TMS interference with primacy and recency mechanisms reveals bimodal episodic encoding in the human brain

Using serial position effects to investigate memory dysfunction in homeless and precariously housed persons

Background: Homeless and precariously housed persons exhibit significant memory impairment, but the component processes underlying memory dysfunction have not been explored. We examined the serial position profile (i.e., primacy and recency effects) of verbal memory and its neuroanatomical correlates to identify the nature of memory difficulties in a large cohort of homeless and precariously housed adults. Method: The sample included 227 community-dwelling homeless and precariously housed adults. Serial position scores (primacy, middle, recency) were computed using the Hopkins Verbal Learning Test-Revised. Paired sample t-tests were used to compare percent recall from each word list region. Age-adjusted correlations assessed associations between serial position scores and other cognitive domains (attention, processing speed, executive functioning). Regression analyses were conducted to examine regional brain volumes of interest (hippocampus, entorhinal cortex, dorsolateral prefrontal cortex [DLPFC]) and their differential associations with serial position scores. Results: The serial position profile was characterized by a diminished recency effect in relation to the primacy effect. Serial position scores positively correlated with sustained attention and cognitive control. Larger hippocampal volume was associated with better primacy item recall. DLPFC volume was not associated with serial position recall after adjustment for false discovery rate. There were no associations between regional brain volumes and recency item recall. Conclusion: Our results suggest that commonly reported memory difficulties in homeless and precariously housed adults are likely secondary to a core deficit in executive control due to compromised frontal lobe functioning. These findings have implications for cognitive rehabilitation in this complex and vulnerable group.

Primacy and recency effects in verbal memory are differentially associated with post-mortem frontal cortex p-tau 217 and 202 levels in a mixed sample of community-dwelling older adults

INTRODUCTION

Serial position effects in verbal memory are associated with in vivo fluid biomarkers and neuropathological outcomes in Alzheimer's disease (AD). To extend the biomarker literature, associations between serial position scores and postmortem levels of brain phosphorylated tau (p-tau) were examined, in the context of Braak stage of neurofibrillary tangle progression.

METHOD

Participants were 1091 community-dwelling adults (Mage = 80.2, 68.9% female) from the Rush University Religious Orders Study and Memory and Aging Project who were non-demented at enrollment and followed for a mean of 9.2 years until death. The CERAD Word List Memory test administered at baseline and within 1 year of death was used to calculate serial position (primacy, recency) and total recall scores. Proteomic analyses quantified p-tau 217 and 202 from dorsolateral prefrontal cortex samples. Linear regressions assessed associations between cognitive scores and p-tau with Braak stage as a moderator.

RESULTS

Cognitive status proximal to death indicated 34.7% were unimpaired, 26.2% met criteria for MCI, and 39.0% for dementia. Better baseline primacy recall, but not recency recall, was associated with lower p-tau 217 levels across Braak stages. Delayed recall showed a similar pattern as primacy. There was no main effect of immediate recall, but an interaction with Braak stages indicated a negative association with p-tau 217 level only in Braak V-VI. Within 1 year of death, there were no main effects for cognitive scores; however, recency, immediate and delayed recall scores interacted with Braak stage showing better recall was associated with lower p-tau 217 only in Braak V-VI. No associations were observed with p-tau 202.

CONCLUSIONS

Primacy recall measured in non-demented adults may be sensitive to emergent tau phosphorylation that occurs in the earliest stages of AD. Serial position scores may complement the routinely used delayed recall score and p-tau biomarkers to detect preclinical AD.

Neuromodulatory effects of transcranial magnetic stimulation on language performance in healthy participants: Systematic review and meta-analysis

Background

The causal relationships between neural substrates and human language have been investigated by transcranial magnetic stimulation (TMS). However, the robustness of TMS neuromodulatory effects is still largely unspecified. This study aims to systematically examine the efficacy of TMS on healthy participants' language performance.

