Time dysperception perspective for acquired brain injury

Anaesthetics and time perception: A review

Consciousness requires subjective experience in the "now." Establishing "now," however, necessitates temporal processing. In the current article, we review one method of altering consciousness, anaesthetic drug administration, and its effects on perceived duration. We searched PubMed, PsycInfo, and ScienceDirect databases, and article reference sections, for combinations of anaesthetic drugs and time perception tasks, finding a total of 36 articles which met our inclusion criteria. We categorised these articles with regard to whether they altered the felt passage of time, short or long interval timing, or were motor timing tasks. We found that various drugs alter the perceived passage of time; ketamine makes time subjectively slow down while GABAergic drugs make time subjectively speed up. At a short interval there is little established evidence of a shift in time perception, though temporal estimates appear more variable. Similarly, when asked to use time to optimise responses (i.e., in motor timing tasks), various anaesthetic agents make timing more variable. Longer durations are estimated as lasting longer than their objective duration, though there is some variation across articles in this regard. We conclude by proposing further experiments to examine time perception under altered states of consciousness and ask whether it is possible to perceive the passage of time of events which do not necessarily reach the level of conscious perception. The variety of methods used raises the need for more systematic investigations of time perception under anaesthesia. We encourage future investigations into the overlap of consciousness and time perception to advance both fields.

Temporal judgments of actions following unilateral brain damage

Sense of time is a complex construct, and its neural correlates remain to date in most part unknown. To complicate the frame, physical attributes of the stimulus, such as its intensity or movement, influence temporal perception. Although previous studies have shown that time perception can be compromised after a brain lesion, the evidence on the role of the left and right hemispheres are meager. In two experiments, the study explores the ability of temporal estimation of multi-second actions and non-biological movements in 33 patients suffering from unilateral brain lesion. Furthermore, the modulatory role of induced embodiment processes is investigated. The results reveal a joint contribution of the two hemispheres depending not only on different durations but also on the presence of actions. Indeed, the left hemisphere damaged patients find it difficult to estimate 4500 ms or longer durations, while the right hemisphere damaged patients fail in 3000 ms durations. Furthermore, the former fail when a biological action is shown, while the latter fail in non-biological movement. Embodiment processes have a modulatory effect only after right hemisphere lesions. Among neuropsychological variables, only spatial neglect influences estimation of non-biological movement.

Time perception changes in stroke patients: A systematic literature review

Introduction

Time perception comprises the subjective experience of passing of time and of the duration of an event. Although already described in some neurological and psychiatric conditions, there is a paucity of details regarding this neurocognitive change in stroke patients. We aimed to describe time perception dysfunction in stroke patient.

Methods

We performed a systematic review of the literature in Pubmed, PsycInfo and EMBASE including manuscripts from their inception until December 2020. We collected data regarding the type of time perception that was detected, type of stroke, most common location of lesions, evaluation tests that were used and time of evaluation after stroke onset.

Results

A total of 27 manuscripts were selected, concerning a total of 418 patients (n = 253 male; 60.5%). Most manuscripts (n = 21) evaluated patients with ischaemic lesions (n = 407; 97.4%). The majority referred to evaluations between 2 months and seven years after stroke. Underestimation in temporal evaluation in sub- and supra-second was the most common dysfunction (n = 165; 41.7%). Overestimation of time (n = 116; 27.8%) and impaired time interval comparison (n = 88; 22.2%) were also found. Most patients had right hemisphere lesions (n = 219 patients; 52.4%). Common reported lesion locations included the thalamus, insula, basal ganglia, dorsolateral prefrontal cortex, parietal cortex including supramarginal, angular gyrus and right inferior parietal cortex and cerebellum.

Conclusion

There are multiple stroke locations associated with time perception dysfunction, which highlights the complex system involved in time perception. There is still scarce knowledge about specific time perception deficits after stroke. Most studies rely in psychometric analysis without clear clinical and functional translation, namely regarding impact on daily activities.

