Maintenance of spatial and motor codes during oculomotor delayed response tasks

Neural correlates of memory updating in the primate prefrontal cortex

Working memory allows temporary storage and manipulation of information during cognitive tasks. While the primate lateral prefrontal cortex (PFC) is involved in working memory, little is known about neuronal activity during memory updating. We trained macaque monkeys on an oculomotor n-back task, requiring them to remember locations of sequentially presented visual stimuli and generate a saccade to the location of the most recent or previous stimulus based on task rules. Many PFC neurons showed transient activity when a memory of a particular stimulus location was no longer needed, whereas others showed sustained activity for remembered locations. Decoding analysis successfully predicted future target selection based on the task rule from neuronal activity, indicating that these neuronal populations contain sufficient information to guide behavior. Furthermore, electrical stimulation at recording sites erased specific spatial memories, demonstrating a causal role of prefrontal neurons in maintaining and updating short-term memory.

Stimulus representation in human frontal cortex supports flexible control in working memory

When holding visual information temporarily in working memory (WM), the neural representation of the memorandum is distributed across various cortical regions, including visual and frontal cortices. However, the role of stimulus representation in visual and frontal cortices during WM has been controversial. Here, we tested the hypothesis that stimulus representation persists in the frontal cortex to facilitate flexible control demands in WM. During functional MRI, participants flexibly switched between simple WM maintenance of visual stimulus or more complex rule-based categorization of maintained stimulus on a trial-by-trial basis. Our results demonstrated enhanced stimulus representation in the frontal cortex that tracked demands for active WM control and enhanced stimulus representation in the visual cortex that tracked demands for precise WM maintenance. This differential frontal stimulus representation traded off with the newly-generated category representation with varying control demands. Simulation using multi-module recurrent neural networks replicated human neural patterns when stimulus information was preserved for network readout. Altogether, these findings help reconcile the long-standing debate in WM research, and provide empirical and computational evidence that flexible stimulus representation in the frontal cortex during WM serves as a potential neural coding scheme to accommodate the ever-changing environment.

A Translational Neuroscience & Computational Evaluation of a D1R Partial Agonist for Schizophrenia (TRANSCENDS): Rationale and Study Design of a Brain-Based Clinical Trial

Despite decades of research, cognitive impairment remains a critical untreated symptom for many patients with schizophrenia. One way to accelerate the development of pro-cognitive therapies for schizophrenia is to evaluate compounds using biomarker approaches tailored to relevant neural mechanisms. While D1/D5 receptor (D1R/D5R) agonism has been extensively studied in neuroscience, its therapeutic potential for cognitive impairment in schizophrenia remains untapped. The Translational Neuroscience & Computational Evaluation of a D1R Partial Agonist for Schizophrenia (TRANSCENDS) clinical trial tests this mechanism using a 'target engagement' approach. Multiple, double-blind doses of a D1/D5R partial agonist were administered in advance of a functional neuroimaging (fMRI) session that deployed a cognitive paradigm explicitly designed to capture a translational micro-circuit mechanism underlying spatial working memory in patients with schizophrenia. Specifically, this study will assess whether the D1R/D5R partial agonist CVL-562 induces a dose-dependent engagement of spatial working memory circuits in schizophrenia using fMRI. This design, and the use of spatial working memory neural circuits as a dependent measure, was selected on the basis of a translational and computational understanding of prefrontal micro-circuitry and a mechanistic understanding of the role of D1R/D5Rs in schizophrenia. To enhance data integration and scalability, TRANSCENDS employs an automated informatics framework for seamless neuroimaging data sharing and electronic clinical data capture. This ensures high-standards for regulatory compliance, data quality, and data sharing across sites, improving aspects of current clinical trial data management. We share the study design and approach with the goal of advancing future pro-cognitive drug development and strategies for developing mechanistically-driven biomarkers in psychiatry.

Maintenance of Bodily Expressions Modulates Functional Connectivity Between Prefrontal Cortex and Extrastriate Body Area During Working Memory Processing

Background/Objectives: As a form of visual input, bodily expressions can be maintained and manipulated in visual working memory (VWM) over a short period of time. While the prefrontal cortex (PFC) plays an indispensable role in top-down control, it remains largely unclear whether this region also modulates the VWM storage of bodily expressions during a delay period. Therefore, the two primary goals of this study were to examine whether the emotional bodies would elicit heightened brain activity among areas such as the PFC and extrastriate body area (EBA) and whether the emotional effects subsequently modulate the functional connectivity patterns for active maintenance during delay periods. Methods: During functional magnetic resonance imaging (fMRI) scanning, participants performed a delayed-response task in which they were instructed to view and maintain a body stimulus in working memory before emotion categorization (happiness, anger, and neutral). If processing happy and angry bodies consume increased cognitive demands, stronger PFC activation and its functional connectivity with perceptual areas would be observed. Results: Results based on univariate and multivariate analyses conducted on the data collected during stimulus presentation revealed an enhanced processing of the left PFC and left EBA. Importantly, subsequent functional connectivity analyses performed on delayed-period data using a psychophysiological interaction model indicated that functional connectivity between the PFC and EBA increases for happy and angry bodies compared to neutral bodies. Conclusions: The emotion-modulated coupling between the PFC and EBA during maintenance deepens our understanding of the functional organization underlying the VWM processing of bodily information.

Medication improves velocity, reaction time, and movement time but not amplitude or error during memory-guided reaching in Parkinson's disease

The motor impairments experienced by people with Parkinson's disease (PD) are exacerbated during memory-guided movements. Despite this, the effect of antiparkinson medication on memory-guided movements has not been elucidated. We evaluated the effect of antiparkinson medication on motor control during a memory-guided reaching task with short and long retention delays in participants with PD and compared performance to age-matched healthy control (HC) participants. Thirty-two participants with PD completed the motor section of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS III) and performed a memory-guided reaching task with two retention delays (0.5 s and 5 s) while on and off medication. Thirteen HC participants completed the MDS-UPDRS III and performed the memory-guided reaching task. In the task, medication increased movement velocity, decreased movement time, and decreased reaction time toward what was seen in the HC. However, movement amplitude and reaching error were unaffected by medication. Shorter retention delays increased movement velocity and amplitude, decreased movement time, and decreased error, but increased reaction times in the participants with PD and HC. Together, these results imply that antiparkinson medication is more effective at altering the neurophysiological mechanisms controlling movement velocity and reaction time compared with other aspects of movement control.

