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Benjamin L, Sablé-Meyer M, Fló A, Dehaene-Lambertz G, Al Roumi F. Long-Horizon Associative Learning Explains Human Sensitivity to Statistical and Network Structures in Auditory Sequences. J Neurosci 2024; 44:e1369232024. [PMID: 38408873 PMCID: PMC10993028 DOI: 10.1523/jneurosci.1369-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 01/16/2024] [Accepted: 02/07/2024] [Indexed: 02/28/2024] Open
Abstract
Networks are a useful mathematical tool for capturing the complexity of the world. In a previous behavioral study, we showed that human adults were sensitive to the high-level network structure underlying auditory sequences, even when presented with incomplete information. Their performance was best explained by a mathematical model compatible with associative learning principles, based on the integration of the transition probabilities between adjacent and nonadjacent elements with a memory decay. In the present study, we explored the neural correlates of this hypothesis via magnetoencephalography (MEG). Participants (N = 23, 16 females) passively listened to sequences of tones organized in a sparse community network structure comprising two communities. An early difference (∼150 ms) was observed in the brain responses to tone transitions with similar transition probability but occurring either within or between communities. This result implies a rapid and automatic encoding of the sequence structure. Using time-resolved decoding, we estimated the duration and overlap of the representation of each tone. The decoding performance exhibited exponential decay, resulting in a significant overlap between the representations of successive tones. Based on this extended decay profile, we estimated a long-horizon associative learning novelty index for each transition and found a correlation of this measure with the MEG signal. Overall, our study sheds light on the neural mechanisms underlying human sensitivity to network structures and highlights the potential role of Hebbian-like mechanisms in supporting learning at various temporal scales.
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Affiliation(s)
- Lucas Benjamin
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, 91190 Gif/Yvette, France
| | - Mathias Sablé-Meyer
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, 91190 Gif/Yvette, France
- Sainsbury Wellcome Centre for Neural Circuits and Behaviour, University College London, London W1T 4JG, United Kingdom
| | - Ana Fló
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, 91190 Gif/Yvette, France
- Department of Developmental Psychology and Socialization, University of Padova, Padova 35131, Italy
| | - Ghislaine Dehaene-Lambertz
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, 91190 Gif/Yvette, France
| | - Fosca Al Roumi
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, 91190 Gif/Yvette, France
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Benjamin L, Fló A, Palu M, Naik S, Melloni L, Dehaene-Lambertz G. Tracking transitional probabilities and segmenting auditory sequences are dissociable processes in adults and neonates. Dev Sci 2023; 26:e13300. [PMID: 35772033 DOI: 10.1111/desc.13300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/31/2022] [Accepted: 06/11/2022] [Indexed: 11/27/2022]
Abstract
Since speech is a continuous stream with no systematic boundaries between words, how do pre-verbal infants manage to discover words? A proposed solution is that they might use the transitional probability between adjacent syllables, which drops at word boundaries. Here, we tested the limits of this mechanism by increasing the size of the word-unit to four syllables, and its automaticity by testing asleep neonates. Using markers of statistical learning in neonates' EEG, compared to adult behavioral performances in the same task, we confirmed that statistical learning is automatic enough to be efficient even in sleeping neonates. We also revealed that: (1) Successfully tracking transition probabilities (TP) in a sequence is not sufficient to segment it. (2) Prosodic cues, as subtle as subliminal pauses, enable to recover words segmenting capacities. (3) Adults' and neonates' capacities to segment streams seem remarkably similar despite the difference of maturation and expertise. Finally, we observed that learning increased the overall similarity of neural responses across infants during exposure to the stream, providing a novel neural marker to monitor learning. Thus, from birth, infants are equipped with adult-like tools, allowing them to extract small coherent word-like units from auditory streams, based on the combination of statistical analyses and auditory parsing cues. RESEARCH HIGHLIGHTS: Successfully tracking transitional probabilities in a sequence is not always sufficient to segment it. Word segmentation solely based on transitional probability is limited to bi- or tri-syllabic elements. Prosodic cues, as subtle as subliminal pauses, enable to recover chunking capacities in sleeping neonates and awake adults for quadriplets.