Dysfunctional Timing in Traumatic Brain Injury Patients: Co-occurrence of Cognitive, Motor, and Perceptual Deficits

Timing is an essential part of human cognition and of everyday life activities, such as walking or holding a conversation. Previous studies showed that traumatic brain injury (TBI) often affects cognitive functions such as processing speed and time-sensitive abilities, causing long-term sequelae as well as daily impairments. However, the existing evidence on timing capacities in TBI is mostly limited to perception and the processing of isolated intervals. It is therefore open whether the observed deficits extend to motor timing and to continuous dynamic tasks that more closely match daily life activities. The current study set out to answer these questions by assessing audio motor timing abilities and their relationship with cognitive functioning in a group of TBI patients (n = 15) and healthy matched controls. We employed a comprehensive set of tasks aiming at testing timing abilities across perception and production and from single intervals to continuous auditory sequences. In line with previous research, we report functional impairments in TBI patients concerning cognitive processing speed and perceptual timing. Critically, these deficits extended to motor timing: The ability to adjust to tempo changes in an auditory pacing sequence was impaired in TBI patients, and this motor timing deficit covaried with measures of processing speed. These findings confirm previous evidence on perceptual and cognitive timing deficits resulting from TBI and provide first evidence for comparable deficits in motor behavior. This suggests basic co-occurring perceptual and motor timing impairments that may factor into a wide range of daily activities. Our results thus place TBI into the wider range of pathologies with well-documented timing deficits (such as Parkinson’s disease) and encourage the search for novel timing-based therapeutic interventions (e.g., employing dynamic and/or musical stimuli) with high transfer potential to everyday life activities.

Pitch and Rhythm Perception and Verbal Short-Term Memory in Acute Traumatic Brain Injury

Music perception deficits are common following acquired brain injury due to stroke, epilepsy surgeries, and aneurysmal clipping. Few studies have examined these deficits following traumatic brain injury (TBI), resulting in an under-diagnosis in this population. We aimed to (1) compare TBI patients to controls on pitch and rhythm perception during the acute phase; (2) determine whether pitch and rhythm perception disorders co-occur; (3) examine lateralization of injury in the context of pitch and rhythm perception; and (4) determine the relationship between verbal short-term memory (STM) and pitch and rhythm perception. Music perception was examined using the Scale and Rhythm tests of the Montreal Battery of Evaluation of Amusia, in association with CT scans to identify lesion laterality. Verbal short-term memory was examined using Digit Span Forward. TBI patients had greater impairment than controls, with 43% demonstrating deficits in pitch perception, and 40% in rhythm perception. Deficits were greater with right hemisphere damage than left. Pitch and rhythm deficits co-occurred 31% of the time, suggesting partly dissociable networks. There was a dissociation between performance on verbal STM and pitch and rhythm perception 39 to 42% of the time (respectively), with most individuals (92%) demonstrating intact verbal STM, with impaired pitch or rhythm perception. The clinical implications of music perception deficits following TBI are discussed.

Prospective and retrospective timing in mild cognitive impairment and Alzheimer's disease patients: A systematic review and meta-analysis

Performance on timing tasks changes with age. Whether these changes reflect a real "clock" problem due to aging or a secondary effect of the reduced cognitive resources of older adults is still an unsettled question. Research on processing of time in aged populations marked by severe mnemonic and/or attentional deficits, such as patients with Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI), may help elucidate the role of cognitive resources in age-related temporal distortions. To this end, we conducted a systematic review and meta-analysis of timing studies in AD and MCI patients; both prospective and retrospective timing tasks were considered and analysed separately. As concerns prospective timing, a first random-effect model showed a medium overall effect of neurodegeneration on timing performance. When considering the role of moderator variables(i.e., neurodegenerative condition, type of measure, participants' age and years of education, interval length, and type of timing task), mean score appeared to be a less sensitive measure than accuracy and variability, and the observed temporal impairment was smaller in older samples. In addition, AD patients only exhibited medium-to-high impairment on prospective timing tasks, whereas MCI patients did not significantly differ from controls. However, assuming a mean age of 70 years old and absolute error as dependent variable, a second fitted meta-regression model predicted a significant outcome also for MCI patients. Concerning retrospective timing, a significant but small effect of neurodegeneration was observed for retrospective judgments. None of the moderators, however, explained between-studies variability. Collectively, our findings highlight a clear deficit in prospective timing for AD patients and underscore several issues that future work should carefully consider to better investigate the effect of MCI on prospective temporal judgements. Results from retrospective timing also point to a possible impairment of retrospective judgments in neurodegenerative conditions, albeit more studies are needed to substantiate this finding.

