The Value of a Virtual Assistant to Improve Engagement in Computerized Cognitive Training at Home: Exploratory Study.

BACKGROUND: Impaired cognitive function is observed in many pathologies, including neurodegenerative diseases such as Alzheimer disease. At present, the pharmaceutical treatments available to counter cognitive decline have only modest effects, with significant side effects. A nonpharmacological treatment that has received considerable attention is computerized cognitive training (CCT), which aims to maintain or improve cognitive functioning through repeated practice in standardized exercises. CCT allows for more regular and thorough training of cognitive functions directly at home, which represents a significant opportunity to prevent and fight cognitive decline. However, the presence of assistance during training seems to be an important parameter to improve patients' motivation and adherence to treatment. To compensate for the absence of a therapist during at-home CCT, a relevant option could be to include a virtual assistant to accompany patients throughout their training. OBJECTIVE: The objective of this exploratory study was to evaluate the interest of including a virtual assistant to accompany patients during CCT. We investigated the relationship between various individual factors (eg, age, psycho-affective functioning, personality, personal motivations, and cognitive skills) and the appreciation and usefulness of a virtual assistant during CCT. This study is part of the THERADIA (Thérapies Digitales Augmentées par l'Intelligence Artificielle) project, which aims to develop an empathetic virtual assistant. METHODS: A total of 104 participants were recruited, including 52 (50%) young adults (mean age 21.2, range 18 to 27, SD 2.9 years) and 52 (50%) older adults (mean age 67.9, range 60 to 79, SD 5.1 years). All participants were invited to the laboratory to answer several questionnaires and perform 1 CCT session, which consisted of 4 cognitive exercises supervised by a virtual assistant animated by a human pilot via the Wizard of Oz method. The participants evaluated the virtual assistant and CCT at the end of the session. RESULTS: Analyses were performed using the Bayesian framework. The results suggest that the virtual assistant was appreciated and perceived as useful during CCT in both age groups. However, older adults rated the assistant and CCT more positively overall than young adults. Certain characteristics of users, especially their current affective state (ie, arousal, intrinsic relevance, goal conduciveness, and anxiety state), appeared to be related to their evaluation of the session. CONCLUSIONS: This study provides, for the first time, insight into how young and older adults perceive a virtual assistant during CCT. The results suggest that such an assistant could have a beneficial influence on users' motivation, provided that it can handle different situations, particularly their emotional state. The next step of our project will be to evaluate our device with patients experiencing mild cognitive impairment and to test its effectiveness in long-term cognitive training.

Emotional attention: Time course and effects of agonistic and antagonistic overlay of intrinsic and goal relevances.

Emotional attention can be explained within a goal-directed theory framework according to which attention is captured by the goal relevance of stimuli, that is, their conduciveness nature to a momentarily important goal. However, such an explanation does not consider the attentional impact of intrinsic relevance of stimuli, that is, their general pleasantness. This problem could be resolved by appraisal theories, suggesting that attention is captured by intrinsic relevance and goal relevance of stimuli, whether the relevance overlay is agonistic (e.g., pleasant and goal-conducive) or antagonistic (e.g., unpleasant and goal-conducive). Moreover, appraisal theories suggest that early and late attentional capture would be more impacted by intrinsic relevance and goal relevance, respectively. In the present study, we confronted the predictions of appraisal theories with that of goal-directed theory. To this end, 120 participants performed parallelly an induction task to induce different relevance values to three colored squares, and a dot-probe task with two different stimulus onset asynchrony, to measure early and late attentional captures. This paradigm allowed us to measure attentional capture between a neutral stimulus, a goal-relevant stimulus, and an overlay stimulus. The overlay stimulus was agonistic in one group, while it was antagonistic in the other group. Our results showed evidence in favor of appraisal theories. Namely, the overlay stimulus captured more attention than the goal-relevant and the neutral stimulus, regardless of whether the overlay was agonistic or antagonistic. However, our results were mixed regarding the effects of intrinsic relevance and goal relevance on attentional capture as a function of temporality. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Combined effects of intrinsic and goal relevances on attention and action tendency during the emotional episode.