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Affiliation(s)
- Lucas Benjamin
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, Gif-sur-Yvette, Île-de-France, France
| | - Ana Fló
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, Gif-sur-Yvette, Île-de-France, France
| | - Marie Palu
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, Gif-sur-Yvette, Île-de-France, France
| | - Shruti Naik
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, Gif-sur-Yvette, Île-de-France, France
| | - Lucia Melloni
- Department of Neuroscience, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Hessen, Germany.,Department of Neurology, NYU Grossman School of Medicine, New York City, New York, USA
| | - Ghislaine Dehaene-Lambertz
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, Gif-sur-Yvette, Île-de-France, France
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Kabdebon C, Fló A, de Heering A, Aslin R. The power of rhythms: how steady-state evoked responses reveal early neurocognitive development. Neuroimage 2022; 254:119150. [PMID: 35351649 PMCID: PMC9294992 DOI: 10.1016/j.neuroimage.2022.119150] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 12/17/2022] Open
Abstract
Electroencephalography (EEG) is a non-invasive and painless recording of cerebral activity, particularly well-suited for studying young infants, allowing the inspection of cerebral responses in a constellation of different ways. Of particular interest for developmental cognitive neuroscientists is the use of rhythmic stimulation, and the analysis of steady-state evoked potentials (SS-EPs) - an approach also known as frequency tagging. In this paper we rely on the existing SS-EP early developmental literature to illustrate the important advantages of SS-EPs for studying the developing brain. We argue that (1) the technique is both objective and predictive: the response is expected at the stimulation frequency (and/or higher harmonics), (2) its high spectral specificity makes the computed responses particularly robust to artifacts, and (3) the technique allows for short and efficient recordings, compatible with infants' limited attentional spans. We additionally provide an overview of some recent inspiring use of the SS-EP technique in adult research, in order to argue that (4) the SS-EP approach can be implemented creatively to target a wide range of cognitive and neural processes. For all these reasons, we expect SS-EPs to play an increasing role in the understanding of early cognitive processes. Finally, we provide practical guidelines for implementing and analyzing SS-EP studies.
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Affiliation(s)
- Claire Kabdebon
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'études cognitives, ENS, EHESS, CNRS, PSL University, Paris, France; Haskins Laboratories, New Haven, CT, USA.
| | - Ana Fló
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, Gif/Yvette, France
| | - Adélaïde de Heering
- Center for Research in Cognition & Neuroscience (CRCN), Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Richard Aslin
- Haskins Laboratories, New Haven, CT, USA; Department of Psychology, Yale University, New Haven, CT, USA
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Fló A, Gennari G, Benjamin L, Dehaene-Lambertz G. Automated Pipeline for Infants Continuous EEG (APICE): a flexible pipeline for developmental cognitive studies. Dev Cogn Neurosci 2022; 54:101077. [PMID: 35093730 PMCID: PMC8804179 DOI: 10.1016/j.dcn.2022.101077] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 01/01/2023] Open
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Benjamin L, Dehaene-Lambertz G, Fló A. Remarks on the analysis of steady-state responses: Spurious artifacts introduced by overlapping epochs. Cortex 2021; 142:370-378. [PMID: 34311971 DOI: 10.1016/j.cortex.2021.05.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/10/2021] [Accepted: 05/10/2021] [Indexed: 01/23/2023]
Abstract
Periodic and stable sensory input can result in rhythmic and stable neural responses, a phenomenon commonly referred to as neural entrainment. Although the use of neural entrainment to investigate the regularities the brain tracks has increased in recent years, the methods used for its quantification are not well-defined in the literature. Here we argue that some strategies used in previous papers, are inadequate for the study of steady-state response, and lead to methodological artefacts. The aim of this commentary is to discuss these articles and to propose alternative measures of neural entrainment. Specifically, we applied four possible alternatives and two epoching approaches reported in the literature to quantify neural entrainment on simulated datasets. Our results demonstrate that overlapping epochs, as used in the original Batterink and colleagues articles, inevitably lead to a methodological artefact at the frequency corresponding to the overlap. We therefore strongly discourage this approach and encourage the re-analysis of data based on overlapping epochs. Additionally, we argue that the use of time-frequency decomposition to compute phase coherence at low frequencies to reveal neural entrainment is not optimal.
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Affiliation(s)
- Lucas Benjamin
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, Gif/Yvette, France
| | - Ghislaine Dehaene-Lambertz
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, Gif/Yvette, France
| | - Ana Fló
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, Gif/Yvette, France.
