Inter-brain synchronization occurs without physical co-presence during cooperative online gaming.

Inter-brain synchronization during social interaction has been linked with several positive phenomena, including closeness, cooperation, prosociality, and team performance. However, the temporal dynamics of inter-brain synchronization during collaboration are not yet fully understood. Furthermore, with collaboration increasingly happening online, the dependence of inter-brain phase synchronization of oscillatory activity on physical presence is an important but understudied question. In this study, physically isolated participants performed a collaborative coordination task in the form of a cooperative multiplayer game. We measured EEG from 42 subjects working together as pairs in the task. During the measurement, the only interaction between the participants happened through on-screen movement of a racing car, controlled by button presses of both participants working with distinct roles, either controlling the speed or the direction of the car. Pairs working together in the task were found to have elevated neural coupling in the alpha, beta, and gamma frequency bands, compared to performance matched false pairs. Higher gamma synchrony was associated with better momentary performance within dyads and higher alpha synchrony was associated with better mean performance across dyads. These results are in line with previous findings of increased inter-brain synchrony during interaction, and show that phase synchronization of oscillatory activity occurs during online real-time joint coordination without any physical co-presence or video and audio connection. Synchrony decreased during a playing session, but was found to be higher during the second session compared to the first. The novel paradigm, developed for the measurement of real-time collaborative performance, demonstrates that changes in inter-brain EEG phase synchrony can be observed continuously during interaction.

Perceptions of Doctors' Empathy and Patients' Subjective Health Status at an Online Clinic: Development of an Empathic Anamnesis Questionnaire.

OBJECTIVE: Medical doctors' empathy is known to support patients' health status after face-to-face clinical visits. However, the role of doctors' empathy in chat-based encounters is not yet well understood. This study investigates whether patients' evaluations of doctors' empathy are associated with their health perceptions after a meeting at an online clinic and whether experiences of empathy could be enhanced by augmenting an automated anamnesis questionnaire completed before the visit. METHODS: A total of 209 adult patients agreed to participate in the study. First 103 patients filled out the regular version of the questionnaire (June-August 2019) and then 106 filled out the augmented version of the online anamnesis questionnaire (August-November 2019). Patients' perceptions of doctors' empathy were measured with the Consultation and Relational Empathy questionnaire. Patients' self-perceived health status, potential confounders, and demographic background information were measured via questionnaires. RESULTS: Patients' perceptions of doctors' empathy during a chat-based encounter were associated with patients being less concerned about their symptoms (estimated odds ratios varied between 0.45 and 0.55 depending on the model, p values < .003) and considering their symptoms as less severe (estimated odds ratios = 0.54-0.61, p values < .007), as well as a higher probability of alleviation of symptoms as rated by the patients (estimated odds ratios = 2.16-2.24, p values < .001). Augmenting the anamnesis questionnaire did not affect patient reports on doctors' overall empathy, but it did have positive effects on specific areas of doctors' empathy covered by the questionnaire. CONCLUSIONS: These results show that patients' experience of doctors' empathy not only is important during face-to-face encounters but also supports patients' perceptions of health when the interaction is text based. The results also encourage further development of means to support patients' experiences of empathy during online interaction with medical doctors.

Repeated Parental Singing During Kangaroo Care Improved Neural Processing of Speech Sound Changes in Preterm Infants at Term Age.

Preterm birth carries a risk for adverse neurodevelopment. Cognitive dysfunctions, such as language disorders may manifest as atypical sound discrimination already in early infancy. As infant-directed singing has been shown to enhance language acquisition in infants, we examined whether parental singing during skin-to-skin care (kangaroo care) improves speech sound discrimination in preterm infants. Forty-five preterm infants born between 26 and 33 gestational weeks (GW) and their parents participated in this cluster-randomized controlled trial (ClinicalTrials ID IRB00003181SK). In both groups, parents conducted kangaroo care during 33-40 GW. In the singing intervention group (n = 24), a certified music therapist guided parents to sing or hum during daily kangaroo care. In the control group (n = 21), parents conducted standard kangaroo care and were not instructed to use their voices. Parents in both groups reported the duration of daily intervention. Auditory event-related potentials were recorded with electroencephalogram at term age using a multi-feature paradigm consisting of phonetic and emotional speech sound changes and a one-deviant oddball paradigm with pure tones. In the multi-feature paradigm, prominent mismatch responses (MMR) were elicited to the emotional sounds and many of the phonetic deviants in the singing intervention group and in the control group to some of the emotional and phonetic deviants. A group difference was found as the MMRs were larger in the singing intervention group, mainly due to larger MMRs being elicited to the emotional sounds, especially in females. The overall duration of the singing intervention (range 15-63 days) was positively associated with the MMR amplitudes for both phonetic and emotional stimuli in both sexes, unlike the daily singing time (range 8-120 min/day). In the oddball paradigm, MMRs for the non-speech sounds were elicited in both groups and no group differences nor connections between the singing time and the response amplitudes were found. These results imply that repeated parental singing during kangaroo care improved auditory discrimination of phonetic and emotional speech sounds in preterm infants at term age. Regular singing routines can be recommended for parents to promote the development of the auditory system and auditory processing of speech sounds in preterm infants.

Collaborative block design task for assessing pair performance in virtual reality and reality.

Collaborative problem solving is more important than ever as the problems we try to solve become increasingly complex. Meanwhile, personal and professional communication has moved from face-to-face to computer-mediated environments, but there is little understanding on how the characteristics of these environments affect the quality of interaction and joint problem solving. To develop this understanding, methods are needed for measuring success of collaboration. For this purpose, we created a collaborative block design task intended to evaluate and quantify pair performance. In this task, participants need to share information to complete visuospatial puzzles. Two versions of the task are described: a physical version and one that can be completed in virtual reality. A preliminary study was conducted with the physical version (N = 18 pairs) and the results were used to develop the task for a second study in virtual reality (N = 31 pairs). Performance measures were developed for the task, and we found that pair performance was normally distributed and positively associated with visuospatial skills, but not with other participant-specific background factors. The task specifications are released for the research community to apply and adapt in the study of computer-mediated social interaction.

