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1.
Neurosci Biobehav Rev ; 162: 105696, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38723734

ABSTRACT

Human brain activity consists of different frequency bands associated with varying functions. Oscillatory activity of frontal brain regions in the theta range (4-8 Hz) is linked to cognitive processing and can be modulated by neurofeedback - a technique where participants receive real-time feedback about their brain activity and learn to modulate it. However, criticism of this technique evolved, and high heterogeneity of study designs complicates a valid evaluation of its effectiveness. This meta-analysis provides the first systematic overview over studies attempting to modulate frontal midline theta with neurofeedback in healthy human participants. Out of 1261 articles screened, 14 studies were eligible for systematic review and 11 for quantitative meta-analyses. Studies were evaluated following the DIAD model and the PRISMA guidelines. A significant across-study effect of medium size (Hedges' g = .66; 95%-CI [-0.62, 1.73]) with substantial between-study heterogeneity (Q(16) = 167.43, p < .001) was observed and subanalysis revealed effective frontal midline theta upregulation. We discuss moderators of effect sizes and provide guidelines for future research in this dynamic field.


Subject(s)
Frontal Lobe , Neurofeedback , Theta Rhythm , Humans , Theta Rhythm/physiology , Neurofeedback/physiology , Neurofeedback/methods , Frontal Lobe/physiology
2.
Neuroimage ; 290: 120563, 2024 Apr 15.
Article in English | MEDLINE | ID: mdl-38492685

ABSTRACT

Individual differences in general cognitive ability (GCA) have a biological basis within the structure and function of the human brain. Network neuroscience investigations revealed neural correlates of GCA in structural as well as in functional brain networks. However, whether the relationship between structural and functional networks, the structural-functional brain network coupling (SC-FC coupling), is related to individual differences in GCA remains an open question. We used data from 1030 adults of the Human Connectome Project, derived structural connectivity from diffusion weighted imaging, functional connectivity from resting-state fMRI, and assessed GCA as a latent g-factor from 12 cognitive tasks. Two similarity measures and six communication measures were used to model possible functional interactions arising from structural brain networks. SC-FC coupling was estimated as the degree to which these measures align with the actual functional connectivity, providing insights into different neural communication strategies. At the whole-brain level, higher GCA was associated with higher SC-FC coupling, but only when considering path transitivity as neural communication strategy. Taking region-specific variations in the SC-FC coupling strategy into account and differentiating between positive and negative associations with GCA, allows for prediction of individual cognitive ability scores in a cross-validated prediction framework (correlation between predicted and observed scores: r = 0.25, p < .001). The same model also predicts GCA scores in a completely independent sample (N = 567, r = 0.19, p < .001). Our results propose structural-functional brain network coupling as a neurobiological correlate of GCA and suggest brain region-specific coupling strategies as neural basis of efficient information processing predictive of cognitive ability.


Subject(s)
Brain , Connectome , Adult , Humans , Brain/diagnostic imaging , Cognition , Magnetic Resonance Imaging/methods , Connectome/methods , Diffusion Magnetic Resonance Imaging
3.
J Clin Psychol ; 80(1): 23-38, 2024 01.
Article in English | MEDLINE | ID: mdl-37531080

ABSTRACT

BACKGROUND: Anxiety, approach, and avoidance motivation crucially influence mental and physical health, especially when environments are stressful. The interplay between anxiety and behavioral motivation is modulated by multiple individual factors. This proof-of-concept study applies graph-theoretical network analysis to explore complex associations between self-reported trait anxiety, approach and avoidance motivation, situational anxiety, stress symptoms, perceived threat, perceived positive consequences of approach, and self-reported avoidance behavior in real-life threat situations. METHODS: A total of 436 participants who were matched on age and gender (218 psychotherapy patients, 218 online-recruited nonpatients) completed an online survey assessing these factors in response to the COVID-19 pandemic. RESULTS AND DISCUSSION: The resulting cross-sectional psychological network revealed a complex pattern with multiple positive (e.g., between trait anxiety, avoidance motivation, and avoidance behavior) and negative associations (e.g., between approach and avoidance motivation). The patient and online subsample networks did not differ significantly, however, descriptive differences may inform future research.


