The Influence of Preoperative Physical Activity on Intraoperative Brain Function in Cardiac Surgical patients.

Background Preoperative physical activity and intraoperative brain health are recognized to influence postoperative delirium (POD). Electroencephalogram (EEG) burst suppression and cerebral desaturation are indicators of abnormal intraoperative brain health. Our study aimed to investigate the associations between preoperative physical activity and intraoperative EEG burst suppression and cerebral desaturation. Methods We retrospectively analyzed data from 67 patients from one of the institutions participating in a multisite randomized controlled trial, PANDORA, involving patients undergoing cardiac surgery. The preoperative PCS12 score calculated using the SF12 questionnaire was used as an indicator of preoperative physical activity. Intraoperative EEG and cerebral oximetry data (not the current standard of care in this facility) were collected, and the anesthesiologists were blinded to the information. We analyzed the following associations between the PCS12 score and i) burst suppression duration, ii) the number of cerebral desaturations, and iii) the number of observations with concurrent cerebral desaturation and burst suppression using a generalized linear model. The results are presented as percentage changes in outcomes, and a 95% C.I. p value < 0.05 was considered to indicate statistical significance. Results Each unit increase in the PCS12 score was associated with a 3.3% decrease in the duration of burst suppression (-3.3 [-5.3, -1.2], p value = 0.002). The duration of burst suppression decreased by 29.2% with each successive quartile increase in the PCS-12 score, indicating a dose‒response relationship (-29.2 [-41.6, -16], p < 0.001). Specifically, the patients in the last three quartiles exhibited a 55.4% reduction in BSD compared to those in the first quartile (-55.4 [-74.4, -24.6], p = 0.002) (Fig. 2). We did not observe any significant association between the PCS12 score and cerebral desaturation. Conclusion Decreased preoperative physical activity, as measured by the SF-12 questionnaire, is significantly associated with increased EEG burst suppression duration. Preoperative physical activity did not show any association with cerebral desaturations and concurrent cerebral desaturation and burst suppression. Clinical Trial information ClinicalTrials.gov Identifier- NCT04093219 https://clinicaltrials.gov/ct2/show/NCT04093219 Principal Investigator - Balachundhar Subramaniam Date of registration - September 13, 2019.

The shared signal hypothesis: Facial and bodily expressions of emotion mutually inform one another.

Decades of research show that contextual information from the body, visual scene, and voices can facilitate judgments of facial expressions of emotion. To date, most research suggests that bodily expressions of emotion offer context for interpreting facial expressions, but not vice versa. The present research aimed to investigate the conditions under which mutual processing of facial and bodily displays of emotion facilitate and/or interfere with emotion recognition. In the current two studies, we examined whether body and face emotion recognition are enhanced through integration of shared emotion cues, and/or hindered through mixed signals (i.e., interference). We tested whether faces and bodies facilitate or interfere with emotion processing by pairing briefly presented (33 ms), backward-masked presentations of faces with supraliminally presented bodies (Experiment 1) and vice versa (Experiment 2). Both studies revealed strong support for integration effects, but not interference. Integration effects are most pronounced for low-emotional clarity facial and bodily expressions, suggesting that when more information is needed in one channel, the other channel is recruited to disentangle any ambiguity. That this occurs for briefly presented, backward-masked presentations reveals low-level visual integration of shared emotional signal value.

Short Term Effects of Inner Engineering Completion Online Program on Stress and Well-Being Measures.

