexed by salivary cortisol. The phenotypic and aetiological association of cortisol productivity with ADHD was investigated. A selected twin design using 68 male twin-pairs aged 12–15, concordant or discordant for high ADHD symptom scores, or control twin-pairs with low ADHD symptoms, based on developmentally stable parental ADHD ratings. A genetic growth curve model was applied to cortisol samples obtained across three points during a cognitive-electroencephalography assessment, to examine the aetiological overlap of ADHD affection status (high versus low ADHD symptom scores) with latent intercept and slope factors. A significant phenotypic correlation emerged between ADHD and the slope factor, with cortisol levels dropping faster for the group with high ADHD symptom scores. The analyses further suggested this overlap was mostly driven by correlated genetic effects. We identified change in cortisol activity over time as significantly associated with ADHD affection status, primarily explained by shared genetic effects, suggesting that blunted cortisol productivity can be a marker of genetic risk in ADHD.

Reliable Attention Network Scores and Mutually Inhibited Inter-network Relationships Revealed by Mixed Design and Non-orthogonal Method

The attention system can be divided into alerting, orienting, and executive control networks. The efficiency and independence of attention networks have been widely tested with the attention network test (ANT) and its revised versions. However, many studies have failed to find effects of attention network scores (ANSs) and inter-network relationships (INRs). Moreover, the low reliability of ANSs can not meet the demands of theoretical and empirical investigations. Two methodological factors (the inter-trial influence in the event-related design and the inter-network interference in orthogonal contrast) may be responsible for the unreliability of ANT. In this study, we combined the mixed design and non-orthogonal method to explore ANSs and directional INRs. With a small number of trials, we obtained reliable and independent ANSs (split-half reliability of alerting: 0.684; orienting: 0.588; and executive control: 0.616), suggesting an individual and specific attention system. Furthermore, mutual inhibition was observed when two networks were operated simultaneously, indicating a differentiated but integrated attention system. Overall, the reliable and individual specific ANSs and mutually inhibited INRs provide novel insight into the understanding of the developmental, physiological and pathological mechanisms of attention networks, and can benefit future experimental and clinical investigations of attention using ANT.

The effects of a Self-Alert Training (SAT) program in adults with ADHD

Attention-Deficit/Hyperactivity Disorder (ADHD), a neuropsychiatric condition characterized by attention and impulsivity problems, is one of the most common behavioral disorders. The first line of treatment for ADHD is psychostimulant medication, but this has limited effectiveness, particularly in adults, and is often associated with adverse side-effects. Thus, it is imperative that new non-pharmaceutical approaches to treatment are developed. This study aims to evaluate the impact of a non-pharmacological Self-Alert Training (SAT) intervention on ADHD symptom prevalence, psychological and cognitive functioning, and on everyday functional impairment in adults with ADHD. Fifty-one adult participants with a current diagnosis of ADHD were randomized to either SAT or a Control Training (CT) program. They were assessed at baseline, immediately following the 5-week training period, and after 3-months using ADHD symptoms scales, as well as a series of neuropsychological tests and psychological questionnaires. Subjective ratings of everyday life attention and memory problems were also collected. The SAT group showed significant improvements in ADHD inattentive and impulsive symptoms, depressive symptoms and in self-efficacy ratings compared to the CT group at both post-training and at the 3-month assessment. Pre-post improvements in SAT participants on untrained cognitive tasks measuring selective attention and executive functions were also observed. Finally, the SAT group reported improved subjective ratings of everyday life attention at both assessment points. This pattern of results suggests that SAT may be beneficial in treating ADHD symptoms as well as psychological and cognitive impairments in adult ADHD. A large-scale randomized controlled trial (RCT) is needed.

Biofeedback-based self-alert training reduces alpha activity and stabilizes accuracy in the Sustained Attention to Response Task

OBJECTIVE

Deficits in sustaining attention are common in various organic brain diseases. A recent study proposed self-alert training (SAT) as a technique to improve sustained attention. In the SAT, individuals learn to gain volitional control over their own state of arousal by means of electrodermal biofeedback.

METHOD

In this study, we investigated the behavioral, electrodermal, and electroencephalogram correlates of the SAT with a blinded, randomized, and active-controlled pre-post study design. Sustained attention capacity was assessed with the Sustained Attention to Response Task (SART).