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Fló A. Evidence of ordinal position encoding of sequences extracted from continuous speech. Cognition 2021; 213:104646. [PMID: 33707004 DOI: 10.1016/j.cognition.2021.104646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/11/2020] [Accepted: 02/23/2021] [Indexed: 10/22/2022]
Abstract
Infants' capacity to extract statistical regularities from sequential information is impressive and well documented. However, statistical learning's underlying mechanism remains mostly unknown, and its role in language acquisition is still under debate. To shed light on these issues, here we address the question of which information human subjects extract and encode after familiarisation with a continuous sequence of stimuli and its dependence on the type of segmentation cues and on the stimuli modality. Specifically, we investigate whether adults and 5-month-old infants learn the syllables' co-occurrence in the stream or generate a representation of the Words that include syllables' ordinal position. We test if subtle pauses signalling word boundaries change the encoding and, in adults, if it varies across modalities. In six behavioural experiments, we show that: (i) Adults and infants learn the streams' statistical structure. (ii) Ordinal encoding emerges in the auditory modality, and pauses enhanced it. However, (iii) ordinal encoding seems to depend on the learning stage and not on pauses marking Words' edges. Interestingly, (iv) for visual presentation of orthographic syllables, we do not find evidence of ordinal encoding in adults. Our results support the emergence, in the auditory modality, of a Word representation where its constituents are associated with an ordinal position at play already early in life, bringing new insights into speech processing and language acquisition. Additionally, we successfully use for the first time pupillometry in an infant segmentation task.
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Affiliation(s)
- Ana Fló
- Language, Cognition, and Development Laboratory, Scuola Internazionale di Studi Avanzati, Trieste, Italy; Cognitive Neuroimaging Unit, Institut National de la Santé et de la Recherche Médicale, Commissariat à l'Energie Atomique et aux énergies alternatives, Université Paris-Saclay, NeuroSpin Center, 91191 Gif/Yvette, France.
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Fló A, Brusini P, Macagno F, Nespor M, Mehler J, Ferry AL. Newborns are sensitive to multiple cues for word segmentation in continuous speech. Dev Sci 2019; 22:e12802. [PMID: 30681763 DOI: 10.1111/desc.12802] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 11/30/2022]
Abstract
Before infants can learn words, they must identify those words in continuous speech. Yet, the speech signal lacks obvious boundary markers, which poses a potential problem for language acquisition (Swingley, Philos Trans R Soc Lond. Series B, Biol Sci 364(1536), 3617-3632, 2009). By the middle of the first year, infants seem to have solved this problem (Bergelson & Swingley, Proc Natl Acad Sci 109(9), 3253-3258, 2012; Jusczyk & Aslin, Cogn Psychol 29, 1-23, 1995), but it is unknown if segmentation abilities are present from birth, or if they only emerge after sufficient language exposure and/or brain maturation. Here, in two independent experiments, we looked at two cues known to be crucial for the segmentation of human speech: the computation of statistical co-occurrences between syllables and the use of the language's prosody. After a brief familiarization of about 3 min with continuous speech, using functional near-infrared spectroscopy, neonates showed differential brain responses on a recognition test to words that violated either the statistical (Experiment 1) or prosodic (Experiment 2) boundaries of the familiarization, compared to words that conformed to those boundaries. Importantly, word recognition in Experiment 2 occurred even in the absence of prosodic information at test, meaning that newborns encoded the phonological content independently of its prosody. These data indicate that humans are born with operational language processing and memory capacities and can use at least two types of cues to segment otherwise continuous speech, a key first step in language acquisition.