Introduction: The Covid-19 pandemic has been a major disruptor of routine life, resulting in increased stress and predisposing people to negative outcomes, such as insomnia, anxiety and hopelessness. Mind-body interventions have improved concentration, emotional balance, and positive emotions, with an enhanced sense of productivity, and self-confidence. We therefore hypothesized that exposure to an online mind-body intervention, "Inner Engineering Completion Online (IECO)," would reduce stress and promote well-being. Methods: This prospective cohort study enrolled participants registered for the IECO courses, which for the first time were delivered remotely, online. Participants learned a 21-min meditation practice called Shambhavi Mahamudra Kriya during the course, which incorporates controlled breathing and mediation techniques. Each enrolled participant was asked to complete self-reported electronic surveys at three key time points: at the time of consent, immediately after completing IECO, and 6 weeks after IECO completion. Effects of IECO practice were assessed using four well-validated neuropsychological scales: Perceived Stress Scale (PSS), Positive Emotion/Relationship/Engagement Scale (PERMA) Profiler, Pittsburgh Sleep Quality Index (PSQI), and Mindful Attention Awareness Scale (MAAS). A Signed Rank test was used to analyze the survey data and P-values of < 0.05 were considered statistically significant. Results: Of the 375 participants interested in participation, 164 participants were eligible. Sixty-eight participants completed surveys at all time points and were identified as compliant participants. The baseline median score for PSS in compliant participants (n = 95) was 13.5 (IQR 9, 18); immediate post-IECO median PSS score was 12 (IQR 8, 16) demonstrating a 1.5 unit decrease in PSS scores (p-value = 0.0023). Similarly, comparing PSS scores in compliant participants (n = 68) for immediate Post IECO [11.5 (IQR 8, 15.5)] to PSS scores at six weeks [8 (IQR 4.5, 12.5)] showed a statistically significant 3.5-unit decrease, indicating a reduction in stress upon routine practice of the intervention (p < 0.0001). Conclusion: Incorporating the remotely delivered mind-body intervention Shambhavi Mahamudra Kriya into daily life via the IECO program over as few as 6 weeks produced a significant stress reduction, improvement in sleep quality and mindfulness. Clinical Trial Registration: [ClinicalTrials.gov], identifier [NCT04189146].

Differential neurodynamics and connectivity in the dorsal and ventral visual pathways during perception of emotional crowds and individuals: a MEG study.

Reading the prevailing emotion of groups of people ("crowd emotion") is critical to understanding their overall intention and disposition. It alerts us to potential dangers, such as angry mobs or panicked crowds, giving us time to escape. A critical aspect of processing crowd emotion is that it must occur rapidly, because delays often are costly. Although knowing the timing of neural events is crucial for understanding how the brain guides behaviors using coherent signals from a glimpse of multiple faces, this information is currently lacking in the literature on face ensemble coding. Therefore, we used magnetoencephalography to examine the neurodynamics in the dorsal and ventral visual streams and the periamygdaloid cortex to compare perception of groups of faces versus individual faces. Forty-six participants compared two groups of four faces or two individual faces with varying emotional expressions and chose which group or individual they would avoid. We found that the dorsal stream was activated as early as 68 msec after the onset of stimuli containing groups of faces. In contrast, the ventral stream was activated later and predominantly for individual face stimuli. The latencies of the dorsal stream activation peaks correlated with participants' response times for facial crowds. We also found enhanced connectivity earlier between the periamygdaloid cortex and the dorsal stream regions for crowd emotion perception. Our findings suggest that ensemble coding of facial crowds proceeds rapidly and in parallel by engaging the dorsal stream to mediate adaptive social behaviors, via a distinct route from single face perception.

Fast saccadic and manual responses to faces presented to the koniocellular visual pathway.

The parallel pathways of the human visual system differ in their tuning to luminance, color, and spatial frequency. These attunements recently have been shown to propagate to differential processing of higher-order stimuli, facial threat cues, in the magnocellular (M) and parvocellular (P) pathways, with greater sensitivity to clear and ambiguous threat, respectively. The role of the third, koniocellular (K) pathway in facial threat processing, however, remains unknown. To address this gap in knowledge, we briefly presented peripheral face stimuli psychophysically biased towards M, P, or K pathways. Observers were instructed to report via a key-press whether the face was angry or neutral while their eye movements and manual responses were recorded. We found that short-latency saccades were made more frequently to faces presented in the K channel than to P or M channels. Saccade latencies were not significantly modulated by expressive and identity cues. In contrast, manual response latencies and accuracy were modulated by both pathway biasing and by interactions of facial expression with facial masculinity, such that angry male faces elicited the fastest, and angry female faces, the least accurate, responses. We conclude that face stimuli can evoke fast saccadic and manual responses when projected to the K pathway.