RESULTS

The SAT resulted in strong phasic increases in skin conductance response (SCR), but endogenous control of SCR without feedback was problematic. Electroencephalogram analysis revealed stronger alpha reduction during SART for the SAT than for the control group. Behaviorally, the SAT group performed more accurately and more slowly after intervention than the control group.

CONCLUSION

The study provides further evidence that SAT helps to maintain SART accuracy over prolonged periods of time. Whether this accuracy is more related to sustained attention or response inhibition is discussed.

Connecting clinical and experimental investigations of awareness in traumatic brain injury

Questionnaire-based demonstrations of impaired self-awareness (SA) after traumatic brain injury (TBI) are not always supported by experimental studies of in-the-moment or online awareness. This chapter begins by describing the clinical phenomenon of impaired SA, how it is measured, and why its interdependency with mechanisms of online awareness may provide the scaffolding from which appraisals of cognitive functioning can be accurately revised following a brain injury. We review research that has measured unawareness of errors in routine action in TBI patients and propose more rigorous methodological approaches to studying the emergent properties of awareness with greater clarity in the laboratory. We discuss how neuropsychological and electrophysiologic studies are beginning to inform our understanding of impaired error processing in TBI patients and we highlight recent theory proposing that online metacognitive processes accumulate evidence of erroneous responses in a graded fashion. Neural signals with amplitudes that scale with the strength of accruing evidence and peak latencies that mark the threshold at which awareness emerges represent important neural mechanisms to examine the breakdown of error awareness after brain injury. We also discuss how errors can be investigated in relation to different sources of evidence that contribute to aware experiences after brain injury. Finally, we explore conditions beyond error signaling, and how different "objects of insight" that require retrospective and prospective judgments of confidence need to be examined in relation to the clinical phenomenon of impaired SA.

Attention deficit and attention training in early twentieth-century Japan

Yuzero Motora (1856-1912), regarded as the first professional Japanese psychologist, tried to address students' attention difficulties through attention training methods of his own design. His reports contain the first description of ADHD-like symptoms in the history of Japan. Motora viewed "distractibility" as the irregular transition of attention. Students with low scores and attention difficulties who participated in Motora's exercises showed improvement in arithmetic, psychological testing, and certain aspects of daily life. This article describes Motora's theoretical conception of attention and attention training methodology, the history of attention deficit and attention training, and the significance of Motora's experiments.

Testing attention: comparing the ANT with TVA-based assessment

Posner's attention network model and Bundesen's theory of visual attention (TVA) are two influential accounts of attention. Each model has led to the development of a test method: the attention network test (ANT) and TVA-based assessment, respectively. Both tests have been widely used to investigate attentional function in normal and clinical populations. Here we report on the first direct comparison of the ANT to TVA-based assessment. A group of 68 young healthy participants were tested in three consecutive sessions that each contained standard versions of the two tests. The parameters derived from TVA-based assessment had better internal reliability and retest reliability than did those of the standard version of the ANT, where only the executive network score reached comparable levels. However, when corrected for differences in test length, the retest reliability of the orienting network score equaled the least reliable TVA parameters. Both tests were susceptible to practice effects, which improved performance for some parameters while leaving others constant. All pairwise correlations between the eight attention parameters measured by the two tests were small and nonsignificant, with one exception: A strong correlation (r = 0.72) was found between two parameters of TVA-based assessment, visual processing speed and the capacity of visual short-term memory. We conclude that TVA-based assessment and the ANT measure complementary aspects of attention, but the scores derived from TVA-based assessment are more reliable.

EEG predictors of covert vigilant attention

OBJECTIVE

The present study addressed the question whether neurophysiological signals exhibit characteristic modulations preceding a miss in a covert vigilant attention task which mimics a natural environment in which critical stimuli may appear in the periphery of the visual field.

APPROACH

Subjective, behavioural and encephalographic (EEG) data of 12 participants performing a modified Mackworth Clock task were obtained and analysed offline. The stimulus consisted of a pointer performing regular ticks in a clockwise sequence across 42 dots arranged in a circle. Participants were requested to covertly attend to the pointer and press a response button as quickly as possible in the event of a jump, a rare and random event.