Recent work on emotional attention suggests that attention is prioritized toward stimuli that are intrinsically relevant and toward events that are conducive to momentaneous important goals. The appraisal of intrinsic relevance and goal relevance is aimed to alert individuals to the presence of events that may require action that could affect their well-being and is part of the process that leads to an emotional episode. However, to our knowledge, no empirical data has yet highlighted how precisely intrinsic and goal relevances combine with each other to trigger attentional biases. The aim of this study was to test the hypothesis that intrinsic and goal relevances have multiplicative effects on attention and trigger action tendency. To this end, participants appraised the level of intrinsic relevance, goal relevance and action tendency associated with 4 stimuli (2 related to hunger and 2 to thirst), before performing a dot-probe task in which these stimuli were in competition. We observed that intrinsic and goal relevances appraisals had indeed multiplicative effects on attention. In addition, the action tendency reported by participants was best predicted when intrinsic and goal relevances were considered together. These results show the importance of considering both intrinsic and goal relevances in research on emotion and attention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Single Session of Bifrontal tDCS Can Improve Facial Emotion Recognition in Major Depressive Disorder: An Exploratory Pilot Study.

Emotional processing deficits are key features in major depressive disorder (MDD). Neuroimaging studies indicate that the dorsolateral prefrontal cortex (DLPFC) plays a pivotal role in both depressive symptoms and emotional processing. Recently, transcranial Direct Current Stimulations (tDCS) applied over the DLPFCs have held the promise to alleviate the symptoms in patients with MDD, but the effect on emotional processing in the patients is unclear. Here, we investigated the effect of a single session of tDCS over the DLPFCs on the emotional processing in patients with treatment-resistant MDD. In a randomized sham-controlled study, 35 patients received a single 30 min session of either active (2 mA, n = 18) or sham tDCS (n = 17). The anode was placed over the left and the cathode over the right DLPFC. Emotional processing accuracy was measured by a facial emotion recognition (FER) task. We observed an overall improvement in FER performance after the active tDCS, but not the sham tDCS. These exploratory results suggest that a single session of tDCS over the DLPFCs may improve FER in MDD, a crucial function of social cognition. Further studies are needed to investigate whether this acute improvement of FER in response to a single tDCS session could translate into clinical benefits or predict remission following repeated sessions of stimulation.

Relearn Faster and Retain Longer.

Both repeated practice and sleep improve long-term retention of information. The assumed common mechanism underlying these effects is memory reactivation, either on-line and effortful or off-line and effortless. In the study reported here, we investigated whether sleep-dependent memory consolidation could help to save practice time during relearning. During two sessions occurring 12 hr apart, 40 participants practiced foreign vocabulary until they reached a perfect level of performance. Half of them learned in the morning and relearned in the evening of a single day. The other half learned in the evening of one day, slept, and then relearned in the morning of the next day. Their retention was assessed 1 week later and 6 months later. We found that interleaving sleep between learning sessions not only reduced the amount of practice needed by half but also ensured much better long-term retention. Sleeping after learning is definitely a good strategy, but sleeping between two learning sessions is a better strategy.

Ugly aesthetic perception associated with emotional changes in experience of art by behavioural variant of frontotemporal dementia patients.

The aesthetic experience through art is a window into the study of emotions. Patients with behavioural variant of frontotemporal dementia (bvFTD) have early alteration of emotional processing. A new appreciation of art has been reported in some of these patients. We designed a computerized task using 32 abstract paintings that allowed us to investigate the integrity of patients' emotions when viewing the artwork. We evaluated both conscious and explicit appraisal of emotions [aesthetic judgment (beautiful/ugly), emotional relevance (affected or not by the painting), emotional valence (pleasant/unpleasant), emotional reaction (adjective choice) and arousal] and unconscious processing. Fifteen bvFTD patients and 15 healthy controls were included. BvFTD patients reported that they were "little touched" by the paintings. Aesthetic judgment was very different between the two groups: the paintings were considered ugly (negative aesthetic bias) and unpleasant (negative emotional bias) more often by the patients than by controls. Valence and aesthetic judgments correlated in both groups. In addition, there was a positive bias in the implicit task and for explicit emotional responses. Patients frequently chose the word "sad" and rarely expressed themselves with such adjectives as "happy". Our results suggest that bvFTD patients can give an aesthetic judgment, but present abstraction difficulties, as spectators, resulting from impairments in the cognitive processes involved. They also have difficulties in terms of emotional processes with the loss of the ability to feel the emotion per se (i.e., to feel an emotion faced with art) linked to behaviour assessment. This cognitive approach allows us to better understand which spectators are bvFTD patients and to show interactions between emotions and behavioural disorders.