Differential magnocellular versus parvocellular pathway contributions to the combinatorial processing of facial threat.

Recently, speed of presentation of facially expressive stimuli was found to influence the processing of compound threat cues (e.g., anger/fear/gaze). For instance, greater amygdala responses were found to clear (e.g., direct gaze anger/averted gaze fear) versus ambiguous (averted gaze anger/direct gaze fear) combinations of threat cues when rapidly presented (33 and 300ms), but greater to ambiguous versus clear threat cues when presented for more sustained durations (1, 1.5, and 2s). A working hypothesis was put forth (Adams et al., 2012) that these effects were due to differential magnocellular versus parvocellular pathways contributions to the rapid versus sustained processing of threat, respectively. To test this possibility directly here, we restricted visual stream processing in the fMRI environment using facially expressive stimuli specifically designed to bias visual input exclusively to the magnocellular versus parvocellular pathways. We found that for magnocellular-biased stimuli, activations were predominantly greater to clear versus ambiguous threat-gaze pairs (on par with that previously found for rapid presentations of threat cues), whereas activations to ambiguous versus clear threat-gaze pairs were greater for parvocellular-biased stimuli (on par with that previously found for sustained presentations). We couch these findings in an adaptive dual process account of threat perception and highlight implications for other dual process models within psychology.

Magnocellular and parvocellular pathway contributions to facial threat cue processing.

Human faces evolved to signal emotions, with their meaning contextualized by eye gaze. For instance, a fearful expression paired with averted gaze clearly signals both presence of threat and its probable location. Conversely, direct gaze paired with facial fear leaves the source of the fear-evoking threat ambiguous. Given that visual perception occurs in parallel streams with different processing emphases, our goal was to test a recently developed hypothesis that clear and ambiguous threat cues would differentially engage the magnocellular (M) and parvocellular (P) pathways, respectively. We employed two-tone face images to characterize the neurodynamics evoked by stimuli that were biased toward M or P pathways. Human observers (N = 57) had to identify the expression of fearful or neutral faces with direct or averted gaze while their magnetoencephalogram was recorded. Phase locking between the amygdaloid complex, orbitofrontal cortex (OFC) and fusiform gyrus increased early (0-300 ms) for M-biased clear threat cues (averted-gaze fear) in the ß-band (13-30 Hz) while P-biased ambiguous threat cues (direct-gaze fear) evoked increased θ (4-8 Hz) phase locking in connections with OFC of the right hemisphere. We show that M and P pathways are relatively more sensitive toward clear and ambiguous threat processing, respectively, and characterize the neurodynamics underlying emotional face processing in the M and P pathways.

Spatial and feature-based attention to expressive faces.

Facial emotion is an important cue for deciding whether an individual is potentially helpful or harmful. However, facial expressions are inherently ambiguous and observers typically employ other cues to categorize emotion expressed on the face, such as race, sex, and context. Here, we explored the effect of increasing or reducing different types of uncertainty associated with a facial expression that is to be categorized. On each trial, observers responded according to the emotion and location of a peripherally presented face stimulus and were provided with either: (1) no information about the upcoming face; (2) its location; (3) its expressed emotion; or (4) both its location and emotion. While cueing emotion or location resulted in faster response times than cueing unpredictive information, cueing face emotion alone resulted in faster responses than cueing face location alone. Moreover, cueing both stimulus location and emotion resulted in a superadditive reduction of response times compared with cueing location or emotion alone, suggesting that feature-based attention to emotion and spatially selective attention interact to facilitate perception of face stimuli. While categorization of facial expressions was significantly affected by stable identity cues (sex and race) in the face, we found that these interactions were eliminated when uncertainty about facial expression, but not spatial uncertainty about stimulus location, was reduced by predictive cueing. This demonstrates that feature-based attention to facial expression greatly attenuates the need to rely on stable identity cues to interpret facial emotion.

Line-Drawn Scenes Provide Sufficient Information for Discrimination of Threat and Mere Negativity.