Subject(s)
Anxiety , Pandemics , Humans , Cross-Sectional Studies , Anxiety/psychology , Anxiety Disorders , Motivation , Avoidance Learning
4.
Sci Rep ; 13(1): 13799, 2023 08 23.
Article in English | MEDLINE | ID: mdl-37612345

ABSTRACT

Pain-associated approach and avoidance behaviours are critically involved in the development and maintenance of chronic pain. Empirical research suggests a key role of operant learning mechanisms, and first experimental paradigms were developed for their investigation within a controlled laboratory setting. We introduce a new Virtual Reality paradigm to the study of pain-related behaviour and investigate pain experiences on multiple dimensions. The paradigm evaluates the effects of three-tiered heat-pain stimuli applied contingent versus non-contingent with three types of arm movements in naturalistic virtual sceneries. Behaviour, self-reported pain-related fear, pain expectancy and electrodermal activity were assessed in 42 healthy participants during an acquisition phase (contingent movement-pain association) and a modification phase (no contingent movement-pain association). Pain-associated approach behaviour, as measured by arm movements followed by a severe heat stimulus, quickly decreased in-line with the arm movement-pain contingency. Slower effects were observed in fear of movement-related pain and pain expectancy ratings. During the subsequent modification phase, the removal of the pain contingencies modified all three indices. In both phases, skin conductance responses resemble the pattern observed for approach behaviour, while skin conductance levels equal the pattern observed for the self-ratings. Our findings highlight a fast reduction in approach behaviour in the face of acute pain and inform about accompanying psychological and physiological processes. We discuss strength and limitations of our paradigm for future investigations with the ultimate goal of gaining a comprehensive understanding of the mechanisms involved in chronic pain development, maintenance, and its therapy.


Subject(s)
Acute Pain , Chronic Pain , Humans , Choice Behavior , Proof of Concept Study
5.
Elife ; 122023 08 09.
Article in English | MEDLINE | ID: mdl-37555830

ABSTRACT

Human neuroscience has always been pushing the boundary of what is measurable. During the last decade, concerns about statistical power and replicability - in science in general, but also specifically in human neuroscience - have fueled an extensive debate. One important insight from this discourse is the need for larger samples, which naturally increases statistical power. An alternative is to increase the precision of measurements, which is the focus of this review. This option is often overlooked, even though statistical power benefits from increasing precision as much as from increasing sample size. Nonetheless, precision has always been at the heart of good scientific practice in human neuroscience, with researchers relying on lab traditions or rules of thumb to ensure sufficient precision for their studies. In this review, we encourage a more systematic approach to precision. We start by introducing measurement precision and its importance for well-powered studies in human neuroscience. Then, determinants for precision in a range of neuroscientific methods (MRI, M/EEG, EDA, Eye-Tracking, and Endocrinology) are elaborated. We end by discussing how a more systematic evaluation of precision and the application of respective insights can lead to an increase in reproducibility in human neuroscience.


Subject(s)
Neurosciences , Humans , Reproducibility of Results , Sample Size , Magnetic Resonance Imaging
6.
Neuroimage ; 277: 120246, 2023 08 15.
Article in English | MEDLINE | ID: mdl-37364742

ABSTRACT

Human functional brain connectivity can be temporally decomposed into states of high and low cofluctuation, defined as coactivation of brain regions over time. Rare states of particularly high cofluctuation have been shown to reflect fundamentals of intrinsic functional network architecture and to be highly subject-specific. However, it is unclear whether such network-defining states also contribute to individual variations in cognitive abilities - which strongly rely on the interactions among distributed brain regions. By introducing CMEP, a new eigenvector-based prediction framework, we show that as few as 16 temporally separated time frames (< 1.5% of 10 min resting-state fMRI) can significantly predict individual differences in intelligence (N = 263, p < .001). Against previous expectations, individual's network-defining time frames of particularly high cofluctuation do not predict intelligence. Multiple functional brain networks contribute to the prediction, and all results replicate in an independent sample (N = 831). Our results suggest that although fundamentals of person-specific functional connectomes can be derived from few time frames of highest connectivity, temporally distributed information is necessary to extract information about cognitive abilities. This information is not restricted to specific connectivity states, like network-defining high-cofluctuation states, but rather reflected across the entire length of the brain connectivity time series.


