Facilitation and interference are asymmetric in holistic face processing.

A hallmark of face specificity is holistic processing. It is typically measured by paradigms such as the part-whole and composite tasks. However, these tasks show little evidence for common variance, so a comprehensive account of holistic processing remains elusive. One aspect that varies between tasks is whether they measure facilitation or interference from holistic processing. In this study, we examined facilitation and interference in a single paradigm to determine the way in which they manifest during a face perception task. Using congruent and incongruent trials in the complete composite face task, we found that these two aspects are asymmetrically influenced by the location and cueing probabilities of the target facial half, suggesting that they may operate somewhat independently. We argue that distinguishing facilitation and interference has the potential to disentangle mixed findings from different popular paradigms measuring holistic processing in one unified framework.

Procedural Motor Memory Deficits in Patients With Long-COVID.

BACKGROUND AND OBJECTIVES: At least 15% of patients who recover from acute severe acute respiratory syndrome coronavirus 2 infection experience lasting symptoms ("Long-COVID") including "brain fog" and deficits in declarative memory. It is not known if Long-COVID affects patients' ability to form and retain procedural motor skill memories. The objective was to determine the ability of patients with Long-COVID to acquire and consolidate a new procedural motor skill over 2 training days. The primary outcome was to determine difference in early learning, measured as the increase in correct sequence typing speed over the initial 11 practice trials of a new skill. The secondary outcomes were initial and final typing speed on days 1 and 2, learning rate, overnight consolidation, and typing accuracy. METHODS: In this prospective, cross-sectional, online, case-control study, participants learned a sequential motor skill over 2 consecutive days (NCT05746624). Patients with Long-COVID (reporting persistent post-coronavirus disease 2019 [COVID-19] symptoms for more than 4 weeks) were recruited at the NIH. Patients were matched one-to-one by age and sex to controls recruited during the pandemic using a crowd-sourcing platform. Selection criteria included age 18-90 years, English speaking, right-handed, able to type with the left hand, denied active fever or respiratory infection, and no previous task exposure. Data were also compared with an age-matched and sex-matched control group who performed the task online before the COVID-19 pandemic (prepandemic controls). RESULTS: In total, 105 of 236 patients contacted agreed to participate and completed the experiment (mean ± SD age 46 ± 12.8 years, 82% female). Both healthy control groups had 105 participants (mean age 46 ± 13.1 and 46 ± 11.9 years, 82% female). Early learning was comparable across groups (Long-COVID: 0.36 ± 0.24 correct sequences/second, pandemic controls: 0.36 ± 0.53 prepandemic controls: 0.38 ± 0.57, patients vs pandemic controls [CI -0.068 to 0.067], vs prepandemic controls [CI -0.084 to 0.052], and between controls [CI -0.083 to 0.053], p = 0.82). Initial and final typing speeds on days 1 and 2 were slower in patients than controls. Patients with Long-COVID showed a significantly reduced overnight consolidation and a nonsignificant trend to reduced learning rates. DISCUSSION: Early learning was comparable in patients with Long-COVID and controls. Anomalous initial performance is consistent with executive dysfunction. Reduction in overnight consolidation may relate to deficits in procedural memory formation.

Combined low-frequency brain oscillatory activity and behavior predict future errors in human motor skill.

Human skills are composed of sequences of individual actions performed with utmost precision. When occasional errors occur, they may have serious consequences, for example, when pilots are manually landing a plane. In such cases, the ability to predict an error before it occurs would clearly be advantageous. Here, we asked whether it is possible to predict future errors in a keyboard procedural human motor skill. We report that prolonged keypress transition times (KTTs), reflecting slower speed, and anomalous delta-band oscillatory activity in cingulate-entorhinal-precuneus brain regions precede upcoming errors in skill. Combined anomalous low-frequency activity and prolonged KTTs predicted up to 70% of future errors. Decoding strength (posterior probability of error) increased progressively approaching the errors. We conclude that it is possible to predict future individual errors in skill sequential performance.