Methods

For this meta-analysis, we searched PubMed, Web of Science, PsycINFO, Scopus, and Google Scholar from database inception until October 15, 2022 for eligible TMS studies on language comprehension and production in healthy adults published in English. The quality of the included studies was assessed with the Cochrane risk of bias tool. Potential publication biases were assessed by funnel plots and the Egger Test. We conducted overall as well as moderator meta-analyses. Effect sizes were estimated using Hedges'g (g) and entered into a three-level random effects model.

Results

Thirty-seven studies (797 participants) with 77 effect sizes were included. The three-level random effects model revealed significant overall TMS effects on language performance in healthy participants (RT: g = 0.16, 95% CI: 0.04-0.29; ACC: g = 0.14, 95% CI: 0.04-0.24). Further moderator analyses indicated that (a) for language tasks, TMS induced significant neuromodulatory effects on semantic and phonological tasks, but didn't show significance for syntactic tasks; (b) for cortical targets, TMS effects were not significant in left frontal, temporal or parietal regions, but were marginally significant in the inferior frontal gyrus in a finer-scale analysis; (c) for stimulation parameters, stimulation sites extracted from previous studies, rTMS, and intensities calibrated to the individual resting motor threshold are more prone to induce robust TMS effects. As for stimulation frequencies and timing, both high and low frequencies, online and offline stimulation elicited significant effects; (d) for experimental designs, studies adopting sham TMS or no TMS as the control condition and within-subject design obtained more significant effects.

Discussion

Overall, the results show that TMS may robustly modulate healthy adults' language performance and scrutinize the brain-and-language relation in a profound fashion. However, due to limited sample size and constraints in the current meta-analysis approach, analyses at a more comprehensive level were not conducted and results need to be confirmed by future studies.

Systematic review registration

[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=366481], identifier [CRD42022366481].

Negative recency effects in delayed recognition: Spacing, consolidation, and retrieval strategy processes

While items learned immediately before testing are generally remembered better than prior items in a study list, in delayed testing this relationship is reversed, yielding a negative recency effect. To adjudicate between the strategic rehearsal and spacing accounts of this phenomenon, we examined performance of 169 participants on a delayed recognition test following multiple sessions requiring the study and immediate free recall testing of 16 lists of 16 words. This revealed a strong effect of the amount of spacing between initial study position and initial free recall position on the degree of negative recency, supporting the spacing account. Furthermore, these spacing effects were nonmonotonic, suggesting that they are mediated by consolidation processes. Additional analyses indicate that strategies and rehearsal opportunities may also contribute to the effects of within-list encoding position on subsequent long-term memory, but for recall more than for recognition.

Long-lasting, dissociable improvements in working memory and long-term memory in older adults with repetitive neuromodulation

The development of technologies to protect or enhance memory in older people is an enduring goal of translational medicine. Here we describe repetitive (4-day) transcranial alternating current stimulation (tACS) protocols for the selective, sustainable enhancement of auditory-verbal working memory and long-term memory in 65-88-year-old people. Modulation of synchronous low-frequency, but not high-frequency, activity in parietal cortex preferentially improved working memory on day 3 and day 4 and 1 month after intervention, whereas modulation of synchronous high-frequency, but not low-frequency, activity in prefrontal cortex preferentially improved long-term memory on days 2-4 and 1 month after intervention. The rate of memory improvements over 4 days predicted the size of memory benefits 1 month later. Individuals with lower baseline cognitive function experienced larger, more enduring memory improvements. Our findings demonstrate that the plasticity of the aging brain can be selectively and sustainably exploited using repetitive and highly focalized neuromodulation grounded in spatiospectral parameters of memory-specific cortical circuitry.