Maternal sleep quality during pregnancy is associated with neonatal auditory ERPs.

Poor maternal sleep quality during pregnancy may act as a prenatal stress factor for the fetus and associate with neonate neurocognition, for example via fetal programming. The impacts of worsened maternal sleep on neonatal development and, more specifically on neonatal auditory brain responses, have not been studied. A total of 155 mother-neonate dyads drawn from the FinnBrain Birth Cohort Study participated in our study including maternal self-report questionnaires on sleep at gestational week 24 and an event-related potential (ERP) measurement among 1-2-day-old neonates. For sleep quality assessment, the Basic Nordic Sleep Questionnaire (BNSQ) was used and calculated scores for (1) insomnia, (2) subjective sleep loss and (3) sleepiness were formed and applied in the analyses. In the auditory ERP protocol, three emotionally uttered pseudo words (in happy, angry and sad valence) were presented among neutrally uttered pseudo words. To study the relations between prenatal maternal sleep quality and auditory emotion-related ERP responses, mixed-effects regression models were computed for early (100-200 ms) and late (300-500 ms) ERP response time-windows. All of the selected BNSQ scores were associated with neonatal ERP responses for happy and angry emotion stimuli (sleep loss and sleepiness in the early, and insomnia, sleep loss and sleepiness in the late time-window). For sad stimuli, only maternal sleep loss predicted the neonatal ERP response in the late time-window, likely because the overall ERP was weakest in the sad condition. We conclude that maternal sleep quality during pregnancy is associated with changes in neonatal auditory ERP responses.

Neural processing of changes in phonetic and emotional speech sounds and tones in preterm infants at term age.

OBJECTIVE: Auditory change-detection responses provide information on sound discrimination and memory skills in infants. We examined both the automatic change-detection process and the processing of emotional information content in speech in preterm infants in comparison to full-term infants at term age. METHODS: Preterm (n = 21) and full-term infants' (n = 20) event-related potentials (ERP) were recorded at term age. A challenging multi-feature mismatch negativity (MMN) paradigm with phonetic deviants and rare emotional speech sounds (happy, sad, angry), and a simple one-deviant oddball paradigm with pure tones were used. RESULTS: Positive mismatch responses (MMR) were found to the emotional sounds and some of the phonetic deviants in preterm and full-term infants in the multi-feature MMN paradigm. Additionally, late positive MMRs to the phonetic deviants were elicited in the preterm group. However, no group differences to speech-sound changes were discovered. In the oddball paradigm, preterm infants had positive MMRs to the deviant change in all latency windows. Responses to non-speech sounds were larger in preterm infants in the second latency window, as well as in the first latency window at the left hemisphere electrodes (F3, C3). CONCLUSIONS: No significant group-level differences were discovered in the neural processing of speech sounds between preterm and full-term infants at term age. Change-detection of non-speech sounds, however, may be enhanced in preterm infants at term age. SIGNIFICANCE: Auditory processing of speech sounds in healthy preterm infants showed similarities to full-term infants at term age. Large individual variations within the groups may reflect some underlying differences that call for further studies.

Prenatal exposure to antiepileptic drugs and early processing of emotionally relevant sounds.

INTRODUCTION: Prenatal exposure to antiepileptic drugs (AEDs) is associated with developmental compromises in verbal intelligence and social skills in childhood. Our aim was to evaluate whether a multifeature Mismatch Negativity (MMN) paradigm assessing semantic and emotional components of linguistic and emotional processing would be useful to detect possible alterations in early auditory processing of newborns with prenatal AED exposure. MATERIAL AND METHODS: Data on AED exposure, pregnancy outcome, neuropsychological evaluation of the mothers, information on maternal epilepsy type, and a structured neurological examination of the newborn were collected prospectively. Blinded to AED exposure, we compared a cohort of 36 AED-exposed with 46 control newborns at the age of two weeks by measuring MMN with a multifeature paradigm with six linguistically relevant deviant sounds and three emotionally uttered sounds. RESULTS: Frontal responses for the emotionally uttered stimulus Happy differed significantly in the exposed newborns compared with the control newborns. In addition, responses to sounds with or without emotional component differed in newborns exposed to multiple AEDs compared with control newborns or to newborns exposed to only one AED. CONCLUSIONS: These preliminary findings suggest that prenatal AED exposure may alter early processing of emotionally and linguistically relevant sound information.

Healthy full-term infants' brain responses to emotionally and linguistically relevant sounds using a multi-feature mismatch negativity (MMN) paradigm.

We evaluated the feasibility of a multi-feature mismatch negativity (MMN) paradigm in studying auditory processing of healthy newborns. The aim was to examine the automatic change-detection and processing of semantic and emotional information in speech in newborns. Brain responses of 202 healthy newborns were recorded with a multi-feature paradigm including a Finnish bi-syllabic pseudo-word/ta-ta/as a standard stimulus, six linguistically relevant deviant stimuli and three emotionally relevant stimuli (happy, sad, angry). Clear responses to emotional sounds were found already at the early latency window 100-200 ms, whereas responses to linguistically relevant minor changes and emotional stimuli at the later latency window 300-500 ms did not reach significance. Moreover, significant interaction between gender and emotional stimuli was found in the early latency window. Further studies on using multi-feature paradigms with linguistic and emotional stimuli in newborns are needed, especially those containing of follow-ups, enabling the assessment of the predictive value of early variations between subjects.