The psychophysiology of "covert" goal-directed behavior

Covert behavior is defined as behavior that is not directly visible and is thus comparable to a type of behavioral silence that requires modern psychophysiological techniques to reveal. Goal-directed behavior is teleologically purposive. Fundamentally, there are two approaches to accounting for purposeful behavior. One is the cybernetic approach, which views behavior as homeostatic and largely reflexive. The other one views behavior as a cognitive process that involves an interaction between neural events representing the previous experience, the present state of the individual, and the occurrence of particular features in the environment. This review, based on published data, presents a non-invasive psychophysiological method for investigating the electrical brain activity associated with those "silent" behaviors such as intention, evaluation of results, and memorization. Movement-related potentials (MRPs) are ideal for studying these processes. The MRPs are recorded during the execution of the skilled performance task (SPT). This task requires the execution of fast ballistic movements with the thumbs of both hands, learning a precise and short time interval between the two thumb presses, and scoring the highest number of target performances. The subject receives real-time feedback about the results of his performance. The MRPs associated with this task and present during covert behavior are the Bereitschaftspotential (BP) present before the onset of movement and the Skilled Performance Positivity (SPP) after movement, which coincides with the subject's awareness of the success or failure of his performance. These potentials show a maturational trend, reaching the adult form around the age of 10 when formal and abstract thinking progress. SPT and MRPs are particularly suitable to study neurodevelopmental disorders. Children with developmental dyslexia show abnormal MRPs, both in latency and amplitude, in different brain areas.

Predictors and moderators of outcome of psychotherapeutic interventions for mental disorders in adolescents and young adults: protocol for systematic reviews

BACKGROUND

Adolescence and young adulthood is a risk period for the emergence of mental disorders. There is strong evidence that psychotherapeutic interventions are effective for most mental disorders. However, very little is known about which of the different psychotherapeutic treatment modalities are effective for whom. This large systematic review aims to address this critical gap within the literature on non-specific predictors and moderators of the outcomes of psychotherapeutic interventions among adolescents and young adults with mental disorders.

METHODS

The protocol is being reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) Statement. PubMed and PsycINFO databases will be searched for randomized controlled and quasi-experimental/naturalistic clinical trials. Risk of bias of all included studies will be assessed by the Mixed Methods Appraisal Tool. The quality of predictor and moderator variables will be also assessed. A narrative synthesis will be conducted for all included studies.

DISCUSSION

This systematic review will strengthen the evidence base on effective mental health interventions for young people, being the first to explore predictors and moderators of outcome of psychotherapeutic interventions for a wide range of mental disorders in young people.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020166756 .

Intermediate lengths of the C9ORF72 hexanucleotide repeat expansion may synergistically contribute to attention deficit hyperactivity disorder in child and his father: case report

We have summarized the abstract section as follows: "We report a son and his father affected by Attention Deficit Hyperactivity Disorder (ADHD). They belonged to a larger cohort (116 ADHD children, 20 related parents, 77 controls) wholly genotyped forC9ORF72 expansion. Ten ADHD susceptibility genes were further investigated in the family. We revealed that son and father shared an intermediateC9ORF72 expansion and common variants inCDH23, ITGAE and MTRR. Bioinformatics highlighted aC9ORF72-MTRR interaction. This case-report underlines that in relatives with ADHD, carrying variants in ADHD susceptibility genes, the intermediateC9ORF72 repeats might have a potentially pathogenetic synergistic effect, supporting the multifactorial polygenic aetiopathogenetic profile of disease".

Quantitative EEG in Childhood Attention Deficit Hyperactivity Disorder and Learning Disabilities

The clinical use of the quantitative EEG (QEEG) from the pioneering work of John has received a new impetus thanks to new neuroimaging techniques and the possibility of using a number of normative databases both of normal subjects and of subjects with definite pathologies. In this direction, the term personalized medicine is becoming more and more common, a medical procedure that separates patients into different groups based on their predicted response to the quantitative EEG. This has allowed the study of single subjects and to customize health care, with decisions and treatments tailored to each individual patient, as well as improvement of knowledge of the pathophysiological mechanisms of specific diseases. This review article will present the most recent evidence in the field of developmental neuropsychiatric disorders obtained from the application of quantitative EEG both in clinical group studies (attention deficit hyperactivity disorder, developmental dyslexia, oppositional defiant disorder) and in individual case studies not yet published.