Associative-memory deficit as a function of age and stimuli serial position

Studies have shown associative-memory decline in aging. While the literature is inconclusive regarding the source of the deficit, some researchers argue that it is caused by impaired encoding and maintenance processes in working-memory (WM). Successful retrieval of a stimulus depends on its sequential presentation in the learning list: stimuli at the beginning or the end of the learning list benefit from higher retrieval probability. These effects are known as “primacy” and “recency” effects, respectively. In the case of the primacy-effect, stimuli at early list positions benefit from extensive rehearsal that results in enhanced consolidation and trace in long-term memory (LTM). In the case of the recency-effect, target stimuli at later serial positions are still maintained in WM and can therefore be effortlessly retrieved. Considering these effects could shed light on the involvement of WM in associative-binding. Both behavioral and neuroimaging researchers have studied associative-decline in aging. However, no work has explicitly tested age differences in memory for items versus associations as a function of stimuli serial position (SSP). In the current study, 22 younger and 22 older adults were recruited to participate in a study aimed to test the separate and joint effects of both SSP and aging on memory-recognition of items and associations. In the task used, retrieval was manipulated for SSP (beginning/middle/end of the list) and item/associations recognition modes. We hypothesized that greater associative-decline will be observed in older adults, specifically for recently presented material. The results showed that both groups presented a significant associative-deficit at the recency positions; this decrease was additive and did not correspond to the expected interaction effect. Further analysis showed that the source of associative-memory decline for stimuli at recency position in older adults resulted from an increase in false-alarm (FA) rates. These results support the involvement of WM-binding impairment in aging.

Emotional Context Shapes the Serial Position Curve

Emotional contexts affect memory processes. However, the impact of contextual priming as a function of the emotional valence on the recall of neutral information is not fully understood. The aim of the present study was to evaluate how a conditioning of emotional context during encoding may influence the subsequent memory of otherwise neutral materials in a well-established phenomenon as the serial position effect. Participants performed a free recall task for neutral words in three conditions: (i) word list alone; (ii) word list coupled with positive or neutral images; and (iii) word list coupled with negative or neutral images. Images were presented before each word stimulus. In three different experiments, the emotional context during the word list presentation was manipulated separately for primacy and recency clusters, and for the middle words ('middlecy'). Emotional context affects free recall of neutral stimuli, changing the serial position curve effect across conditions. Namely, emotional images presented in the primacy and recency clusters worsen accuracy, whereas their occurrence in the 'middlecy' cluster reduces the oblivion. The present findings show that the typical pattern related to the serial position curve for neutral information can be shaped by the conditioning of emotional context. Findings have implications in medical-legal contexts in the case of the recollection of events with high emotional content.

Performance monitoring for sensorimotor confidence: A visuomotor tracking study

To best interact with the external world, humans are often required to consider the quality of their actions. Sometimes the environment furnishes rewards or punishments to signal action efficacy. However, when such feedback is absent or only partial, we must rely on internally generated signals to evaluate our performance (i.e., metacognition). Yet, very little is known about how humans form such judgements of sensorimotor confidence. Do they monitor their actual performance or do they rely on cues to sensorimotor uncertainty? We investigated sensorimotor metacognition in two visuomotor tracking experiments, where participants followed an unpredictably moving dot cloud with a mouse cursor as it followed a random horizontal trajectory. Their goal was to infer the underlying target generating the dots, track it for several seconds, and then report their confidence in their tracking as better or worse than their average. In Experiment 1, we manipulated task difficulty with two methods: varying the size of the dot cloud and varying the stability of the target's velocity. In Experiment 2, the stimulus statistics were fixed and duration of the stimulus presentation was varied. We found similar levels of metacognitive sensitivity in all experiments, which was evidence against the cue-based strategy. The temporal analysis of metacognitive sensitivity revealed a recency effect, where error later in the trial had a greater influence on the sensorimotor confidence, consistent with a performance-monitoring strategy. From these results, we conclude that humans predominantly monitored their tracking performance, albeit inefficiently, to build a sense of sensorimotor confidence.