All-or-none neural mechanisms underlying face categorization: evidence from the N170.

Categorization of visual stimuli is an intrinsic aspect of human perception. Whether the cortical mechanisms underlying categorization operate in an all-or-none or graded fashion remains unclear. In this study, we addressed this issue in the context of the face-specific N170. Specifically, we investigated whether N170 amplitudes grade with the amount of face information available in an image, or a full response is generated whenever a face is perceived. We employed linear mixed-effects modeling to inspect the dependency of N170 amplitudes on stimulus properties and duration, and their relationships to participants' subjective perception. Consistent with previous studies, we found a stronger N170 evoked by faces presented for longer durations. However, further analysis with equivalence tests revealed that this duration effect was eliminated when only faces perceived with high confidence were considered. Therefore, previous evidence supporting the graded hypothesis is more likely to be an artifact of mixing heterogeneous "all" and "none" trial types in signal averaging. These results support the hypothesis that the N170 is generated in an all-or-none manner and, by extension, suggest that categorization of faces may follow a similar pattern.

Outcomes and Complications of Corticosteroid Injection of Rheumatoid Nodules.

Objective: Rheumatoid nodules (RN), a classic cutaneous extra-articular manifestation of rheumatoid arthritis, can often cause discomfort or cosmetic embarrassment. This research determined the effectiveness and complications of corticosteroid injection of the RN. Methods: Using a repeated measure design, 66 consecutive symptomatic RN were measured, underwent corticosteroid injection with 1 to 2mL of a 50:50 mixture of 1% lidocaine and triamcinolone acetonide (20-40mg), and then reassessed at four months for softening, reduction in size, and complications, including infection. Results: The mean age of our patient group was 53.3±10.6 years; 45 percent were Hispanic, 55 percent were non-Hispanic White, 100 percent were seropositive (rheumatoid factor and/or anti-CCP antibody), and 87.5 percent were female. Baseline mean RN diameter was 0.50±0.51cm and four months after injection was reduced to 0.29±0.33cm (decreased 42% or 0.21±0.57cm reduction, 95% CI: 0.46 <0.21< 0.37, p=0.013), 100 percent (66/66) were less painful, and 77 percent (51/66) were palpably softened. However, 70 percent (46/66) demonstrated cutaneous atrophy and/or hypopigmentation at four months, 53 percent (35/66) nodules recurred within 12 months, and 47 percent (31/66) nodules were eventually surgically removed. Limitations: Two (3%) of the larger RN (2.5cm on the olecranon and 2cm on the 2nd toe) became infected and failed antibiotic therapy, necessitating surgical excision for complete resolution. Conclusion: For short-term symptomatic relief, smaller RN can be safely injected with triamcinolone. Large symptomatic RN (≥2cm) are at greater risk of infection; thus, in these cases, lower corticosteroid doses or surgical excision may be preferred. In the long-term, effective systemic antirheumatic therapy with treat-to-target is the best approach.

Intraarticular injection of the interphalangeal joint for therapy of digital mucoid cysts.

Mucoid cysts are associated with osteoarthritis (OA) of the digital joints and frequently recur after needle drainage, injection, or surgical ablation. This study determined whether intraarticular injection of the adjacent interphalangeal joint rather than the cyst itself might be effective in resolving digital mucoid cysts. Using paired case series design and sterile technique, 25 consecutive OA digital joints with an adjacent mucoid cyst underwent dorsal non-transtendinous intraarticular injection with a 25-gauge needle and 20-mg triamcinolone acetonide, followed by puncture and manual expression of cyst fluid. Patient pain was measured with the 10-cm Visual Analogue Pain Scale prior to the procedure and at 6 months. Cyst resolution was determined at 6 months and 3 years. The subjects were 61.0 ± 7.7 years old and 60% (15/25) female. Mucoid cysts were adjacent to 19 distal interphalangeal, 3 metacarpophalangeal, and 3 interphalangeal joints. Pre-procedural pain was 4.7 ± 1.0; procedural pain was 6.2 ± 0.6 cm, and post-procedural pain at 6 months was 1.2 ± 0.8 cm (74.5% reduction, 95% CI of difference: 3.0 < 3.5 < 4.0 (p < 0.0001)). 84% (21/25) of the cysts resolved at 6 months; however, 60% (15/25) of the mucoid cysts recurred within 3 years and required retreatment (14 adjacent joints re-injected and 1 ablative cyst surgery). No complications were noted. Intraarticular corticosteroid injection using a dorsal non-transtendinous approach of the joint adjacent to a mucoid cyst is effective resolving cysts and reducing pain at 6 months; however, 60% of mucoid cysts reoccur within 3 years and may require reinjection or surgery.Trial registration: This was not a clinical trial.

