[Show abstract][Hide abstract] ABSTRACT: We report experiments designed to learn whether different kinds of perceptually unstable visual images engage different neural mechanisms. 21 subjects viewed two types of bi-stable images while we scanned the activity in their brains with functional magnetic resonance imaging (fMRI); in one (intra-categorical type) the two percepts remained within the same category (e.g. face-face) while in the other (cross-categorical type) they crossed categorical boundaries (e.g. face-body). The results showed that cross- and intra-categorical reversals share a common reversal-related neural circuitry, which includes fronto-parietal cortex and primary visual cortex (area V1). Cross-categorical reversals alone engaged additional areas, notably anterior cingulate cortex and superior temporal gyrus, which have been posited to be involved in conflict resolution.
[Show abstract][Hide abstract] ABSTRACT: Human choice behavior often reflects a competition between inflexible computationally efficient control on the one hand and a slower more flexible system of control on the other. This distinction is well captured by model-free and model-based reinforcement learning algorithms. Here, studying human subjects, we show it is possible to shift the balance of control between these systems by disruption of right dorsolateral prefrontal cortex, such that participants manifest a dominance of the less optimal model-free control. In contrast, disruption of left dorsolateral prefrontal cortex impaired model-based performance only in those participants with low working memory capacity.
[Show abstract][Hide abstract] ABSTRACT: An enduring and richly elaborated dichotomy in cognitive neuroscience is that of reflective versus reflexive decision making and choice. Other literatures refer to the two ends of what is likely to be a spectrum with terms such as goal-directed versus habitual, model-based versus model-free or prospective versus retrospective. One of the most rigorous traditions of experimental work in the field started with studies in rodents and graduated via human versions and enrichments of those experiments to a current state in which new paradigms are probing and challenging the very heart of the distinction. We review four generations of work in this tradition and provide pointers to the forefront of the field's fifth generation.
[Show abstract][Hide abstract] ABSTRACT: This study tested the efficacy of audio-visual reading training in nine patients with pure alexia, an acquired reading disorder caused by damage to the left ventral occipitotemporal cortex. As well as testing the therapy's impact on reading speed, we investigated the functional reorganization underlying therapy-induced behavioural changes using magnetoencephalography. Reading ability was tested twice before training (t1 and t2) and twice after completion of the 6-week training period (t3 and t4). At t3 there was a significant improvement in word reading speed and reduction of the word length effect for trained words only. Magnetoencephalography at t3 demonstrated significant differences in reading network connectivity for trained and untrained words. The training effects were supported by increased bidirectional connectivity between the left occipital and ventral occipitotemporal perilesional cortex, and increased feedback connectivity from the left inferior frontal gyrus. Conversely, connection strengths between right hemisphere regions became weaker after training.
[Show abstract][Hide abstract] ABSTRACT: Prosody (i. e. speech melody) is an important cue to infer an interlocutor's emotional state, complementing information from face expression and body posture. Inferring fear from face expression is reported as impaired after amygdala lesions. It remains unclear whether this deficit is specific to face expression, or is a more global fear recognition deficit. Here, we report data from two twins with bilateral selective amygdala lesions and show they are unimpaired in a multinomial emotional prosody classification task. In a two-alternative forced choice task, they demonstrate increased ability to discriminate fearful and neutral prosody, the opposite of what would be expected under an hypothesis of a global role for the amygdala in fear recognition. Hence, we provide evidence that the amygdala is not required for recognition of fearful prosody.
[Show abstract][Hide abstract] ABSTRACT: Patients undergoing vascular surgery are a high-risk population with widespread atherosclerosis, an adverse cardiovascular risk profile and often multiple co-morbidities. Postoperative cardiovascular complications, including myocardial infarct (MI), are common. Statins are the medical treatment of choice to reduce high cholesterol levels. Evidence is accumulating that patients taking statins at the time of surgery are protected against a range of perioperative complications, but the specific benefits for patients undergoing noncardiac vascular surgery are not clear.
We examined whether short-term statin therapy, commenced before or on the day of noncardiac vascular surgery and continuing for at least 48 hours afterwards, improves patient outcomes including the risk of complications, pain, quality of life and length of hospital stay. We also examined whether the effect of statin therapy on these outcomes changes depending on the dose of statin received.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 7), MEDLINE via Ovid SP (1966 to August 2012), EMBASE via Ovid SP (1966 to August 2012), CINAHL via EBSCO host (1966 to August 2012) and ISI Web of Science (1946 to July 2012) without any language restriction. We used a combination of free text search and controlled vocabulary search. The results were limited to randomized controlled clinical trials (RCTs). We conducted forwards and backwards citation of key articles and searched two clinical trial Websites for ongoing trials (www.clinicaltrials.gov and http://www.controlled-trials.com).