Effects of High-Definition Transcranial Direct Current Stimulation and Theta Burst Stimulation for Modulating the Posterior Parietal Cortex

OBJECTIVES

Noninvasive brain stimulation methods, including high-definition transcranial direct current stimulation (HD-tDCS) and theta burst stimulation (TBS) have emerged as novel tools to modulate and explore brain function. However, the relative efficacy of these newer stimulation approaches for modulating cognitive functioning remains unclear. This study investigated the cognitive effects of HD-tDCS, intermittent TBS (iTBS) and prolonged continuous TBS (ProcTBS) and explored the potential of these approaches for modulating hypothesized functions of the left posterior parietal cortex (PPC).

METHODS

Twenty-two healthy volunteers attended four experimental sessions in a cross-over experimental design. In each session, participants either received HD-tDCS, iTBS, ProcTBS or sham, and completed cognitive tasks, including a divided attention task, a working memory maintenance task and an attention task (emotional Stroop test).

RESULTS

The results showed that compared to sham, HD-tDCS, iTBS and ProcTBS caused significantly faster response times on the emotional Stroop task. The effect size (Cohen's d) was d = .32 for iTBS (p < .001), .21 for ProcTBS (p = .01) and .15 for HD-tDCS (p = .044). However, for the performance on the divided attention and working memory maintenance tasks, no significant effect of stimulation was found.

CONCLUSIONS

The results suggest that repetitive transcranial magnetic stimulation techniques, including TBS, may have greater efficacy for modulating cognition compared with HD-tDCS, and extend existing knowledge about specific functions of the left PPC.

Cognitive and neural mechanisms underlying the mnemonic effect of songs after stroke

Sung melody provides a mnemonic cue that can enhance the acquisition of novel verbal material in healthy subjects. Recent evidence suggests that also stroke patients, especially those with mild aphasia, can learn and recall novel narrative stories better when they are presented in sung than spoken format. Extending this finding, the present study explored the cognitive mechanisms underlying this effect by determining whether learning and recall of novel sung vs. spoken stories show a differential pattern of serial position effects (SPEs) and chunking effects in non-aphasic and aphasic stroke patients (N = 31) studied 6 months post-stroke. The structural neural correlates of these effects were also explored using voxel-based morphometry (VBM) and deterministic tractography (DT) analyses of structural MRI data. Non-aphasic patients showed more stable recall with reduced SPEs in the sung than spoken task, which was coupled with greater volume and integrity (indicated by fractional anisotropy, FA) of the left arcuate fasciculus. In contrast, compared to non-aphasic patients, the aphasic patients showed a larger recency effect (better recall of the last vs. middle part of the story) and enhanced chunking (larger units of correctly recalled consecutive items) in the sung than spoken task. In aphasics, the enhanced chunking and better recall on the middle verse in the sung vs. spoken task correlated also with better ability to perceive emotional prosody in speech. Neurally, the sung > spoken recency effect in aphasic patients was coupled with greater grey matter volume in a bilateral network of temporal, frontal, and parietal regions and also greater volume of the right inferior fronto-occipital fasciculus (IFOF). These results provide novel cognitive and neurobiological insight on how a repetitive sung melody can function as a verbal mnemonic aid after stroke.

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Non-aphasic stroke patients show more stable recall of sung than spoken stories.

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Aphasic patients show larger recency and chunking effects to sung vs. spoken stories.

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The left dorsal pathway mediates better recall of sung stories in non-aphasics.

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The right ventral pathway mediates better recall of sung stories in aphasics.

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Large-scale bilateral cortical networks are linked to musical mnemonics in aphasia.

