Specific effects of an amnesic drug: effect of lorazepam on study time allocation and on judgment of learning

Contributions of age and clinical depression to metacognitive performance

One aspect of metacognition is the ability to judge the accuracy of our own performance, even in the absence of external feedback, which is often measured using confidence ratings. Past research suggests that confidence is lower in Major Depressive Disorder (MDD). Less is known about the ability of MDD patients to discriminate correct from incorrect performance (metacognitive efficiency). The metacognitive performance of aged MDD patients (62-89y) was compared to an age-matched control group. A younger control group (21-28y) was included to also explore the relationshipbetweenageandmetacognitive performance. We found no difference in confidence bias nor metacognitive efficiency between MDD patients and age-matched controls.We found age-related differences in metacognition:normal aging was associated with higher confidencebut lower metacognitive efficiency. The overconfidence was specifically driven by overconfidence in incorrect trials. Our results point to the importance ofage while investigating the relation between MDD and metacognitive performance.

Acute aerobic exercise improves memory across intensity and fitness levels

The present study was designed to examine the impact of exercise intensity and aerobic fitness on free recall, judgments of learning (JOLs), and metacognitive accuracy. In Experiment 1, 30 college students engaged in either (1) no exercise, (2) light exercise (55% of predicted maximal heart rate), or (3) moderate exercise (75% of predicted maximal heart rate) on three different days. In Experiment 2, 29 high-fit students (VO₂ max ≥ 70th percentile) and 28 low-fit students (VO₂ max ≤ 50th percentile) completed sedentary and light exercise conditions. In both experiments, free recall scores significantly increased in the exercise conditions compared with the sedentary condition, but JOL magnitude and metacognitive accuracy were largely unaffected. These results demonstrate that exercise can improve recall at both light and high intensities, and that the benefit can be obtained by individuals regardless of their fitness level.

Dopamine, psychosis and schizophrenia: the widening gap between basic and clinical neuroscience

The stagnation in drug development for schizophrenia highlights the need for better translation between basic and clinical research. Understanding the neurobiology of schizophrenia presents substantial challenges but a key feature continues to be the involvement of subcortical dopaminergic dysfunction in those with psychotic symptoms. Our contemporary knowledge regarding dopamine dysfunction has clarified where and when dopaminergic alterations may present in schizophrenia. For example, clinical studies have shown patients with schizophrenia show increased presynaptic dopamine function in the associative striatum, rather than the limbic striatum as previously presumed. Furthermore, subjects deemed at high risk of developing schizophrenia show similar presynaptic dopamine abnormalities in the associative striatum. Thus, our view of subcortical dopamine function in schizophrenia continues to evolve as we accommodate this newly acquired information. However, basic research in animal models has been slow to incorporate these clinical findings. For example, psychostimulant-induced locomotion, the commonly utilised phenotype for positive symptoms in rodents, is heavily associated with dopaminergic activation in the limbic striatum. This anatomical misalignment has brought into question how we assess positive symptoms in animal models and represents an opportunity for improved translation between basic and clinical research. The current review focuses on the role of subcortical dopamine dysfunction in psychosis and schizophrenia. We present and discuss alternative phenotypes that may provide a more translational approach to assess the neurobiology of positive symptoms in schizophrenia. Incorporation of recent clinical findings is essential if we are to develop meaningful translational animal models.

Grasping others' movements: Rapid discrimination of object size from observed hand movements

During reach-to-grasp movements, the hand is gradually molded to conform to the size and shape of the object to be grasped. Yet the ability to glean information about object properties by observing grasping movements is poorly understood. In this study, we capitalized on the effect of object size to investigate the ability to discriminate the size of an invisible object from movement kinematics. The study consisted of 2 phases. In the first action execution phase, to assess grip scaling, we recorded and analyzed reach-to-grasp movements performed toward differently sized objects. In the second action observation phase, video clips of the corresponding movements were presented to participants in a two-alternative forced-choice task. To probe discrimination performance over time, videos were edited to provide selective vision of different periods from 2 viewpoints. Separate analyses were conducted to determine how the participants' ability to discriminate between stimulus alternatives (Type I sensitivity) and their metacognitive ability to discriminate between correct and incorrect responses (Type II sensitivity) varied over time and viewpoint. We found that as early as 80 ms after movement onset, participants were able to discriminate object size from the observation of grasping movements delivered from the lateral viewpoint. For both viewpoints, information pickup closely matched the evolution of the hand's kinematics, reaching an almost perfect performance well before the fingers made contact with the object (60% of movement duration). These findings suggest that observers are able to decode object size from kinematic sources specified early on in the movement. (PsycINFO Database Record

