Joaquin A. Anguera

UCSF University of California, San Francisco | UCSF · Department of Neurology

Cognitive control is defined by a set of neural processes that allow us to interact with our complex environment in a goal-directed manner. Humans regularly challenge these control processes when attempting to simultaneously accomplish multiple goals (multitasking), generating interference as the result of fundamental information processing limitat...

The dorsolateral prefrontal cortex (DLPFC) has been proposed to play an important role in neural processes that underlie multitasking performance. However, this claim is underexplored in terms of direct causal evidence. The current study aimed to delineate the causal involvement of the DLPFC during multitasking by modulating neural activity with tr...

Bad actors and bots present threats to data integrity in remote research designs, compromising estimates of cognitive task performance. Here, we share our experiences and recommendations for identifying and preventing bad actors and bots from enrolling in remote studies of cognitive task performance. As part of a large-scale study, 3,488 participan...

BACKGROUND Executive functions (EFs) predict positive life outcomes and educational attainment. As such, it is imperative that our measures of EF constructs are both reliable and valid, with advantages for research tools that offer efficiency and remote capabilities. OBJECTIVE The objective of this study was to evaluate initial reliability and val...

Background Cancer‐related cognitive impairment (CRCI) and anxiety co‐occur in patients with cancer. Little is known about mechanisms for the co‐occurrence of these two symptoms. The purposes of this secondary analysis were to evaluate for perturbed pathways associated with the co‐occurrence of self‐reported CRCI and anxiety in patients with low ver...

Musical instrument training has been linked to improved academic and cognitive abilities in children, but it remains unclear why this occurs. Moreover, access to instrument training is not always feasible, thereby leaving less fortunate children without opportunity to benefit from such training. Although music‐based video games may be more accessib...

Introduction Executive functions (EFs) are linked to positive outcomes across the lifespan. Yet, methodological challenges have prevented precise understanding of the developmental trajectory of their organization. Methods We introduce novel methods to address challenges for both measuring and modeling EFs using an accelerated longitudinal design...

Introduction: Studies examining sustained attention abilities typically utilize metrics that quantify performance on vigilance tasks, such as response time and response time variability. However, approaches that assess the duration that an individual can maintain their attention over time are lacking. Methods: Here we developed an objective attent...

Introduction The incorporation of game features into cognitive tasks can inform us about the influence of reward and motivation on attention. Continuous performance tasks (CPTs), designed to assess attention abilities, are examples of cognitive tasks that have been targeted for the addition of game features. However, previous results have been mixe...

Background: Up to 45% of patients report cancer-related cognitive impairment (CRCI). A variety of characteristics are associated with the occurrence and/or severity of CRCI. However, an important gap in knowledge of risk factors for CRCI is the relative contribution of each factor. The Multifactorial Model of Cancer-Related Cognitive Impairment (M...

Inattention can negatively impact several aspects of a child’s life, including at home and school. Cognitive and physical interventions are two promising non-pharmaceutical approaches used to enhance attention abilities, with combined approaches often being marketed to teachers, therapists, and parents typically without research validation. Here, w...

Introduction: Cognitive impairment is a debilitating symptom in people with multiple sclerosis (MS). Most of the neuropsychological tasks have little resemblance to everyday life. There is a need for ecologically valid tools for assessing cognition in real-life functional contexts in MS. One potential solution would involve the use of virtual reali...

Problem identification: Cancer-related cognitive impairment (CRCI) is common and is associated with cancer and its treatments. Evidence suggests that the causes are multifactorial, but the field is lacking a comprehensive conceptual model of CRCI to summarize existing knowledge and provide a way to understand and predict causal links, as well as t...

Sustained attention is a critical cognitive ability that improves over the course of development and predicts important real-world outcomes, such as academic achievement. However, the majority of work demonstrating links between sustained attention and academic skills has been conducted in lab-based settings that lack the ecological validity of a m...

Executive functions (EFs) are linked to positive outcomes across the lifespan. Yet, methodological challenges have prevented precise understanding of the developmental trajectory of their organization. We introduce novel methods to address challenges for both measuring and modeling EFs using an accelerated longitudinal design with a large, diverse...