EEG decoding reveals task-dependent recoding of sensory information in working memory

Working memory (WM) supports future behavior by retaining perceptual information obtained in the recent past. The present study tested the hypothesis that WM recodes sensory information in a format that better supports behavioral goals. We recorded EEG while participants performed color delayed-estimation tasks where the colorwheel for the response was either randomly rotated or held fixed across trials. Accordingly, observers had to remember the exact colors in the Rotation condition, whereas they could prepare for a response based on the fixed mapping between the colors and their corresponding locations on the colorwheel in the No-Rotation condition. Results showed that the color reports were faster and more precise in the No-Rotation condition even when exactly the same set of colors were tested in both conditions. To investigate how the color information was maintained in the brain, we decoded the color using a multivariate EEG classification method. The decoding was limited to the stimulus encoding period in the Rotation condition, whereas it continued to be significant during the maintenance period in the No-Rotation condition, indicating that the color information was actively maintained in the condition. Follow-up analyses suggested that the prolonged decoding was not merely driven by the covert shift of attention but rather by the recoding of sensory information into an action-oriented response format. Together, these results provide converging evidence that WM flexibly recodes sensory information depending on the specific task context to optimize subsequent behavioral performance.

Individual differences in spatial working memory strategies differentially reflected in the engagement of control and default brain networks

Spatial locations can be encoded and maintained in working memory using different representations and strategies. Fine-grained representations provide detailed stimulus information, but are cognitively demanding and prone to inexactness. The uncertainty in fine-grained representations can be compensated by the use of coarse, but robust categorical representations. In this study, we employed an individual differences approach to identify brain activity correlates of the use of fine-grained and categorical representations in spatial working memory. We combined data from six functional magnetic resonance imaging studies, resulting in a sample of $155$ ($77$ women, $25 \pm 5$ years) healthy participants performing a spatial working memory task. Our results showed that individual differences in the use of spatial representations in working memory were associated with distinct patterns of brain activity. Higher precision of fine-grained representations was related to greater engagement of attentional and control brain systems throughout the task trial, and the stronger deactivation of the default network at the time of stimulus encoding. In contrast, the use of categorical representations was associated with lower default network activity during encoding and higher frontoparietal network activation during maintenance. These results may indicate a greater need for attentional resources and protection against interference for fine-grained compared with categorical representations.

Individual differences in spatial working memory strategies differentially reflected in the engagement of control and default brain networks

Spatial locations can be encoded and maintained in working memory using different representations and strategies. Fine-grained representations provide detailed stimulus information, but are cognitively demanding and prone to inexactness. The uncertainty in fine-grained representations can be compensated by the use of coarse, but robust categorical representations. In this study, we employed an individual differences approach to identify brain activity correlates of the use of fine-grained and categorical representations in spatial working memory. We combined data from six fMRI studies, resulting in a sample of 155 (77 women, 25 ± 5 years) healthy participants performing a spatial working memory task. Our results showed that individual differences in the use of spatial representations in working memory were associated with distinct patterns of brain activity. Higher precision of fine-grained representations was related to greater engagement of attentional and control brain systems throughout the task trial, and the stronger deactivation of the default network at the time of stimulus encoding. In contrast, the use of categorical representations was associated with lower default network activity during encoding and higher frontoparietal network activation during maintenance. These results may indicate a greater need for attentional resources and protection against interference for fine-grained compared to categorical representations.

The prefrontal cortex: from monkey to man

The prefrontal cortex is so important to human beings that, if deprived of it, our behaviour is reduced to action-reactions and automatisms, with no ability to make deliberate decisions. Why does the prefrontal cortex hold such importance in humans? In answer, this review draws on the proximity between humans and other primates, which enables us, through comparative anatomical-functional analysis, to understand the cognitive functions we have in common and specify those that distinguish humans from their closest cousins. First, a focus on the lateral region of the prefrontal cortex illustrates the existence of a continuum between rhesus monkeys (the most studied primates in neuroscience) and humans for most of the major cognitive functions in which this region of the brain plays a central role. This continuum involves the presence of elementary mental operations in the rhesus monkey (e.g. working memory or response inhibition) that are constitutive of 'macro-functions' such as planning, problem-solving and even language production. Second, the human prefrontal cortex has developed dramatically compared to that of other primates. This increase seems to concern the most anterior part (the frontopolar cortex). In humans, the development of the most anterior prefrontal cortex is associated with three major and interrelated cognitive changes: (i) a greater working memory capacity, allowing for greater integration of past experiences and prospective futures; (ii) a greater capacity to link discontinuous or distant data, whether temporal or semantic; and (iii) a greater capacity for abstraction, allowing humans to classify knowledge in different ways, to engage in analogical reasoning or to acquire abstract values that give rise to our beliefs and morals. Together, these new skills enable us, among other things, to develop highly sophisticated social interactions based on language, enabling us to conceive beliefs and moral judgements and to conceptualize, create and extend our vision of our environment beyond what we can physically grasp. Finally, a model of the transition of prefrontal functions between humans and non-human primates concludes this review.

Dissociable Codes in Motor Working Memory

Working memory has been comprehensively studied in sensory domains, like vision, but little attention has been paid to how motor information (e.g., kinematics of recent movements) is maintained and manipulated in working memory. "Motor working memory" (MWM) is important for short-term behavioral control and skill learning. Here, we employed tasks that required participants to encode and recall reaching movements over short timescales. We conducted three experiments (N = 65 undergraduates) to examine MWM under varying cognitive loads, delays, and degrees of interference. The results support a model of MWM that includes an abstract code that flexibly transfers across effectors, and an effector-specific code vulnerable to interfering movements, even when interfering movements are irrelevant to the task. Neither code was disrupted by increasing visuospatial working memory load. These results echo distinctions between representational formats in other domains, suggesting that MWM shares a basic computational structure with other working memory subsystems.