Goal directed behavior and dyslexia

Goal directed behavior is explained by two approaches: the first, which can be named as cybertetic (behavior is wieved as homeostatic and reflexive), and second, as cognitive approach, a learned response, (skills developed by whaching the behavior of another individual). The aim of the paper is to present a noninvasive method described as an interaction of human beings with environment, recording the electrical activity of the brain from the human scalp. Obtained results are in agreement of psychological theories that place at determined levels of age the acquisition of the capacities of abstract thinking and with the functional neuroanatomic studies according to which biological maturation is necessary for learning processes to develop. An acquired level of learning is in close relationship with the maturation level of the cerebral structures.

The quantified EEG characteristics of responders and non-responders to long-term treatment with atomoxetine in children with attention deficit hyperactivity disorders

OBJECTIVE

The aim of our study is to examine quantitative Electroencephalogram (QEEG) differences between ADHD patients that are responders and non-responders to long-term treatment with Atomoxetine at baseline and after 6 and 12months of treatment. Patients with attention deficit hyperactivity disorder (ADHD) received atomoxetine titrated, over 7days, from 0.5 to 1.2mg/kg/day. QEEG and Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV) scores were recorded before treatment and after therapy.

METHODS

Twenty minutes of eyes closed resting EEG was recorded from 19 electrodes referenced to linked earlobes. Full frequency and narrow band spectra of two minutes of artifact-free EEG were computed as well as source localization using Variable Resolution Electrical Tomography (VARETA). Abnormalities were identified using Z-spectra relative to normative values.

RESULTS

Patients were classified as responders, non-responders and partial responders based upon the SNAP-IV findings. At baseline, the responders showed increased absolute power in alpha and delta in frontal and temporal regions, whereas, non-responders showed increased absolute power in all frequency bands that was widely distributed. With treatment responders' absolute power values moved toward normal values, whereas, non-responders remained at baseline values.

CONCLUSIONS

Patients with increased power in the alpha band with no evidence of alterations in the beta or theta range, might be responders to treatment with atomoxetine. Increased power in the beta band coupled with increased alpha seems to be related to non-responders and one should consider atomoxetine withdrawal, especially if there is persistence of increased alpha and beta accompanied by an increase of theta.

Spatiotemporal dynamics of single-letter reading: a combined ERP-FMRI study

This work investigates the neural correlates of single-letter reading by combining event-related potentials (ERPs) and functional magnetic resonance imaging (fMRI), thus exploiting their complementary spatiotemporal resolutions. Three externally-paced reading tasks were administered with an event-related design: passive observation of letters and symbols and active reading aloud of letters. ERP and fMRI data were separately recorded from 8 healthy adults during the same experimental conditions. Due to the presence of artifacts in the EEG signals, two subjects were discarded from further analysis. Independent Component Analysis was applied to ERPs, after dimensionality reduction by Principal Component Analysis: some independent components were clearly related to specific reading functions and the associated current density distributions in the brain were estimated with Low Resolution Electromagnetic Tomography Analysis method (LORETA). The impulse hemodynamic response function was modeled as a linear combination of linear B-spline functions and fMRI statistical analysis was performed by multiple linear regression. fMRI and LORETA maps were superimposed in order to identify the overlapping activations and the activated regions specifically revealed by each modality. The results showed the existence of neuronal networks functionally specific for letter processing and for explicit verbal-motor articulation, including the temporo-parietal and frontal regions. Overlap between fMRI and LORETA results was observed in the inferior temporal-middle occipital gyrus, suggesting that this area has a crucial and multifunctional role for linguistic and reading processes, likely because its spatial location and strong interconnection with the main visual and auditory sensory systems may have favored its specialization in grapheme-phoneme matching.

[Multiple sclerosis and acute disseminated encephalomyelitis in children: a difficult diagnostic differentiation. Report of a young boy with early onset of the disease]

We report the case of an eight year old boy who developed suddenly acute left-sided hemiparesis syndrome. Brain magnetic resonance imaging (MRI) showed multiple white matter lesions. Therefore we considered in the differential diagnosis multiple sclerosis (MS) and acute disseminated encephalomyelitis (ADEM). The patient received intravenous immunoglobulin (IVIG), 1 g/kg/d over 2 days with complete regression of clinical symptoms. No relapses occurred within six months, although brain magnetic resonance imaging studies found new white matter lesions, suggesting multiple sclerosis with very early onset.