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Affiliation(s)
- Ana Fló
- Language, Cognition, and Development Laboratory, Scuola Internazionale di Studi Avanzati, Trieste, Italy.,Cognitive Neuroimaging Unit, Commissariat à l'Energie Atomique (CEA), Institut National de la Santé et de la Recherche Médicale (INSERM) U992, NeuroSpin Center, Gif-sur-Yvette, France
| | - Perrine Brusini
- Language, Cognition, and Development Laboratory, Scuola Internazionale di Studi Avanzati, Trieste, Italy.,Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - Francesco Macagno
- Neonatology Unit, Azienda Ospedaliera Santa Maria della Misericordia, Udine, Italy
| | - Marina Nespor
- Language, Cognition, and Development Laboratory, Scuola Internazionale di Studi Avanzati, Trieste, Italy
| | - Jacques Mehler
- Language, Cognition, and Development Laboratory, Scuola Internazionale di Studi Avanzati, Trieste, Italy
| | - Alissa L Ferry
- Language, Cognition, and Development Laboratory, Scuola Internazionale di Studi Avanzati, Trieste, Italy.,Division of Human Communication, Hearing, and Development, University of Manchester, Manchester, UK
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Spinelli L, Zucchelli L, Contini D, Caffini M, Mehler J, Fló A, Ferry AL, Filippin L, Macagno F, Cattarossi L, Torricelli A. In vivo measure of neonate brain optical properties and hemodynamic parameters by time-domain near-infrared spectroscopy. Neurophotonics 2017; 4:041414. [PMID: 28840165 PMCID: PMC5561670 DOI: 10.1117/1.nph.4.4.041414] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/11/2017] [Indexed: 05/20/2023]
Abstract
By exploiting a multichannel portable instrument for time-domain near-infrared spectroscopy (TD-NIRS), we characterized healthy neonates' brains in term of optical properties and hemodynamic parameters. In particular, we assessed the absolute values of the absorption and reduced scattering coefficients at two wavelengths, together with oxy-, deoxy- and total hemoglobin concentrations, and the blood oxygen saturation of the neonates' brains. In this study, 33 healthy full-term neonates were tested, obtaining the following median values: 0.28 and [Formula: see text] for [Formula: see text] at 690 and 820 nm, respectively; 5.8 and [Formula: see text] for [Formula: see text] at 690 and 820 nm, respectively; [Formula: see text] for [Formula: see text]; [Formula: see text] for [Formula: see text]; [Formula: see text] for [Formula: see text]; 72% for [Formula: see text]. In general, the agreement of these values with the sparse existing literature appears not always consistent. These findings demonstrate the first measurements of optical properties of the healthy neonate brain using TD-NIRS and show the need for clarification of optical properties across methods and populations.
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Affiliation(s)
- Lorenzo Spinelli
- CNR, Istituto di Fotonica e Nanotecnologie, Milano, Italy
- Address all correspondence to: Lorenzo Spinelli, E-mail:
| | - Lucia Zucchelli
- Politecnico di Milano, Dipartimento di Fisica, Milano, Italy
| | - Davide Contini
- Politecnico di Milano, Dipartimento di Fisica, Milano, Italy
| | - Matteo Caffini
- Politecnico di Milano, Dipartimento di Fisica, Milano, Italy
| | - Jacques Mehler
- SISSA, Language, Cognition, and Development Laboratory, Trieste, Italy
| | - Ana Fló
- SISSA, Language, Cognition, and Development Laboratory, Trieste, Italy
| | - Alissa L. Ferry
- SISSA, Language, Cognition, and Development Laboratory, Trieste, Italy
| | - Luca Filippin
- SISSA, Language, Cognition, and Development Laboratory, Trieste, Italy
- CNRS-EHESS-ENS, Laboratoire de Sciences Cognitives et Psycholinguistique, Paris, France
| | - Francesco Macagno
- Presidio Ospedaliero Universitario “Santa Maria della Misericordia,” Neonatology Unit, Udine, Italy
| | - Luigi Cattarossi
- Presidio Ospedaliero Universitario “Santa Maria della Misericordia,” Neonatology Unit, Udine, Italy
| | - Alessandro Torricelli
- CNR, Istituto di Fotonica e Nanotecnologie, Milano, Italy
- Politecnico di Milano, Dipartimento di Fisica, Milano, Italy
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Affiliation(s)
- Jean-Rémy Hochmann
- CNRS-Institut des Sciences Cognitives -Marc Jeannerod-UMR 5304; Univ Lyon
| | | | - Ana Fló
- Cognitive Neuroscience Department; SISSA, International School for Advanced Studies
| | - Marina Nespor
- Cognitive Neuroscience Department; SISSA, International School for Advanced Studies
| | - Jacques Mehler
- Cognitive Neuroscience Department; SISSA, International School for Advanced Studies
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Ferry AL, Fló A, Brusini P, Cattarossi L, Macagno F, Nespor M, Mehler J. On the edge of language acquisition: inherent constraints on encoding multisyllabic sequences in the neonate brain. Dev Sci 2015; 19:488-503. [DOI: 10.1111/desc.12323] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 04/11/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Alissa L. Ferry
- Language, Cognition, and Development Laboratory; Scuola Internazional Superiore di Studi Avanzati; Trieste Italy
| | - Ana Fló