Optimising retention through multiple study opportunities over days: The benefit of an expanding schedule of repetitions.

Few studies have investigated how scheduling repeated studies of the same material over several days influences its subsequent retention. The study-phase retrieval hypothesis predicts that, under these circumstances, expanding intervals between repetitions will promote the greatest likelihood that the participant will be reminded of previous occurrences of the item, thus leading to a benefit for subsequent recall. In the present article, participants studied vocabulary pairs that were repeated according to one of three schedules. In the expanding schedule, pairs were presented on days 1, 2 and 13; in the uniform schedule, on days 1, 7 and 13; and in the contracting schedule, on days 1, 12 and 13. Cued-recall was assessed after a retention interval (RI) of 2, 6 or 13 days. Consistent with predictions, the expanding schedule generally led to better performance than the other schedules. However, further analyses suggested that the benefit of an expanding schedule may be greater when the RI is longer.

From stimulus-driven to appraisal-driven attention: towards differential effects of goal relevance and goal relatedness on attention?

The Component Process Model posits that attention is appraisal-driven rather than stimulus-driven and that the appraisal of relevance is of critical importance in such a mechanism. This means that any stimulus can attract attention or not depending on how relevant it is appraised. This hypothesis was tested in an implicit border similarity judgement task, in which thirsty participants were presented with bottles and vases that were respectively very relevant and weakly relevant to their goal to quench their thirst. These stimuli were also presented to quenched participants for whom none of the stimuli was relevant. The findings support the idea that our attention is more likely to be appraisal-driven than stimulus-driven, since bottles produced an attentional interference in thirsty participants only. It was also observed that, even if vases were judged weakly relevant by thirsty participants, they produced an attentional interference compared to empty stimuli, which was not the case in the quenched participants group. The concept of goal relatedness was proposed as an explanation for this result, and methodological implications were also discussed.

Emergence of hyper empathy after right amygdalohippocampectomy.

We report a fascinating case of a patient with a hyper empathy that appeared after resective epilepsy surgery. This behavioral modification has remained unchanged since the surgery took place 13 years ago. Recent neuropsychological objective assessments confirmed hyper empathy in a self-report questionnaire, and revealed higher affective theory of mind than controls in a "Reading the Mind in the Eyes Task." Temporal lobe epilepsy is the most common form of epilepsy and the investigation of emotional processes after surgery in these patients deserves to be related.

The relevance bias: valence-specific, relevance-modulated performance in a two-choice detection task.

The aim of this study was to test the hypothesis that relevance modulates subsequent non-emotional behaviour, using a personalised mental-imagery-cued relevance manipulation paradigm. Participants had to build positive, negative and neutral mental images based on personalised scenarios that had been selected during an earlier picture-cued imagery phase. Participants imagined situations that were highly relevant for them and situations that were moderately relevant for them, depending on the effects the situations could exert on them. After each mental image, the effect of the relevance manipulation was tested in a two-choice detection task. The interaction of relevance and valence was found to be predictive of the response times. Moreover, in the high-relevance condition, longer response times were observed for positive scenarios compared to negative ones, whereas in the low-relevance condition, shorter response times were observed for positive scenarios compared to negative ones. Results are consistent with the motivational theory of emotions, which posits that low-relevance stimuli trigger valence-specific attention modulations, whereas high-relevance stimuli trigger valence-specific action tendencies.