Microsaccades Track Location-Based Object Rehearsal in Visual Working Memory

Besides controlling eye movements, the brain's oculomotor system has been implicated in the control of covert spatial attention and the rehearsal of spatial information in working memory. We investigated whether the oculomotor system also contributes to rehearsing visual objects in working memory when object location is never asked about. To address this, we tracked the incidental use of locations for mnemonic rehearsal via directional biases in microsaccades while participants maintained two visual objects (colored oriented gratings) in working memory. By varying the stimulus configuration (horizontal, diagonal, and vertical) at encoding, we could quantify whether microsaccades were more aligned with the configurational axis of the memory contents, as opposed to the orthogonal axis. Experiment 1 revealed that microsaccades continued to be biased along the axis of the memory content several seconds into the working memory delay. In Experiment 2, we confirmed that this directional microsaccade bias was specific to memory demands, ruling out lingering effects from passive and attentive encoding of the same visual objects in the same configurations. Thus, by studying microsaccade directions, we uncover oculomotor-driven rehearsal of visual objects in working memory through their associated locations.

Neural evidence for advantaged representation of first items in memory

Visual areas activated during perception can retain specific information held in memory without the presence of physical stimuli via distributed activity patterns. Neuroimaging studies have shown that the delay-period representation of information in visual areas is modulated by factors such as memory load and task demands, raising the possibility of serial position as another potential modulator. Specifically, enhanced representation of first items during the post-encoding delay period may serve as a mechanism underlying the well-established but not well-understood primacy effect - the mnemonic advantage of first items. To test this hypothesis, 13 males and 16 females performed a human fMRI task, wherein each trial consisted of the sequential encoding of two stimuli (a famous face and landscape, order counterbalanced), followed by a distracting task, a delay period, and then a cued recall of one of the items. Participants exhibited the expected behavioral primacy effect, manifested as faster recall of the first items. In order to elucidate the still debated neural underpinnings of this effect, using multivariate decoding, a classifier was trained on data collected during encoding to differentiate stimulus categories (i.e., faces vs. landscapes) and tested on data collected during the post-encoding period. Greater reactivation of first versus second items was observed in the ventral occipito-temporal cortex during the entire post-encoding period but not during encoding. Moreover, trial-level analyses revealed that the degree of first-item neural advantage during the post-encoding delay predicted the behavioral primacy effect. These findings highlight the role of item reinstatement in ventral occipito-temporal cortex in the primacy effect and are discussed in the context of the uniqueness of the very first item and event boundaries, illuminating putative neural mechanisms underlying the effect.

The Diversity of Strategies Used in Working Memory for Colors, Orientations, and Positions: A Quantitative Approach to a First-Person Inquiry

The study of individual experience during the performance of a psychological task using a phenomenological approach is a relatively new area of research. The aim of this paper was to combine first- and third-person approaches to investigate whether the strategies individuals use during a working memory task are associated with specific task conditions, whether the strategies combine to form stable patterns, and whether the use of specific strategies is related to task accuracy. Thirty-one participants took part in an experiment in which they were instructed to remember colors, orientations, or positions of stimuli presented in a change detection task. After every 7th-15th trial, participants took part in an in-depth phenomenological interview in which they described their experiences during the trial that immediately preceded the interview. Qualitative analysis revealed a set of 18 strategies that participants used while performing the task, which we divided into active and passive strategies of encoding, maintenance, and retrieval. Quantitative analysis revealed that while many strategies were used in all task conditions, some strategies and their combinations may be better suited to the specific task demands, while others are more general in nature. The results also suggest a distinction between strategies for encoding object identity and spatial features. Finally, our results did not provide robust evidence for a relationship between specific strategies and task accuracy.

Dorsolateral Prefrontal Cortex Glutamate/Gamma-Aminobutyric Acid (GABA) Alterations in Clinical High Risk and First-Episode Schizophrenia: A Preliminary 7-T Magnetic Resonance Spectroscopy Imaging Study

Converging lines of evidence suggest that an imbalance between excitation and inhibition is present in the dorsolateral prefrontal cortex (DLPFC) of schizophrenia (SCZ). Gamma-aminobutyric-acid (GABA) and, to a lesser extent, glutamate (Glu) abnormalities were reported in the DLPFC of SCZ patients, especially on the right hemisphere, by post-mortem studies. However, in vivo evidence of GABA, Glu, and Glu/GABA DLPFC abnormalities, particularly on the right side and the early stages of illness, is limited. In this preliminary study, we utilized 7-Tesla magnetic resonance spectroscopic imaging (MRSI) to investigate bilateral Glu/Creatine (Cre), GABA/Cre, and Glu/GABA in the DLPFC of sixteen first episode schizophrenia (FES), seventeen clinical high risk (CHR), and twenty-six healthy comparison (HC) subjects. FES and CHR had abnormal GABA/Cre and Glu/GABA in the right DLPFC (rDLPFC) compared with HC participants, while no differences were observed in the left DLPFC (lDLPFC) among the three groups. Furthermore, HC had higher Glu/GABA in rDLPFC compared to lDLPFC (R > L), whereas the opposite relationship (R < L) was observed in the DLPFC Glu/GABA of FES patients. Altogether, these findings indicate that GABA/Cre and Glu/GABA DLPFC alterations are present before illness manifestation and worsen in FES patients, thus representing a putative early pathophysiological biomarker for SCZ and related psychotic disorders.

In search for consciousness in animals: Using working memory and voluntary attention as behavioral indicators

Whether animals have subjective experiences about the content of their sensory input, i.e., whether they are aware of stimuli, is a notoriously difficult question to answer. If consciousness is present in animals, it must share fundamental characteristics with human awareness. Working memory and voluntary/endogenous attention are suggested as diagnostic features of conscious awareness. Behavioral evidence shows clear signatures of both working memory and voluntary attention as minimal criterium for sensory consciousness in mammals and birds. In contrast, reptiles and amphibians show no sign of either working memory or volitional attention. Surprisingly, some species of teleost fishes exhibit elementary working memory and voluntary attention effects suggestive of possibly rudimentary forms of subjective experience. With the potential exception of honeybees, evidence for conscious processing is lacking in invertebrates. These findings suggest that consciousness is not ubiquitous in the animal kingdom but also not exclusive to humans. The phylogenetic gap between animal taxa argues that evolution does not rely on specific neural substrates to endow distantly related species with basic forms of consciousness.