Enhanced arthrocentesis of the effusive knee with pneumatic compression.

AIM: Complete arthrocentesis of the effusive knee ameliorates patient pain, reduces intra-articular and intraosseous pressure, removes inflammatory cytokines, and has been shown to substantially improve the therapeutic outcomes of intra-articular injections. However, conventional arthrocentesis incompletely decompresses the knee, leaving considerable residual synovial fluid in the intra-articular space. The present study determined whether external pneumatic circumferential compression of the effusive knee permitted more successful arthrocentesis and complete joint decompression. METHODS: Using a paired sample design, 50 consecutive effusive knees underwent conventional arthrocentesis and then arthrocentesis with pneumatic compression. Pneumatic compression was applied to the superior knee using a conventional thigh blood pressure cuff inflated to 100 mm Hg which compressed the suprapatellar bursa and patellofemoral joint, forcing fluid from the superior knee to the anterolateral portal where the fluid could be accessed. Arthrocentesis success and fluid yield in mL before and after pneumatic compression were determined. RESULTS: Successful diagnostic arthrocentesis (≥3 mL) of the effusive knee was 82% (41/50) with conventional arthrocentesis and increased to 100% (50/50) with pneumatic compression (P = .001). Synovial fluid yields increased by 144% (19.8 ± 17.1 mL) with pneumatic compression (conventional arthrocentesis; 13.7 ± 16.4 mL, pneumatic compression: 33.4 ± 26.5 mL; 95% CI: 10.9 < 19.7 < 28.9 mL, P < .0001). CONCLUSIONS: Conventional arthrocentesis routinely does not fully decompress the effusive knee. External circumferential pneumatic compression markedly improves arthrocentesis success and fluid yield, and permits complete decompression of the effusive knee. Pneumatic compression of the effusive knee with a thigh blood pressure cuff is an inexpensive and widely available technique to improve arthrocentesis outcomes.

Holistic face processing is influenced by non-conscious visual information.

Holistic face processing has been widely implicated in conscious face perception. Yet, little is known about whether holistic face processing occurs when faces are processed unconsciously. The present study used the composite face task and continuous flash suppression (CFS) to inspect whether the processing of target facial information (the top half of a face) is influenced by irrelevant information (the bottom half) that is presented unconsciously. Results of multiple experiments showed that the composite effect was observed in both monocular and CFS conditions, providing the first evidence that the processing of top facial halves is influenced by the aligned bottom halves no matter whether they are presented consciously or unconsciously. However, much of the composite effect for faces without masking was disrupted when bottom facial parts were rendered with CFS. These results suggest that holistic face processing can occur unconsciously, but also highlight the significance of holistic processing of consciously presented faces.

Repetition blindness for words and pictures: A failure to form stable type representations?