Analysis of single trial movement-related brain macropotential

A parametric method of identification of movement-related brain macropotentials on a single trial basis through an ARX (autoregressive with exogenous inputs) algorithm is presented. The basic estimation of the information contained in the single trial is taken from an average carried out on a sufficient number of trials, while the noise sources, EEG and EOG are characterized as exogenous inputs in the model. The simulations as well as the experimental results confirm the capability of the model to drastically improve the signal/noise ratio in each single trial and to satisfactorily identify the contributions of signal and noise in the overall recording. This way, using the same algorithm, a particularly efficient reduction of ocular artifacts is also achieved. The movement-related brain macropotentials recorded in three subjects show a high degree of variability from trial and this effect seems to be related to programming processes and evaluation of errors.

Movement-related brain macropotentials of persons with Down syndrome during skilled performance

Motor performances and movement-related brain macropotentials of nine 23-year-old males with Down syndrome whose mean MA was 10.2 years were compared to those of two control groups whose members were matched to the experimental subjects on CA or MA. A self-paced, voluntary, goal-directed task, which consisted of calculating a time interval of 40 to 60 msec by pressing two buttons, was employed. Subjects with Down syndrome had great difficulty in organizing and timing a correct temporal sequence of ballistic movements. They were much slower, less accurate, and achieved a smaller number of target performances. These behavioral patterns were associated with movement-related brain macropotentials altered in amplitude and latency. The potentials related to programming movements and processing reafferent sensory information were absent, and those involved in the evaluation of the outcome of the performance were reduced.

Developmental course of brain-stem auditory evoked potentials in the first days of full term infants

Modifications of brain-stem acoustic evoked potentials (BAEPs) in the first 5 days of life of normal full-term infants are reported. BAEPs were recorded using rarefaction clicks at 70, 60, 40, 20 dB HL. Multiple linear regression analysis was performed to evaluate chronological and gestational age differences for all positive and negative peaks, interpeak latencies, amplitudes and amplitude ratios. The percentage of newborn infants with auditory threshold of 20 dB HL increased with the number of days. At all intensities the latency of PIII and PV decreased significantly between the 2nd and 3rd day, while the latency of PI decreased significantly between the 3rd and the 4th day; PIII and PV latencies decreased also between the 4th and the 5th day. The longer the period of gestation the longer was the PI latency recorded between the 2nd and 5th day after birth. The anatomical and physiological changes developing shortly after birth are probably responsible for the above findings. These changes most probably appear firstly in the cochlear and trapezoid nuclei and later on in the organ of Corti.

Brain activity associated with skilled finger movements: multichannel magnetic recordings

We recorded with a 24-channel SQUID magnetometer cerebral activity preceding and following self-paced voluntary 'skilled' movements in four healthy adults. The subject pressed buttons successively with the right index and middle fingers aiming at a time difference of 40-60 ms; on-line feedback on performance was given after each movement. Slow magnetic readiness fields (RFs) preceded the movements by 0.5 s and culminated about 20 ms after the electromyogram (EMG) onset. Movement-evoked fields, MEFs, opposite in polarity to RFs, were observed 90-120 ms after the EMG onset. They were followed by an additional 'skilled-performance field', SPF, 400-500 ms after the EMG onset. The source locations of RF, MEF, and SPF were within 2 cm from sources of the somatosensory evoked responses, which were situated in the posterior wall of the Rolandic fissure; the sources of MEF were closest to the midline. Neural generators of these deflections and of the corresponding electric potentials are discussed.

A critical review of physiological and clinical aspects of movement related brain macropotentials in humans

The methodological, developmental and clinical aspects of movement related brain macropotentials (MRBMs) are reviewed. The physiological differences between unskilled and skilled movements are described and the importance of interactive paradigms in studying movement organization from childhood to adulthood is emphasized. The developmental characteristics of the MRBMs in 119 normal males using a skilled motor perceptual task are presented together with a few clinical applications. This test has been performed by children with learning disabilities, boys with Down syndrome, subjects with chronic schizophrenia and patients with Parkinson syndrome. The results of the MRBMs are discussed for their relevance for our understanding of the cognitive processes and for their therapeutic implications.