How Can Transcranial Magnetic Stimulation Be Used to Modulate Episodic Memory?: A Systematic Review and Meta-Analysis

A systematic review and meta-analysis were conducted to synthesize the existing literature on how transcranial magnetic stimulation (TMS) has been used to modulate episodic memory. Given the numerous parameters of TMS protocols and experimental design characteristics that can be manipulated, a mechanistic understanding of how changes in the combination of parameters (e.g., frequency, timing, intensity, targeted brain region, memory task) modulate episodic memory is needed. To address this, we reviewed 59 studies and conducted a meta-analysis on 245 effect sizes from 37 articles on healthy younger adults (N = 1,061). Analyses revealed generally more beneficial effects of 1-Hz rTMS vs. other frequencies on episodic memory. Moderation analyses revealed complex interactions as online 20-Hz rTMS protocols led to negative effects, while offline 20-Hz rTMS led to enhancing effects. There was also an interaction between stimulation intensity and frequency as 20-Hz rTMS had more negative effects when applied below- vs. at-motor threshold. Conversely, 1-Hz rTMS had more beneficial effects than other frequencies when applied below- vs. at- or above-motor threshold. No reliable aggregate or hypothesized interactions were found when assessing stimulation site (frontal vs. parietal cortex, left vs. right hemisphere), stimulated memory process (during encoding vs. retrieval), the type of retrieval (associative/recollection vs. item/familiarity), or the type of control comparison (active vs. sham or no TMS) on episodic memory. However, there is insufficient data to make strong inference based on the lack of aggregate or two-way interactions between these factors, or to assess more complex (e.g., 3-way) interactions. We reviewed the effects on other populations (healthy older adults and clinical populations), but systematic comparison of parameters was also prevented due to insufficient data. A database of parameters and effects sizes is available as an open source repository so that data from studies can be continuously accumulated in order to facilitate future meta-analysis. In conclusion, modulating episodic memory relies on complex interactions among the numerous moderator variables that can be manipulated. Therefore, rigorous, systematic comparisons need to be further investigated as the body of literature grows in order to fully understand the combination of parameters that lead to enhancing, detrimental or null effects on episodic memory.

ENDOWMENT EFFECT AND HOUSING DECISIONS

Endowment effect refers to the reported gaps between willingness to accept and willingness to pay. According to prospect theory, this effect is a result of the underweighting of opportunity costs. Given the high stake involved in a typical housing transaction, endowment effect is expected to have a significant influence on housing decisions. We develop a theoretical framework to study the presence of endowment effect and its role in housing decision-making process. Three hypotheses are derived and tested through a field experiment conducted in Beijing, China. Our empirical results show that endowment effect plays an important role in the formation of judgmental biases in housing decisions. Moreover, endowment effect interacts with housing cycles. Our study highlights the application of prospect theory in the housing market; thus, it not only extends existing theoretical and empirical works in this important sector, but also clarifies consumer behavior in the emerging property market of China.

A study on the specificity of the association between hippocampal volume and delayed primacy performance in cognitively intact elderly individuals

Delayed recall at the primacy position (first few items on a list) has been shown to predict cognitive decline in cognitively intact elderly participants, with poorer delayed primacy performance associated with more pronounced generalized cognitive decline during follow-up. We have previously suggested that this association is due to delayed primacy performance indexing memory consolidation, which in turn is thought to depend upon hippocampal function. Here, we test the hypothesis that hippocampal size is associated with delayed primacy performance in cognitively intact elderly individuals. Data were analyzed from a group (N=81) of cognitively intact participants, aged 60 or above. Serial position performance was measured with the Buschke selective reminding test (BSRT). Hippocampal size was automatically measured via MRI, and unbiased voxel-based analyses were also conducted to explore further regional specificity of memory performance. We conducted regression analyses of hippocampus volumes on serial position performance; other predictors included age, family history of Alzheimer's disease (AD), APOE ε4 status, education, and total intracranial volume. Our results collectively suggest that there is a preferential association between hippocampal volume and delayed primacy performance. These findings are consistent with the hypothesis that delayed primacy consolidation is associated with hippocampal size, and shed light on the relationship between delayed primacy performance and generalized cognitive decline in cognitively intact individuals, suggesting that delayed primacy consolidation may serve as a sensitive marker of hippocampal health in these individuals.