Subject(s)
Brain , Connectome , Humans , Brain/diagnostic imaging , Brain/physiology , Cognition/physiology , Brain Mapping/methods , Connectome/methods , Magnetic Resonance Imaging/methods , Intelligence , Nerve Net/diagnostic imaging
7.
eNeuro ; 10(2)2023 02.
Article in English | MEDLINE | ID: mdl-36657966

ABSTRACT

Spontaneous brain activity builds the foundation for human cognitive processing during external demands. Neuroimaging studies based on functional magnetic resonance imaging (fMRI) identified specific characteristics of spontaneous (intrinsic) brain dynamics to be associated with individual differences in general cognitive ability, i.e., intelligence. However, fMRI research is inherently limited by low temporal resolution, thus, preventing conclusions about neural fluctuations within the range of milliseconds. Here, we used resting-state electroencephalographical (EEG) recordings from 144 healthy adults to test whether individual differences in intelligence (Raven's Advanced Progressive Matrices scores) can be predicted from the complexity of temporally highly resolved intrinsic brain signals. We compared different operationalizations of brain signal complexity (multiscale entropy, Shannon entropy, Fuzzy entropy, and specific characteristics of microstates) regarding their relation to intelligence. The results indicate that associations between brain signal complexity measures and intelligence are of small effect sizes (r ∼ 0.20) and vary across different spatial and temporal scales. Specifically, higher intelligence scores were associated with lower complexity in local aspects of neural processing, and less activity in task-negative brain regions belonging to the default-mode network. Finally, we combined multiple measures of brain signal complexity to show that individual intelligence scores can be significantly predicted with a multimodal model within the sample (10-fold cross-validation) as well as in an independent sample (external replication, N = 57). In sum, our results highlight the temporal and spatial dependency of associations between intelligence and intrinsic brain dynamics, proposing multimodal approaches as promising means for future neuroscientific research on complex human traits.


Subject(s)
Brain Mapping , Brain , Adult , Humans , Brain/diagnostic imaging , Brain Mapping/methods , Mental Processes , Electroencephalography/methods , Magnetic Resonance Imaging/methods , Intelligence
8.
J Cogn Neurosci ; : 1-17, 2022 Nov 28.
Article in English | MEDLINE | ID: mdl-36473095

ABSTRACT

EEG has been used for decades to identify neurocognitive processes related to intelligence. Evidence is accumulating for associations with neural markers of higher-order cognitive processes (e.g., working memory); however, whether associations are specific to complex processes or also relate to earlier processing stages remains unclear. Addressing these issues has implications for improving our understanding of intelligence and its neural correlates. The MMN is an ERP that is elicited when, within a series of frequent standard stimuli, rare deviant stimuli are presented. As stimuli are typically presented outside the focus of attention, the MMN is suggested to capture automatic pre-attentive discrimination processes. However, the MMN and its relation to intelligence has largely only been studied in the auditory domain, thus preventing conclusions about the involvement of automatic discrimination processes in humans' dominant sensory modality-vision. EEG was recorded from 50 healthy participants during a passive visual oddball task that presented simple sequence violations and deviations within a more complex hidden pattern. Signed area amplitudes and fractional area latencies of the visual MMN were calculated with and without Laplacian transformation. Correlations between visual MMN and intelligence (Raven's Advanced Progressive Matrices) were of negligible to small effect sizes, differed critically between measurement approaches, and Bayes Factors provided anecdotal to substantial evidence for the absence of an association. We discuss differences between the auditory and visual MMN, the implications of different measurement approaches, and offer recommendations for further research in this evolving field.