Goal or near miss! Movement potential differences between adults and children in skilled performance

In this study, the performances and the movement-related brain macropotentials of a group of adults and 10-year-old children were analyzed to test whether and how they were correlated to the success or failure in the performance. Bereitschaftspotential (BP), motor cortex potential (MCP) and skilled performance positivity (SPP) related to preparation, execution and evaluation of performance respectively showed a significant relationship to the performance outcome. The BP area in the left precentral decreased significantly with increasing performance time. The amplitude of the MCP was maximum during target performances and decreased with increasing range of error of performance. There was a difference in trend between adults and children in the SPP latency. During target performances, SPP latency in Pz was maximum in children and minimum in adults. In children, the SPP amplitude was greater in frontal and precentral areas during target performance and decreased with increasing inaccuracy of performance. This trend was not evident in adults. The results seem to indicate that the SPP latency does not seem to depend on the performance time but on the evaluation of information conveyed by the stimulus. How this evaluation takes place seems to be different in children and adults; this evaluation process is also reflected in the SPP amplitude of children during target performances. For the adults who have already developed formal thinking, the probability that any outcome is possible exists and so the significant relationship between SPP amplitude and performance is not seen.

The acute and chronic administrations of piracetam affect the movement-related brain macropotentials

Neurophysiological and neurochemical studies have demonstrated that piracetam improves learning and memory both in animals and humans. In recent years it has been shown that when a subject is engaged in a motor perceptual task, some psychomotor functions are correlated with a consistent pattern of brain electrical activity. Given the relationship between the movement-related brain macropotentials (MRBMs) and the cognitive processes associated with them, we considered the MRBMs particularly suitable for the neurophysiological assessment of the efficacy of piracetam in man. The aim of this study was to test the acute and chronic effect of piracetam administration on the MRBMs in normal children during the performance of a motor perceptual task. The design was a triple-blind study, during which the subjects took either placebo or piracetam in random sequence, with a washout period of 3 weeks. The dose was 170 mg/kg for the acute treatment and 140 mg/kg/day for chronic treatment. No side-effects were reported by the children during or after acute or chronic treatment with piracetam. There was no statistically significant difference between placebo or piracetam treatment with regard to 'performance', which was already optimal at baseline, and to electromyographic activity. On the contrary, the MRBMs were significantly modified by treatment. In particular the Bereitschaftspotential was present as a positive shift during acute treatment with piracetam and increased after chronic treatment. Skilled performance positivity (SPP) amplitudes were significantly increased and SPP latency reduced by chronic treatment with piracetam. piracetam appears to act on the catecholaminergic and cholinergic systems via an increase of the inhibitory hyperpolarizing processes.

The skilled performance positivity after learning a skilled task

The effect of an intensive training period and that of a time-distributed training on skilled performance positivity (SPP) have been studied. SPP is a potential associated with knowledge and evaluation of the results of a goal-directed bimanual self-paced task requiring particular ability. Nine subjects with average intelligence but with some difficulties in the motor-perceptive sphere were studied. The task consisted of initiating the sweep of an oscilloscope with a self-paced movement and terminating it within 50 msec +/- 10 msec. The subjects had to repeat this task several times at various time intervals. The electrical activity was recorded from Fpz, Fz, Cz, Pz, P4, P3 and the right/left precentral areas. For each performance, performance time, performance shift taken as the accuracy index, as well as the percentage of target performances were evaluated. Motor performances improved with both distributed and intensive practice. Only distributed practice had a significant effect on SPP latency and amplitude. SPP latency decreased in all brain areas, whereas amplitude increased in the prefrontal, frontal and left precentral areas. These results seem to suggest that the performance evaluation processes take place more quickly and efficiently through distributed practice.