Temporal discrimination deficits as a function of lag interference in older adults

A vital component of episodic memory is the ability to determine the temporal order of remembered events. Although it has been demonstrated that the hippocampus plays a crucial role in this ability, the details of its contributions are not yet fully understood. One proposed contribution of the hippocampus is the reduction of mnemonic interference through pattern separation. Prior studies have used behavioral paradigms designed to assess this function in the temporal domain by evaluating the ability to determine the order of remembered events as a function of proximity in time. Results from these paradigms in older adults (OA) have been mixed, possibly due to limitations in controlling elapsed time and narrow range of temporal lags. Here, we introduce a novel behavioral paradigm designed to overcome these limitations. We report that OAs are impaired relative to younger adults at moderate and high temporal lags but not at low lags (where performance approached floor). We evaluated OAs' ability to benefit from primacy (enhanced order judgment on the first few items of any given sequence) and found two distinct subgroups: one group was on par with young adults [aged-unimpaired (AU)] and the other group was two standard deviations below the mean of young adults [aged-impaired (AI)]. Temporal discrimination performance in AU adults was consistent with a pattern separation deficit, while performance in AI adults was consistent with a generalized temporal processing deficit. We propose that the task introduced is a sensitive marker for episodic memory deficits with age, and may have diagnostic value for early detection of age-related pathology.

Entrainment of prefrontal beta oscillations induces an endogenous echo and impairs memory formation

Brain oscillations across all frequency bands play a key role for memory formation. Specifically, desynchronization of local neuronal assemblies in the left inferior prefrontal cortex (PFC) in the beta frequency (∼18 Hz) has been shown to be central for encoding of verbal memories. However, it remains elusive whether prefrontal beta desynchronization is causally relevant for memory formation and whether these endogenous beta oscillations can be entrained by external stimulation. By using combined EEG-TMS (transcranial magnetic stimulation), we here address these fundamental questions in human participants performing a word-list learning task. Confirming our predictions, memory encoding was selectively impaired when the left inferior frontal gyrus (IFG) was driven at beta (18.7 Hz) compared to stimulation at other frequencies (6.8 Hz and 10.7 Hz) and to ineffective sham stimulation (18.7 Hz). Furthermore, a sustained oscillatory "echo" in the left IFG, which outlasted the stimulation period by approximately 1.5 s, was observed solely after beta stimulation. The strength of this beta echo was related to memory impairment on a between-subjects level. These results show endogenous oscillatory entrainment effects and behavioral impairment selectively in beta frequency for stimulation of the left IFG, demonstrating an intimate causal relationship between prefrontal beta desynchronization and memory formation.

The effects of lateral prefrontal transcranial magnetic stimulation on item memory encoding

Previous neuroimaging research has established that the left ventrolateral prefrontal cortex (VLPFC) is involved in long-term memory (LTM) encoding for individual items. Dorsolateral prefrontal cortex (DLPFC) is implicated less frequently, and one theory that has gained support to explain this discrepancy is that DLPFC is involved in forming item-item relational but not item LTM. Given that neuroimaging results are correlational, complimentary methods such as repetitive transcranial magnetic stimulation (TMS) have been used to test causal hypotheses generated from imaging data. Most TMS studies of LTM encoding have found that disruption of lateral PFC activity impairs subsequent memory. However these studies have lacked methods to precisely localize and directly compare TMS effects from frontal subregions implicated by the neuroimaging literature. Here, we target specific subregions of lateral PFC with TMS to test the prediction from the item/relational framework that temporary disruption of VLPFC during encoding will impair subsequent memory whereas TMS to DLPFC during item encoding will not. Frontal TMS was administered prior to a LTM encoding task in which participants were presented with a list of individual nouns and asked to judge whether each noun was concrete or abstract. After a 40 min delay period, item recognition memory was tested. Results indicate that VLPFC and DLPFC TMS have differential effects on subsequent item memory. VLPFC TMS reliably disrupted subsequent item memory whereas DLPFC TMS led to numerical enhancement in item memory, relative to TMS to a control region.