Differential Neural Correlates Underlie Judgment of Learning and Subsequent Memory Performance

Judgment of learning (JOL) plays a pivotal role in self-regulated learning. Although the JOLs are in general accurate, important deviations from memory performance are often reported, especially when the JOLs are made immediately after learning. Nevertheless, existing studies have not clearly dissociated the neural processes underlying subjective JOL and objective memory. In the present study, participants were asked to study a list of words that would be tested 1 day later. Immediately after learning an item, participants predicted how likely they would remember that item. Critically, the JOL was performed on only half of the studied items to avoid its contamination on subsequent memory. We found that during encoding, compared to items later judged as "will be forgotten," those judged as "will be remembered" showed stronger activities in the default-mode network, including the ventromedial prefrontal cortex (PFC) and posterior cingulate cortex, as well as weaker functional connectivity between the left dorsolateral PFC and the visual cortex. The exact opposite pattern was found when comparing items that were actually remembered with those that were later forgotten. These important neural dissociations between JOL and memory performance shed light on the neural mechanisms of human metamemory bias.

Transcranial random noise stimulation-induced plasticity is NMDA-receptor independent but sodium-channel blocker and benzodiazepines sensitive

BACKGROUND

Application of transcranial random noise stimulation (tRNS) between 0.1 and 640 Hz of the primary motor cortex (M1) for 10 min induces a persistent excitability increase lasting for at least 60 min. However, the mechanism of tRNS-induced cortical excitability alterations is not yet fully understood.

OBJECTIVE

The main aim of this study was to get first efficacy data with regard to the possible neuronal effect of tRNS.

METHODS

Single-pulse transcranial magnetic stimulation (TMS) was used to measure levels of cortical excitability before and after combined application of tRNS at an intensity of 1 mA for 10 min stimulation duration and a pharmacological agent (or sham) on eight healthy male participants.

RESULTS

The sodium channel blocker carbamazepine showed a tendency toward inhibiting MEPs 5-60 min poststimulation. The GABA A agonist lorazepam suppressed tRNS-induced cortical excitability increases at 0-20 and 60 min time points. The partial NMDA receptor agonist D-cycloserine, the NMDA receptor antagonist dextromethorphan and the D2/D3 receptor agonist ropinirole had no significant effects on the excitability increases seen with tRNS.

CONCLUSIONS

In contrast to transcranial direct current stimulation (tDCS), aftereffects of tRNS are seem to be not NMDA receptor dependent and can be suppressed by benzodiazepines suggesting that tDCS and tRNS depend upon different mechanisms.

Metamemory in schizophrenia: retrospective confidence ratings interact with neurocognitive deficits

Prior studies with schizophrenia patients described a reduced ability to discriminate between correct and false memories in terms of confidence compared to control groups. This metamemory bias has been associated with the emergence and maintenance of delusions. The relation to neuropsychological performance and other clinical dimensions is incompletely understood. In a cross-sectional study, metamemory functioning was explored in 32 schizophrenia patients and 25 healthy controls. Metamemory was assessed using a verbal recognition task combined with retrospective confidence level ratings. Associations of metamemory performance with six neuropsychological domains (executive functioning/problem solving, speed of processing, working memory, verbal and visual learning, and attention/vigilance) and psychopathological measures were analyzed. Results revealed a significantly smaller discrepancy between confidence ratings for correct and incorrect recognitions in the patient group. Furthermore, patients showed significantly lower recognition accuracy in the metamemory task and marked deficits in all neuropsychological domains. Across all participants, metamemory performance significantly correlated with executive functioning and working memory. No associations with delusions were found. This data confirms prior findings of metamemory biases in schizophrenia. Selective neuropsychological abilities seem to be modulating factors of metamemory functioning. Longitudinal studies in at risk mental state and first-episode patients are needed to reveal causal interrelations.

The neural basis of metacognitive ability

Ability in various cognitive domains is often assessed by measuring task performance, such as the accuracy of a perceptual categorization. A similar analysis can be applied to metacognitive reports about a task to quantify the degree to which an individual is aware of his or her success or failure. Here, we review the psychological and neural underpinnings of metacognitive accuracy, drawing on research in memory and decision-making. These data show that metacognitive accuracy is dissociable from task performance and varies across individuals. Convergent evidence indicates that the function of the rostral and dorsal aspect of the lateral prefrontal cortex (PFC) is important for the accuracy of retrospective judgements of performance. In contrast, prospective judgements of performance may depend upon medial PFC. We close with a discussion of how metacognitive processes relate to concepts of cognitive control, and propose a neural synthesis in which dorsolateral and anterior prefrontal cortical subregions interact with interoceptive cortices (cingulate and insula) to promote accurate judgements of performance.