Previous work using color photographic scenes has shown that human observers are keenly sensitive to different types of threatening and negative stimuli and reliably classify them by the presence, and spatial and temporal directions of threat. To test whether such distinctions can be extracted from impoverished visual information, we used 500 line drawings made by hand-tracing the original set of photographic scenes. Sixty participants rated the scenes on spatial and temporal dimensions of threat. Based on these ratings, trend analysis revealed five scene categories that were comparable to those identified for the matching color photographic scenes. Another 61 participants were randomly assigned to rate the valence or arousal evoked by the line drawings. The line drawings perceived to be the most negative were also perceived to be the most arousing, replicating the finding for color photographic scenes. We demonstrate here that humans are very sensitive to the spatial and temporal directions of threat even when they must extract this information from simple line drawings, and rate the line drawings very similarly to matched color photographs. The set of 500 hand-traced line-drawing scenes has been made freely available to the research community: http://www.kveragalab.org/threat.html.

Sex-related differences in behavioral and amygdalar responses to compound facial threat cues.

During face perception, we integrate facial expression and eye gaze to take advantage of their shared signals. For example, fear with averted gaze provides a congruent avoidance cue, signaling both threat presence and its location, whereas fear with direct gaze sends an incongruent cue, leaving threat location ambiguous. It has been proposed that the processing of different combinations of threat cues is mediated by dual processing routes: reflexive processing via magnocellular (M) pathway and reflective processing via parvocellular (P) pathway. Because growing evidence has identified a variety of sex differences in emotional perception, here we also investigated how M and P processing of fear and eye gaze might be modulated by observer's sex, focusing on the amygdala, a structure important to threat perception and affective appraisal. We adjusted luminance and color of face stimuli to selectively engage M or P processing and asked observers to identify emotion of the face. Female observers showed more accurate behavioral responses to faces with averted gaze and greater left amygdala reactivity both to fearful and neutral faces. Conversely, males showed greater right amygdala activation only for M-biased averted-gaze fear faces. In addition to functional reactivity differences, females had proportionately greater bilateral amygdala volumes, which positively correlated with behavioral accuracy for M-biased fear. Conversely, in males only the right amygdala volume was positively correlated with accuracy for M-biased fear faces. Our findings suggest that M and P processing of facial threat cues is modulated by functional and structural differences in the amygdalae associated with observer's sex.

Neurodynamics and connectivity during facial fear perception: The role of threat exposure and signal congruity.

Fearful faces convey threat cues whose meaning is contextualized by eye gaze: While averted gaze is congruent with facial fear (both signal avoidance), direct gaze (an approach signal) is incongruent with it. We have previously shown using fMRI that the amygdala is engaged more strongly by fear with averted gaze during brief exposures. However, the amygdala also responds more to fear with direct gaze during longer exposures. Here we examined previously unexplored brain oscillatory responses to characterize the neurodynamics and connectivity during brief (~250 ms) and longer (~883 ms) exposures of fearful faces with direct or averted eye gaze. We performed two experiments: one replicating the exposure time by gaze direction interaction in fMRI (N = 23), and another where we confirmed greater early phase locking to averted-gaze fear (congruent threat signal) with MEG (N = 60) in a network of face processing regions, regardless of exposure duration. Phase locking to direct-gaze fear (incongruent threat signal) then increased significantly for brief exposures at ~350 ms, and at ~700 ms for longer exposures. Our results characterize the stages of congruent and incongruent facial threat signal processing and show that stimulus exposure strongly affects the onset and duration of these stages.

Cross-cultural and hemispheric laterality effects on the ensemble coding of emotion in facial crowds.

