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Objective: Brain-computer interface (BCI) provide a non-muscular communication channel for patients with impairments of the motor system. A significant number of BCI users is unable to obtain voluntary control of a BCI-system in proper time. This makes methods that can be used to determine the aptitude of a user necessary.
Methods: We hypothesized that integrity and connectivity of involved white matter connections may serve as a predictor of individual BCI-performance. Therefore, we analyzed structural data from anatomical scans and DTI of motor imagery BCI-users differentiated into high and low BCI-aptitude groups based on their overall performance.
Results: Using a machine learning classification method we identified discriminating structural brain trait features and correlated the best features with a continuous measure of individual BCI-performance. Prediction of the aptitude group of each participant was possible with near perfect accuracy (one error).
Conclusions: Tissue volumetric analysis yielded only poor classification results. In contrast, the structural integrity and myelination quality of deep white matter structures such as the Corpus Callosum, Cingulum, and Superior Fronto-Occipital Fascicle were positively correlated with individual BCI-performance.
Significance: This confirms that structural brain traits contribute to individual performance in BCI use.
The serotonin (5-HT) and neuropeptide S (NPS) systems are discussed as important genetic modulators of fear and sustained anxiety contributing to the etiology of anxiety disorders. Sustained anxiety is a crucial characteristic of most anxiety disorders which likely develops through contextual fear conditioning. This study investigated if and how genetic alterations of the 5-HT and the NPS systems as well as their interaction modulate contextual fear conditioning; specifically, function polymorphic variants in the genes coding for the 5-HT transporter (5HTT) and the NPS receptor (NPSR1) were studied. A large group of healthy volunteers was therefore stratified for 5HTTLPR (S+ vs. LL carriers) and NPSR1 rs324981 (T+ vs. AA carriers) polymorphisms resulting in four genotype groups (S+/T+, S+/AA, LL/T+, LL/AA) of 20 participants each. All participants underwent contextual fear conditioning and extinction using a virtual reality (VR) paradigm. During acquisition, one virtual office room (anxiety context, CXT+) was paired with an unpredictable electric stimulus (unconditioned stimulus, US), whereas another virtual office room was not paired with any US (safety context, CXT−). During extinction no US was administered. Anxiety responses were quantified by fear-potentiated startle and ratings. Most importantly, we found a gene × gene interaction on fear-potentiated startle. Only carriers of both risk alleles (S+/T+) exhibited higher startle responses in CXT+ compared to CXT−. In contrast, anxiety ratings were only influenced by the NPSR1 polymorphism with AA carriers showing higher anxiety ratings in CXT+ as compared to CXT−. Our results speak in favor of a two level account of fear conditioning with diverging effects on implicit vs. explicit fear responses. Enhanced contextual fear conditioning as reflected in potentiated startle responses may be an endophenotype for anxiety disorders.
This study examined the impact of three clinical psychological variables (non-pathological levels of depression and anxiety, as well as experimentally manipulated mood) on fat and taste perception in healthy subjects. After a baseline orosensory evaluation, ‘sad’, ‘happy’ and ‘neutral’ video clips were presented to induce corresponding moods in eighty participants. Following mood manipulation, subjects rated five different oral stimuli, appearing sweet, umami, sour, bitter, fatty, which were delivered at five different concentrations each. Depression levels were assessed with Beck’s Depression Inventory (BDI) and anxiety levels were assessed via the Spielberger’s STAI-trait and state questionnaire. Overall, subjects were able to track the concentrations of the stimuli correctly, yet depression level affected taste ratings. First, depression scores were positively correlated with sucrose ratings. Second, subjects with depression scores above the sample median rated sucrose and quinine as more intense after mood induction (positive, negative and neutral). Third and most important, the group with enhanced depression scores did not rate low and high fat stimuli differently after positive or negative mood induction, whereas, during baseline or during the non-emotional neutral condition they rated the fat intensity as increasing with concentration. Consistent with others’ prior observations we also found that sweet and bitter stimuli at baseline were rated as more intense by participants with higher anxiety scores and that after positive and negative mood induction, citric acid was rated as stronger tasting compared to baseline. The observation that subjects with mild subclinical depression rated low and high fat stimuli similarly when in positive or negative mood is novel and likely has potential implications for unhealthy eating patterns. This deficit may foster unconscious eating of fatty foods in sub-clinical mildly depressed populations.