Dose effects of triazolam and scopolamine on metamemory

The present study compared the acute dose effects of the benzodiazepine triazolam and the anticholinergic scopolamine on metamemory (knowledge and awareness of one's own memory) in a two-phase paradigm designed to assess effects on both monitoring and control components of metamemory in both semantic (general knowledge) and episodic memory (cued-recall) tasks. Placebo and 2 doses each of triazolam (0.125, 0.25 mg/70 kg, oral) and scopolamine (0.25, 0.50 mg/70 kg, subcutaneous) were administered to 80 healthy volunteers (16 per group) in a double-blind, double-dummy, independent groups design. Both triazolam and scopolamine impaired episodic memory (quantity and accuracy) but not semantic memory. Results suggested that both drugs impaired monitoring as reflected in absolute accuracy measures (impaired calibration in the direction of overconfidence) and control sensitivity (the relationship between confidence and behavior). Overall, the results did not provide evidence for differences between triazolam and scopolamine in memory or metamemory. In addition to the clinical relevance of the observed effects, this study adds to the accumulating body of cognitive psychopharmacological research illustrating the usefulness of drug-induced amnesia as a vehicle to explore memory and metamemory.

Judgments of learning do not reduce to memory encoding operations: event-related potential evidence for distinct metacognitive processes

To examine how judgments of learning (JOLs) are made, we used event-related potentials (ERPs) to compare neural correlates of JOLs and successful memory encoding. Participants saw word pairs, and for each made a JOL indicating how confident they were that they would remember the pairing on a later cued recall task. ERPs were recorded while JOLs were made and were separated according to whether items were: (i) remembered or forgotten on the subsequent test, and (ii) rated likely or unlikely to be remembered. An early positive-going ERP effect was associated with both of these comparisons, whereas a later negative-going effect was present only in the separation based upon JOL ratings. ERP data therefore indicate that JOLs do not reduce to encoding processes that predict the accuracy of memory judgments.

The pharmacokinetic and pharmacodynamic effects of SL65.1498, a GABA-A alpha2,3 selective agonist, in comparison with lorazepam in healthy volunteers

Benzodiazepines are effective short-term treatments for anxiety disorders, but their use is limited by undesirable side effects related to Central Nervous System impairment and tolerance development. SL65.1498 is a new compound that acts in vitro as a full agonist at the gamma-aminobutyric acid(A) 2 and 3 receptor and as a partial agonist at the 1 and 5 receptor subtypes. It is thought that the compound could be anxiolytic by its activation at the alpha2 and alpha3 receptor subtypes, without causing unfavourable side effects, which are believed to be mediated by the alpha1 and alpha5 subtypes. This study was a double-blind, five-way cross-over study to investigate the effects of three doses of SL65.1498 in comparison with placebo and lorazepam 2 mg in healthy volunteers. The objective was to select a dose level (expected to be therapeutically active), free of any significant deleterious effect. Psychomotor and cognitive effects were measured using a validated battery of measurements, including eye movements, body sway, memory tests, reaction-time assessments, and visual analogue scales. The highest dose of SL65.1498 showed slight effects on saccadic peak velocity and smooth pursuit performance, although to a much lesser extent than lorazepam. In contrast to lorazepam, none of the SL65.1498 doses affected body sway, visual analogue scale alertness, attention, or memory tests. This study showed that the three doses of SL65.1498 were well tolerated and induced no impairments on memory, sedation, psychomotor, and cognitive functions.

Pharmacodynamic and pharmacokinetic effects of MK-0343, a GABA(A) alpha2,3 subtype selective agonist, compared to lorazepam and placebo in healthy male volunteers

