Stimulus-Elicited Involuntary Cognition: Boundary Conditions and Systematic Effects.

For decades, researchers have been presenting participants with stimuli and instructing the participants not to respond to the stimuli in some way. Today, researchers are studying the effects that such stimuli have, not only on behavior, but on conscious experience. To this end, researchers have used several laboratory tasks, including the reflexive imagery task (RIT). In the RIT, participants are instructed not to respond in a specific way to stimuli. Participants often cannot suppress such responses. Knowledge of the conditions under which RIT effects fail to arise can illuminate the limitations of involuntary processes. We observed that the RIT effect can survive with brand symbols (Experiment 1, n = 30), which are different from everyday objects in interesting ways. In addition, we investigated systematic effects. Systematic effects are unlikely to be due to experimental demand. In Experiment 2 (n = 48), we observed that RIT effects could arise from associations learned, not across the participant's lifetime, but only in the laboratory. Participants studied nonsense shapes that were associated with pseudowords that preceded or followed the shapes. Afterward, these new associations led to RIT effects. In addition, RIT effects were more likely for pseudowords that preceded the shapes rather than for the pseudowords that followed the shapes (a systematic effect). In Experiment 3 (n = 46), systematic effects involving two sensory modalities were observed: olfactory stimuli were more likely to elicit involuntary visual imagery than visual stimuli were to elicit involuntary olfactory imagery. We discuss the theoretical implications of these effects.

Involuntary refreshing of mental representations.

Laboratory tasks have revealed that mental representations (e.g., mental imagery) can enter consciousness in a manner that is involuntary, reliable, and insuppressible. These effects illuminate the capacities of involuntary processes as well as the function of voluntary, conscious processing. The Reflexive Imagery Task was developed a decade ago to investigate these involuntary effects systematically. Can refreshing yield such involuntary effects? Refreshing is the reactivating in mind of a mental representation that was activated moments ago. It is associated with mental rehearsal and executive function. We investigated whether a mental representation (subvocalization of an object name) can arise in consciousness involuntarily after a delayed interval, when the relevant stimulus is no longer present, and in response to a cue. In Experiment 1, participants were instructed not to refresh a previously presented (6 s before) stimulus in response to a cue. Involuntary refreshing occurred on a substantive proportion (0.56) of the trials. Experiment 2 replicated and extended this finding (proportion of the trials = 0.53) with a refreshing task that was more challenging than that of Experiment 1. Our findings suggest that mental representations arising from processes such as refreshing can occur involuntarily. We discuss the theoretical implications of this conclusion.

Insuppressible cognitions in the reflexive imagery task: Insights and future directions.

In 1959, Neal Miller made the bold claim that the Stimulus-Response, Behaviorist models of that era were describing the way in which stimuli lead to the entry of contents into consciousness ("entry," for short). Today, researchers have begun to investigate the link between external stimuli and involuntary entry, using paradigms such as the reflexive imagery task (RIT), the focus of our review. The RIT has revealed that stimuli can elicit insuppressible entry of high-level cognitions. Knowledge of the boundary conditions of the RIT effect illuminates the limitations of involuntary processes and the role of consciousness in the regulation of behavior. We review the boundary conditions of this paradigm as well as its systematic effects. Systematic effects are unlikely to be due to experimental demand. While reviewing each effect, we consider its theoretical implications. In addition, throughout our review, we discuss future directions for the study of insuppressible entry using the RIT. Last, we discuss a theoretical development (passive frame theory) that stems from the RIT and illuminates how involuntary entry and encapsulation, though at times disadvantageous for the actor, are essential for adaptive action selection during the course of ontogeny.

Encapsulation and subjectivity from the standpoint of viewpoint theory.

The groundbreaking, viewpoint theory of Merker et al. explains several properties of the conscious field, including why the observer cannot directly apprehend itself. We propose that viewpoint theory might also provide a progressive, constitutive marker of consciousness and shed light on why most of the contents of consciousness are encapsulated.

Clinical Efficacy and Dosing of Vibrotactile Coordinated Reset Stimulation in Motor and Non-motor Symptoms of Parkinson's Disease: A Study Protocol.

Enhanced neuronal synchronization of the subthalamic nucleus (STN) is commonly found in PD patients and corresponds to decreased motor ability. Coordinated reset (CR) was developed to decouple synchronized states causing long lasting desynchronization of neural networks. Vibrotactile CR stimulation (vCR) was developed as non-invasive therapeutic that delivers gentle vibrations to the fingertips. A previous study has shown that vCR can desynchronize abnormal brain rhythms within the sensorimotor cortex of PD patients, corresponding to sustained motor relief after 3 months of daily treatment. To further develop vCR, we created a protocol that has two phases. Study 1, a double blinded randomized sham-controlled study, is designed to address motor and non-motor symptoms, sensorimotor integration, and potential calibration methods. Study 2 examines dosing effects of vCR using a remote study design. In Study 1, we will perform a 7-month double-blind sham-controlled study including 30 PD patients randomly placed into an active vCR or inactive (sham) vCR condition. Patients will receive stimulation for 4 h a day in 2-h blocks for 6 months followed by a 1-month pause in stimulation to assess long lasting effects. Our primary outcome measure is the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III off medication after 6 months of treatment. Secondary measures include a freezing of gait (FOG) questionnaire, objective motor evaluations, sensorimotor electroencephalography (EEG) results, a vibratory temporal discrimination task (VTDT), non-motor symptom evaluations/tests such as sleep, smell, speech, quality of life measurements and Levodopa Equivalent Daily Dose (LEDD). Patients will be evaluated at baseline, 3, 6, and 7 months. In the second, unblinded study phase (Study 2), all patients will be given the option to receive active vCR stimulation at a reduced dose for an additional 6 months remotely. The remote MDS-UPDRS part III off medication will be our primary outcome measure. Secondary measures include sleep, quality of life, objective motor evaluations, FOG and LEDD. Patients will be evaluated in the same time periods as the first study. Results from this study will provide clinical efficacy of vCR and help validate our investigational vibrotactile device for the purpose of obtaining FDA clearance. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT04877015.

Treatment Tone Spacing and Acute Effects of Acoustic Coordinated Reset Stimulation in Tinnitus Patients.

Acoustic coordinated reset (aCR) therapy for tinnitus aims to desynchronize neuronal populations in the auditory cortex that exhibit pathologically increased coincident firing. The original therapeutic paradigm involves fixed spacing of four low-intensity tones centered around the frequency of a tone matching the tinnitus pitch, f T , but it is unknown whether these tones are optimally spaced for induction of desynchronization. Computational and animal studies suggest that stimulus amplitude, and relatedly, spatial stimulation profiles, of coordinated reset pulses can have a major impact on the degree of desynchronization achievable. In this study, we transform the tone spacing of aCR into a scale that takes into account the frequency selectivity of the auditory system at each therapeutic tone's center frequency via a measure called the gap index. Higher gap indices are indicative of more loosely spaced aCR tones. The gap index was found to be a significant predictor of symptomatic improvement, with larger gap indices, i.e., more loosely spaced aCR tones, resulting in reduction of tinnitus loudness and annoyance scores in the acute stimulation setting. A notable limitation of this study is the intimate relationship of hearing impairment with the gap index. Particularly, the shape of the audiogram in the vicinity of the tinnitus frequency can have a major impact on tone spacing. However, based on our findings we suggest hypotheses-based experimental protocols that may help to disentangle the impact of hearing loss and tone spacing on clinical outcome, to assess the electrophysiologic correlates of clinical improvement, and to elucidate the effects following chronic rather than acute stimulation.