9.
Behav Brain Res ; 426: 113834, 2022 05 24.
Article in English | MEDLINE | ID: mdl-35304186

ABSTRACT

Adaptive approach and avoidance in responses to reward and threat are fundamental to prevent harm and to ensure well-being. In contrast, maladaptive approach or avoidance behavior likely contributes to anxiety or substance abuse disorders, respectively. Therefore, there is a need to assess such behavior in humans objectively. Conditioned place preference (CPP) is a well-established animal paradigm investigating approach-avoidance mechanisms, i.e., context-associated appetitive/aversive effects of unconditioned stimuli. Recently, the retranslation of this paradigm for human research started. This meta-analysis provides the first systematic overview of this developing field. A total of 17 studies published before June 2020 fulfil our inclusion criteria: (1) Usage of a rewarding agent, (2) implementation of either virtual or real environments, (3) human subjects, and (4) report of standardized outcome measures. These studies were evaluated and analyzed following the DIAD model and the PRISMA guidelines, respectively, and specific subanalyses were preformed to identify modulating factors of CPP effects (e.g., Virtual Reality applications, biased/unbiased). Overall, a significant medium effect size for the behavioral measure of dwell time (g =.62, p < .001, 95%-CI =.43-.81) and a significant small effect size for verbal self-ratings (g =.33, p < .001, 95%-CI =.04-.63) were observed, although across-study results were characterized by substantial heterogeneity (l2 > 65%). These results indicate great potential for CPP to study approach-avoidance behavior in humans, directly in analogy to animal studies. We provide guidelines for future CPP research to improve comparability of studies and to facilitate new insights into anxiety disorders and drug abuse.


Subject(s)
Conditioning, Classical , Substance-Related Disorders , Animals , Anxiety Disorders , Conditioning, Operant , Humans , Reward
10.
Cereb Cortex ; 32(19): 4172-4182, 2022 09 19.
Article in English | MEDLINE | ID: mdl-35136956

ABSTRACT

Intelligence describes the general cognitive ability level of a person. It is one of the most fundamental concepts in psychological science and is crucial for the effective adaption of behavior to varying environmental demands. Changing external task demands have been shown to induce reconfiguration of functional brain networks. However, whether neural reconfiguration between different tasks is associated with intelligence has not yet been investigated. We used functional magnetic resonance imaging data from 812 subjects to show that higher scores of general intelligence are related to less brain network reconfiguration between resting state and seven different task states as well as to network reconfiguration between tasks. This association holds for all functional brain networks except the motor system and replicates in two independent samples (n = 138 and n = 184). Our findings suggest that the intrinsic network architecture of individuals with higher intelligence scores is closer to the network architecture as required by various cognitive demands. Multitask brain network reconfiguration may, therefore, represent a neural reflection of the behavioral positive manifold - the essence of the concept of general intelligence. Finally, our results support neural efficiency theories of cognitive ability and reveal insights into human intelligence as an emergent property from a distributed multitask brain network.


Subject(s)
Brain , Nerve Net , Brain/diagnostic imaging , Brain Mapping , Humans , Intelligence , Magnetic Resonance Imaging , Nerve Net/diagnostic imaging
12.
Netw Neurosci ; 5(3): 631-645, 2021.
Article in English | MEDLINE | ID: mdl-34746620

ABSTRACT

We propose that the application of network theory to established psychological personality conceptions has great potential to advance a biologically plausible model of human personality. Stable behavioral tendencies are conceived as personality "traits." Such traits demonstrate considerable variability between individuals, and extreme expressions represent risk factors for psychological disorders. Although the psychometric assessment of personality has more than hundred years tradition, it is not yet clear whether traits indeed represent "biophysical entities" with specific and dissociable neural substrates. For instance, it is an open question whether there exists a correspondence between the multilayer structure of psychometrically derived personality factors and the organizational properties of traitlike brain systems. After a short introduction into fundamental personality conceptions, this article will point out how network neuroscience can enhance our understanding about human personality. We will examine the importance of intrinsic (task-independent) brain connectivity networks and show means to link brain features to stable behavioral tendencies. Questions and challenges arising from each discipline itself and their combination are discussed and potential solutions are developed. We close by outlining future trends and by discussing how further developments of network neuroscience can be applied to personality research.