Reward and loss incentives improve spatial working memory by shaping trial-by-trial posterior frontoparietal signals

Integrating motivational signals with cognition is critical for goal-directed activities. The mechanisms that link neural changes with motivated working memory continue to be understood. Here, we tested how externally cued and non-cued (internally represented) reward and loss impact spatial working memory precision and neural circuits in human subjects using fMRI. We translated the classic delayed-response spatial working memory paradigm from non-human primate studies to take advantage of a continuous numeric measure of working memory precision, and the wealth of translational neuroscience yielded by these studies. Our results demonstrated that both cued and non-cued reward and loss improved spatial working memory precision. Visual association regions of the posterior prefrontal and parietal cortices, specifically the precentral sulcus (PCS) and intraparietal sulcus (IPS), had increased BOLD signal during incentivized spatial working memory. A subset of these regions had trial-by-trial increases in BOLD signal that were associated with better working memory precision, suggesting that these regions may be critical for linking neural signals with motivated working memory. In contrast, regions straddling executive networks, including areas in the dorsolateral prefrontal cortex, anterior parietal cortex and cerebellum displayed decreased BOLD signal during incentivized working memory. While reward and loss similarly impacted working memory processes, they dissociated during feedback when money won or avoided in loss was given based on working memory performance. During feedback, the trial-by-trial amount and valence of reward/loss received was dissociated amongst regions such as the ventral striatum, habenula and periaqueductal gray. Overall, this work suggests motivated spatial working memory is supported by complex sensory processes, and that the IPS and PCS in the posterior frontoparietal cortices may be key regions for integrating motivational signals with spatial working memory precision.

Flexible utilization of spatial- and motor-based codes for the storage of visuo-spatial information

Working memory provides flexible storage of information in service of upcoming behavioral goals. Some models propose specific fixed loci and mechanisms for the storage of visual information in working memory, such as sustained spiking in parietal and prefrontal cortex during working memory maintenance. An alternative view is that information can be remembered in a flexible format that best suits current behavioral goals. For example, remembered visual information might be stored in sensory areas for easier comparison to future sensory inputs, or might be re-coded into a more abstract action-oriented format and stored in motor areas. Here, we tested this hypothesis using a visuo-spatial working memory task where the required behavioral response was either known or unknown during the memory delay period. Using functional magnetic resonance imaging (fMRI) and multivariate decoding, we found that there was less information about remembered spatial position in early visual and parietal regions when the required response was known versus unknown. Furthermore, a representation of the planned motor action emerged in primary somatosensory, primary motor, and premotor cortex during the same task condition where spatial information was reduced in early visual cortex. These results suggest that the neural networks supporting working memory can be strategically reconfigured depending on specific behavioral requirements during a canonical visual working memory paradigm.

Neural Evidence for Different Types of Position Coding Strategies in Spatial Working Memory

Sustained neural activity during the delay phase of spatial working memory tasks is compelling evidence for the neural correlate of active storage and maintenance of spatial information, however, it does not provide insight into specific mechanisms of spatial coding. This activity may reflect a range of processes, such as maintenance of a stimulus position or a prepared motor response plan. The aim of our study was to examine neural evidence for the use of different coding strategies, depending on the characteristics and demands of a spatial working memory task. Thirty-one (20 women, 23 ± 5 years) and 44 (23 women, 21 ± 2 years) participants performed a spatial working memory task while we measured their brain activity using fMRI in two separate experiments. Participants were asked to remember the position of a briefly presented target stimulus and, after a delay period, to use a joystick to indicate either the position of the remembered target or an indicated non-matching location. The task was designed so that the predictability of the response could be manipulated independently of task difficulty and memory retrieval process. We were particularly interested in contrasting conditions in which participants (i) could use prospective coding of the motor response or (ii) had to rely on retrospective sensory information. Prospective motor coding was associated with activity in somatomotor, premotor, and motor cortices and increased integration of brain activity with and within the somatomotor network. In contrast, retrospective sensory coding was associated with increased activity in parietal regions and increased functional connectivity with and within secondary visual and dorsal attentional networks. The observed differences in activation levels, dynamics of differences over trial duration, and integration of information within and between brain networks provide compelling evidence for the use of complementary spatial working memory strategies optimized to meet task demands.

Delay activity during visual working memory: A meta-analysis of 30 fMRI experiments

Visual working memory refers to the temporary maintenance and manipulation of task-related visual information. Recent debate on the underlying neural substrates of visual working memory has focused on the delay period of relevant tasks. Persistent neural activity throughout the delay period has been recognized as a correlate of working memory, yet regions demonstrating sustained hemodynamic responses show inconsistency across individual studies. To develop a more precise understanding of delay-period activations during visual working memory, we conducted a coordinate-based meta-analysis on 30 fMRI experiments involving 515 healthy adults with a mean age of 25.65 years. The main analysis revealed a widespread frontoparietal network associated with delay-period activity, as well as activation in the right inferior temporal cortex. These findings were replicated using different meta-analytical algorithms and were shown to be robust against between-study heterogeneity and publication bias. Further meta-analyses on different subgroups of experiments with specific task demands and stimulus types revealed similar delay-period networks, with activations distributed across the frontal and parietal cortices. The roles of prefrontal regions, posterior parietal regions, and inferior temporal areas are reviewed and discussed in the context of content-specific storage. We conclude that cognitive operations that occur during the unfilled delay period in visual working memory tasks can be flexibly expressed across a frontoparietal-temporal network depending on experimental parameters.

Examining the relationship between working memory consolidation and long-term consolidation

An emerging area of research is focused on the relationship between working memory and long-term memory and the likely overlap between these processes. Of particular interest is how some information first maintained in working memory is retained for longer periods and eventually preserved in long-term memory. The process of stabilizing transient memory representations for lasting retention is referred to as consolidation in both the working memory and long-term memory literature, although these have historically been viewed as independent constructs. The present review aims to investigate the relationship between working memory consolidation and long-term memory consolidation, which both have rich, but distinct, histories. This review provides an overview of the proposed models and neural mechanisms of both types of consolidation, as well as clinical findings related to consolidation and potential approaches for the manipulation of consolidation. Finally, two hypotheses are proposed to explain the relationship between working memory consolidation and long-term memory consolidation.

Unveiling the abstract format of mnemonic representations

Working memory (WM) enables information storage for future use, bridging the gap between perception and behavior. We hypothesize that WM representations are abstractions of low-level perceptual features. However, the neural nature of these putative abstract representations has thus far remained impenetrable. Here, we demonstrate that distinct visual stimuli (oriented gratings and moving dots) are flexibly recoded into the same WM format in visual and parietal cortices when that representation is useful for memory-guided behavior. Specifically, the behaviorally relevant features of the stimuli (orientation and direction) were extracted and recoded into a shared mnemonic format that takes the form of an abstract line-like pattern. We conclude that mnemonic representations are abstractions of percepts that are more efficient than and proximal to the behaviors they guide.