This scoping review was designed to synthesize the extant literature on associations between subjective and/or objective measures of cancer-related cognitive impairment (CRCI) and blood-based biomarkers in adults with non-central nervous system cancers. The literature search was done for studies published from the start of each database searched (i...

Preserving attention abilities is of great concern to older adults who are motivated to maintain their quality of life. Both cognitive and physical fitness interventions have been utilized in intervention studies to assess maintenance and enhancement of attention abilities in seniors, and a coupling of these approaches is a compelling strategy to b...

Most people with mental health disorders cannot receive timely and evidence-based care despite billions of dollars spent by healthcare systems. Researchers have been exploring using digital health technologies to measure behavior in real-world settings with mixed results. There is a need to create accessible and computable digital mental health dat...

As population aging advances at an increasing rate, efforts to help people maintain or improve cognitive function late in life are critical. Although some studies have shown promise, the question of whether cognitive training is an effective tool for improving general cognitive ability remains incompletely explored, and study results to date have b...

[https://doi.org/10.5281/zenodo.6373681] These are the datasets about the experimental group (N=20, where N is the sample size, that is, 20 participants in total) and control group (N=20, where N is the sample size, that is, 20 participants in total) for our published paper entitled "Multimodal Biosensing for Vestibular Network-Based Cybersickness...

Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition characterized by diminished attentional control. Critically, these difficulties are related to negative consequences in real-life functioning both during development and into adulthood. There is now growing evidence that modulating the underlying neural circ...

Background Cognitive impairment (CI) is one of the most prevalent symptoms of multiple sclerosis (MS). However, it is difficult to include cognitive assessment as part of MS standard care since the comprehensive neuropsychological examinations are usually time-consuming and extensive. Objective To improve access to CI assessment, we evaluated the...

Preserving attention abilities is of great concern to older adults who are motivated to maintain their quality of life as they age. Both cognitive and physical fitness interventions have been utilized in intervention studies to assess maintenance and enhancement of attention abilities in seniors, and a coupling of these approaches is a compelling s...

Virtual reality (VR) has the potential to induce cybersickness (CS), which impedes CS-susceptible VR users from the benefit of emerging VR applications. To better detect CS, the current study investigated whether/how the newly proposed human vestibular network (HVN) is involved in flagship consumer VR-induced CS by simultaneously recording autonomi...

Cancer-related cognitive impairment (CRCI) is a significant problem for patients receiving chemotherapy. While a growing amount of pre-clinical and clinical evidence suggests that inflammatory mechanisms underlie CRCI, no clinical studies have evaluated for associations between CRCI and changes in gene expression. Therefore, the purpose of this stu...

Executive functions (EFs) are linked to positive outcomes across the lifespan. Yet, methodological challenges have prevented rigorous understanding of the precise ways EFs are organized in childhood and how they develop over time. We introduce novel methods to address these challenges for both measuring and modeling EFs using a large, accelerated l...

Executive functions (EFs) are linked to positive outcomes across the lifespan. Yet, methodological challenges have prevented rigorous understanding of the precise ways EFs are organized in childhood and how they develop over time. We introduce novel methods to address these challenges for both measuring and modeling EFs using a large, accelerated l...

The relationship between executive functions (EF) and academic achievement is well-established, but leveraging this insight to improve educational outcomes remains elusive. Here, we propose a framework for relating the role of specific EF on specific precursor skills that support later academic learning. Starting from the premise that executive fun...

Groupitizing – the ability to take advantage of grouping cues to rapidly enumerate sets that otherwise require serial counting – is linked to conceptual aspects of numbers (accessing the cardinality of subgroups) and math (combining the subgroups values) that rapidly emerge during the first years of schooling (Starkey & McCandliss, 2014). Little el...

The use of cognitive interventions to remediate deficient cognitive functions, or to enhance or preserve intact cognitive abilities, has been explored for some time, especially in older adults. However, few studies have investigated the long-term persistence of any positive benefits, with none examining whether changes in functional brain activity...