MAIN RESULTS

Significant increases in response latencies and decreases in the detection rates were found as a function of time-on-task, a characteristic effect of sustained attention tasks known as the vigilance decrement. Subjective sleepiness showed a significant increase over the duration of the experiment. Increased activity in the α-frequency range (8-14 Hz) was observed emerging and gradually accumulating 10 s before a missed target. Additionally, a significant gradual attenuation of the P3 event-related component was found to antecede misses by 5 s.

SIGNIFICANCE

The results corroborate recent findings that behavioural errors are presaged by specific neurophysiological activity and demonstrate that lapses of attention can be predicted in a covert setting up to 10 s in advance reinforcing the prospective use of brain-computer interface (BCI) technology for the detection of waning vigilance in real-world scenarios. Combining these findings with real-time single-trial analysis from BCI may pave the way for cognitive states monitoring systems able to determine the current, and predict the near-future development of the brain's attentional processes.

An evaluation of alertness training for older adults

We present an evaluation of a self-administered, biofeedback-aided, alertness training programme called the Alertness: Training for Focused Living (ATFL) Programme, which was developed as part of the Technology Research for Independent Living (TRIL) collaboration. We conducted two studies in order to evaluate the programme. A randomized controlled trial was, first of all, conducted with 40 older adults aged between 60 and 83. A series of five single case studies was then conducted to examine the suitability of the programme for use with people with more severe memory difficulties. In the randomized controlled trial, participants were assigned to the ATFL Programme or to a placebo programme. Aspects of participants' memory, attention and executive functioning were assessed via telephone prior to and following completion of the training programmes and at 1, 3, and 6-month follow-up sessions. Significant improvements in sustained attention and verbal fluency were noted in the ATFL group. The series of single case studies illustrated the importance of tailoring a programme to the needs and abilities of the clients in question. The potential benefits of the ATFL programme in terms of periodically boosting alertness and aiding executive functioning are discussed.

Investigating sustained attention ability in the elderly by using two different approaches: inhibiting ongoing behavior versus responding on rare occasions

Previous studies on sustained attention ability in the elderly produced inconsistent results. The aim of this study was to evaluate sustained attention performance in younger and older individuals by using, in a within-subjects design, two versions of the same task (the sustained attention to response task, SART) in which only in the response mode differed: in a traditionally formatted task (TFT), subjects had to respond to rare targets, and in a Go/No-Go task they had to withhold response to rare targets. Results showed that in the TFT SART only the older group exhibited a vigilance decrement. On the contrary, only young individuals showed a vigilance decrement in the Go/No-Go SART. These results showed that older individuals, who also reported less mind wandering and a higher level of motivation, exhibited preserved sustained attention ability in the Go/No-Go SART, which could be explained by increased engagement of cognitive control mechanisms in this population. The discrepancy in performance depending on the approach used also underlines the need for further studies on the nature of attention failures and their underlying mechanisms.

Alcohol intoxication alters cognitive skills mediated by frontal and temporal brain regions

Alcohol intoxication affects frontal and temporal brain areas and may functionally impair cognitive processes mediated by these regions. This study examined this hypothesis by testing the effects of alcohol on sustained attention, impulsivity, and verbal memory. Sober and placebo control groups were used to distinguish pharmacological from expectancy effects of alcohol. One hundred nine university students were assigned to an alcohol (low, medium, or high dose), placebo or sober group. Moderate and high doses of alcohol impaired all cognitive measures. A gender effect was revealed in that alcohol impaired sustained attention in males, but not females. Both sustained attention and verbal memory exhibited a U-shaped pattern, in that the medium-dose alcohol group showed the greatest impairment. This study adds to knowledge about the effects of alcohol intoxication on frontally- and temporally-mediated cognitive function. These findings have specific relevance for heavy-drinking undergraduate populations, particularly in light of the fact that repeated alcohol administration produces persistent changes in brain neurocircuitry.