Impaired cognitive modification for estimating time duration in Parkinson's disease

Parkinson's disease (PD) is associated with various cognitive impairments. However, the nature of cognitive modification in patients with PD remains to be elucidated. In the present study, we examined whether patients with PD could correct and maintain subjective time duration and line length estimation. After training sessions, in which participants repeatedly memorized either a duration or a length, we compared a learning performance in 20 PD patients with 20 healthy controls. In the case of duration in the PD patients, the learned durations immediately returned to baseline of pre-training within a few minutes. However, the patients’ ability to learn length estimation remained unimpaired. In contrast, healthy controls were able to retain the learned duration and length estimations. Time compression in PD's internal clock may become entrained to their altered duration estimation even after learning of accurate time duration. These deficits may be associated with disrupting cognitive modification in PD.

Metastable States of Multiscale Brain Networks Are Keys to Crack the Timing Problem

The dynamics of the environment where we live in and the interaction with it, predicting events, provided strong evolutionary pressures for the brain functioning to process temporal information and generate timed responses. As a result, the human brain is able to process temporal information and generate temporal patterns. Despite the clear importance of temporal processing to cognition, learning, communication and sensory, motor and emotional processing, the basal mechanisms of how animals differentiate simple intervals or provide timed responses are still under debate. The lesson we learned from the last decade of research in neuroscience is that functional and structural brain connectivity matter. Specifically, it has been accepted that the organization of the brain in interacting segregated networks enables its function. In this paper we delineate the route to a promising approach for investigating timing mechanisms. We illustrate how novel insight into timing mechanisms can come by investigating brain functioning as a multi-layer dynamical network whose clustered dynamics is bound to report the presence of metastable states. We anticipate that metastable dynamics underlie the real-time coordination necessary for the brain's dynamic functioning associated to time perception. This new point of view will help further clarifying mechanisms of neuropsychiatric disorders.

A tRNS investigation of the sensory representation of time

The understanding of the mechanisms underlying the representation of temporal intervals in the range of milliseconds/seconds remains a complex issue. Different brain areas have been identified as critical in temporal processing. The activation of specific areas is depending on temporal range involved in the tasks and on the modalities used for marking time. Here, for the first time, transcranial random noise stimulation (tRNS) was applied over the right posterior parietal (P4) and right frontal (F4) cortex to investigate their role in intra- and intermodal temporal processing involving brief temporal intervals (<1 sec). Eighty University students performed a time bisection task involving standard durations lasting 300 ms (short) and 900 ms (long). Each empty interval to be judged was marked by two successive brief visual (V) or auditory (A) signals defining four conditions: VV, VA, AV or AA. Participants were assigned to one of these four conditions. Half of the participants received tRNS over P4 and half over F4. No effect of stimulation was observed on temporal variability (Weber ratio). However, participants that were stimulated over P4 overestimated temporal intervals in the random condition compared to the sham condition. In addition to showing an effect of tRNS on perceived duration rather than on temporal variability, the results of the present study confirm that the right posterior parietal cortex is involved in the processing of time intervals and extend this finding to several sensory modality conditions.

