Alpha-band EEG suppression as a neural marker of sustained attentional engagement to conditioned threat stimuli.

Attention helps us to be aware of the external world, and this may be especially important when a threat stimulus predicts an aversive outcome. Electroencephalogram (EEG) alpha-band suppression has long been considered as a neural signature of attentional engagement. The present study was designed to test whether attentional engagement, as indexed by alpha-band suppression, is increased in a sustained manner following a conditioned stimulus (CS) that is paired with an aversive (CS+) vs neutral (CS-) outcome. We tested 70 healthy young adults in aversive conditioning and extinction paradigms. One of three colored circles served as the CS+, which was paired in 50% of the trials with a noise burst (unconditioned stimulus, US). The other colored circles (CS-) were never paired with the US. For conditioning, we found greater alpha-band suppression for the CS+ compared to the CS-; this suppression was sustained through the time of the predicted US. This effect was significantly reduced for extinction. These results indicate that conditioned threat stimuli trigger an increase in attentional engagement as subjects monitor the environment for the predicted aversive stimulus. Moreover, this alpha-band suppression effect may be valuable for future studies examining normal or pathological increases in attentional monitoring following threat stimuli.

Lateralized Suppression of Alpha-Band EEG Activity As a Mechanism of Target Processing.

Alpha-band (8-12 Hz) EEG activity has been linked to visual attention since the earliest EEG studies. More recent studies using spatial cuing paradigms have shown that alpha is suppressed over the hemisphere contralateral to a to-be-attended location, suggesting that alpha serves as a mechanism of preparatory attention. Here, we demonstrate that alpha also plays a role in active target processing. EEG activity was recorded from a group of healthy male and female human subjects in two visual search experiments. In addition to alpha activity, we also assessed the N2pc event-related potential component, a lateralized transient EEG response that has been tightly linked with the focusing of attention on visual targets. We found that the visual search targets triggered both an N2pc component and a suppression of alpha-band activity that was greatest over the hemisphere contralateral to the target (which we call "target-elicited lateralized alpha suppression" or TELAS). In Experiment 1, both N2pc and TELAS were observed for targets presented in the lower visual field but were absent for upper-field targets. However, these two lateralized effects had different time courses and they responded differently to manipulations of crowding in Experiment 2. These results indicate that lateralized alpha-band activity is involved in active target processing and is not solely a preparatory mechanism and also that TELAS and N2pc reflect a related but separable neural mechanism of visuospatial attention.SIGNIFICANCE STATEMENT The very first EEG studies demonstrated that alpha-band (8-12 Hz) EEG oscillations are suppressed when people attend to visual information and more recent research has shown that cuing an individual to expect a target at a specific location produces lateralized suppression in the contralateral hemisphere. Therefore, lateralized alpha may serve as a preparatory mechanism. In the present study, we found that a similar lateralized alpha effect is triggered by the appearance of a visual target even though the location could not be anticipated, demonstrating that alpha also serves as an active mechanism of target processing. Moreover, we found that alpha lateralization can be dissociated from other lateralized measures of target selection, indicating that it reflects a distinct mechanism of attention.

Event-related potential components as measures of aversive conditioning in humans.

For more than 60 years, the gold standard for assessing aversive conditioning in humans has been the skin conductance response (SCR), which arises from the activation of the peripheral nervous system. Although the SCR has been proven useful, it has some properties that impact the kinds of questions it can be used to answer. In particular, the SCR is slow, reaching a peak 4-5 s after stimulus onset, and it decreases in amplitude after a few trials (habituation). The present study asked whether the late positive potential (LPP) of the ERP waveform could be a useful complementary method for assessing aversive conditioning in humans. The SCR and LPP were measured in an aversive conditioning paradigm consisting of three blocks in which one color was paired with a loud noise (CS+) and other colors were not paired with the noise (CS-). Participants also reported the perceived likelihood of being exposed to the noise for each color. Both SCR and LPP were significantly larger on CS+ trials than on CS- trials. However, SCR decreased steeply after the first conditioning block, whereas LPP and self-reports were stable over blocks. These results indicate that the LPP can be used to assess aversive conditioning and has several useful properties: (a) it is a direct response of the central nervous system, (b) it is fast, with an onset latency of 300 ms, (c) it does not habituate over time.

The allocation of attention and working memory in visual crowding.

When the distance between a visual target and nearby flankers falls below a critical distance, target discrimination declines precipitously. This is called "crowding." Many researchers have proposed that selective attention plays a role in crowding. However, although some research has examined the effects of directing attention toward versus away from the targets, no previous research has assessed how attentional allocation varies as a function of target-flanker distance in crowding. Here, we used ERPs to assess the operation of attention during crowding, focusing on the attention-related N2pc component. We used a typical crowding task in which participants were asked to report the category (vowel/consonant) of a lateralized target letter flanked by distractor letters at different distances. We tested the hypothesis that attention fails when the target-flanker distance becomes too small for attention to operate effectively. Consistent with this hypothesis, we found that N2pc amplitude was maximal at intermediate target-flanker distances and decreased substantially when crowding became severe. In addition, we examined the sustained posterior contralateral negativity (SPCN), which reflects the amount of information being maintained in working memory. Unlike the N2pc component, the SPCN increased in amplitude at small target-flanker distances, suggesting that observers stored information about the target and flankers in working memory when attention failed to select the target. Together, the N2pc and SPCN results suggest that attention and working memory play distinctive roles in crowding: Attention operates to minimize interference from the flankers at intermediate target-flanker distances, whereas working memory may be recruited when attention fails to select the target at small target-flanker distances.