13.
Brain Struct Funct ; 225(7): 2111-2129, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32696074

ABSTRACT

A positive association between brain size and intelligence is firmly established, but whether region-specific anatomical differences contribute to general intelligence remains an open question. Results from voxel-based morphometry (VBM) - one of the most widely used morphometric methods - have remained inconclusive so far. Here, we applied cross-validated machine learning-based predictive modeling to test whether out-of-sample prediction of individual intelligence scores is possible on the basis of voxel-wise gray matter volume. Features were derived from structural magnetic resonance imaging data (N = 308) using (a) a purely data-driven method (principal component analysis) and (b) a domain knowledge-based approach (atlas parcellation). When using relative gray matter (corrected for total brain size), only the atlas-based approach provided significant prediction, while absolute gray matter (uncorrected) allowed for above-chance prediction with both approaches. Importantly, in all significant predictions, the absolute error was relatively high, i.e., greater than ten IQ points, and in the atlas-based models, the predicted IQ scores varied closely around the sample mean. This renders the practical value even of statistically significant prediction results questionable. Analyses based on the gray matter of functional brain networks yielded significant predictions for the fronto-parietal network and the cerebellum. However, the mean absolute errors were not reduced in contrast to the global models, suggesting that general intelligence may be related more to global than region-specific differences in gray matter volume. More generally, our study highlights the importance of predictive statistical analysis approaches for clarifying the neurobiological bases of intelligence and provides important suggestions for future research using predictive modeling.


Subject(s)
Brain/diagnostic imaging , Gray Matter/diagnostic imaging , Intelligence/physiology , Adolescent , Adult , Female , Humans , Image Processing, Computer-Assisted , Intelligence Tests , Magnetic Resonance Imaging , Male , Middle Aged , Organ Size/physiology , Young Adult
14.
Sci Rep ; 10(1): 22460, 2020 12 31.
Article in English | MEDLINE | ID: mdl-33384437

ABSTRACT

Children with attention-deficit/hyperactivity disorder (ADHD) are characterized by symptoms of inattention, impulsivity, and hyperactivity. Neurophysiological correlates of ADHD include changes in the P3 component of event-related brain potentials (ERPs). Motivated by recent advances towards a more dimensional understanding of ADHD, we investigate whether ADHD-related ERP markers relate to continuous variations in attention and executive functioning also in typically-developing children. ERPs were measured while 31 school children (9-11 years) completed an adapted version of the Continuous Performance Task that additionally to inhibitory processes also isolates effects of physical stimulus salience. Children with higher levels of parent-reported ADHD symptoms did not differ in task performance, but exhibited smaller P3 amplitudes related to stimulus salience. Furthermore, ADHD symptoms were associated with the variability of neural responses over time: Children with higher levels of ADHD symptoms demonstrated lower variability in inhibition- and salience-related P3 amplitudes. No effects were observed for ERP latencies and the salience-related N2. By demonstrating that ADHD-associated neurophysiological mechanisms of inhibition and salience processing covary with attention and executive functioning in a children community sample, our study provides neurophysiological support for dimensional models of ADHD. Also, temporal variability in event-related potentials is highlighted as additional indicator of ADHD requiring further investigation.


Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/psychology , Biomarkers , Attention , Attention Deficit Disorder with Hyperactivity/epidemiology , Child , Cognition , Electroencephalography , Evoked Potentials , Female , Humans , Inhibition, Psychological , Male , Social Behavior , Surveys and Questionnaires , Symptom Assessment
15.
Hum Brain Mapp ; 41(2): 362-372, 2020 02 01.
Article in English | MEDLINE | ID: mdl-31587450

ABSTRACT

Individual differences in general cognitive ability (i.e., intelligence) have been linked to individual variations in the modular organization of functional brain networks. However, these analyses have been limited to static (time-averaged) connectivity, and have not yet addressed whether dynamic changes in the configuration of brain networks relate to general intelligence. Here, we used multiband functional MRI resting-state data (N = 281) and estimated subject-specific time-varying functional connectivity networks. Modularity optimization was applied to determine individual time-variant module partitions and to assess fluctuations in modularity across time. We show that higher intelligence, indexed by an established composite measure, the Wechsler Abbreviated Scale of Intelligence (WASI), is associated with higher temporal stability (lower temporal variability) of brain network modularity. Post-hoc analyses reveal that subjects with higher intelligence scores engage in fewer periods of extremely high modularity - which are characterized by greater disconnection of task-positive from task-negative networks. Further, we show that brain regions of the dorsal attention network contribute most to the observed effect. In sum, our study suggests that investigating the temporal dynamics of functional brain network topology contributes to our understanding of the neural bases of general cognitive abilities.