Repetition blindness (RB) is the failure to detect and report a repeated item during rapid serial visual presentation (RSVP). The RB literature reveals consistent and robust RB for word stimuli, but somewhat variable RB effects for pictorial stimuli. We directly compared RB for object pictures and their word labels, using exactly the same procedure in the same participants. Experiment 1 used a large pool of stimuli that only occurred once during the experiment and found significant RB for words, but significant repetition facilitation for pictures. These differential repetition effects were replicated when the task required participants to only report the last item of the stream. Experiment 2 used a small pool of stimuli presented several times throughout the experiment. Significant RB was found for both words and pictures, although it was more pronounced for words. These findings present a challenge to the token individuation hypothesis (Kanwisher, Cognition, 27, 117-143, 1987) and suggest that RB is more likely to be due to a difficulty in establishing a robust type representation. We propose that an experimental context that contains high levels of overlap in visual features (e.g., letters in the case of words, visual fragments in the case of repeatedly presented pictures) may prevent the formation of distinct object-level episodic representations, resulting in RB.

Metacognition of average face perception.

Individuals have the ability to extract summary statistics from multiple items presented simultaneously. However, it is unclear yet whether we have insight into the process of ensemble coding. The aim of this study was to investigate metacognition about average face perception. Participants saw a group of four faces presented for 2 s or 5 s, and then they were asked to judge whether the following test face was present in the previous set (Experiment 1), or whether the test face was the average of the four member faces (Experiment 2). After each response, participants rated their confidence. Replicating previous findings, there was substantial endorsement for the average face derived from the four member faces in Experiment 1, even though it was not present in the set. When judging faces that had been presented in the set, confidence correlated positively with accuracy, providing evidence for metacognitive awareness of previously studied faces. Importantly, there was a negative confidence-accuracy relationship for judging average faces when duration was 2 s, and a near-zero relationship when duration was 5 s. By contrast, when the average face had to be identified explicitly in Experiment 2, performance was above chance level and there was a positive correlation between confidence and accuracy. These results suggest that people have metacognitive awareness about average face perception when averaging is required explicitly, but they lack insight into the averaging process when member identification is required.

Prediction errors in surface segmentation are reflected in the visual mismatch negativity, independently of task and surface features.

The visual system quickly registers perceptual regularities in the environment and responds to violations in these patterns. Errors of perceptual prediction are associated with electrocortical modulation, including the visual mismatch negativity (vMMN) and P2 event-related potential. One relatively unexplored question is whether these prediction error signals can encode higher-level properties such as surface segmentation, or whether they are limited to lower-level perceptual features. Using a roving standard paradigm, a triangle surface appeared either behind (featuring amodal contours) or in front of (featuring real contours) a second surface with hole-like windows. A surface layout appeared for two to five repetitions before switching to the other "deviant" layout; lighting and orientation of stimuli varied across presentations while remaining isoluminant. Observers responded when they detected a rare "pinched" triangle, which occasionally appeared. Cortical activity-reflected in mismatch responses affecting the P2-N2 and P300 amplitudes-was sensitive to a change in stimulus layout, when surfaces shifted position in depth, following several repetitions. Specifically, layout deviants led to a more negative P2-N2 complex at posterior electrodes, and greater P300 positivity at central sites. Independently of these signals of a deviant surface layout, further modulations of the P2 encoded differences between layouts and detection of the rare target stimulus. Comparison of the effect of preceding layout repetitions on this prediction error signal suggests that it is all or none and not graded with respect to the number of previous repetitions. We show that within the visual domain, unnoticed and task-irrelevant changes in visual surface segmentation leads to observable electrophysiological signals of prediction error that are dissociable from stimulus-specific encoding and lower-level perceptual processing.

The Subjective Experience of Inner Speech in Aphasia Is a Meaningful Reflection of Lexical Retrieval.