Behavioral Prioritization Enhances Working Memory Precision and Neural Population Gain

Humans allocate visual working memory (WM) resource according to behavioral relevance, resulting in more precise memories for more important items. Theoretically, items may be maintained by feature-tuned neural populations, where the relative gain of the populations encoding each item determines precision. To test this hypothesis, we compared the amplitudes of delay period activity in the different parts of retinotopic maps representing each of several WM items, predicting the amplitudes would track behavioral priority. Using fMRI, we scanned participants while they remembered the location of multiple items over a WM delay and then reported the location of one probed item using a memory-guided saccade. Importantly, items were not equally probable to be probed (0.6, 0.3, 0.1, 0.0), which was indicated with a precue. We analyzed fMRI activity in 10 visual field maps in occipital, parietal, and frontal cortex known to be important for visual WM. In early visual cortex, but not association cortex, the amplitude of BOLD activation within voxels corresponding to the retinotopic location of visual WM items increased with the priority of the item. Interestingly, these results were contrasted with a common finding that higher-level brain regions had greater delay period activity, demonstrating a dissociation between the absolute amount of activity in a brain area and the activity of different spatially selective populations within it. These results suggest that the distribution of WM resources according to priority sculpts the relative gains of neural populations that encode items, offering a neural mechanism for how prioritization impacts memory precision.

Persistent Activity During Working Memory From Front to Back

Working memory (WM) extends the duration over which information is available for processing. Given its importance in supporting a wide-array of high level cognitive abilities, uncovering the neural mechanisms that underlie WM has been a primary goal of neuroscience research over the past century. Here, we critically review what we consider the two major "arcs" of inquiry, with a specific focus on findings that were theoretically transformative. For the first arc, we briefly review classic studies that led to the canonical WM theory that cast the prefrontal cortex (PFC) as a central player utilizing persistent activity of neurons as a mechanism for memory storage. We then consider recent challenges to the theory regarding the role of persistent neural activity. The second arc, which evolved over the last decade, stemmed from sophisticated computational neuroimaging approaches enabling researchers to decode the contents of WM from the patterns of neural activity in many parts of the brain including early visual cortex. We summarize key findings from these studies, their implications for WM theory, and finally the challenges these findings pose. Our goal in doing so is to identify barriers to developing a comprehensive theory of WM that will require a unification of these two "arcs" of research.

Errors in visuospatial working memory across space and time

Visuospatial working memory (VSWM) involves cortical regions along the dorsal visual pathway, which are topographically organized with respect to the visual space. However, it remains unclear how such functional organization may constrain VSWM behavior across space and time. Here, we systematically mapped VSWM performance across the 2-dimensional (2D) space in various retention intervals in human subjects using the memory-guided and visually guided saccade tasks in two experiments. Relative to visually guided saccades, memory-guided saccades showed significant increases in unsystematic errors, or response variability, with increasing target eccentricity (3°-13° of visual angle). Unsystematic errors also increased with increasing delay (1.5-3 s, Experiment 1; 0.5-5 s, Experiment 2), while there was little or no interaction between delay and eccentricity. Continuous bump attractor modeling suggested neurophysiological and functional organization factors in the increasing unsystematic errors in VSWM across space and time. These findings indicate that: (1) VSWM representation may be limited by the functional topology of the visual pathway for the 2D space; (2) Unsystematic errors may reflect accumulated noise from memory maintenance while systematic errors may originate from non-mnemonic processes such as noisy sensorimotor transformation; (3) There may be independent mechanisms supporting the spatial and temporal processing of VSWM.

Delayed-matching-to-position working memory in mice relies on NMDA-receptors in prefrontal pyramidal cells

A hypofunction of N-methyl-D-aspartate glutamate receptors (NMDARs) has been implicated in the pathogenesis of schizophrenia by clinical and rodent studies. However, to what extent NMDAR-hypofunction in distinct cell-types across the brain causes different symptoms of this disease is largely unknown. One pharmaco-resistant core symptom of schizophrenia is impaired working memory (WM). NMDARs have been suggested to mediate sustained firing in excitatory neurons of the prefrontal cortex (PFC) that might underlie WM storage. However, if NMDAR-hypofunction in prefrontal excitatory neurons may indeed entail WM impairments is unknown. We here investigated this question in mice, in which NMDARs were genetically-ablated in PFC excitatory cells. This cell type-selective NMDAR-hypofunction caused a specific deficit in a delayed-matching-to-position (DMTP) 5-choice-based operant WM task. In contrast, T-maze rewarded alternation and several psychological functions including attention, spatial short-term habituation, novelty-processing, motivation, sociability, impulsivity, and hedonic valuation remained unimpaired at the level of GluN1-hypofunction caused by our manipulation. Our data suggest that a hypofunction of NMDARs in prefrontal excitatory neurons may indeed cause WM impairments, but are possibly not accounting for most other deficits in schizophrenia.

Output planning at the input stage in visual working memory

Working memory serves as the buffer between past sensations and future behavior, making it vital to understand not only how we encode and retain sensory information in memory but also how we plan for its upcoming use. We ask when prospective action goals emerge alongside the encoding and retention of visual information in working memory. We show that prospective action plans do not emerge gradually during memory delays but are brought into memory early, in tandem with sensory encoding. This action encoding (i) precedes a second stage of action preparation that adapts to the time of expected memory utilization, (ii) occurs even ahead of an intervening motor task, and (iii) predicts visual memory-guided behavior several seconds later. By bringing prospective action plans into working memory at an early stage, the brain creates a dual (visual-motor) memory code that can make memories more effective and robust for serving ensuing behavior.

Delay-dependent cholinergic modulation of visual short-term memory in rhesus macaques

Cholinergic neuromodulation is known to play a key role in visual working memory (VWM) - keeping relevant stimulus representations available for cognitive processes for short time periods (up to a few minutes). Despite the growing body of evidence on how the neural and cognitive mechanisms of VWM dynamically change over retention time, there is mixed evidence available on cholinergic effects as a function of VWM delay period in non-human primates. Using the delayed matching to sample VWM task in rhesus macaques (N = 6), we aimed to characterize VWM maintenance in terms of performance changes as a function of delay duration (across a wide range of delays from 1 to 76 s). Then, we studied how cholinergic neuromodulation influences VWM maintenance using the muscarinic receptor antagonist scopolamine administered alone as transient amnestic treatment, and in combination with two doses of the acetylcholinesterase inhibitor donepezil, a widely used Alzheimer's medication probing for the reversal of scopolamine-induced impairments. Results indicate that scopolamine-induced impairments of VWM maintenance are delay-dependent and specifically affect the 15-33 s time range, suggesting that scopolamine worsens the normal decay of VWM with the passage of time. Donepezil partially rescued the observed scopolamine-induced impairments of VWM performance. These results provide strong behavioral evidence for the role of increased cholinergic tone and muscarinic neuromodulation in the maintenance of VWM beyond a few seconds, in line with our current knowledge on the role of muscarinic acetylcholine receptors in sustained neural activity during VWM delay periods.