We included RCTs that had compared short-term statin therapy, either commenced de novo or with existing users randomly assigned to different dosages, in adult participants undergoing elective and emergency noncardiac arterial surgery, including both open and endovascular procedures. We defined short-term as commencing before or on the day of surgery and continuing for at least 48 hours afterwards.
Two authors independently assessed trial quality and extracted data, including information on adverse events. We contacted study authors for additional information. We performed separate analyses for the comparisons of statin with placebo/no treatment and between different doses of statin. We presented results as pooled risk ratios (RRs) with 95% confidence intervals (CIs) based on random-effects models (inverse variance method). We employed the Chi(2) test and calculated the I(2) statistic to investigate study heterogeneity.
We identified six eligible studies in total. The six Included studies were generally of high quality, but the largest eligible study was excluded because of concerns about its validity. Study populations were statin naive, which led to a considerable loss of eligible participants.Five RCTs compared statin use with placebo or standard care. We pooled results from three studies, with a total of 178 participants, for mortality and non-fatal event outcomes. In the statin group, 7/105 (6.7%) participants died within 30 days of surgery, as did 10/73 (13.7%) participants in the control group. Only one death in each group was from cardiovascular causes, with an incidence of 0.95% in statin participants and 1.4% in control participants, respectively. All deaths occurred in a single study population, and so effect estimates were derived from one study only. The risk ratio (RR) of all-cause mortality in statin users showed a non-significant decrease in risk (RR 0.73, 95% CI 0.31 to 1.75). For cardiovascular death, the risk ratio was 1.05 (95% CI 0.07 to 16.20). Non-fatal MI within 30 days of surgery was reported in three studies and occurred in 4/105 (3.8%) participants in the statin group and 8/73 (11.0%) participants receiving placebo, for a non-significant decrease in risk (RR 0.47, 95% CI 0.15 to 1.52). Several studies reported muscle enzyme levels as safety measures, but only three (with a total of 188 participants) reported explicitly on clinical muscle syndromes, with seven events reported and no significant difference found between statin users and controls (RR 0.94, 95% CI 0.24 to 3.63). The only participant-reported outcome was nausea in one small study,with no significant difference in risk between groups.Two studies compared different doses of atorvastatin, with a total of 145 participants, but reported data were not sufficient to allow us to determine the effect of higher doses on any outcome.
Evidence was insufficient to allow review authors to conclude that statin use resulted in either a reduction or an increase in any of the outcomes examined. The existing body of evidence leaves questions about the benefits of perioperative use of statins for vascular surgery unanswered. Widespread use of statins in the target population means that it may now be difficult for researchers to undertake the large RCTs needed to demonstrate any effect on the incidence of postoperative cardiovascular events. However, participant-reported outcomes have been neglected and warrant further study.
Cochrane database of systematic reviews (Online) 07/2013; 7:CD009971.
[Show abstract][Hide abstract] ABSTRACT: Reward outcome signalling in sensory cortex is held as important for linking stimuli to their consequences and for modulating perceptual learning in response to incentives. Evidence for reward outcome signalling has been found in sensory regions including visual, auditory and somatosensory cortices across a range of different paradigms, but it is unknown whether the population of neurons signalling reward outcome the same as those processing predictive stimuli. We addressed this question using a multivariate analysis of high-resolution functional magnetic resonance imaging (fMRI), in a task where subjects were engaged in instrumental learning with visual predictive cues and auditory signalled reward feedback. We found evidence that outcome signals in sensory regions localise to the same areas involved in stimulus processing. These outcome signals are non-specific and we show that the neuronal populations involved in stimulus representation are not their exclusive target, in keeping with theoretical models of value learning. Thus, our results reveal one likely mechanism through which rewarding outcomes are linked to predictive sensory stimuli, a link that may be key for both reward and perceptual learning.
[Show abstract][Hide abstract] ABSTRACT: Intelligence Quotient (IQ) is regularly used in both education and employment as a measure of cognitive ability. Although an individual's IQ is generally assumed to stay constant across the lifespan, a few studies have suggested that there may be substantial variation at the individual level. Motivated by previous reports that reading quality/quantity has a positive influence on vocabulary acquisition, we hypothesised that reading ability in the early teenage years might contribute to changes in verbal IQ (VIQ) over the next few years. We found that good readers were more likely to experience relative improvements in VIQ over time, with the reverse true for poor readers. These effects were largest when there was a discrepancy between Time 1 reading ability and Time 1 VIQ. In other words, VIQ increases tended to be greatest when reading ability was high relative to VIQ. Additional analyses supported these findings by showing that variance in VIQ change associated with Time 1 behaviour was also associated with independent measurements of brain structure. Our finding that reading in the early teenage years can predict a significant proportion of the variance in subsequent VIQ change has implications for targeted education in both home and school environments.
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