Purpose Individuals with aphasia often report that they feel able to say words in their heads, regardless of speech output ability. Here, we examine whether these subjective reports of successful "inner speech" (IS) are meaningful and test the hypothesis that they reflect lexical retrieval. Method Participants were 53 individuals with chronic aphasia. During silent picture naming, participants reported whether or not they could say the name of each item inside their heads. Using the same items, they also completed 3 picture-based tasks that required phonological retrieval and 3 matched auditory tasks that did not. We compared participants' performance on these tasks for items they reported being able to say internally versus those they reported being unable to say internally. Then, we examined the relationship of psycholinguistic word features to self-reported IS and spoken naming accuracy. Results Twenty-six participants reported successful IS on nearly all items, so they could not be included in the item-level analyses. These individuals performed correspondingly better than the remaining participants on tasks requiring phonological retrieval, but not on most other language measures. In the remaining group ( n = 27), IS reports related item-wise to performance on tasks requiring phonological retrieval, but not to matched control tasks. Additionally, IS reports were related to 3 word characteristics associated with lexical retrieval, but not to articulatory complexity; spoken naming accuracy related to all 4 word characteristics. Six participants demonstrated evidence of unreliable IS reporting; compared with the group, they also detected fewer errors in their spoken responses and showed more severe language impairments overall. Conclusions Self-reported IS is meaningful in many individuals with aphasia and reflects lexical phonological retrieval. These findings have potential implications for treatment planning in aphasia and for our understanding of IS in the general population.

Extractable synovial fluid in inflammatory and non-inflammatory arthritis of the knee.

INTRODUCTION/OBJECTIVES: We hypothesized that mechanical compression of the knee in rheumatoid arthritis (RA) would mobilize occult extractable fluid and improve arthrocentesis success. METHODS: Sixty-seven consecutive knees with RA and 186 knees with OA and were included. Conventional arthrocentesis was performed and success and volume (milliliters) determined; the needle was left intraarticularly, and mechanical compression was applied with an elastomeric knee brace. Arthrocentesis was then resumed until fluid return ceased. Fluid was characterized as to volume and cell counts. RESULTS: In the RA, knee mechanical compression decreased failed diagnostic arthrocentesis from 56.7% (38/67) to 26.9% (18/67) (- 47.4%, p = 0.003) and increased absolute arthrocentesis yield from 4.7 ± 10.3 ml to 9.8 ± 9.8 ml (108% increase, 95% CI - 8.5 < - 5.1 < - 1.7 p = 0.0038). Total extractable fluid yield was 96% greater in RA (9.8 ± 9.8 ml) than OA (5.0 ± 9.4 ml, p = 0.0008), and occult extractable fluid was 77% greater in RA than OA (RA 5.3 ± 8.7 ml, OA 3.0 ± 5.5 ml, p = 0.046). Large effusions versus small effusions in RA demonstrated increased neutrophils in synovial fluid (p = 0.04) but no difference in radiologic arthritis grade (p = 0.87). In contrast, large effusions versus small effusions in OA demonstrated no difference in neutrophils in synovial fluid (p = 0.87) but significant different radiologic arthritis grade (p = 0.04). CONCLUSION: Mechanical compression improves the success of diagnostic and therapeutic knee arthrocentesis in both RA and OA. Large effusions in RA are associated with increased neutrophil counts but not arthritis grade; in contrast, large effusions in OA are associated with more severe arthritis grades but not increased neutrophil counts. Key points• Mechanical compression of the painful knee improves arthrocentesis success and fluid yield in both rheumatoid arthritis and osteoarthritis.• The painful rheumatoid knee contains approximately 100% more fluid than the osteoarthritic knee.• Large effusions in the osteoarthritic knee are characterized by higher grades of mechanical destruction but not increased neutrophil counts.• In contrast, large effusions in the rheumatoid knee are characterized by higher synovial fluid neutrophil counts but not the grade of mechanical destruction, indicating different mechanisms of effusion formation in rheumatoid arthritis versus osteoarthritis.

Self-reported inner speech relates to phonological retrieval ability in people with aphasia.

Many individuals with aphasia report the ability to say words in their heads despite spoken naming difficulty. Here, we examined individual differences in the experience of inner speech (IS) in participants with aphasia to test the hypotheses that self-reported IS reflects intact phonological retrieval and that articulatory output processing is not essential to IS. Participants (N = 53) reported their ability to name items correctly internally during a silent picture-naming task. We compared this measure of self-reported IS to spoken picture naming and a battery of tasks measuring the underlying processes required for naming (i.e., phonological retrieval and output processing). Results from three separate analyses of these measures indicate that self-reported IS relates to phonological retrieval and that speech output processes are not a necessary component of IS. We suggest that self-reported IS may be a clinically valuable measure that could assist in clinical decision-making regarding anomia diagnosis and treatment.