Nonpharmacological interventions targeting putative network mechanisms of major depressive disorder (MDD) may represent novel treatments. This mechanistic study investigates how a video game-like intervention, designed to improve cognitive control network (CCN) functioning by targeting multitasking, influences the CCN of middle-aged and older adult...

This manuscript describes data collection, cleaning, and quality control procedures used in a large-scale, longitudinal, in-school study of executive function skills (EFs) and academic achievement in middle childhood, Project iLEAD (in-school Longitudinal Executive Function and Academic Achievement Database). Assessments were administered in real-w...

The goal of this study was to test for long-term benefits three years after the completion of a cognitive training intervention (Project: EVO™) in a subset of children with Sensory Processing Dysfunction (SPD). Our initial findings revealed that children with SPD who also met research criteria for Attention Deficit Hyperactivity Disorder (SPD+IA) s...

[This corrects the article DOI: 10.2196/24356.].

Background Cognitive impairment is one of the most debilitating manifestations of multiple sclerosis. Currently, the assessment of cognition relies on a time-consuming and extensive neuropsychological examination, which is only available in some centers. Objective To enable simpler, more accessible cognitive screening, we sought to determine the fe...

BACKGROUND Cognitive impairment (CI) is one of the most prevalent symptoms of multiple sclerosis (MS). However, it is difficult to include cognitive assessment as part of MS standard care since the comprehensive neuropsychological examinations are usually time-consuming and extensive. OBJECTIVE To improve access to CI assessment, we evaluated the...

BACKGROUND Cognitive impairment is one of the most debilitating manifestations of multiple sclerosis. Currently, the assessment of cognition relies on a time-consuming and extensive neuropsychological examination, which is only available in some centers. OBJECTIVE To enable simpler, more accessible cognitive screening, we sought to determine the f...

Cross-level interactions among fixed effects in linear mixed models (also known as multilevel models) can be complicated by heterogeneity stemming from random effects and residuals. When heterogeneity is present, tests of fixed effects (including cross-level interaction terms) are subject to inflated type I or type II error. While the impact of var...

Objective To assess whether a videogame-like digital treatment is superior to a control in improving processing speed in adults with multiple sclerosis (MS). Methods Adults with MS and baseline Symbol Digit Modalities Test (SDMT) z-scores between −2 and 0 were enrolled in a double-blind randomized controlled clinical trial. After completing a base...

The relationship between executive functions (EF) and academic achievement is well-established, but leveraging this insight to improve educational outcomes remains elusive. Here, we propose a framework for relating the role of specific EF on specific precursor skills that support later academic learning. Specifically, we hypothesize that executive...

Some evidence suggests that experiencing a given scenario using virtual reality (VR) may engage greater attentional resources than experiencing the same scenario on a 2D computer monitor. However, the underlying neural processes associated with these VR-related effects, especially those pertaining to current consumer-friendly head-mounted displays...

Attention is a fundamental cognitive process that is critical for essentially all aspects of higher-order cognition and real-world activities. Younger generations have deeply embraced information technology and multitasking in their personal lives, school and the workplace, creating myriad challenges to their attention. While improving sustained at...

Background: Decrements in attentional function-perceived effectiveness in everyday functioning related to cognitive dysfunction-are frequently reported by cancer patients during treatment. However, patients vary widely in their experiences of changes in attentional function. Objective: The aim of this study was to understand differences in atten...

Cross-level interactions among fixed effects in linear mixed models (also known as multilevel models) are often complicated by the variances stemming from random effects and residuals. When these variances change across clusters, tests of fixed effects (including cross-level interaction terms) are subject to inflated Type I or Type II error. While...

Objective: Recent evidence suggests that co-occurring deficits in cognitive control and visuomotor control are common to many neurodevelopmental disorders. Specifically, children with sensory processing dysfunction (SPD), a condition characterized by sensory hyper/hypo-sensitivity, show varying degrees of overlapping attention and visuomotor challe...

Introduction Self-administered in-home digital therapeutics could expand access to cognitive rehabilitation for individuals with multiple sclerosis (MS), over half of whom experience cognitive impairment (CI). However, feasibility in an MS population must be clarified. This study was conducted to assess the feasibility of deploying a videogame-like...

