Marek Binder

Dissecting medial temporal lobe contributions to item and associative memory formation

A fundamental and intensively discussed question is whether medial temporal lobe (MTL) processes that lead to non-associative item memories differ in their anatomical substrate from processes underlying associative memory formation. Using event-related functional magnetic resonance imaging, we implemented a novel design to dissociate brain activity related to item and associative memory formation not only by subsequent memory performance and anatomy but also in time, because the two constituents of each pair to be memorized were presented sequentially with an intra-pair delay of several seconds. Furthermore, the design enabled us to reduce potential differences in memory strength between item and associative memory by increasing task difficulty in the item recognition memory test. Confidence ratings for correct item recognition for both constituents did not differ between trials in which only item memory was correct and trials in which item and associative memory were correct. Specific subsequent memory analyses for item and associative memory formation revealed brain activity that appears selectively related to item memory formation in the posterior inferior temporal, posterior parahippocampal, and perirhinal cortices. In contrast, hippocampal and inferior prefrontal activity predicted successful retrieval of newly formed inter-item associations. Our findings therefore suggest that different MTL subregions indeed play distinct roles in the formation of item memory and inter-item associative memory as expected by several dual process models of the MTL memory system.

Cognitive functions in patients with liver cirrhosis: A tendency to commit more memory errors

Background Minimal hepatic encephalopathy (MHE) is the mildest form of hepatic encephalopathy (HE). For diagnostic purposes, 2 alternative batteries of psychometric screening tests are recommended. They differ from each other in terms of the cognitive domains assessed. The research was designed to provide a profile of cognitive functioning in patients with liver cirrhosis, using an assessment that covers a wider range of cognitive functions than the usual screening battery. Material/Methods We examined 138 persons, including 88 with liver cirrhosis and 50 healthy volunteers. The Mini Mental State Examination (MMSE) was used for screening and excluding advanced cognitive impairment. Then, to assess cognitive functions in more detail, the following tests were used: Auditory Verbal Learning Test (AVLT), Letter and Semantic Fluency Tests (LF and SF), Trail Making Test (TMT A&B), Digit Symbol Test (DST), Block Design Test (BDT), and Mental Rotation Test (MRT). The MRT task has not been used in MHE diagnosis so far. Finally, 57 patients and 48 controls took part in the entire study. Results Patients with liver cirrhosis commit significantly more errors of intrusions in the AVLT during the delayed free recall trial. Results significantly deviating from the norm in at least 2 tests were found only in 7 cirrhosis patients. Conclusions The results do not provide any specific profile of cognitive disturbances in MHE, but suggest that cirrhosis patients have a tendency to commit more memory errors, probably due to subtle impairments of executive function.

Four-Dimensional Graded Consciousness

Both the multidimensional phenomenon and the polysemous notion of consciousness continue to prove resistant to consistent measurement and unambiguous definition. This is hardly surprising, given that there is no agreement even as regards the most fundamental issues they involve. One of the basic disagreements present in the continuing debate about consciousness pertains to its gradational nature. The general aim of this article is to show how consciousness might be graded and multidimensional at the same time. We therefore focus on the question of what it is, exactly, that is or could be graded in cases of consciousness, and how we can measure it. Ultimately, four different gradable aspects of consciousness will be described: quality, abstractness, complexity and usefulness, which belong to four different dimensions, these being understood, respectively, as phenomenal, semantic, physiological, and functional. Consequently, consciousness may be said to vary with respect to phenomenal quality, semantic abstraction, physiological complexity, and functional usefulness. It is hoped that such a four-dimensional approach will help to clarify and justify claims about the hierarchical nature of consciousness. The approach also proves explanatorily advantageous, as it enables us not only to draw attention to certain new and important differences in respect of subjective measures of awareness and to justify how a given creature may be ranked higher in one dimension of consciousness and lower in terms of another, but also allows for innovative explanations of a variety of well-known phenomena (amongst these, the interpretations of blindsight and locked-in syndrome will be briefly outlined here). Moreover, a 4D framework makes possible many predictions and hypotheses that may be experimentally tested (We point out a few such possibilities pertaining to interdimensional dependencies).