Remember how to use it: Effector-dependent modulation of spatial working memory activity in posterior parietal cortex

Working memory (WM) is the key process linking perception to action. Several lines of research have, accordingly, highlighted WM’s engagement in sensori-motor associations between retrospective stimuli and future behavior. Using human fMRI we investigated whether prior information about the effector used to respond in a WM task would have an impact on the way the same sensory stimulus is maintained in memory despite a behavioral response could not be readily planned. We focused on WM-related activity in posterior parietal cortex during the maintenance of spatial items for a subsequent match-to-sample comparison, which was reported either with a verbal or with a manual response. We expected WM activity to be higher for manual response trials, because of posterior parietal cortex’s engagement in both spatial WM and hand movement preparation. Increased fMRI activity for manual response trials in bilateral anterior intraparietal sulcus confirmed our expectations. These results imply that the maintenance of sensory material in WM is optimized for motor context, i.e. for the effector that will be relevant in the upcoming behavioral responses.

Spatiotemporal transformations for gaze control

Sensorimotor transformations require spatiotemporal coordination of signals, that is, through both time and space. For example, the gaze control system employs signals that are time-locked to various sensorimotor events, but the spatial content of these signals is difficult to assess during ordinary gaze shifts. In this review, we describe the various models and methods that have been devised to test this question, and their limitations. We then describe a new method that can (a) simultaneously test between all of these models during natural, head-unrestrained conditions, and (b) track the evolving spatial continuum from target (T) to future gaze coding (G, including errors) through time. We then summarize some applications of this technique, comparing spatiotemporal coding in the primate frontal eye field (FEF) and superior colliculus (SC). The results confirm that these areas preferentially encode eye-centered, effector-independent parameters, and show-for the first time in ordinary gaze shifts-a spatial transformation between visual and motor responses from T to G coding. We introduce a new set of spatial models (T-G continuum) that revealed task-dependent timing of this transformation: progressive during a memory delay between vision and action, and almost immediate without such a delay. We synthesize the results from our studies and supplement it with previous knowledge of anatomy and physiology to propose a conceptual model where cumulative transformation noise is realized as inaccuracies in gaze behavior. We conclude that the spatiotemporal transformation for gaze is both local (observed within and across neurons in a given area) and distributed (with common signals shared across remote but interconnected structures).

Visual working memory and action: Functional links and bi-directional influences

Working memory bridges perception to action over extended delays, enabling flexible goal-directed behaviour. To date, studies of visual working memory – concerned with detailed visual representations such as shape and colour – have considered visual memory predominantly in the context of visual task demands, such as visual identification and search. Another key purpose of visual working memory is to directly inform and guide upcoming actions. Taking this as a starting point, I review emerging evidence for the pervasive bi-directional links between visual working memory and (planned) action, and discuss these links from the perspective of their common goal of enabling flexible and precise behaviour.

The what, where and how of delay activity

Working memory is characterized by neural activity that persists during the retention interval of delay tasks. Despite the ubiquity of this delay activity across tasks, species and experimental techniques, our understanding of this phenomenon remains incomplete. Although initially there was a narrow focus on sustained activation in a small number of brain regions, methodological and analytical advances have allowed researchers to uncover previously unobserved forms of delay activity various parts of the brain. In light of these new findings, this Review reconsiders what delay activity is, where in the brain it is found, what roles it serves and how it may be generated.

The topographical organization of motor processing: An ALE meta-analysis on six action domains and the relevance of Broca's region

Action is a cover term used to refer to a large set of motor processes differing in domain specificities (e.g. execution or observation). Here we review neuroimaging evidence on action processing (N = 416; Subjects = 5912) using quantitative Activation Likelihood Estimation (ALE) and Meta-Analytic Connectivity Modeling (MACM) approaches to delineate the functional specificities of six domains: (1) Action Execution, (2) Action Imitation, (3) Motor Imagery, (4) Action Observation, (5) Motor Learning, (6) Motor Preparation. Our results show distinct functional patterns for the different domains with convergence in posterior BA44 (pBA44) for execution, imitation and imagery processing. The functional connectivity network seeding in the motor-based localized cluster of pBA44 differs from the connectivity network seeding in the (language-related) anterior BA44. The two networks implement distinct cognitive functions. We propose that the motor-related network encompassing pBA44 is recruited when processing movements requiring a mental representation of the action itself.

Neural activity during working memory encoding, maintenance, and retrieval: A network-based model and meta-analysis

It remains unclear whether and to what extent working memory (WM) temporal subprocesses (i.e., encoding, maintenance, and retrieval) involve shared or distinct intrinsic networks. To address this issue, I constructed a model of intrinsic network contributions to different WM phases and then evaluated the validity of the model by performing a quantitative meta-analysis of relevant functional neuroimaging data. The model suggests that the transition from the encoding to maintenance and to retrieval stages involves progressively decreasing involvement of the dorsal attention network (DAN), but progressively increasing involvement of the frontoparietal control network (FPCN). Separate meta-analysis of each phase effect and direct comparisons between them yielded results that were largely consistent with the model. This evidence included between-phase double dissociations that were consistent with the model, such as encoding > maintenance contrast showing some DAN, but no FPCN, regions, and maintenance > encoding contrast showing the reverse, that is, some FPCN, but no DAN, regions. Two closely juxtaposed regions that are members of the DAN and FPCN, such as inferior frontal junction versus caudal prefrontal cortex and superior versus inferior intraparietal sulcus, showed a high degree of functional differentiation. Although all regions identified in the present study were already identified in previous WM studies, this study uniquely enhances our understating of their roles by clarifying their network membership and specific associations with different WM phases.