Subject(s)
Brain/physiology , Connectome , Intelligence/physiology , Nerve Net/physiology , Adult , Brain/diagnostic imaging , Female , Humans , Individuality , Magnetic Resonance Imaging , Male , Middle Aged , Nerve Net/diagnostic imaging
16.
Netw Neurosci ; 3(2): 567-588, 2019.
Article in English | MEDLINE | ID: mdl-31089485

ABSTRACT

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with significant and often lifelong effects on social, emotional, and cognitive functioning. Influential neurocognitive models of ADHD link behavioral symptoms to altered connections between and within functional brain networks. Here, we investigate whether network-based theories of ADHD can be generalized to understanding variations in ADHD-related behaviors within the normal (i.e., clinically unaffected) adult population. In a large and representative sample, self-rated presence of ADHD symptoms varied widely; only 8 out of 291 participants scored in the clinical range. Subject-specific brain network graphs were modeled from functional MRI resting-state data and revealed significant associations between (nonclinical) ADHD symptoms and region-specific profiles of between-module and within-module connectivity. Effects were located in brain regions associated with multiple neuronal systems including the default-mode network, the salience network, and the central executive system. Our results are consistent with network perspectives of ADHD and provide further evidence for the relevance of an appropriate information transfer between task-negative (default-mode) and task-positive brain regions. More generally, our findings support a dimensional conceptualization of ADHD and contribute to a growing understanding of cognition as an emerging property of functional brain networks.

17.
Sci Rep ; 7(1): 16088, 2017 11 22.
Article in English | MEDLINE | ID: mdl-29167455

ABSTRACT

General intelligence is a psychological construct that captures in a single metric the overall level of behavioural and cognitive performance in an individual. While previous research has attempted to localise intelligence in circumscribed brain regions, more recent work focuses on functional interactions between regions. However, even though brain networks are characterised by substantial modularity, it is unclear whether and how the brain's modular organisation is associated with general intelligence. Modelling subject-specific brain network graphs from functional MRI resting-state data (N = 309), we found that intelligence was not associated with global modularity features (e.g., number or size of modules) or the whole-brain proportions of different node types (e.g., connector hubs or provincial hubs). In contrast, we observed characteristic associations between intelligence and node-specific measures of within- and between-module connectivity, particularly in frontal and parietal brain regions that have previously been linked to intelligence. We propose that the connectivity profile of these regions may shape intelligence-relevant aspects of information processing. Our data demonstrate that not only region-specific differences in brain structure and function, but also the network-topological embedding of fronto-parietal as well as other cortical and subcortical brain regions is related to individual differences in higher cognitive abilities, i.e., intelligence.


Subject(s)
Brain/physiology , Intelligence/physiology , Nerve Net/physiology , Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult
18.
Neuroimage ; 146: 404-418, 2017 02 01.
Article in English | MEDLINE | ID: mdl-27721028

ABSTRACT

Limitations in visual working memory (WM) quality (i.e., WM precision) may depend on perceptual and attentional limitations during stimulus encoding, thereby affecting WM capacity. WM encoding relies on the interaction between sensory processing systems and fronto-parietal 'control' regions, and differences in the quality of this interaction are a plausible source of individual differences in WM capacity. Accordingly, we hypothesized that the coupling between perceptual and attentional systems affects the quality of WM encoding. We combined fMRI connectivity analysis with behavioral modeling by fitting a variable precision and fixed capacity model to the performance data obtained while participants performed a visual delayed continuous response WM task. We quantified functional connectivity during WM encoding between occipital and parietal brain regions activated during both perception and WM encoding, as determined using a conjunction of two independent experiments. The multivariate pattern of voxel-wise inter-areal functional connectivity significantly predicted WM performance, most specifically the mean of WM precision but not the individual number of items that could be stored in memory. In particular, higher occipito-parietal connectivity was associated with higher behavioral mean precision. These results are consistent with a network perspective of WM capacity, suggesting that the efficiency of information flow between perceptual and attentional neural systems is a critical determinant of limitations in WM quality.


Subject(s)
Attention/physiology , Memory, Short-Term/physiology , Occipital Lobe/physiology , Parietal Lobe/physiology , Visual Perception/physiology , Adult , Brain Mapping/methods , Female , Humans , Magnetic Resonance Imaging , Male , Multivariate Analysis , Neural Pathways/physiology , Photic Stimulation , Young Adult
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