Influence of multiple-day temporal distribution of repetitions on memory: a comparison of uniform, expanding, and contracting schedules.

Very few studies have examined the influence of schedules of repetitions across multiple days (e.g., Tsai, 1927 ). Three temporal schedules of four presentations of pseudoword/word pairs over a 7-day learning period were compared: a uniform (presentations on Days 1, 3, 5, and 7), an expanding (1, 2, 3, 7), and a contracting (1, 5, 6, 7) schedule. Schedule was a within-subjects variable. Experiment 1 was performed on the Internet and showed that cued recall on Day 9 led to higher scores for the stimuli of the expanding schedule. Experiment 2 was performed in the laboratory and showed that the expanding and the uniform schedules led to the highest scores on Day 9. A recognition task performed during the learning phase revealed that stimuli recognized at the time of their repetition were more likely to be retrieved later than the others. Our results are discussed within the framework of the study-phase retrieval and encoding variability theories.

Mental rotation in schizophrenia.

Motor imagery provides a direct insight into action representations. The aim of the present study was to investigate the level of impairment of action monitoring in schizophrenia by evaluating the performance of schizophrenic patients on mental rotation tasks. We raised the following questions: (1) Are schizophrenic patients impaired in motor imagery both at the explicit and at the implicit level? (2) Are body parts more difficult for them to mentally rotate than objects? (3) Is there any link between the performance and the hallucinating symptom profile? The schizophrenic patients (n = 13) displayed the same pattern of performance as the control subjects (n = 13). More particularly, schizophrenic patients' reaction time varied as a function of the angular disparity of the stimuli. On the other hand, they were significantly slower and less accurate. Interestingly, patients suffering from hallucinations made significantly more errors than non-hallucinatory patients. We discussed these latter results in terms of deficit of the forward model. We emphasized the necessity to distinguish different levels of action, more or less impaired in schizophrenia.

Levels-of-processing effects on a task of olfactory naming.

The effects of odor processing were investigated at various analytical levels, from simple sensory analysis to deep or semantic analysis, on a subsequent task of odor naming. Students (106 women, 23.6 +/- 5.5 yr. old; 65 men, 25.1 +/- 7.1 yr. old) were tested. The experimental procedure included two successive sessions, a first session to characterize a set of 30 odors with criteria that used various depths of processing and a second session to name the odors as quickly as possible. Four processing conditions rated the odors using descriptors before naming the odor. The control condition did not rate the odors before naming. The processing conditions were based on lower-level olfactory judgments (superficial processing), higher-level olfactory-gustatory-somesthetic judgments (deep processing), and higher-level nonolfactory judgments (Deep-Control processing, with subjects rating odors with auditory and visual descriptors). One experimental condition successively grouped lower- and higher-level olfactory judgments (Superficial-Deep processing). A naming index which depended on response accuracy and the subjects' response time were calculated. Odor naming was modified for 18 out of 30 odorants as a function of the level of processing required. For 94.5% of significant variations, the scores for odor naming were higher following those tasks for which it was hypothesized that the necessary olfactory processing was carried out at a deeper level. Performance in the naming task was progressively improved as follows: no rating of odors, then superficial, deep-control, deep, and superficial-deep processings. These data show that the deepest olfactory encoding was later associated with progressively higher performance in naming.

Investigation of functional hemispheric asymmetry of language in tinnitus sufferers.

The authors tested functional hemispheric asymmetry through word dichotic listening and lateralized lexical decision tasks in tinnitus patients and controls stimulated by a continuous tinnitus-like noise to test the influence of a tinnitus-like external stimulation. A classic right-ear advantage was shown in the auditory task for all but right-ear tinnitus patients, who performed as equally badly when the stimuli were presented to the right and left ears. Concerning the visual task, all participants demonstrated the expected right visual field advantage for word stimuli. Moreover, those who submitted to external stimulation demonstrated normal asymmetric patterns. These data suggest a specific effect of tinnitus on central processing and provide evidence for a functional reorganization induced by this auditory phantom perception.