Background
Positive associations have been found between quality of life, emotion regulation strategies, and heart rate variability (HRV) in people without intellectual disabilities. However, emotion regulation and HRV have rarely been investigated in people with intellectual disabilities. Assessment of subjectively reported quality of life and emotion regulation strategies in this population is even more difficult when participants are also visually impaired.
Methods
Subjective and objective quality of life, emotion regulation strategies, and HRV at rest were measured in a sample of people with intellectual disabilities and concomitant impaired vision (N = 35). Heart rate was recorded during a 10 min resting period. For the assessment of quality of life and emotion regulation, custom made tactile versions of questionnaire-based instruments were used that enabled participants to grasp response categories.
Results
The combined use of reappraisal and suppression as emotion regulation strategies was associated with higher HRV and quality of life. HRV was associated with objective quality of life only. Emotion regulation strategies partially mediated the relationship between HRV and quality of life.
Conclusions
Results replicate findings about associations between quality of life, emotion regulation, and HRV and extend them to individuals with intellectual disabilities. Furthermore, this study demonstrated that quality of life and emotion regulation could be assessed in such populations even with concomitant impaired vision with modified tactile versions of established questionnaires. HRV may be used as a physiological index to evaluate physical and affective conditions in this population.
Objective: Brain Computer Interfaces (BCI) provide a muscle independent interaction channel making them particularly valuable for individuals with severe motor impairment. Thus, different BCI systems and applications have been proposed as assistive technology (AT) solutions for such patients. The most prominent system for communication utilizes event-related potentials (ERP) obtained from the electroencephalogram (EEG) to allow for communication on a character-by-character basis. Yet in their current state of technology, daily life use cases of such systems are rare. In addition to the high EEG preparation effort, one of the main reasons is the low information throughput compared to other existing AT solutions. Furthermore, when testing BCI systems in patients, a performance drop is usually observed compared to healthy users. Patients often display a low signal-to-noise ratio of the recorded EEG and detection of brain responses may be aggravated due to internally (e.g. spasm) or externally induced artifacts (e.g. from ventilation devices). Consequently, practical BCI systems need to cope with mani-fold inter-individual differences. Whilst these high demands lead to increasing complexity of the technology, daily life use of BCI systems requires straightforward setup including an easy-to-use graphical user interface that nonprofessionals can handle without expert support. Research questions of this thesis: This dissertation project aimed at bringing forward BCI technology toward a possible integration into end-users' daily life. Four basic research questions were addressed: (1) Can we identify performance predictors so that we can provide users with individual BCI solutions without the need of multiple, demanding testing sessions? (2) Can we provide complex BCI technology in an automated, user-friendly and easy-to-use manner, so that BCIs can be used without expert support at end-users' homes? (3) How can we account for and improve the low information transfer rates as compared to other existing assistive technology solutions? (4) How can we prevent the performance drop often seen when bringing BCI technology that was tested in healthy users to those with severe motor impairment? Results and discussion: (1) Heart rate variability (HRV) as an index of inhibitory control (i.e. the ability to allocate attention resources and inhibit distracting stimuli) was significantly related to ERP-BCI performance and accounted for almost 26% of variance. HRV is easy to assess from short heartbeat recordings and may thus serve as a performance predictor for ERP-BCIs. Due to missing software solutions for appropriate processing of artifacts in heartbeat data (electrocardiogram and inter-beat interval data), our own tool was developed that is available free of charge. To date, more than 100 researchers worldwide have requested the tool. Recently, a new version was developed and released together with a website (www.artiifact.de). (2) Furthermore, a study of this thesis demonstrated that BCI technology can be incorporated into easy-to-use software, including auto-calibration and predictive text entry. Naïve, healthy nonprofessionals were able to control the software without expert support and successfully spelled words using the auto-calibrated BCI. They reported that software handling was straightforward and that they would be able to explain the system to others. However, future research is required to study transfer of the results to patient samples. (3) The commonly used ERP-BCI paradigm was significantly improved. Instead of simply highlighting visually displayed characters as is usually done, pictures of famous faces were used as stimulus material. As a result, specific brain potentials involved in face recognition and face processing were elicited. The event-related EEG thus displayed an increased signal-to-noise ratio, which facilitated the detection of ERPs extremely well. Consequently, BCI performance was significantly increased. (4) The good results of this new face-flashing paradigm achieved with healthy participants transferred well to users with neurodegenerative disease. Using a face paradigm boosted information throughput. Importantly, two users who were highly inefficient with the commonly used paradigm displayed high accuracy when exposed to the face paradigm. The increased signal-to-noise ratio of the recorded EEG thus helped them to overcome their BCI inefficiency. Significance: The presented work at hand (1) successfully identified a physiological predictor of ERP-BCI performance, (2) proved the technology ready to be operated by naïve nonprofessionals without expert support, (3) significantly improved the commonly used spelling paradigm and (4) thereby displayed a way to effectively prevent BCI inefficiency in patients with neurodegenerative disease. Additionally, missing software solutions for appropriate handling of artifacts in heartbeat data encouraged development of our own software tool that is available to the research community free of charge. In sum, this thesis significantly improved current BCI technology and enhanced our understanding of physiological correlates of BCI performance.