Background: Smartphones provide a low-cost and efficient means to collect population level data. Several small studies have shown promise in predicting mood variability from smartphone-based sensor and usage data, but have not been generalized to nationally recruited samples. This study used passive smartphone data, demographic characteristics, an...

Background: To inform measurement-based care, practice guidelines suggest routine symptom monitoring, often on a weekly or monthly basis. Increasingly, patient-provider contacts occur remotely (eg, by telephone and Web-based portals), and mobile health tools can now monitor depressed mood daily or more frequently. However, the reliability and util...

Background: Most people with mental health disorders fail to receive timely access to adequate care. US Hispanic/Latino individuals are particularly underrepresented in mental health care and are historically a very difficult population to recruit into clinical trials; however, they have increasing access to mobile technology, with over 75% owning...

Objective: Children with autism spectrum disorders (ASD) and sensory processing dysfunction (SPD) are reported to show difficulties involving cognitive and visuomotor control. We sought to determine whether performance on computerized, behavioral measures of cognitive control aimed at assessing selective attention, as well as visuomotor abilities...

Mental Health conditions are now amongst the top five burdensome diseases in the US. Disparities in access to services and health outcomes vary due to several factors including socioeconomic status, shortage of mental health professionals, stigma and the linguistic gap between providers and non-English speaking minority population. This study explo...

Daily experiences demand both focused and broad allocation of attention for us to interact efficiently with our complex environments. Many types of attention have shown age-related decline, although there is also evidence that such deficits may be remediated with cognitive training. However, spatial attention abilities have shown inconsistent age-r...

Introduction Sports performance relies on quick visual decision-making and reaction time. In baseball, a fastball takes only 400 ms to travel from pitcher to hitter. This requires visual search strategies to distinguish amongst different types of pitches and react quickly. Fatigue over a season, however, can negatively impact performance and pitch...

Background: Despite decades of research and development, depression has risen from the fifth to the leading cause of disability in the United States. Barriers to progress in the field are (1) poor access to high-quality care; (2) limited mental health workforce; and (3) few providers trained in the delivery of evidence-based treatments (EBTs). Alt...

Children with Sensory Processing Dysfunction (SPD) experience incoming information in atypical, distracting ways. Qualitative challenges with attention have been reported in these children, but such difficulties have not been quantified using either behavioral or functional neuroimaging methods. Furthermore, the efficacy of evidence-based cognitive...

EVO Training Protocol. Study protocol approved by UCSF Ethics Committee. (DOCX)

TREND Statement Checklist. (PDF)

EVO Training Data. The number of days in training, training rounds completed, and diagnostic rounds passed by group. (DOCX)

EEG Analysis. Pre-processing and statistical analyses protocols for the EEG data. (DOCX)

Participant Medication Information. Overview of medication taken by the study participants. (DOCX)

Demographic Information. Age, Handedness, IQ, and Ethnicity by group. (DOCX)

Dataset. Data from Experiment #1 and #2 presented by group for each test reported. (XLSX)

Background Mobile apps for mental health have the potential to overcome access barriers to mental health care, but there is little information on whether patients use the interventions as intended and the impact they have on mental health outcomes. Objective The objective of our study was to document and compare use patterns and clinical outcomes...

Background: Existing treatments for depression are known to have only modest effects, are insufficiently targeted, and are inconsistently utilized, particularly in older adults. Indeed, older adults with impaired cognitive control networks tend to demonstrate poor response to a majority of existing depression interventions. Cognitive control inter...

Assessing cognitive abilities in children is challenging for two primary reasons: lack of testing engagement can lead to low testing sensitivity and inherent performance variability. Here we sought to explore whether an engaging, adaptive digital cognitive platform built to look and feel like a video game would reliably measure attention-based abil...

Background/Aims: Effective treatments to depression exist, but treatment response is variable. Persons likely to respond to antidepressants often show early change in emotional processing and attentional bias. Methods to assess these constructs passively and at low burden/cost are now available via smartphone apps, with potential for broad dissemin...