In many social situations, we make a snap judgment about crowds of people relying on their overall mood (termed "crowd emotion"). Although reading crowd emotion is critical for interpersonal dynamics, the sociocultural aspects of this process have not been explored. The current study examined how culture modulates the processing of crowd emotion in Korean and American observers. Korean and American (non-East Asian) participants were briefly presented with two groups of faces that were individually varying in emotional expressions and asked to choose which group between the two they would rather avoid. We found that Korean participants were more accurate than American participants overall, in line with the framework on cultural viewpoints: Holistic versus analytic processing in East Asians versus Westerners. Moreover, we found a speed advantage for other-race crowds in both cultural groups. Finally, we found different hemispheric lateralization patterns: American participants were more accurate to perceive the facial crowd to be avoided when it was presented in the left visual field than the right visual field, indicating a right hemisphere advantage for processing crowd emotion of both European American and Korean facial crowds. However, Korean participants showed weak or nonexistent laterality effects, with a slight right hemisphere advantage for European American facial crowds and no advantage in perceiving Korean facial crowds. Instead, Korean participants showed positive emotion bias for own-race faces. This work suggests that culture plays a role in modulating our crowd emotion perception of groups of faces and responses to them.

Differential hemispheric and visual stream contributions to ensemble coding of crowd emotion.

In crowds, where scrutinizing individual facial expressions is inefficient, humans can make snap judgments about the prevailing mood by reading "crowd emotion". We investigated how the brain accomplishes this feat in a set of behavioral and fMRI studies. Participants were asked to either avoid or approach one of two crowds of faces presented in the left and right visual hemifields. Perception of crowd emotion was improved when crowd stimuli contained goal-congruent cues and was highly lateralized to the right hemisphere. The dorsal visual stream was preferentially activated in crowd emotion processing, with activity in the intraparietal sulcus and superior frontal gyrus predicting perceptual accuracy for crowd emotion perception, whereas activity in the fusiform cortex in the ventral stream predicted better perception of individual facial expressions. Our findings thus reveal significant behavioral differences and differential involvement of the hemispheres and the major visual streams in reading crowd versus individual face expressions.

Observer's anxiety facilitates magnocellular processing of clear facial threat cues, but impairs parvocellular processing of ambiguous facial threat cues.

Facial expression and eye gaze provide a shared signal about threats. While a fear expression with averted gaze clearly points to the source of threat, direct-gaze fear renders the source of threat ambiguous. Separable routes have been proposed to mediate these processes, with preferential attunement of the magnocellular (M) pathway to clear threat, and of the parvocellular (P) pathway to threat ambiguity. Here we investigated how observers' trait anxiety modulates M- and P-pathway processing of clear and ambiguous threat cues. We scanned subjects (N = 108) widely ranging in trait anxiety while they viewed fearful or neutral faces with averted or directed gaze, with the luminance and color of face stimuli calibrated to selectively engage M- or P-pathways. Higher anxiety facilitated processing of clear threat projected to M-pathway, but impaired perception of ambiguous threat projected to P-pathway. Increased right amygdala reactivity was associated with higher anxiety for M-biased averted-gaze fear, while increased left amygdala reactivity was associated with higher anxiety for P-biased, direct-gaze fear. This lateralization was more pronounced with higher anxiety. Our findings suggest that trait anxiety differentially affects perception of clear (averted-gaze fear) and ambiguous (direct-gaze fear) facial threat cues via selective engagement of M and P pathways and lateralized amygdala reactivity.

Internal valence modulates the speed of object recognition.

Brain regions that process affect are strongly connected with visual regions, but the functional consequences of this structural organization have been relatively unexplored. How does the momentary affect of an observer influence perception? We induced either pleasant or unpleasant affect in participants and then recorded their neural activity using magnetoencephalography while they completed an object recognition task. We hypothesized, and found, that affect influenced the speed of object recognition by modulating the speed and amplitude of evoked responses in occipitotemporal cortex and regions important for representing affect. Furthermore, affect modulated functional interactions between affective and perceptual regions early during perceptual processing. These findings indicate that affect can serve as an important contextual influence on object recognition processes.

Social Vision: Applying a Social-Functional Approach to Face and Expression Perception.

A social-functional approach to face processing comes with a number of assumptions. First, given that humans possess limited cognitive resources, it assumes that we naturally allocate attention to processing and integrating the most adaptively relevant social cues. Second, from these cues, we make behavioral forecasts about others in order to respond in an efficient and adaptive manner. This assumption aligns with broader ecological accounts of vision that highlight a direct action-perception link, even for nonsocial vision. Third, humans are naturally predisposed to process faces in this functionally adaptive manner. This latter contention is implied by our attraction to dynamic aspects of the face, including looking behavior and facial expressions, from which we tend to overgeneralize inferences, even when forming impressions of stable traits. The functional approach helps to address how and why observers are able to integrate functionally related compound social cues in a manner that is ecologically relevant and thus adaptive.