- Language, Cognition, and Development Laboratory; Scuola Internazional Superiore di Studi Avanzati; Trieste Italy
| | - Perrine Brusini
- Language, Cognition, and Development Laboratory; Scuola Internazional Superiore di Studi Avanzati; Trieste Italy
| | - Luigi Cattarossi
- Neonatology Unit; Azienda Ospedaliera Santa Maria della Misericordia; Udine Italy
| | - Francesco Macagno
- Neonatology Unit; Azienda Ospedaliera Santa Maria della Misericordia; Udine Italy
| | - Marina Nespor
- Language, Cognition, and Development Laboratory; Scuola Internazional Superiore di Studi Avanzati; Trieste Italy
| | - Jacques Mehler
- Language, Cognition, and Development Laboratory; Scuola Internazional Superiore di Studi Avanzati; Trieste Italy
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Villalta JI, Landi SM, Fló A, Della-Maggiore V. Extinction interferes with the retrieval of visuomotor memories through a mechanism involving the sensorimotor cortex. Cereb Cortex 2013; 25:1535-43. [PMID: 24363266 DOI: 10.1093/cercor/bht346] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Savings is a fundamental property of learning. In motor adaptation, it refers to the improvement in learning observed when adaptation to a perturbation A (A1) is followed by re-adaptation to the same perturbation (A2). A common procedure to equate the initial level of error across sessions consists of restoring native sensorimotor coordinates by inserting null--unperturbed--trials (N) just before re-adaptation (washout). Here, we hypothesized that the washout is not innocuous but interferes with the expression of the new memory at recall. To assess this possibility, we measured savings following the A1NA2 protocol, where A was a 40° visual rotation. In Experiment 1, we increased the time window between N and A2 from 1 min to 24 h. This manipulation increased the amount of savings during middle to late phases of adaptation, suggesting that N interfered with the retrieval of A. In Experiment 2, we used repetitive TMS to evaluate if this interference was partly mediated by the sensorimotor cortex (SM). We conclude that the washout does not just restore the unperturbed sensorimotor coordinates, but inhibits the expression of the recently acquired visuomotor map through a mechanism involving SM. Our results resemble the phenomenon of extinction in classical conditioning.
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Affiliation(s)
- Jorge I Villalta
- Department of Physiology and Biophysics, School of Medicine, University of Buenos Aires, C1121ABG Buenos Aires, Argentina
| | - Sofia M Landi
- Department of Physiology and Biophysics, School of Medicine, University of Buenos Aires, C1121ABG Buenos Aires, Argentina
| | - Ana Fló
- Department of Physiology and Biophysics, School of Medicine, University of Buenos Aires, C1121ABG Buenos Aires, Argentina
| | - Valeria Della-Maggiore
- Department of Physiology and Biophysics, School of Medicine, University of Buenos Aires, C1121ABG Buenos Aires, Argentina
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Basora M, Fita G, Panigua P, Litvan H, Fló A, Reverter JC. [Survey of perioperative hemostasis and transfusion management in cardiac surgery: how do anesthesiologists practice?]. Rev Esp Anestesiol Reanim 2010; 57:3-10. [PMID: 20196517 DOI: 10.1016/s0034-9356(10)70156-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To determine practices related to control of perioperative hemostasis and transfusion in patients undergoing cardiac surgery in Spain, including the extent to which protocols are being used. METHODS A questionnaire was created to collect information from physicians in anesthesiology and postoperative recovery care between July 1 and September 20, 2007. The physicians were asked about practice in the 12 months prior to the survey. RESULTS Thirty-four hospitals responded. Seventy percent reported that they did not have protocols or guidelines for the control of hemostasis during cardiac surgery. Forty-four percent did not have information on the proportion of patients who received transfusions; 47% gave transfusions to 75% of patients. The standard preoperative tests were platelet counts, activated partial thromboplastin time, and prothrombin time. Acetylsalicylic acid and clopidogrel were suspended before surgery at 15 (44%) and 25 (73%) hospitals, respectively. In cases of resistance to heparin, additional doses of the drug were injected, in combination with plasma or antithrombin in 29% and 12% of the hospitals, respectively. In the intensive postoperative recovery care unit, only 1 hospital used thromboelastography. Only 1 other hospital used a platelet function analyzer. CONCLUSIONS Hemostasis, perioperative coagulation, and criteria for transfusion vary widely among the hospitals surveyed. Few guidelines are available and they are not often being followed. A high percentage of patients receive transfusions, although not all hospitals can cite a figure. New technology has not been widely applied.
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Affiliation(s)
- M Basora
- Servicio de Anestesiología y Reanimación, Hospital Clínic, Barcelona.
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