Other-race faces are given more weight than own-race faces when assessing the composition of crowds.

In two experiments we examined the performance of Asian and Caucasian participants as they were asked to estimate the ethnic composition of arrays of 16 concurrently presented faces. Across trials we systematically varied the physical proportion of Asian and Caucasian faces presented in the arrays using the method of constant stimuli. The task was to explicitly indicate which group was in the majority. The position of the 16 faces within the array were continuously shuffled using a 4 × 4 moving grid to block explicit enumeration. Measures of bias and sensitivity were estimated by fitting cumulative normal distributions to individual response data. Consistent with recent findings on "ensemble" face processing, all participants were able to make group estimates quite accurately. This was true using both full-colour, non-normalised, headshots (Exp1) and centre-apertured, normalised, grey-scale images (Exp2). However, the main finding was that performance estimates from the two groups of participants did not overlap. Specifically, patterns of bias suggest that other-race faces are weighted more heavily than own-race faces (Exps 1 & 2), while sensitivity is better for groups instructed to decide if the other-race, rather than own-race, is more numerous (Exp 2). To our knowledge, these are the first demonstrations of other-race biases affecting decisions that have to be made about groups of faces.

Intralesional Injection of Triamcinolone Acetonide for Subcutaneous Lipoma causing Musculoskeletal and Neurologic Symptoms.

Objective: Benign subcutaneous lipomas can cause musculoskeletal pain and nerve impingement. We hypothesized that the potent lipolytic and atrophic effect of 40mg/mL triamcinolone acetonide would atrophy symptomatic lipomas so surgical excision could be avoided. Design: This was a cohort study. Setting: This study took place in an ultrasound injection clinic. Participants: Eight subjects with painful symptomatic lipoma were included. Measurements: Preprocedurally, the margins of the lipomas were palpated and marked with ink, then measured in centimeters (cm). Small lipomas (1-3cm) were injected with 40mg triamcinolone acetonide, while large lipomas (4-6cm) were injected with 80mg of triamcinolone acetonide. The subjects were reassessed at a four-month follow-up appointment and then again at one year and two years after the procedure. Results: Pre-injection, all eight subjects had symptoms related to impingement or pain with compression of the lipoma. At four months post-injection, none of the patients had symptoms attributable to the lipoma (p<0.001). The mean lipoma palpable dimension was 5.0±1.2cm prior to the injection and was 2.0±1.1cm at four months after the injection, with a significant mean 3.0±0.3cm (60%) reduction in lipoma dimensions (p<0.001). Two subjects demonstrated some mild hypopigmentation of the skin at four months post-injection. Within two years, three lipomas had symptomatically recurred, one of which was removed surgically and the two of which were reinjected. There were no infections or other serious adverse reactions that occurred. Conclusions: For individuals with painful subcutaneous lipoma, intralesional injection of 40mg/mL of triamcinolone acetonide is an effective and safe alternative to surgical excision or injection of sclerosing agents and should be considered as a reasonable therapeutic alternative in select patients.

Integrating predictive frameworks and cognitive models of face perception.

The idea of a "predictive brain"-that is, the interpretation of internal and external information based on prior expectations-has been elaborated intensely over the past decade. Several domains in cognitive neuroscience have embraced this idea, including studies in perception, motor control, language, and affective, social, and clinical neuroscience. Despite the various studies that have used face stimuli to address questions related to predictive processing, there has been surprisingly little connection between this work and established cognitive models of face recognition. Here we suggest that the predictive framework can serve as an important complement of established cognitive face models. Conversely, the link to cognitive face models has the potential to shed light on issues that remain open in predictive frameworks.