Reduced Visual and Frontal Cortex Activation During Visual Working Memory in Grapheme-Color Synaesthetes Relative to Young and Older Adults

The sensory recruitment model envisages visual working memory (VWM) as an emergent property that is encoded and maintained in sensory (visual) regions. The model implies that enhanced sensory-perceptual functions, as in synaesthesia, entail a dedicated VWM-system, showing reduced visual cortex activity as a result of neural specificity. By contrast, sensory-perceptual decline, as in old age, is expected to show enhanced visual cortex activity as a result of neural broadening. To test this model, young grapheme-color synaesthetes, older adults and young controls engaged in a delayed pair-associative retrieval and a delayed matching-to-sample task, consisting of achromatic fractal stimuli that do not induce synaesthesia. While a previous analysis of this dataset (Pfeifer et al., 2016) has focused on cued retrieval and recognition of pair-associates (i.e., long-term memory), the current study focuses on visual working memory and considers, for the first time, the crucial delay period in which no visual stimuli are present, but working memory processes are engaged. Participants were trained to criterion and demonstrated comparable behavioral performance on VWM tasks. Whole-brain and region-of-interest-analyses revealed significantly lower activity in synaesthetes’ middle frontal gyrus and visual regions (cuneus, inferior temporal cortex), respectively, suggesting greater neural efficiency relative to young and older adults in both tasks. The results support the sensory recruitment model and can explain age and individual WM-differences based on neural specificity in visual cortex.

Updating spatial working memory in a dynamic visual environment

The present review describes recent developments regarding the role of the eye movement system in representing spatial information and keeping track of locations of relevant objects. First, we discuss the active vision perspective and why eye movements are considered crucial for perception and attention. The second part focuses on the question of how the oculomotor system is used to represent spatial attentional priority, and the role of the oculomotor system in maintenance of this spatial information. Lastly, we discuss recent findings demonstrating rapid updating of information across saccadic eye movements. We argue that the eye movement system plays a key role in maintaining and rapidly updating spatial information. Furthermore, we suggest that rapid updating emerges primarily to make sure actions are minimally affected by intervening eye movements, allowing us to efficiently interact with the world around us.

Load effects on spatial working memory performance are linked to distributed alpha and beta oscillations

Increasing spatial working memory (SWM) load is generally associated with declines in behavioral performance, but the neural correlates of load-related behavioral effects remain poorly understood. Herein, we examine the alterations in oscillatory activity that accompany such performance changes in 22 healthy adults who performed a two- and four-load SWM task during magnetoencephalography (MEG). All MEG data were transformed into the time-frequency domain and significant oscillatory responses were imaged separately per load using a beamformer. Whole-brain correlation maps were computed using the load-related beamformer difference images and load-related accuracy effects on the SWM task. The results indicated that load-related differences in left inferior frontal alpha activity during encoding and maintenance were negatively correlated with load-related accuracy differences on the SWM task. That is, individuals who had more substantial decreases in prefrontal alpha during high-relative to low-load SWM trials tended to have smaller performance decrements on the high-load condition (i.e., they performed more accurately). The same pattern of neurobehavioral correlations was observed during the maintenance period for right superior temporal alpha activity and right superior parietal beta activity. Importantly, this is the first study to employ a voxel-wise whole-brain approach to significantly link load-related oscillatory differences and load-related SWM performance differences.

Saccade selection and inhibition: motor and attentional components

Motor responses are fundamentally spatial in their function and neural organization. However, studies of inhibitory motor control, focused on global stopping of all actions, have ignored whether inhibitory control can be exercised selectively for specific actions. We used a new approach to elicit and measure motor inhibition by asking human participants to either look at (select) or avoid looking at (inhibit) a location in space. We found that instructing a location to be avoided resulted in an inhibitory bias specific to that location. When compared with the facilitatory bias observed in the Look task, it differed significantly in both its spatiotemporal dynamics and its modulation of attentional processing. While action selection was evident in oculomotor system and interacted with attentional processing, action inhibition was evident mainly in the oculomotor system. Our findings suggest that action inhibition is implemented by spatially specific mechanisms that are separate from action selection. NEW & NOTEWORTHY We show that cognitive control of saccadic responses evokes separable action selection and inhibition processes. Both action selection and inhibition are represented in the saccadic system, but only action selection interacts with the attentional system.

Beta Oscillatory Dynamics in the Prefrontal and Superior Temporal Cortices Predict Spatial Working Memory Performance

The oscillatory dynamics serving spatial working memory (SWM), and how such dynamics relate to performance, are poorly understood. To address these topics, the present study recruited 22 healthy adults to perform a SWM task during magnetoencephalography (MEG). The resulting MEG data were transformed into the time-frequency domain, and significant oscillatory responses were imaged using a beamformer. Voxel time series data were extracted from the cluster peaks to quantify the dynamics, while whole-brain partial correlation maps were computed to identify regions where oscillatory strength varied with accuracy on the SWM task. The results indicated transient theta oscillations in spatially distinct subregions of the prefrontal cortices at the onset of encoding and maintenance, which may underlie selection of goal-relevant information. Additionally, strong and persistent decreases in alpha and beta oscillations were observed throughout encoding and maintenance in parietal, temporal, and occipital regions, which could serve sustained attention and maintenance processes during SWM performance. The neuro-behavioral correlations revealed that beta activity within left dorsolateral prefrontal control regions and bilateral superior temporal integration regions was negatively correlated with SWM accuracy. Notably, this is the first study to employ a whole-brain approach to significantly link neural oscillations to behavioral performance in the context of SWM.

Time-resolved decoding of planned delayed and immediate prehension movements

Different contexts require us either to react immediately, or to delay (or suppress) a planned movement. Previous studies that aimed at decoding movement plans typically dissociated movement preparation and execution by means of delayed-movement paradigms. Here we asked whether these results can be generalized to the planning and execution of immediate movements. To directly compare delayed, non-delayed, and suppressed reaching and grasping movements, we used a slow event-related functional magnetic resonance imaging (fMRI) design. To examine how neural representations evolved throughout movement planning, execution, and suppression, we performed time-resolved multivariate pattern analysis (MVPA). During the planning phase, we were able to decode upcoming reaching and grasping movements in contralateral parietal and premotor areas. During the execution phase, we were able to decode movements in a widespread bilateral network of motor, premotor, and somatosensory areas. Moreover, we obtained significant decoding across delayed and non-delayed movement plans in contralateral primary motor cortex. Our results demonstrate the feasibility of time-resolved MVPA and provide new insights into the dynamics of the prehension network, suggesting early neural representations of movement plans in the primary motor cortex that are shared between delayed and non-delayed contexts.