Meta-analysis of functional magnetic resonance imaging studies of timing and cognitive control in schizophrenia and bipolar disorder: Evidence of a primary time deficit

Schizophrenia (SZ) and Bipolar Disorder (BD) are associated with deficits in both timing and cognitive control functions. However, the underlying neurological dysfunctions remain poorly understood. The main goal of this study was to identify brain structures activated both by increases in cognitive activity and during timing tasks in patients with SZ and BD relative to controls. We conducted two signed differential mapping (SDM) meta-analyses of functional magnetic resonance imaging studies assessing the brain response to increasing levels of cognitive difficulty: one concerned SZ, and the other BD patients. We conducted a similar SDM meta-analysis on neuroimaging of timing in SZ (no studies in BD could be included). Finally, we carried out a multimodal meta-analysis to identify common brain regions in the findings of the two previous meta-analyses. We found that SZ patients showed hypoactivation in timing-related cortical-subcortical areas. The dysfunction observed during timing partially coincided with deficits for cognitive control functions. We hypothesize that a dysfunctional temporal/cognitive control network underlies the persistent cognitive impairment observed in SZ.

Time perception of simultaneous and sequential events in early-onset schizophrenia

Timing disorders in schizophrenia are a well-known phenomenon. However, no studies have yet assessed the role of temporal distortions in early-onset schizophrenia (EOS), despite evidence that distorted time perception may share genetic risk factors with schizophrenia and may be a useful indicator in identifying individuals at risk for schizophrenia. In the present study, we investigated the ability of 10 patients with EOS (mean age = 21.5 years, SD = 6) matched with 20 healthy control participants (mean age = 25.3 years, SD = 4.6) in order to compare the durations of two visual events, presented either sequentially or overlapping in time, along with neuropsychological assessments of attention, working memory, and executive functions. Each participant had to judge a total of 336 stimuli. We found that temporal overlap had a greater negative effect on ability to judge the duration of a pair of stimuli in EOS patients than in healthy control participants. In addition, EOS patients showed impairments in attention and executive functions. Furthermore, in EOS patients, the scores for executive and attentional functions were significantly correlated with accuracy of temporal estimation in the overlap condition (r = 0.31, p < 0.05 and r = 0.57, p < 0.05, respectively). These preliminary results suggest that impairments in neuropsychological functions participate in the deficit in time estimation observed in patients with EOS. These conclusions highlight the importance of testing time perception in patients with EOS and could contribute to the development of cognitive remediation-based therapy for these patients.

Cognitive Aging and Time Perception: Roles of Bayesian Optimization and Degeneracy

This review outlines the basic psychological and neurobiological processes associated with age-related distortions in timing and time perception in the hundredths of milliseconds-to-minutes range. The difficulty in separating indirect effects of impairments in attention and memory from direct effects on timing mechanisms is addressed. The main premise is that normal aging is commonly associated with increased noise and temporal uncertainty as a result of impairments in attention and memory as well as the possible reduction in the accuracy and precision of a central timing mechanism supported by dopamine-glutamate interactions in cortico-striatal circuits. Pertinent to these findings, potential interventions that may reduce the likelihood of observing age-related declines in timing are discussed. Bayesian optimization models are able to account for the adaptive changes observed in time perception by assuming that older adults are more likely to base their temporal judgments on statistical inferences derived from multiple trials than on a single trial's clock reading, which is more susceptible to distortion. We propose that the timing functions assigned to the age-sensitive fronto-striatal network can be subserved by other neural networks typically associated with finely-tuned perceptuo-motor adjustments, through degeneracy principles (different structures serving a common function).

Dysfunctional counting of mental time in Parkinson's disease

Patients with Parkinson’s disease (PD) often underestimate time intervals, however it remains unclear why they underestimate rather than overestimate them. The current study examined time underestimation and counting in patients with PD, in relation to dopamine transporter (DaT) located on presynaptic nerve endings in the striatum. Nineteen non-dementia patients with PD and 20 age- and sex-matched healthy controls performed two time estimation tasks to produce or reproduce time intervals with counting in the head, to examine dysfunctional time counting processing. They also performed tapping tasks to measure cycles of counting with 1 s interval with time estimation. Compared to controls, patients underestimated time intervals above 10 s on time production not reproduction tasks, and the underestimation correlated with fast counting on the tapping task. Furthermore, striatal DaT protein levels strongly correlated with underestimation of time intervals. These findings suggest that distortion of time intervals is guided by cumulative output of fast cycle counting and that this is linked with striatal DaT protein deficit.