A validation of the Polish version of the Coma Recovery Scale-Revised (CRSR)

ABSTRACT Primary objective: The aim of this study was to determine the validity of the Polish version of the Coma Recovery Scale—Revised (CRS-R). Methods and design: Two trained raters, A and B, administered CRS-R on a group of 20 patients with severe brain injury (median age ± SD, 38.0 ± 14.39 years). Both rater A and rater B completed their assessment on day 1, and rater A repeated their assessment on day 2. Inter-rater and test-retest reliability were evaluated with an intra-class correlation coefficient and Spearman rank correlation. Internal consistency was estimated with Cronbach’s α. Agreement in diagnostic impression was determined using Cohen’s κ. Results: Inter-rater reliability for CRS-R total scores and test-retest reliability was excellent: (ρ = 0.76, p < 0.001) and (ρ = 0.92, p < 0.001), respectively. Inter-rater diagnostic agreement was good (κ = 0.72, p < 0.001). Inter-rater reliability for subscales was fair to excellent. Internal consistency was excellent (Cronbach’s α = 0.85). Conclusion: The Polish version of CRS-R can be administered reliably by trained raters and can successfully differentiate between vegetative state (VS), minimally conscious (MCS), and patients emerging from a minimally conscious state (EMCS).

The levels of perceptual processing and the neural correlates of increasing subjective visibility

According to the levels-of-processing hypothesis, transitions from unconscious to conscious perception may depend on stimulus processing level, with more gradual changes for low-level stimuli and more dichotomous changes for high-level stimuli. In an event-related fMRI study we explored this hypothesis using a visual backward masking procedure. Task requirements manipulated level of processing. Participants reported the magnitude of the target digit in the high-level task, its color in the low-level task, and rated subjective visibility of stimuli using the Perceptual Awareness Scale. Intermediate stimulus visibility was reported more frequently in the low-level task, confirming prior behavioral results. Visible targets recruited insulo-fronto-parietal regions in both tasks. Task effects were observed in visual areas, with higher activity in the low-level task across all visibility levels. Thus, the influence of level of processing on conscious perception may be mediated by attentional modulation of activity in regions representing features of consciously experienced stimuli.

40 hz auditory steady-state responses in patients with disorders of consciousness: Correlation between phase-locking index and coma recovery scale-revised score

OBJECTIVE We aimed to elucidate whether 40Hz auditory steady-state response (ASSR) could be sensitive to the state of patients with disorders of consciousness (DOC) as estimated with Coma Recovery Scale-Revised (CRS-R) diagnostic tool. METHODS Fifteen DOC patients and 24 healthy controls took part in the study. The 40Hz click trains were used to evoke ASSRs. Mean evoked amplitude (EA) and phase-locking index (PLI) within 38-42Hz window were calculated for 100ms bins, starting from -200 to 700ms relative to stimulus onset. RESULTS The PLI values from the patient group in the period of 200-500ms after the stimulus onset positively correlated with the CRS-R total score and with the scores of the Auditory and Visual subscales. CONCLUSIONS The phase-locking index of 40Hz auditory steady-state responses can be an indicator of the level of dysfunction of the central nervous system in DOC. SIGNIFICANCE Our results emphasize the role of central auditory system integrity in determining the level of functioning of DOC patients and suggest the possibility to use the ASSR protocol as an objective diagnostic method in DOC patients.

An ERP study of audiovisual simultaneity perception

The aim of this study was to examine relation between conscious perception of temporal relation between the elements of an audiovisual pair and the dynamics of accompanying neural activity. This was done by using a simultaneity judgment task and EEG event-related potentials (ERP). During Experiment 1 the pairs of 10 ms white-noise bursts and flashes were used. On presenting each pair subjects pressed one of two buttons to indicate their synchrony. Values of stimulus onset asynchrony (SOA) were based on individual estimates of simultaneity thresholds (50∕50 probability of either response). They were estimated prior to EEG measurement using interleaved staircase involving both sound-first and flash-first stimulus pairs. Experiment 2 had the identical setup, except subjects indicated if audio–visual pair began simultaneously (termination was synchronous). ERP waveforms were time-locked to the second stimulus in the pair. Effects of synchrony perception were studied by comparing ERPs in trials that were judged as simultaneous and non-simultaneous. Subjects were divided into two subgroups with similar SOA values. In both experiments at about 200 ms after the second stimulus onset a stronger ERP wave positivity for trials judged as non-simultaneous was observed in parieto-central sites. This effect was observed for both sound-first and video-first pairs and for both SOA subgroups. The results demonstrate that the perception of temporal relations between multimodal stimuli with identical physical parameters is reflected in localized ERP differences. Given their localization in the posterior parietal regions, these differences may be viewed as correlates of conscious perception of temporal integration vs. separation of audiovisual stimuli.