Predictions penetrate perception: Converging insights from brain, behaviour and disorder.

It is argued that during ongoing visual perception, the brain is generating top-down predictions to facilitate, guide and constrain the processing of incoming sensory input. Here we demonstrate that these predictions are drawn from a diverse range of cognitive processes, in order to generate the richest and most informative prediction signals. This is consistent with a central role for cognitive penetrability in visual perception. We review behavioural and mechanistic evidence that indicate a wide spectrum of domains-including object recognition, contextual associations, cognitive biases and affective state-that can directly influence visual perception. We combine these insights from the healthy brain with novel observations from neuropsychiatric disorders involving visual hallucinations, which highlight the consequences of imbalance between top-down signals and incoming sensory information. Together, these lines of evidence converge to indicate that predictive penetration, be it cognitive, social or emotional, should be considered a fundamental framework that supports visual perception.

Convergent evidence for top-down effects from the "predictive brain".

Modern conceptions of brain function consider the brain as a "predictive organ," where learned regularities about the world are utilised to facilitate perception of incoming sensory input. Critically, this process hinges on a role for cognitive penetrability. We review a mechanism to explain this process and expand our previous proposals of cognitive penetrability in visual recognition to social vision and visual hallucinations.

Social Vision: Functional Forecasting and the Integration of Compound Social Cues.

For decades the study of social perception was largely compartmentalized by type of social cue: race, gender, emotion, eye gaze, body language, facial expression etc. This was partly due to good scientific practice (e.g., controlling for extraneous variability), and partly due to assumptions that each type of social cue was functionally distinct from others. Herein, we present a functional forecast approach to understanding compound social cue processing that emphasizes the importance of shared social affordances across various cues (see too Adams, Franklin, Nelson, & Stevenson, 2010; Adams & Nelson, 2011; Weisbuch & Adams, 2012). We review the traditional theories of emotion and face processing that argued for dissociable and noninteracting pathways (e.g., for specific emotional expressions, gaze, identity cues), as well as more recent evidence for combinatorial processing of social cues. We argue here that early, and presumably reflexive, visual integration of such cues is necessary for adaptive behavioral responding to others. In support of this claim, we review contemporary work that reveals a flexible visual system, one that readily incorporates meaningful contextual influences in even nonsocial visual processing, thereby establishing the functional and neuroanatomical bases necessary for compound social cue integration. Finally, we explicate three likely mechanisms driving such integration. Together, this work implicates a role for cognitive penetrability in visual perceptual abilities that have often been (and in some cases still are) ascribed to direct encapsulated perceptual processes.

If it bleeds, it leads: separating threat from mere negativity.

Most theories of emotion hold that negative stimuli are threatening and aversive. Yet in everyday experiences some negative sights (e.g. car wrecks) attract curiosity, whereas others repel (e.g. a weapon pointed in our face). To examine the diversity in negative stimuli, we employed four classes of visual images (Direct Threat, Indirect Threat, Merely Negative and Neutral) in a set of behavioral and functional magnetic resonance imaging studies. Participants reliably discriminated between the images, evaluating Direct Threat stimuli most quickly, and Merely Negative images most slowly. Threat images evoked greater and earlier blood oxygen level-dependent (BOLD) activations in the amygdala and periaqueductal gray, structures implicated in representing and responding to the motivational salience of stimuli. Conversely, the Merely Negative images evoked larger BOLD signal in the parahippocampal, retrosplenial, and medial prefrontal cortices, regions which have been implicated in contextual association processing. Ventrolateral as well as medial and lateral orbitofrontal cortices were activated by both threatening and Merely Negative images. In conclusion, negative visual stimuli can repel or attract scrutiny depending on their current threat potential, which is assessed by dynamic shifts in large-scale brain network activity.