Meta-Analysis of Functional Neuroimaging and Cognitive Control Studies in Schizophrenia: Preliminary Elucidation of a Core Dysfunctional Timing Network

Timing and other cognitive processes demanding cognitive control become interlinked when there is an increase in the level of difficulty or effort required. Both functions are interrelated and share neuroanatomical bases. A previous meta-analysis of neuroimaging studies found that people with schizophrenia had significantly lower activation, relative to normal controls, of most right hemisphere regions of the time circuit. This finding suggests that a pattern of disconnectivity of this circuit, particularly in the supplementary motor area, is a trait of this mental disease. We hypothesize that a dysfunctional temporal/cognitive control network underlies both cognitive and psychiatric symptoms of schizophrenia and that timing dysfunction is at the root of the cognitive deficits observed. The goal of our study was to look, in schizophrenia patients, for brain structures activated both by execution of cognitive tasks requiring increased effort and by performance of time perception tasks. We conducted a signed differential mapping (SDM) meta-analysis of functional neuroimaging studies in schizophrenia patients assessing the brain response to increasing levels of cognitive difficulty. Then, we performed a multimodal meta-analysis to identify common brain regions in the findings of that SDM meta-analysis and our previously-published activation likelihood estimate (ALE) meta-analysis of neuroimaging of time perception in schizophrenia patients. The current study supports the hypothesis that there exists an overlap between neural structures engaged by both timing tasks and non-temporal cognitive tasks of escalating difficulty in schizophrenia. The implication is that a deficit in timing can be considered as a trait marker of the schizophrenia cognitive profile.

Interval discrimination across different duration ranges with a look at spatial compatibility and context effects

In the present study, a time discrimination task was used to investigate the effect of different contexts for intervals varying from 400 to 1600 ms. A potential time-space interaction was controlled, and participants used both manual responses (Experiments 1 and 2) and vocal responses (Experiment 3). Three ranges of durations were employed (short, middle and long), and within each range condition, three standard values were used (400, 700, and 1000 ms; 700, 1000, and 1300 ms; and 1000, 1300, and 1600 ms). Within each range, standard intervals were randomized (Experiments 1 and 3) or remained constant (Experiment 2) within a block of trials. Our results suggest that context influences time discrimination performances only when the temporal range under investigation is below 1300 ms and the temporal intervals varied within blocks. In the case of temporal intervals longer than 1300 ms, participants presented a tendency to respond “long” independently of the procedure used. Moreover, our results suggested that performances in a discrimination task are mainly influenced by the fact of varying standard durations within blocks, and not much by the time-space compatibility.

Ovarian cycle effects on immediate reward selection bias in humans: a role for estradiol

A variety of evidence suggests that, among humans, the individual tendency to choose immediate rewards ("Now") over larger, delayed rewards ("Later"), or Now bias, varies with frontal dopamine (DA) levels. As cyclic elevations in estradiol (E+) modulate other frontal DA-dependent behaviors, we tested ovarian cycle effects on Now bias, and whether any such effects are E+ mediated. To do so, we quantified Now/Later choice behavior in naturally cycling adult females (n = 87; ages 18-40 years) during both the menstrual phase (MP; cycle day 1-2; low E+), and the follicular phase (FP; cycle day 11-12; high E+). Now bias decreased an average of 3.6% from MP to FP (p = 0.006). Measures of salivary E+ levels at each visit were available in a subsample of participants (n = 34). Participants with a verified E+ rise from MP to FP showed significantly greater decreases in Now bias at mid-cycle (n = 23) than those without a rise (n = 11; p = 0.03); Now bias decreased an average of 10.2% in the E+ rise group but increased an average of 7.9% in the no E+ rise group. The change in Now bias from MP to FP inversely correlated with the change in E+ (ρ = -0.39; p = 0.023), an effect driven by individuals with putatively lower frontal DA based on genotype at the Val(158)Met polymorphism in the COMT gene. This is the first demonstration that intertemporal choice varies across the ovarian cycle, with Now bias declining at mid-cycle, when fertility peaks. Moreover, our data suggest that the interacting effects of estradiol and frontal DA mediate this cycle effect on decision making.