Sex and ear differences of brain-stem acoustic evoked potentials in a sample of normal full-term newborns. Normative study

The present paper reports a normative study of the BAEPs recorded from 80 normal full-term newborns by using a rarefaction click at 70, 60, 40, 20 dB HL. Positive, negative peaks and the relative amplitudes were measured. Means, standard deviations and 95% and 99% confidence limits were calculated for each component, for positive and negative IPLs and amplitude ratios. A normality test distribution showed that each component had normal distribution except for wave PIII at 70 dB and at 60 dB HL because of its index of kurtosis and for IPLs PII-PIII and NII-NIII at 70 and 60 dB HL. MLRA was performed and significant statistical differences were found for sex, ears and intensities. Females had the latencies of waves PIII, PIV, PV, NII and NIV shorter than males. The BAEPs obtained from the left ear had shorter latencies for positive and negative peaks. Latencies, amplitude and morphology of the BAEPs vary with variations of the intensity. The IPLs PII-PV, PIII-PV and PIV-PV were not affected by changes of intensity.

Electrophysiology of skilled performances in children

Skilled performance is a result of appropriate integration of sensorimotor, cognitive and motivational functions. When Piaget was asked about the nature of reality and our knowledge of it, he answered: "I know an object only when I can act on it; before this action I cannot say anything about it". It has been proposed that motor actions are the source from which mental operations emerge. The intellectual growth of a child goes through stages during which actions, perceptions and ability for concrete or abstract thought hold in turn a predominant role. On the grounds of this theoretical framework it could be argued that neuropsychophysiological investigations of skilled performance in children which incorporate the study of performance-related brain electrical activity could contribute unique information with theoretical and clinical implications. A pattern of slow and phasic brain electrical activity is consistently associated with the execution of skilled ballistic tasks. The slow potentials of the preparatory period (Bereitschfts Potential-BP) are of low amplitude in low demand tasks and in young children. The potentials closely associated with the execution of the act and reflecting sensory feedback activity (Motor Cortex Potential-MCP) are constantly present in children of all ages. The potential associated with knowledge of results (Skilled Performance Positivity-SPP) is only present if task relevant exteroceptive information is expected and occurs. The SPP is independent of the action itself and of the existence of non-informative exteroceptive stimulation. The SPP is absent in unskilled tasks and in young children. The motor performance related with the execution of the motor act improves with increasing age.(ABSTRACT TRUNCATED AT 250 WORDS)

Neurophysiological correlates of psychomotor activity in chronic schizophrenics

The movement-related brain macropotentials (MRBMs) of 13 chronic schizophrenics (7 paranoid and 6 hebephrenic) were recorded during a motor perceptual task and compared to those of 13 normal subjects matched by age, sex and IQ. The cerebral activity was recorded from Fpz, Fz, Cz, Pz, and right and left precentral areas and the electromyographic activities from the left and right forearm flexor muscle groups. Analysis of variance was performed to test the correlation between the MRBMs and groups, sets and performances. The results indicate that the performance considered in tests of 'performance time,' as 'performance shift' and as number of 'target performances' was poorer in chronic schizophrenics than it was in the control group. In parallel with the performance, the MRBMs of chronic schizophrenics were also significantly different in comparison to the normal subjects. In particular, the BP amplitude was reduced in all areas; the MCP and P200 were also abnormally reduced. The SPP was present but it had a small amplitude in the parietal region. These differences in chronic schizophrenics could be explained as multidimensional biopsychological deficits: the disturbed performance is the result of impairment in developing appropriate changes of set, defective inhibition of sensory information, and reduced utilization of the outcome data.

Movement-related brain macropotentials during skilled performances. A developmental study

A developmental study of movement-related brain macropotentials (MRBMs) during a self-paced bimanual skilled performance task (Papakostopoulos 1980) was carried out. MRBMs were obtained from Fpz, Cz and right and left pre-central and electromyograms were recorded from the left and right flexor muscles of the forearms in 30 normal children ranging from 8 to 13 years of age. A consistent Bereitschaftspotential appeared in children of 10 years; in the younger children it was absent or it was positive at precentral and central locations. The motor cortex potential and P200 were present in all children. The skilled performance positivity (SPP), absent at 8 and 9 years, appeared at 11 years of age and was present in older children. The latency of P200 and SPP decreased with age. ANOVA tests showed a statistically significant age effect on performance, EMG rise time and MRBMs; MRBMs were not statistically influenced by time in the experiment: MCP and P200 increased in amplitude with improvement of performance. The results indicate different rates of maturation of the neuronal systems underlying the genesis of the various movement-related brain macropotentials.