The separation of ADHD inattention and hyperactivity-impulsivity symptoms: pathways from genetic effects to cognitive impairments and symptoms

Both shared and unique genetic risk factors underlie the two symptom domains of attention deficit hyperactivity disorder (ADHD): inattention and hyperactivity-impulsivity. The developmental course and relationship to co-occurring disorders differs across the two symptom domains, highlighting the importance of their partially distinct etiologies. Familial cognitive impairment factors have been identified in ADHD, but whether they show specificity in relation to the two ADHD symptom domains remains poorly understood. We aimed to investigate whether different cognitive impairments are genetically linked to the ADHD symptom domains of inattention versus hyperactivity-impulsivity. We conducted multivariate genetic model fitting analyses on ADHD symptom scores and cognitive data, from go/no-go and fast tasks, collected on a population twin sample of 1,312 children aged 7-10. Reaction time variability (RTV) showed substantial genetic overlap with inattention, as observed in an additive genetic correlation of 0.64, compared to an additive genetic correlation of 0.31 with hyperactivity-impulsivity. Commission errors (CE) showed low additive genetic correlations with both hyperactivity-impulsivity and inattention (genetic correlations of 0.17 and 0.11, respectively). The additive genetic correlation between RTV and CE was also low and non-significant at -0.10, consistent with the etiological separation between the two indices of cognitive impairments. Overall, two key cognitive impairments phenotypically associated with ADHD symptoms, captured by RTV and CE, showed different genetic relationships to the two ADHD symptom domains. The findings extend a previous model of two familial cognitive impairment factors in combined subtype ADHD by separating pathways underlying inattention and hyperactivity-impulsivity symptoms.

Awakening is not a metaphor: the effects of Buddhist meditation practices on basic wakefulness

Buddhist meditation practices have become a topic of widespread interest in both science and medicine. Traditional Buddhist formulations describe meditation as a state of relaxed alertness that must guard against both excessive hyperarousal (restlessness) and excessive hypoarousal (drowsiness, sleep). Modern applications of meditation have emphasized the hypoarousing and relaxing effects without as much emphasis on the arousing or alertness-promoting effects. In an attempt to counterbalance the plethora of data demonstrating the relaxing and hypoarousing effects of Buddhist meditation, this interdisciplinary review aims to provide evidence of meditation's arousing or wake-promoting effects by drawing both from Buddhist textual sources and from scientific studies, including subjective, behavioral, and neuroimaging studies during wakefulness, meditation, and sleep. Factors that may influence whether meditation increases or decreases arousal are discussed, with particular emphasis on dose, expertise, and contemplative trajectory. The course of meditative progress suggests a nonlinear multiphasic trajectory, such that early phases that are more effortful may produce more fatigue and sleep propensity, while later stages produce greater wakefulness as a result of neuroplastic changes and more efficient processing.

Neurocognitive deficits, craving, and abstinence among alcohol-dependent individuals following detoxification

Alcohol dependence, a chronic relapsing disorder, is characterized by an impaired ability to regulate compulsive urges to consume alcohol. Very few empirical studies have examined the presence of these executive deficits, how they relate to craving, and the enduring nature of these deficits during abstinence. As such, the current study aimed to characterize these cognitive deficits within a sample of 24 alcohol-dependent participants post-detoxification and 23 non-alcohol-dependent participants. Participants were administered the Sustained Attention to Response Task to measure response inhibition and sustained attention and the Random Number Generation Task to examine executive deficits. Correlations between cognitive performance and clinical measures of alcohol dependence were examined. As predicted, the alcohol-dependent group exhibited poorer performance across the domains of response inhibition, executive function, and attentional control. Cognitive performance was related to clinical measures of craving and years of alcohol consumption, whereas the duration of abstinence was not associated with improved cognitive performance. These findings highlight the need for therapeutic strategies to target these enduring neurocognitive deficits in improving the treatment of alcohol dependence.