The use of non-selective gamma-aminobutyric acid (GABA) enhancers, such as benzodiazepines in the treatment of anxiety disorders is still widespread but hampered by unfavourable side effects. some of these may be associated with binding properties to certain subtypes of the GABA(A) receptor that are unnecessary for therapeutic effects. MK-0343 was designed to be a less sedating anxiolytic, based on reduced efficacy at the alpha1 subtype and significant efficacy at alpha2 and alpha3 subtypes of the GABA(A) receptor. This paper is a double-blind, four-way cross-over (n = 12) study to investigate the effects of MK-0343 (0.25 and 0.75 mg) in comparison to placebo and an anxiolytic dose (2 mg) of the non-selective agonist lorazepam. Effects were measured by eye movements, body sway, Visual Analogue scales (VAS) and memory tests. Lorazepam impaired saccadic peak velocity (SPV), VAs alertness scores, postural stability and memory and increased saccadic latency and inaccuracy. MK-0343 0.75 mg was equipotent with lorazepam as indicated by SPV (-42.4 deg/s), saccadic latency (0.02 s) and VAS alertness scores (1.50 ln mm), while effects on memory and postural stability were smaller. MK-0343 0.25 mg only affected postural stability to a similar extent as MK-0343 0.75 mg. The effect profile of MK-0343 0.75 mg is different from the full agonist lorazepam, which could reflect the selective actions of this compound. Although less effect on VAS alertness was expected, diminished effects on memory and postural stability were present. Clinical studies in anxiety patients should show whether this dose of MK-0343 is therapeutically effective with a different side-effect profile.

Effects of the amnesic drug lorazepam on complete and partial information retrieval and monitoring accuracy

RATIONALE

In Koriat's accessibility model (Koriat, Psychol Rev, 100:609-639, 1993; Koriat, J Exp Psychol Gen, 124:311-333, 1995), when a person fails to recall a required target, he or she can nevertheless provide some partial information about the target. Moreover, individuals are able to provide feeling-of-knowing (FOK) judgments about the availability of the target in memory. The cues for the FOK evaluations reside in the products of the retrieval process itself. It was shown that the benzodiazepine lorazepam drug induces some impairment of memory.

OBJECTIVES

The effects of the amnesic benzodiazepine lorazepam on the total and partial recall of recently learned material and on FOK ratings were investigated in healthy volunteers.

METHODS

Twenty-eight healthy volunteers participated in the study: 14 of these received a capsule containing lorazepam (0.038 mg/kg) and 14 a placebo capsule. The material to be learned consisted of four-letter nonsense tetragrams with each letter providing partial information with regard to the four-letter target (Koriat, Psychol Rev, 100:609-639, 1993).

RESULTS

The number of incorrect letters reported was higher for the lorazepam than for the placebo condition. The FOK magnitude was higher for the placebo participants than for the lorazepam participants. The predictive value of FOK for recognition was preserved by the drug.

CONCLUSION

When studying four-letter nonsense letter strings, lorazepam participants present an impairment of episodic short-term memory and the drug has an effect on FOK estimates but not on the predictive accuracy of the FOK. The accessibility hypothesis of FOK was confirmed in this study and seems to retain some validity even under the effect of an amnesic drug.

Neural correlates of actual and predicted memory formation

We aimed to discover the neural correlates of subjective judgments of learning-whereby participants judge whether current experiences will be subsequently remembered or forgotten-and to compare these correlates to the neural correlates of actual memory formation. During event-related functional magnetic resonance imaging, participants viewed 350 scenes and predicted whether they would remember each scene in a later recognition-memory test. Activations in the medial temporal lobe were associated with actual encoding success (greater activation for objectively remembered than forgotten scenes), but not with predicted encoding success (activations did not differ for scenes predicted to be remembered versus forgotten). Conversely, activations in the ventromedial prefrontal cortex were associated with predicted but not actual encoding success, and correlated with individual differences in the accuracy of judgments of learning. Activations in the lateral and dorsomedial prefrontal cortex were associated with both actual and predicted encoding success. These findings indicate specific dissociations and associations between the neural systems that mediate actual and predicted memory formation.

Drugs, memory, and metamemory: a dose-effect study with lorazepam and scopolamine

This experiment was designed to use the graded dose-related amnesia produced by the benzodiazepine lorazepam (1.0, 2.0 mg/70 kg, oral) and the anticholinergic scopolamine (0.3, 0.6 mg/70 kg, subcutaneous) as a tool to explore the cognitive and neurochemical mechanisms underlying metamemory in the judgment of learning paradigm, with a placebo-controlled independent groups design in healthy volunteers (n = 12/group). Results provide evidence for a pharmacological dissociation between effects on memory versus metamemory (relative accuracy of item-by-item monitoring) across a range of levels of memory performance and suggest that the drugs selectively impair those aspects of metamnemonic monitoring that require participants' awareness of their overall current state of functioning (absolute accuracy of prospective item-by-item monitoring, prospective global monitoring) but not those that rely solely on assessment of individual item characteristics (relative accuracy of item-by-item monitoring).