Body image disturbances are core symptoms of eating disorders (EDs). Recent evidence suggests that changes in body image may occur prior to ED onset and are not restricted to in-vivo exposure (e.g. mirror image), but also evident during presentation of abstract cues such as body shape and weight-related words. In the present study startle modulation, heart rate and subjective evaluations were examined during reading of body words and neutral words in 41 student female volunteers screened for risk of EDs. The aim was to determine if responses to body words are attributable to a general negativity bias regardless of ED risk or if activated, ED relevant negative body schemas facilitate priming of defensive responses. Heart rate and word ratings differed between body words and neutral words in the whole female sample, supporting a general processing bias for body weight and shape-related concepts in young women regardless of ED risk. Startle modulation was specifically related to eating disorder symptoms, as was indicated by significant positive correlations with self-reported body dissatisfaction. These results emphasize the relevance of examining body schema representations as a function of ED risk across different levels of responding. Peripheral-physiological measures such as the startle reflex could possibly be used as predictors of females’ risk for developing EDs in the future.
Objective: Brain-computer interfaces (BCIs) provide a non-muscular communication channel for patients with late-stage motoneuron disease (e.g., amyotrophic lateral sclerosis (ALS)) or otherwise motor impaired people and are also used for motor rehabilitation in chronic stroke. Differences in the ability to use a BCI vary from person to person and from session to session. A reliable predictor of aptitude would allow for the selection of suitable BCI paradigms. For this reason, we investigated whether P300 BCI aptitude could be predicted from a short experiment with a standard auditory oddball. Methods: Forty healthy participants performed an electroencephalography (EEG) based visual and auditory P300-BCI spelling task in a single session. In addition, prior to each session an auditory oddball was presented. Features extracted from the auditory oddball were analyzed with respect to predictive power for BCI aptitude. Results: Correlation between auditory oddball response and P300 BCI accuracy revealed a strong relationship between accuracy and N2 amplitude and the amplitude of a late ERP component between 400 and 600 ms. Interestingly, the P3 amplitude of the auditory oddball response was not correlated with accuracy. Conclusions: Event-related potentials recorded during a standard auditory oddball session moderately predict aptitude in an audiory and highly in a visual P300 BCI. The predictor will allow for faster paradigm selection. Significance: Our method will reduce strain on patients because unsuccessful training may be avoided, provided the results can be generalized to the patient population.
The aim of this study was both to investigate the influence of cognitive control on unconscious processing, and to investigate the influence of unconscious processing on cognitive control. At first, different mechanisms and accounts to explain unconscious priming are presented. Here, perceptual and motor processes, as well as stimulus-response learning, semantic categorization, and the action trigger account as theories to explain motor priming are discussed. Then, the issue of the potential limits of unconscious processing is presented. Findings that indicate that active current intentions and expertise modulate unconscious processing are illustrated. Subsequently, results that imply an influence of unconsciously presented stimuli that goes beyond motor processes are discussed, with a special focus on inhibition processes, orienting of attention, task set activation, and conflict adaptation. Then I present the results of my own empirical work. Experiment 1 shows that the effective processing of unconsciously presented stimuli depends on expertise, even when potentially confounding difference between the expert and novice groups are controlled. The results of Experiments 2 and 3 indicate that the intention to use particular stimuli is a crucial factor for the effectiveness of these stimuli when they are presented unconsciously. Additionally, these findings show that shifts of attention can be triggered by centrally presented masked arrow cues. Experiments 4 and 5 broaden these results to cue stimuli that are not inherently associated with a spatial meaning. The finding corroborate that typically endogenously controlled shifts of attention can also be induced by unconscious stimuli. Experiments 6 and 7 demonstrate that even a central cognitive control process like task set activation is not contingent on conscious awareness, but can in contrast be triggered through unconscious stimulation. Finally, these results are integrated and I discuss how the concept of cognitive control and the limits of unconscious processing may have to be reconsidered. Furthermore, potential future research possibilities in this field are presented.