Right hemisphere role in cognitive reserve

High levels of education, occupational complexity, and/or premorbid intelligence are associated with lower levels of cognitive impairment than would be expected from a given brain pathology. This has been observed across a range of conditions including Alzheimer's disease (Roe et al., 2010), stroke (Ojala-Oksala et al., 2012), traumatic brain injury (Kesler et al., 2003), and penetrating brain injury (Grafman, 1986). This cluster of factors, which seemingly protect the brain from expressing symptoms of damage, has been termed "cognitive reserve" (Stern, 2012). The current review considers one possible neural network, which may contribute to cognitive reserve. Based on the evidence that the neurotransmitter, noradrenaline mediates cognitive reserve's protective effects (Robertson, 2013) this review identifies the neurocognitive correlates of noradrenergic (NA) activity. These involve a set of inter-related cognitive processes (arousal, sustained attention, response to novelty, and awareness) with a strongly right hemisphere, fronto-parietal localization, along with working memory, which is also strongly modulated by NA. It is proposed that this set of processes is one plausible candidate for partially mediating the protective effects of cognitive reserve. In addition to its biological effects on brain structure and function, NA function may also facilitate networks for arousal, novelty, attention, awareness, and working memory, which collectively provide for a set of additional, cognitive, mechanisms that help the brain adapt to age-related changes and disease. It is hypothesized that to the extent that the lateral surface of the right prefrontal lobe and/or the right inferior parietal lobe maintain structural (white and gray matter) and functional integrity and connectivity, cognitive reserve should benefit and behavioral expression of pathologic damage should thus be mitigated.

Modulating mind-wandering in dysphoria

Depression is associated with significant difficulty staying “in the moment” as the mind tends to wander away from current activity to focus instead on personal concerns. Mind-wandering (MW) may in some instances be a precursor for depressive rumination, a thinking style believed to confer vulnerability to the likelihood and extent of depression. Thus, MW may be not only a consequence but also a cause of low mood. Identifying a paradigm that could modulate MW, particularly in depressed individuals, would allow future studies to test whether elevated rates of MW causally drive cognitive-affective features of depression, such as rumination and anhedonia. This study therefore explored the feasibility of using an existing task manipulation to modulate behavioral and self-report indices of MW in participants with varying levels of self-reported dysphoria. Participants completed two go/no-go tasks—the SART and a high target probability task—and measures of state and trait MW. The two tasks were identical in all respects apart from the lower probability of no-go targets on the SART, a feature considered to encourage mindless, or inattentive, responding. Across participants, errors of commission (a behavioral indicator of MW) were elevated on the SART relative to the high probability task, a pattern that was particularly pronounced in dysphoric participants. Dysphoric individuals furthermore reported elevated levels of MW, though the modulation of these subjective reports by task was present to a similar rather than greater extent in the dysphoric individuals. These findings provide encouraging preliminary support for the use of this paradigm as one that modulates MW in depressed individuals. The implications of these results and directions for future research are discussed.

Enhancing SART Validity by Statistically Controlling Speed-Accuracy Trade-Offs

Numerous studies focused on elucidating the correlates, causes, and consequences of inattention/attention-lapses employ the Sustained Attention to Response Task (SART), a GO-NOGO task with infrequent withholds. Although the SART has become popular among inattention researchers, recent work has demonstrated its susceptibility to speed-accuracy trade-offs (SATOs), rendering its assessment of inattention problematic. Here, we propose and illustrate methods to statistically control for the occurrence of SATOs during SART performance. The statistical solutions presented here can be used to correct standard SART-error scores, including those of already-published data, thereby allowing researchers to re-examine existing data, and to more sensitively evaluate the validity of earlier conclusions.

Sustained attention and frailty in the older adult population

OBJECTIVES

We investigated whether sustained attention performance and variability were associated with prefrailty and frailty in the older adult population.

METHOD

A total of 4,317 participants aged 50 years and over from the Irish Longitudinal Study on Ageing (TILDA) completed a comprehensive health assessment. Frailty was defined by low gait speed, low grip strength, unintentional weight loss, self-reported exhaustion, and low physical activity. Scores of greater than or equal to 3, 1-2, and 0 indicated that participants were frail, prefrail, and nonfrail, respectively. Multinomial logistic regression computed associations between frailty state and measures of performance and variability on the Sustained Attention to Response Task (SART). Cognitive processing speed and executive function were also measured.

RESULTS

Mean reaction time (RT; odds ratio [OR] = 1.13, p < .05) and RT variability reflective of the top-down aspect of sustained attention (OR = 1.11, p < .05) were associated with prefrailty in the 50-64 age group. Mean RT (OR = 1.72, p < .05) was associated with frailty and RT variability (OR = 1.22, p < .01) with prefrailty in the 65+ age group. Results remained significant following adjustments for cognitive processing speed, executive function, chronic conditions, medications, age, and gender.

DISCUSSION

Sustained attention performance and variability were associated with prefrailty and frailty in the older adult population and may represent a novel, objective, and modifiable cognitive marker of frailty progression.