Persistent neuronal activity in human prefrontal cortex links perception and action

How do humans flexibly respond to changing environmental demands on a sub-second temporal scale? Extensive research has highlighted the key role of the prefrontal cortex in flexible decision-making and adaptive behavior, yet the core mechanisms that translate sensory information into behavior remain undefined. Utilizing direct human cortical recordings, we investigated the temporal and spatial evolution of neuronal activity, indexed by the broadband gamma signal, while sixteen participants performed a broad range of self-paced cognitive tasks. Here we describe a robust domain- and modality-independent pattern of persistent stimulus-to-response neural activation that encodes stimulus features and predicts motor output on a trial-by-trial basis with near-perfect accuracy. Observed across a distributed network of brain areas, this persistent neural activation is centered in the prefrontal cortex and is required for successful response implementation, providing a functional substrate for domain-general transformation of perception into action, critical for flexible behavior.

Population Dynamics of Early Visual Cortex during Working Memory

Although the content of working memory (WM) can be decoded from the spatial patterns of brain activity in early visual cortex, how populations encode WM representations remains unclear. Here, we address this limitation by using a model-based approach that reconstructs the feature encoded by population activity measured with fMRI. Using this approach, we could successfully reconstruct the locations of memory-guided saccade goals based on the pattern of activity in visual cortex during a memory delay. We could reconstruct the saccade goal even when we dissociated the visual stimulus from the saccade goal using a memory-guided antisaccade procedure. By comparing the spatiotemporal population dynamics, we find that the representations in visual cortex are stable but can also evolve from a representation of a remembered visual stimulus to a prospective goal. Moreover, because the representation of the antisaccade goal cannot be the result of bottom-up visual stimulation, it must be evoked by top-down signals presumably originating from frontal and/or parietal cortex. Indeed, we find that trial-by-trial fluctuations in delay period activity in frontal and parietal cortex correlate with the precision with which our model reconstructed the maintained saccade goal based on the pattern of activity in visual cortex. Therefore, the population dynamics in visual cortex encode WM representations, and these representations can be sculpted by top-down signals from frontal and parietal cortex.

Distinct contributions by frontal and parietal cortices support working memory

Although subregions of frontal and parietal cortex both contribute and coordinate to support working memory (WM) functions, their distinct contributions remain elusive. Here, we demonstrate that perturbations to topographically organized human frontal and parietal cortex during WM maintenance cause distinct but systematic distortions in WM. The nature of these distortions supports theories positing that parietal cortex mainly codes for retrospective sensory information, while frontal cortex codes for prospective action.

Altered visual strategies and attention are related to increased force fluctuations during a pinch grip task in older adults

The purpose of the study was to determine the visual strategies used by older adults during a pinch grip task and to assess the relations between visual strategy, deficits in attention, and increased force fluctuations in older adults. Eye movements of 23 older adults (>65 yr) were monitored during a low-force pinch grip task while subjects viewed three common visual feedback displays. Performance on the Grooved Pegboard test and an attention task (which required no concurrent hand movements) was also measured. Visual strategies varied across subjects and depended on the type of visual feedback provided to the subjects. First, while viewing a high-gain compensatory feedback display (horizontal bar moving up and down with force), 9 of 23 older subjects adopted a strategy of performing saccades during the task, which resulted in 2.5 times greater force fluctuations in those that exhibited saccades compared with those who maintained fixation near the target line. Second, during pursuit feedback displays (force trace moving left to right across screen and up and down with force), all subjects exhibited multiple saccades, and increased force fluctuations were associated (r_s = 0.6; P = 0.002) with fewer saccades during the pursuit task. Also, decreased low-frequency (<4 Hz) force fluctuations and Grooved Pegboard times were significantly related (P = 0.033 and P = 0.005, respectively) with higher (i.e., better) attention z scores. Comparison of these results with our previously published results in young subjects indicates that saccadic eye movements and attention are related to force control in older adults.NEW & NOTEWORTHY The significant contributions of the study are the addition of eye movement data and an attention task to explain differences in hand motor control across different visual displays in older adults. Older participants used different visual strategies across varying feedback displays, and saccadic eye movements were related with motor performance. In addition, those older individuals with deficits in attention had impaired motor performance on two different hand motor control tasks, including the Grooved Pegboard test.

Interference between smooth pursuit and color working memory

Spatial working memory (WM) and spatial attention are closely related, but the relationship between non-spatial WM and spatial attention still remains unclear. The present study aimed to investigate the interaction between color WM and smooth pursuit eye movements. A modified delayed-match-to-sample paradigm (DMS) was applied with 2 or 4 items presented in each visual field. Subjects memorized the colors of items in the cued visual field and smoothly moved eyes towards or away from memorized items during retention interval despite that the colored items were no longer visible. The WM performance decreased with higher load in general. More importantly, the WM performance was better when subjects pursued towards rather than away from the cued visual field. Meanwhile, the pursuit gain decreased with higher load and demonstrated a higher result when pursuing away from the cued visual field. These results indicated that spatial attention, guiding attention to the memorized items, benefits color WM. Therefore, we propose that a competition for attention resources exists between color WM and smooth pursuit eye movements.

Reduced brain activity in female patients with non-alcoholic fatty liver disease as measured by near-infrared spectroscopy

Patients with non-alcoholic fatty liver disease (NAFLD) have impaired health-related quality of life including physical and mental state. Near-infrared spectroscopy (NIRS) is a useful tool for evaluation of brain activity and depressive state. This study aimed to determine the brain activity of female NAFLD patients using NIRS. Cerebral oxygenated hemoglobin (oxy-Hb) concentration during a verbal fluency task (VFT) was measured using NIRS in 24 female NAFLD patients and 15 female healthy controls. The Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire was administered to both groups before NIRS. There was no significant difference in CES-D score between groups. However, the oxy-Hb concentration and number of words during the VFT were less in NAFLD compared to healthy controls. The mean value of oxy-Hb concentration during 0–60 s VFT in the frontal lobe was also smaller in NAFLD patients compared to healthy controls (0.082 ± 0.126 vs. 0.183 ± 0.145, P < 0.001). Cerebral oxygen concentration is poorly reactive in response to VFT in female NAFLD patients. This may indicate an association between decreased brain activity and NAFLD regardless of depression.