Renewal of fear is one form of relapse that occurs after successful therapy, resulting from an encounter with a feared object in a context different from the context of the exposure therapy. According to Bouton (1994), the return of fear, provoked by context change, indicates that the fear was not erased in the first place. More importantly, the return of fear indicates that during the exposure session a new association was learned that connected the feared object with “no fear”; yet, as Bouton further argues, this association is context dependent. Such dependence could explain effects like renewal. In a new context, the therapeutic association will not be expressed and thus will no longer inhibit the fear. The assumption that an association is context dependent has been tested and showed robust results (Balooch & Neumann, 2011; Siavash Bandarian Balooch, Neumann, & Boschen, 2012; Culver, Stoyanova, & Craske, 2011; Kim & Richardson, 2009; Neumann & Kitlertsirivatana, 2010). Research for the treatment of anxiety disorders, aiming to reduce fear and, more importantly, prevent relapse, is flourishing. There are several exposure protocols currently under investigation: multiple contexts exposure (MCE), which aims at reducing the return of fear due to renewal (e.g., Balooch & Neumann, 2011); prolonged exposure (PE), which aims at strengthening the inhibitory association during the extinction learning (e.g., Thomas, Vurbic, & Novak, 2009); and reconsolidation update (RU), which aims at “updating” the reconsolidation process by briefly exposing the CS+ before the actual extinction takes place (Schiller et al., 2010). So far, however, few clinical studies conducted on humans have investigated these novel treatment protocols, and as far as I know none has investigated the mechanisms of action behind these protocols with a human clinical sample. The present thesis has three main goals. The first is to demonstrate that exposure therapy in multiple contexts reduces the likelihood of renewal. The second is to examine the mechanisms contributing to the effect of MCE and the third is to shed light on the concept of context in the framework of the conditioning and extinction paradigm. To this end, three studies were conducted. The first study investigated the effect of MCE on renewal, the second and third studies examined working mechanisms of MCE. In the first study thirty spider-phobic participants were exposed four times to a virtual spider. The exposure trials were conducted either in one single context or in four different contexts. Finally, all participants completed both a virtual renewal test, with the virtual spider presented in a novel virtual context, and an in vivo behavioral avoidance test with a real spider. This study successfully demonstrated the efficacy of MCE on reducing renewal. Study 2 investigated the working mechanisms behind MCE by utilizing a differential conditioning paradigm and conducting the extinction in multiple contexts, targeting similar renewal attenuation as achieved in study 1. This was followed by two tests that attempted to reveal extinction-relevant associations like ones causing context inhibitory effects. This study had three main hypotheses: (1) The extinction context is associated with the exposure, and thus operates as a safety signal at some point during the extinction; it will therefore compete with the safety learning of the CS, leading to a decreased extinction effect on the CS if the extinction is conducted in only one context. (2) The elements (e.g., room color, furniture) of the extinction context are connected to the therapeutic association and therefore should serve as reminders of the extinction, causing a stronger fear inhibition when presented during a test. (3) Therapy process factors, according to emotional processing theory, determine the renewal effect (e.g., initial fear activation, and within-session and between-session activation are correlated with the strength of renewal). In this study, however, no differences between the groups at the renewal phase were observed, presumably because the extinction was too strong to enable a renewal of fear at the test phase conducted immediately following the extinction. This hence rendered the two inhibitory tests useless. Study 3 aimed at defining the concept of context in the conditioning and exposure framework. Study 3 utilized the phenomenon known as generalization decrement, whereby a conditioned response is reduced due to change in the environment. This allowed context similarity to be quantified. After an acquisition phase in one context, participants were tested in one of three contexts, two of which differed in only one dimension (configuration of objects vs. features). The third group was tested in the same context and served as control group. The goal was to show that both configuration and features play an important role in the definition of context. There was, however, no significant statistical difference between the groups at the test phases, likely because of context novelty effects (participants exposed to a new context following extinction in another context expected a second extinction phase, and thus demonstrated greater fear than expected in all three groups).