Adverse perinatal outcomes after the February 27th 2010 Chilean earthquake.

OBJECTIVE: To investigate whether the February 27th earthquake exposition was associated to adverse perinatal outcomes in Chilean pregnant women. METHODS: We analyzed all deliveries occurred in 2009 (n = 3,609) and 2010 (n = 3,279) in a reference hospital in the area of the earthquake. Furthermore, we investigated pregnant women who gave birth between March 1st and December 31st 2010 (n = 2,553) and we classified them according to timing of exposition. RESULTS: We found a 9% reduction in birth rate, but an increase in the rate of early preterm deliveries (<34 weeks), premature rupture of membranes (PROM), macrosomia, small for gestational age, and intrauterine growth restriction (IUGR) after the earthquake, in contrast to the previous year. Women exposed to the earthquake during her first trimester delivered smaller newborns (3,340 ± 712 g v/s 3,426 ± 576 g respectively, p = 0.007) and were more likely diagnosed with early preterm delivery, preterm delivery (<37 weeks) and PROM but were less likely diagnosed with IUGR and late delivery (42 weeks, p < 0.05) compared to those exposed at third trimester. Accordingly, IUGR and preterm deliveries presented elevated healthcare costs. CONCLUSION: Natural disasters such as earthquakes are associated to adverse perinatal outcomes that impact negatively the entire maternal-neonatal healthcare system.

The debate about death: an imperishable discussion?

In this concise review we discuss some of the complex edges of the concept of death that arose after the notorious advances in science and medicine over the last 50 years, in which the classical cardio-pulmonary criteria have led to the neurological criteria of death. New complicated questions like the definition of death and the operational criteria for diagnosing it have arisen and we think that they are far from being adequately and satisfactorily solved. A number of important issues--like the reliability and differences between cardio-pulmonary versus brain based criteria of death, if death is an event or a process, the meaning of integration and irreversibility--have not yet received sufficient attention. Here we have approached the death problem from two (biological) complex system perspectives: the organism level and the cellular-molecular level. We also discuss issues from a third systemic approach, that is, the entire society, thus involving legal, religious, bioethical and political aspects of death. Our aim is to integrate new perspectives in order to promote further discussion on these critical yet frequently neglected issues.

The debate about death: an imperishable discussion?

In this concise review we discuss some of the complex edges of the concept of death that arose after the notorious advances in science and medicine over the last 50 years, in which the classical cardio-pulmonary criteria have led to the neurological criteria of death. New complicated questions like the definition of death and the operational criteria for diagnosing it have arisen and we think that they are far from being adequately and satisfactorily solved. A number of important issues -like the reliability and differences between cardio-pulmonary versus brain based criteria of death, if death is an event or a process, the meaning of integration and irreversibility- have not yet received sufficient attention. Here we have approached the death problem from two (biological) complex system perspectives: the organism level and the cellular-molecular level. We also discuss issues from a third systemic approach, that is, the entire society, thus involving legal, religious, bioethical and political aspects of death. Our aim is to integrate new perspectives in order to promote further discussion on these critical yet frequently neglected issues.

[Attention deficit hyperactivity disorder in adults]. / Trastorno por déficit atencional con hiperactividad en adultos.

The attention deficit hyperactivity disorder (ADHD) is the most common diagnosis in child psychiatry, and persists very often in adulthood. These patients have poor lifestyles, especially in affective, work and social areas. Although patients with ADHD have a high rate of comorbidity (e.g. drug and alcohol abuse, depressive and anxiety disorders), this diagnosis is missed by the general physician, deferring its identification and opportune treatment. This article is a review about this disorder and gives tools for its recognition and derivation.

Características clínicas del trastorno de adaptación con síntomas de estrés postraumático / Clinical features of adjustment disorder with postraumatic stress symptomatology

Los accidentes constituyen un acontecimiento traumático y pueden provocar repercusiones psíquicas, entre ellas un trastorno de adaptación. Objetivo: estudiar las características clínicas y la evolución de pacientes con un trastorno de adaptación con síntomas de estrés postraumático (TAD), cuadro que no alcanza a cumplir los criterios diagnósticos para trastorno agudo de estrés o trastorno de estrés postraumático. Metodología: estudio retrospectivo de fichas clínicas de accidentados del trabajao (1996-1998), utilizando criterios diagnósticos de la CIE-10 y un instrumento ad hoc para recoger la información. Se efectuó análisis estadístico con el programa computacional Epi Info 6,04. Resultados: la muestra estuvo constituida por 141 pacientes (54 por ciento hombres), de los cuales el 77,3 por ciento fue derivado a consultar en psiquiatría antes de 30 días de ocurrido el accidente. El tipo de accidente fue una amenaza o ataque intencional (39,3 por ciento), accidente de tránsito (26,4 por ciento) y accidentes en el lugar de trabajo (34,3 por ciento). Los síntomas predominantes fueron los de tipo invasor (95,0 por ciento), ansiedad (93,6 por ciento) y trastornos del sueño (87,9 por ciento). El tratamiento combinado de psicofármacos y psicoterapia duró 85 días y el 62,4 por ciento de los pacientes requirió de reposo médico (en promedio 57,6 días). El 82,3 por ciento de la muestra egresó con el mismo diagnóstico. Los factores que influyeron en una derivación más precoz fueron el tipo de accidente (asalto/violación), los síntomas invasores y los trastornos del sueño. Conclusiones: el diagnóstico de TAD constituye un constructo operacional que ayuda a una derivación más precoz y a un menor tiempo de tratamiento